Peripheral Wall Research Articles

Value of contrast-enhanced ultrasonography in assessing the activity of idiopathic retroperitoneal fibrosis: a prospective study

We aimed to evaluate changes in the contrast-enhanced ultrasound (CEUS) parameters in patients with idiopathic retroperitoneal fibrosis (RPF) before and after treatment, and to analyse the value of CEUS to assess RPF activity. We performed a prospective study that included patients with idiopathic RPF who were treated for RPF at our hospital from April 2016 to April 2019. All patients underwent CEUS examination and some of them underwent positron emission tomography/computed tomography (PET/CT) examination simultaneously. CEUS parameters included tube wall and peripheral thickness, arterial wall intensity, and lumen intensity. The changes in CEUS parameters before and after treatment were evaluated, and their correlations with the standardised uptake value (SUVmax), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were analysed. Thirty-one active idiopathic RPF patients were enrolled, of whom 11 underwent PET/CT examination before treatment. Tube wall and peripheral thickness (r=0.743, p<0.01) and arterial wall intensity (r=0.702, p<0.05) both correlated significantly with SUVmax. Lumen intensity did not correlate significantly with SUVmax (r=0.544, p=0.084). The correlation coefficients between lesion thickness and ESR levels were 0.508 (p=0.037), between lesion thickness and CRP levels were 0.575 (p=0.016). Arterial wall intensity and lumen intensity were not significantly correlated with ESR or CPR levels. Tube wall and peripheral thickness, arterial wall intensity, decreased significantly after treatment (p=0.001), while the lumen intensity was not significantly changed after treatment. Our findings suggest that CEUS, a radiation-free and repeatable detection method, is effective for assessing idiopathic RPF disease activity.

Articles of Significant Interest in This Issue

EloR is an RNA-binding protein recently discovered to be involved in regulating cell elongation in Streptococcus pneumoniae. It has been found to localize to midcell. Winther et al. (e00691-20) discovered that it is the Jag domain of EloR that determines this localization. Using a bacterial two-hybrid assay and coimmunoprecipitation, they found that EloR acts in complex with the lytic transglycosylase MltG, which is crucial for elongating the pneumococcal cell. They hypothesize that EloR regulates the muralytic activity of MltG, allowing controlled opening of the peripheral cell wall for incorporation of new peptidoglycan in the longitudinal direction.

Pericardial calcification with plain radiographic features of tuberculosis in a child: incidental finding and a case report

Tuberculous pericarditis is frequently reported as the primary cause of pericardial calcification and occurs in about 1-2% of individuals with pulmonary tuberculosis, this however is a rare finding in the Western world. This is a 12-year-old male child that was referred from a peripheral health care center for plain radiograph of the chest on account of cough, easy fatiguability, night sweats, loss of weight, loss of appetite and dyspnea most times on excersion for more than a month duration. The plain chest radiograph demonstrated normal cardiac size with a cardiothoracic ratio of about 55/120, there is circumferential radio-opacity of calcic density around the peripheral walls of the heart; the pericardial calcification. The vascular pedicle appears slightly widened. The lung fields show extensive streaky opacities with cystic lung changes bilaterally more marked on the left lung field where consolidation, loss of lung volume and pleural effusion are also demonstrated. A two-dimensional echocardiography showed mild-moderate pericardial effusion, thickening of both visceral and parietal pericardium, and echogenic fond-like structures protruding in to the pericardial cavity. A diagnosis of pulmonary tuberculosis with features of tuberculous pericarditis in a 12-year-old male child was established. The patient has been placed on anti-tuberculous drugs, hematinic, and parents advised on good and adequate diet with adequate rehydration and strict drug compliance. Screening of the siblings and members of the family with close contact have also been emphasized. We report the radiographic features of pulmonary tuberculosis and pericardial calcification in a 12-year-old male child due to its peculiar presentation.

