Physiological Values Research Articles

The Physical and Physiological Demands of Intercounty Camogie During Competitive Match-Play.

Duggan, JD, Byrne, P, Malone, S, Cooper, S-M, and Moody, J. The physical and physiological demands of intercounty camogie during competitive match-play. J Strength Cond Res 38(9): e510-e520, 2024-The aim of this study was to determine the physical and physiological demands of intercounty camogie match-play between positions and halves of play. Data were collected from 28 players during 18 competitive games using global positioning systems (10-Hz) and heart rate monitors (2.4-GHz). The study demonstrated that intercounty camogie players covered a total distance (TD) (m ± SD) of 6,040 ± 628 m, relative distance (RD) of 83 ± 13 m·min-1, and maximum speed of 25 ± 1 km·h-1. Furthermore, the players covered a mean sprint distance of 214 ± 112 m and 14 ± 6 sprints. Players' mean heart rate (HRmean) and HRmax was 138 ± 23 b·min-1 and 164 ± 20 b·min-1, respectively. There were decrements between halves in TD (p < 0.01, ES = -0.45), RD (p < 0.01, ES = -0.45), maximum speed (p < 0.05, ES = -0.18), HRmax (p < 0.05, ES = -0.23), running (p < 0.01, ES = -0.34), high-speed running (p < 0.01, ES = 0.34), sprinting (p < 0.01, ES = -0.10), HRmax (p < 0.05, ES = -0.23), and HRmax % (p < 0.05, ES = -0.24). Midfielders covered a greater TD compared with full-forwards (p < 0.05, ES = -0.38) and half-forwards (p < 0.05, ES = -0.38). Full-backs covered a significantly lower RD than midfielders (p < 0.05, ES = -1.2), half-backs compared with full-forwards (p < 0.05, ES = 1.14), and half-forwards compared with full-forwards (p < 0.05, ES = 1.15). Full-forwards covered significantly less RD when compared with half-backs (p < 0.05, ES = -1.14), midfielders (p < 0.05, ES = -1.47), and half-forwards (p < 0.05, ES = -1.15). The findings provide physical and physiological values on the match demands of intercounty camogie match-play.

Human Serum Albumin Protein Corona in Prussian Blue Nanoparticles.

Prussian Blue nanoparticles (PBnps) are now popular in nanomedicine thanks to the FDA approval of PB. Despite the numerous papers suggesting or describing the in vivo use of PBnps, no studies have been carried out on the formation of a protein corona on the PBnp surface and its stabilizing role. In this paper, we studied qualitatively and quantitatively the corona formed by the most abundant protein of blood, human serum albumin (HSA). Cubic PBnps (41 nm side), prepared in citric acid solution at PB concentration 5 × 10-4 M, readily form a protein corona by redissolving ultracentrifuged PBnp pellets in HSA solutions, with CHSA ranging from 0.025 to 7.0 mg/mL. The basic decomposition of PBnp@HSA was studied in phosphate buffer at the physiological pH value of 7.4. Increased stability with respect to uncoated PBnps was observed at all concentrations, but a minimum CHSA value of 3.0 mg/mL was determined to obtain stability identical to that observed at serum-like HSA concentrations (35-50 mg/mL). Using a modified Lowry protocol, the quantity of firmly bound HSA in the protein corona (hard corona) was determined for all the CHSA used in the PBnp@HSA synthesis, finding increasing quantities with increasing CHSA. In particular, an HSA/PBnp number in the 1500-2300 range was found for CHSA 3.0-7.0 mg/mL, largely exceeding the 180 HSA/PBnp value calculated for an HSA monolayer on a PBnp. Finally, the stabilization brought by the HSA corona allowed us to carry out pH-spectrophotometric titrations on PBnp@HSA in the 3.5-9-0 pH range, revealing a pKa value of 6.68 for the water molecules bound to the Fe3+ centers on the PBnp surface, whose deprotonation is responsible for the blue-shift of the PBnp band from 706 nm (acidic solution) to 685 nm (basic solution).

Printing amphotericin B on microneedles using matrix-assisted pulsed laser evaporation.

Transdermal delivery of amphotericin B, a pharmacological agent with activity against fungi and parasitic protozoa, is a challenge since amphotericin B exhibits poor solubility in aqueous solutions at physiologic pH values. In this study, we have used a laser-based printing approach known as matrix-assisted pulsed laser evaporation to print amphotericin B on the surfaces of polyglycolic acid microneedles that were prepared using a combination of injection molding and drawing lithography. In a modified agar disk diffusion assay, the amphotericin B-loaded microneedles showed concentration-dependent activity against the yeast Candida albicans. The results of this study suggest that matrix-assisted pulsed laser evaporation may be used to print amphotericin B and other drugs that have complex solubility issues on the surfaces of microneedles.

Impact of valve-sparing aortic root replacement on aortic fluid dynamics and biomechanics in patients with syndromic heritable thoracic aortic disease

Patients with syndromic heritable thoracic aortic diseases (sHTAD) who underwent prophylactic aortic root replacement are at high risk of distal aortic events, but the underlying mechanisms are poorly understood. This prospective, longitudinal study aims to assess the impact of valve-sparing aortic root replacement (VSARR) on aortic fluid dynamics and biomechanics in these patients, and to examine whether they present altered haemodynamics or biomechanics prior to surgery compared to sHTAD patients with no indication for surgery (sHTAD-NSx) and healthy volunteers (HV). Sixteen patients with Marfan or Loeys-Dietz syndrome underwent two 4D flow CMR studies before (sHTAD-preSx) and after VSARR (sHTAD-postSx). Two age, sex and BSA matched cohorts of 40 HV and 16 sHTAD-NSx patients with available 4D flow CMR, were selected for comparison. In-plane rotational flow (IRF), systolic flow reversal ratio (SFRR), wall shear stress (WSS), pulse wave velocity (PWV) and aortic strain were analysed in the ascending (AscAo) and descending aorta (DescAo). All patients with sHTAD presented altered haemodynamics and increased aortic stiffness (p<0.05) compared to HV, both in the AscAo (median PWV 7.4 in sHTAD-NSx; 6.8 in sHTAD-preSx; 4.9m/s in HV) and DescAo (median PWV 9.1 in sHTAD-NSx; 8.1 in sHTAD-preSx; 6.3m/s in HV). Patients awaiting VSARR had markedly reduced in-plane (median IRF -2.2 vs 10.4 cm2/s in HV, p=0.001), but increased through-plane flow rotation (median SFRR 7.8 vs 3.8% in HV, p=0.002), and decreased WSS (0.36 vs 0.47N/m2 in HV, p=0.004) in the proximal DescAo. After VSARR, proximal DescAo in-plane rotational flow (p=0.010) and circumferential WSS increased (p=0.011), no longer differing from HV, but through-plane rotational flow, axial WSS and stiffness remained altered. Patients in which aortic tortuosity was reduced after surgery showed greater post-surgical increase in IRF compared to those in which tortuosity increased (median IRF increase 18.1 vs 3.3cm²/s, p=0.047). Most AscAo flow alterations were restored to physiological values after VSARR. In patients with sHTAD, VSARR partially restores downstream fluid dynamics to physiological levels. However, some flow disturbances and increased stiffness persist in the proximal DescAo. Further longitudinal studies are needed to evaluate whether persistent alterations contribute to post-surgical risk.

LsFUL–LsSMU2 module positively controls bolting time in leaf lettuce (Lactuca sativa L.) under high temperature

High temperature (HT) is an environmental factor that considerably affects plant physiology, development, crop yield, and economic value. HT can cause diseases and