Gene expression in the Angiopoietin/TIE axis is altered in peripheral tissue of ovarian cancer patients: A prospective observational study

AimsClinical studies suggest altered systemic vascular biology in cancer patients. We assessed expression patterns of endothelial activation- and vascular leakage-related genes in tumor as well as in tumor-free peripheral tissues from patients with and without ovarian cancer (OC). Main methodsPatients being scheduled for laparotomy for either gynecologic benign diagnosis (n = 10) or for advanced-stage OC (n = 22) were prospectively recruited to this observational study. Serum samples were taken preoperatively, and tissue samples were taken from peripheral abdominal wall musculature, tumor-free peritoneum and the tumor itself. Key findingsPatients in OC group received significantly more fluid per time intraoperatively (p = 0.01). IL-8 and MCP-1/CCL2, VCAM-1 (CD 106) and ICAM-1 (CD 54) as well as Thrombomodulin were significantly increased in cancer patients' serum at baseline (p = 0.03). Expression of distinct vascular leakage-related genes (Angiopoietin-1 (ANG-1), ANG-2, TIE2, VEGFR1, VEGFR2) was significantly altered in tumor tissue of OC patients (p = 0.003), while in tumor-free peritoneal tissue, ANG-2/1 expression ratio was more than doubled in OC group (p = 0.03). In peripheral musculature, particularly genes from the ANG/TIE axis were significantly changed in OC patients (p = 0.005), suggesting a distinct vascular leakage-related genotype. Gene expression changes in OC patients were significantly associated with the postoperative fluid balance (p = 0.03). SignificanceAltered expression of barrier dysfunction- and angiogenesis-associated genes from the ANG/TIE axis was detected not only in tumor but also in peripheral tissues of cancer patients. This may contribute to a systemic vascular leakage-related genotype.

Viscous dissipation and joule heating effects on forced convection power law fluid flow through annular duct

Here we numerically analyse the effects of viscous dissipation and Joule heating on forced convection heat transfer rate of electrically conducting magnetohydrodynamic, ( MHD) power law fluid flow through annular duct. Mathematical model is formulated for constant properties power law fluid with steady, incompressible and laminar fully developed flow assumptions. Heat transfer results are determined by taking constant heat flux with peripheral wall temperature “known as H1 thermal boundary condition” at the solid walls of the channel. It has been observed that the effect of viscous dissipation reduces due to enhance damping magnetic field effect by increasing the value of Hartman number, Ha, especially in the case of shear thickening fluids.

Quantitative Evaluation of a Telerobotic System for Vascular Ultrasound Measurement on a Short Arm Human Centrifuge

Artificial Gravity generated by Short Arm Human Centrifuges is a promising multi-system countermeasure for physiological deconditioning during long duration space flights. To allow a continuous assessment of cardiovascular hemodynamics during centrifugation, a telerobotic robotic system holding an ultrasound probe has been installed on a Short Arm Human Centrifuge. A feasibility study was conducted to define the use capabilities and limitations of such a novel method. The objective of this study is to estimate the reproducibility and precision of remotely controlled vascular ultrasound assessment under centrifugation by assessing peripheral vascular diameter and wall distension. Four repeated centrifugation runs of 5 min, with 2.4 g at feet level, were performed including a 15 min rest between each run for a group of eight healthy male volunteers. Vascular diameter and distention were assessed for the common carotid artery (CCA) and the femoral artery (FA) by ultrasound imaging using a 10 MHz linear array probe (Mylab1, Esaote). Ultrasound measurements were consecutively performed: a) by an expert user in hand-held mode in standing as well as supine position, b) using the telerobotic arm without centrifugation as baseline and c) using the telerobotic arm during centrifugation. Vascular responses were compared between baseline and under centrifugation. Inter-, intra-registration and group variability have been assessed for hand-held and remotely controlled examination. The results show that intra-registration variability, σh , was always smaller than inter-registration variability, σm, that is in turned smaller than the inter-subject variability σg (σh < σm < σg). Centrifugation caused no significant changes in CCA diameter but a lower carotid distension compared to manual and robotic ultrasound in supine position (p < 0.05). Femoral diameter was significantly decreased in hypergravity compared to robotic sonography without centrifugation. A good reproducibility and precision of the remotely controlled vascular ultrasound assessment under centrifugation could be demonstrated. In conclusion, arterial wall dynamics can be precisely assessed for the CCA and femoral artery during centrifugation using a telerobotic ultrasound measurement system. Potential improvements to further enhance reproducibility and safety of the system are discussed.

Preliminary Exploration of the Initial Diagnostic Prediction Model of Moderate Coronavirus Disease 2019 (2019-nCoV) Based on Clinical Data

Objective: To explore those differences and relationships of the initial diagnostic clinical data between confirmed cases of 2019-nCoV and suspected cases of COVID-19, and then to establish prediction models for predicting the probability of the first diagnosis of 2019-nCoV. Methods: A total of 81 suspected cases and 87 confirmed cases of moderate 2019-nCoV diagnosed initially in the isolation wards of the First People’s Hospital of Wuhu and the People’s Hospital of Wuwei and Wuhan Caidian Module Hospital with the help of our hospital doctors were gathered, and retrospectively analyzed. Results: The most common symptoms were fever (76.79%) and cough (64.29%) in the total of 168 cases. The median age was 45 (35 - 56) years old in the 87 confirmed cases of moderate 2019-nCoV, older than the median age 36 (29 - 50) in the 81 suspected cases. There were significant more in the former than in the latter in the incidence of myalgia, ground-glass opacity (GGO), invasions of lesion in the peripheral lobes, vascular thickening and bronchial wall thickening, interlobular septal thicking, and small pulmonary nodules. On the contrary, there were less in the former than in the latter in the total number of leukocytes and neutrophils in blood routine examination and the levels of procalcitonin (PCT). Two groups were statistically significantly different (P P = ex/(1 + ex), x = −6.226 + (0.071 × ages) + (1.720 × fever) + (2.858 × myalgia) + (2.131 × GGO) + (3.000 × vascular thickening and bron-chial wall thickening) + (3.438 × invasions of lesion in the peripheral lobes) + (−0.304 × the number of leukocytes) + (−1.478 × cough) + (−1.830 × pharyngalgia) + (−2.413 × headache), where e is a natural logarithm. The area under the ROC curve (AUC) of this model was calculated to be 0.945 (0.915 - 0.976). The sensitivity is 0.920 and the specificity is 0.827 when the appropriate critical point is 0.360. Conclusions: A mathematical equation prediction model for predicting the probability of the first diagnosis of 2019-nCoV can be established based on the initial diagnostic clinical data of moderate 2019-nCoV. The prediction model is a good assistant diagnostic method for its high accurateness.

Blood pressure dynamics

The article presents data on the dynamics of blood pressure under the influence of the social environment and changes in diet, as well as the impact of various diseases. when science and technology are developing, we are often faced with the problems of high blood pressure. Blood pressure (BP) is the pressure of blood on the walls of the arteries, which depends on the amount of blood flowing from the heart, blood flow, resistance of peripheral arteries and wall elasticity arteries. Blood pressure (BP) is distinguished: Systolic (maximum) blood pressure, diastolic (minimum) blood pressure, pulse blood pressure. Systolic (maximum) blood pressure is the pressure in the arterial system during the maximum rise in the pulse wave that occurs after left ventricular systole. Measuring blood pressure has become an integral part of everyone's daily routine. But it must be borne in mind that blood pressure is influenced not only by our lifestyle and work but also by diet and various diseases, diseases, of course, affect indirectly. During the day, blood pressure indicators change.

Radiological differences in computed tomography findings and texture analysis between cystic lymph node metastases of human papillomavirus-positive oropharyngeal cancer and second branchial cysts.

PurposeThe study aimed to analyse radiological differences in computed tomography (CT) findings and texture analysis between cystic lymph node metastases (CNM) in human papillomavirus (HPV)-positive oropharyngeal cancer (OPC) and second branchial cleft cysts (2nd BC).Material and methodsPatients with pathological evidence of CNM-HPV-OPC and 2nd BC, who underwent contrast-enhanced CT, were retrospectively evaluated. The evaluated characteristics include age, sex, and CT findings. CT findings included the maximum and minimum transverse diameters, maximum caudal diameter, thickness of the peripheral wall, presence of internal septation, presence of surrounding fat stranding, location, and 40 texture parameters.ResultsA total of 13 patients had CNM-HPV-OPC (19 lesions), while 20 patients had 2nd BC (20 lesions). Patients with 2nd BC were significantly younger than those with CNM-HPV-OPC (p < 0.001). In terms of diameter, 2nd BC lesions were significantly larger than the CNM-HPV-OPC lesions (p < 0.001). CNM-HPV OPC lesions had significantly thicker walls than 2nd BC lesions (p < 0.001). CNM-HPV-OPC lesions had significantly higher association with internal septations than 2nd BC lesions (p < 0.001). Second BC lesions were significantly less common at level III than CNM-HPV-OPC lesions (p = 0.047). Among the 40 texture parameters measured, 8 had significant differences (p ≤ 0.001).ConclusionsThere were significant differences in CT findings and textural parameters between CNM-HPV-OPC and 2nd BC lesions. These results may help in differentiating one from the other.

Assessment of Subclinical Manifestations of Atherosclerosis of Coronary and Peripheral Arteries and Bone Strength Parameters in Women

Aim. To study associations between calcification of the coronary arteries (CA), the state of the peripheral vascular wall and bone strength indices.Material and methods. In a cross-sectional study were included 200 women at the age 45-69 y.o. who were observed on an outpatient basis and signed informed consent. A survey was conducted on the presence of cardiovascular risk factors and the risk of fractures. The intima-media thickness (IMT), the presence and number of atherosclerotic plaques (AP) were studied using duplex scanning. Pulse wave velocity (PWV), augmentation index (AI) were measured by applanation tonometry. The presence of calcium deposits in coronary vessels was determined by multispiral computed tomography (MSCT) using the Agatston index. The bone mineral density (BMD) of the spine, hip neck (HN) and proximal hip (PH) was measured using double energy x-ray absorptiometry. The marker of bone resorption C-terminal telopeptide of type-1 collagen (СТх) was determined in blood serum by the β-crosslaps method.Results. There was a positive correlation between the parameters of vascular stiffness, subclinical atherosclerosis of peripheral vessels and CA calcification: AI and calcium index (r=0.25, p&lt;0.05), IMT and calcium index (r=0.23, p&lt;0.05), presence of AP and calcium index (r=0.26, p&lt;0.05). The PWV increased as the calcium index increased, but the correlation remained at the trend level. Women with low bone mass had higher PWV (p&lt;0.05), AI (p&lt;0.01), IMT (p&lt;0.02), CTx level (p&lt;0.001) and a higher number of AP than those with normal BMD. CTx was inversely correlated with PWV and calcium index (p&lt;0.05). Based on multivariate linear regression analysis (adjusted for age, menopause duration, low body weight, smoking factor and total cholesterol) the independent nature of the relationship between the Agatstone index and BMD in all the measured parts of the skeleton, between AI and BMD of HN, and between IMT and BMD of HN was confirmed. The relationship between the marker of bone resorption CTx and BMD of the spine and PH remained highly reliable.Conclusion. The correlation of stiffness indices and subclinical atherosclerosis of peripheral arteries, which is a predictor of high risk of cardiovascular events, allows to suggest an important role of changes in the peripheral vascular wall in increasing cardiovascular risk. A decrease in BMD and an increase in the marker of bone resorption, associated with an increase in indices of vascular stiffness and subclinical atherosclerosis and, especially, CA calcification, allows us to think about the common mechanisms of development and progression of atherosclerosis and osteoporosis. Therefore, early examination of women with a high cardiovascular risk, assessed by the SCORE scale, after 45 years and before menopause to detect vascular rigidity and the presence of subclinical atherosclerosis, and performing x-ray densitometry for individuals with changes in these indices will allow stratify the risks of atherosclerosis and osteoporosis complications and recommend preventive use of drugs that reduce vascular rigidity and increase BMD.

Vesselplasty for the treatment of osteoporotic vertebral compression fractures with peripheral wall damage: a retrospective study

Study design A retrospective study. Objective The clinical efficacy of vertebroplasty and kyphoplasty treating osteoporotic vertebral compression fractures (OVCF) has been widely recognized in recent years. However, there are also disadvantages of bone cement leakage (BCL), limited correction of kyphosis and recovery of vertebral height. Nowadays, in view of these shortcomings, vesselplasty has been widely used in clinical practice. The objective of this study is to assess its clinical effect and application value for the treatment of OVCF with peripheral wall damage. Methods 62 patients (70 vertebrae) treated for OVCF with peripheral wall damage using vesselplasty retrospectively reviewed. The data collection included operation time, volume of bone cement, relevant surgical complications, visual analog scale (VAS), Oswestry disability index (ODI), vertebral body height and kyphosis Cobb angle. Results The volume of bone cement was 3–8 (5.3 ± 1.3) ml. There were 3 vertebrae of BCL (4.3%). VAS and ODI at different time points after operation were decreased compared with before operation (all p < 0.05). There were no statistical differences between VAS or ODI at different postoperative time points (p > 0.05). Vertebral body height and Cobb angle at different time points after operation were improved compared with before operation (all p < 0.05). There were no statistical differences between vertebral body height or Cobb angle at different postoperative time points (all p > 0.05). Conclusions Vesselplasty may reduce the risk of BCL and better control the dispersion of bone cement in the treatment of OVCF. It relieves pain, restores vertebral body height and corrects kyphosis, especially in OVCF with peripheral wall damage. Therefore, vesselplasty is safe and worthy of clinical application.

Simultaneous use of Interphako interference contrast and polarization microscopy in the study of microorganisms.

Simultaneous application of polarization microscopy and Interphako interference contrast has been used to study the internal structure of algal cells. The interference contrast technique showed fine cell structures (important is the selection of interference colors according to the Mach-Zehnder interferometer setting). In a polarization microscope, the crossed polarization filters together with the first-order quartz compensator mounted turntable showed the maximum birefringence of the individual structures. Material containing green algae was collected in the villages Sýkořice and Zbečno, Protected Landscape Area (PLA) Křivoklátsko. The objects were studied in a Carl Zeiss Jena NfpK laboratory microscope equipped with an In 160 base body with an Interphako In contrast interference module including a Mach-Zehnder interferometer with variable phase contrast, a special condenser with interchangeable aperture plates, a turntable, a Meopta Praha polarizer, a LOMO Sankt Petersburg analyzer, and a quartz compensator with first-order red and the digital camera DSLR Nikon D 70. Green algae of three orders were studied: Siphonocladales, Zygnematales, and Desmidiales. Anisotropic structures were found in all studied representatives of the green algae of the phylum Chlorophyta. Especially their cell walls showed strong birefringence (in all representatives of these orders). On the other hand, a representative of the order Siphonocladales (the genus Cladophora, Cladophoraceae, Ulvophyceae) was rarely found to display weak birefringent granules of storage substances due to the setting of the Mach-Zehnder interferometer and the use of the first-order compensator (interference colors are intensified). In addition, a very weak birefringence of periphyton cells (microbial biofilm) was found. In the study of the second algae of the genus Spirogyra (Zygnemataceae, Zygnematales, Conjugatophyceae), a strongly birefringent connecting wall between algal cells was found in contrast to the weaker birefringence of the peripheral wall. It was the use of Interphako interference contrast together with polarization filters and a first-order quartz compensator that particularly emphasized the central part of the connecting wall. In the study of the twinned Pleurotaenium algae (Desmidiaceae, Desmidiales, Conjugatophyceae), a strongly birefringent wall was found along the periphery of the cell with a nucleus in the middle part (isthmus). In this narrowing in the center of the cell, a sharply delimited birefringent edge of the cell wall is visible, especially when using Interphako interference contrast along with crossed polarization filters and a first-order quartz compensator. In conclusion, Interphako interference contrast provides a high degree of image contrast in a microscope and, if suitably simultaneously complemented by polarization microscopy (including a first-order quartz compensator), it will allow us to infer some of the composition of the investigated structures. However, working with Interphako interference contrast is considerably more difficult (setting Mach-Zehnder interferometer) than using other contrast techniques (positive and negative phase contrast, color contrast, relief contrast, and dark field).

Investigating the Impact of the Prefabrication Concept on the Design and Selection of Building Components, Case Study: Peripheral Walls in Mass Housing Projects

Today, Prefabrication is considered as one of the concepts of industrialization in response to the growing needs of human societies for development. It is particularly important to address this concept in mass housing projects. The most important goals in adopting the prefabrication approach are to increase construction speed and quality and reduce costs. A review of the literature on prefabrication illustrates the importance of Design for Manufacturability and Design for Assembly concepts about components of prefabricated systems. In this regard, this research has been carried out to identify the criteria and indicators for selection of prefabricated peripheral walls and to design a system based on updatable databases to select proper options according to the importance of criteria and indicators in various mass housing projects. The research method is descriptive-analytical. The results indicate the necessity of involving building material suppliers in designing the mentioned system. Therefore, it is envisaged to continuously import new material specifications in the form of suggested options by the material suppliers in the system’s database. Peripheral wall selection criteria and indicators extracted from the literature review of prefabrication and an Analytic Hierarchy Process structure is proposed to obtain the appropriate options considering the importance of criteria and indicators. To determine the scoring criteria for options, on the one hand, the standards set for the technical specifications of materials were discussed and on the other hand, examples include materials and Peripheral wall systems based on the prefabrication criteria, were investigated.

A geochemical investigation of an Early Inuit semi-subterranean winter dwelling in a periglacial context

Geochemical investigations using FTIR, ICP-AES and C-N analyses were carried out on a single-family semi-subterranean Inuit house in order to assess the contribution of Inuit domestic activities in the formation of cryosolic soils in a periglacial archaeological context (Kuuvik Bay, Nunavik, Canada). The geochemical elements data were analyzed using box plots and enrichment factors. The information was also summarized and visualized through principal component analysis (PCA). These complementary statistical approaches provided evidence of a moderate but identifiable and significant imprint of Inuit domestic activities on soil geochemistry. The box plots indicate moderate Ca, Mn, Cu and P enrichments and more noticeable Mg, Fe and S enrichments. These enrichment factors and the ICP-AES data show that samples from the peripheral wall and the tunnel entrance of the house and its vicinity are significantly enriched. While FTIR analysis highlighted the main soil element contents (e.g., organic and mineral components), ICP-AES analysis was used to further document variations in the background elements throughout the site. However, the obtained results do not allow us to undertake a spatial analysis of Inuit activities or to describe them in detail. In addition, the data highlight the difficulty of documenting the natural variability of element contents in cryosolic soils, especially in archaeological contexts. Cryo-pedological processes in the active layer as well as house cleaning and nutrient inputs resulting from Inuit occupations may have attenuated chemical signatures of previous Inuit domestic activities.

Feasibility of Ultra-Low-Dose CT for Bronchoscopy of Peripheral Lung Lesions.

Background and objectives: Thin-section computed tomography (CT) is essential for identifying small bronchi during bronchoscopy using radial endobronchial ultrasound. Some patients should receive an additional CT for a thin-section image. We performed a retrospective study with a prospectively collected database to identify the optimal radiation dose for thin-section CT during peripheral bronchoscopy. Materials and Methods: In total, 91 patients with peripheral lung lesions underwent thin-section CT (both standard CT as a reference and ultra-low-dose CT (ultra-LDCT)). The patients were randomly assigned to one of four groups according to the ultra-LDCT parameters: group 1 = 120 kVp, 25 mAs; group 2 = 100 kVp, 15 mAs; group 3 = 120 kVp, 5 mAs; and group 4 = 100 kVp, 5 mAs. Two radiologists and two physicians analyzed both the standard CT and ultra-LDCT. Results: The effective doses (EDs) of ultra-LDCT significantly differed among the four groups (median EDs were 0.88, 0.34, 0.19, and 0.12 mSv for groups 1–4, respectively; p < 0.001). Median differences in peripheral airway wall thickness were higher in group 4 than in other groups (differences in median wall thickness measured by two radiologists were 0.4–0.5 mm and 0.8–0.9 mm for groups 1–3 and group 4, respectively). Bronchus signs on ultra-LDCT in groups 1 and 2 were well correlated with those of the standard-dose CT (accuracies of two radiologists and two pulmonary physicians were 95–100%). Conclusions: Our results indicate that ultra-LDCT with ED of >0.34 mSv (ED of group 2) is feasible for peripheral bronchoscopy.

Salt tectonics in a double salt‐source layer setting (Eastern Persian Gulf, Iran): Insights from interpretation of seismic profiles and sequential cross‐section restoration

AbstractSalt tectonics in the Eastern Persian Gulf (Iran) is linked to a unique salt‐bearing system involving two overlapping ‘autochthonous’ mobile source layers, the Ediacaran–Early Cambrian Hormuz Salt and the Late Oligocene–Early Miocene Fars Salt. Interpretations of reflection seismic profiles and sequential cross‐section restorations are presented to decipher the evolution of salt structures from the two source layers and their kinematic interaction on the style of salt flow. Seismic interpretations illustrate that the Hormuz and Fars salts started flowing in the Early Palaeozoic (likely Cambrian) and Early Miocene, respectively, shortly after their deposition. Differential sedimentary loading (downbuilding) and subsalt basement faults initiated and localized the flow of the Hormuz Salt and the related salt structures. The resultant diapirs grew by passive diapirism until Late Cretaceous, whereas the pillows became inactive during the Mesozoic after a progressive decline of growth in the Late Palaeozoic. The diapirs and pillows were then subjected to a Palaeocene–Eocene contractional deformation event, which squeezed the diapirs. The consequence was significant salt extrusion, leading to the development of allochthonous salt sheets and wings. Subsequent rise of the Hormuz Salt occurred in wider salt stocks and secondary salt walls by coeval passive diapirism and tectonic shortening since Late Oligocene. Evacuation and diapirism of the Fars Salt was driven mainly by differential sedimentary loading in annular and elongate minibasins overlying the salt and locally by downslope gliding around pre‐existing stocks of the Hormuz Salt. At earlier stages, the Fars Salt flowed not only towards the pre‐existing Hormuz stocks but also away from them to initiate ring‐like salt walls and anticlines around some of the stocks. Subsequently, once primary welds developed around these stocks, the Fars Salt flowed outwards to source the peripheral salt walls. Our results reveal that evolving pre‐existing salt structures from an older source layer have triggered the flow of a younger salt layer and controlled the resulting salt structures. This interaction complicates the flow direction of the younger salt layer, the geometry and spatial distribution of its structures, as well as minibasin depocentre migration through time. Even though dealing with a unique case of two ‘autochthonous’ mobile salt layers, this work may also provide constraints on our understanding of the kinematics of salt flow and diapirism in other salt basins having significant ‘allochthonous’ salt that is coevally affected by deformation of the deeper autochthonous salt layer and related structures.

Immunotherapy and chemotherapy combination for chest wall disease: TBCRC 044 trial.

TPS1114 Background: Immunotherapy combined with chemotherapy is being studied in metastatic breast cancer, and may have durable outcomes. Chest wall recurrence represents a difficult to treat subtype of breast cancer with a poor prognosis, with lymphovascular invasion in the primary tumor a significant risk factor. Given the inflammatory nature of this disease and the association of programmed cell death 1 (PD-1) expression with lymphovascular invasion, we hypothesized that the combination of pembrolizumab, an anti-PD-1 antibody, with carboplatin may be effective as treatment for breast cancer chest wall recurrences. Methods: This randomized phase II study is enrolling 84 patients with breast cancer involving the chest wall, who may also have distant metastases. Patients receive treatment with pembrolizumab 200 mg and carboplatin AUC 5 every 3 weeks for 6 cycles (Arm A, n = 56) followed by maintenance pembrolizumab +/- carboplatin (Arm Ax), or carboplatin AUC 5 every 3 weeks for 6 cycles (Arm B, n = 28) with an option to cross-over to pembrolizumab +/- carboplatin on progression (Arm Bx). Patients with all disease subtypes, triple-negative, hormone receptor positive/HER2- after 2 prior lines of hormone therapy, and HER2+ disease (with the option to continue trastuzumab) are eligible, with no limit on the number of prior therapies. Prior platinum chemotherapy is allowed in the absence of overt disease progression. Patients undergo clinical assessment with every cycle of treatment including chest wall photography, scans (CT chest, abdomen, and pelvis) every 2 cycles, and have peripheral blood and chest wall biopsies collected at baseline and the start of cycle 3 for correlative studies. The primary endpoint is the disease control rate in the chest wall and distant sites at 18 weeks of treatment based on RECIST 1.1. The study is powered to determine a 20% difference in disease control between arms (hazard ratio 0.52, α = 0.10, β = 0.20). Additional endpoints include response by tumor programmed death ligand 1 (PD-L1) status and irRECIST, progression-free survival, and toxicity. Chest wall tumor samples will be analyzed for changes in tumor immune composition, and PD-L1 and MYC oncogene expression, based on preclinical data to suggest that PD-L1 may be upregulated by MYC. Peripheral blood samples will be evaluated for changes in PD-L1 expression, cell-free DNA, and circulating tumor cells with treatment. The study is enrolling patients at 7 sites within the Translational Breast Cancer Research Consortium (TBCRC), with current enrollment of 38/84 patients. Clinical trial information: NCT03095352 .

Intermittent CPAP limits hyperoxia-induced lung damage in a rabbit model of bronchopulmonary dysplasia.

A significant proportion of preterm infants develop bronchopulmonary dysplasia (BPD) leading to poor lifelong respiratory health. Limited treatment options exist with continuous positive airway pressure (CPAP) ventilation being one of the few associated with diminished BPD. However, little is known about the effect of the distending pressure of CPAP on the developing lung exposed to hyperoxia. We aimed to identify the functional and structural effects of CPAP in a preterm hyperoxia rabbit model of BPD. Premature rabbit pups were randomized to normoxia, hyperoxia (≥95% O2), or hyperoxia plus 4 h daily CPAP [fraction of inspired oxygen (FiO2) 0.95, 5 cmH2O]. On day 7 postdelivery we performed invasive pressure-volume- and forced oscillation-based pulmonary function tests, before lung harvest for histological evaluation. Alveolar and vascular morphology, airway smooth muscle content, respiratory epithelium height, extracellular matrix components, and inflammatory cytokine expression were quantified. Hyperoxia-reared pups had restrictive lungs: alveolar walls were thickened, with the lung parenchymal tissue, collagen content, and airway smooth muscle content increased. In addition, peripheral pulmonary artery wall thickness was increased. CPAP increased alveolar recruitment and limited the structural effect of hyperoxia on the respiratory epithelium and pulmonary arteries. Additionally, CPAP improved lung function, mitigating hyperoxia-associated changes to respiratory system resistance, tissue damping, and tissue elastance. Hyperoxia disrupted functional and structural lung development. Daily intermittent CPAP limited hyperoxia-associated decreased lung function and attenuated structural changes to pulmonary arteries and respiratory epithelium while having no structural alveolar consequences. The mechanism by which CPAP has these beneficial effects needs further investigation.

Performance of a deep excavation in Lanzhou strong permeable sandy gravel strata

A large air shaft engineered between the Olympic Sports Center Station and Century Avenue Station of the Lanzhou Metro Line one, China, occurred in strong permeable sandy gravel complex strata. The short distance between the Yellow River and the pit (shaft) resulted in many challenges during construction. These challenges mainly included the quick recovery of the water level and the difficulty of plugging the water. Some measures for monitoring the structural safety and response of the surrounding environment were taken. As the data showed, the design combined a bottom-up method with a top-down method using a peripheral cut-off wall for anti-seepage treatment, the underground diaphragm wall and the concrete bracing had a large rigidity, good impermeability and little influence on the surrounding environment in the process of dewatering and excavation, the external plastic concrete cut-off wall could contribute to the groundwater drawdown inside the pit and reduce the soil pressure on the retaining structure of the pit.

Therapeutic effect of percutaneous kyphoplasty combined with anti-osteoporosis drug on postmenopausal women with osteoporotic vertebral compression fracture and analysis of postoperative bone cement leakage risk factors: a retrospective cohort study

BackgroundThe purpose of this study is to explore the therapeutic effect of percutaneous kyphoplasty (PKP) combined with anti-osteoporosis drug, zoledronic acid, on postmenopausal women with osteoporotic vertebral compression fracture (OVCF) and to perform an analysis of postoperative bone cement leakage risk factors.MethodsA total of 112 OVCF patients, according to therapeutic regimens, were divided into control group (n = 52, treated with PKP) and observation group (n = 60, treated with PKP and zoledronic acid injection).ResultsPostoperative tumor necrosis factor-α and interleukin-6 levels were significantly decreased in the two groups, compared with those before treatment (both P < 0.05); bone mineral density (BMD), serum bone gla protein (BGP), and vertebral height ratio of injured vertebrae were significantly increased, and procollagen type I N-terminal propeptide (PINP), Cobb angle, visual analogue scale/score (VAS), and Oswestry disability index (ODI) were significantly decreased compared with those before treatment (all P < 0.05). There were significantly higher changes in difference value of BMD, PINP, BGP, vertebral height ratio of injured vertebrae, Cobb angle, VAS, and ODI levels and significantly better therapeutic effect in the observation group than those in the control group (all P < 0.05). Multivariate logistic regression analysis showed that the use of zoledronic acid, vertebral height ratio of injured vertebrae, and ODI were independent factors affecting the therapeutic effect, and that the dosage of bone cement, and peripheral vertebrae wall damage were independent risk factors causing postoperative bone cement leakage. There were no significant differences in postoperative bone cement leakage rate between the two groups.ConclusionsPeripheral vertebrae wall damage and the dosage of bone cement are independent risk factors causing bone cement leakage in OVCF patients treated with PKP. PKP combined with zoledronic acid has an improvement effect on the condition of postmenopausal women with OVCF and reduces the inflammation and pain in patients, which is beneficial to clinical treatment.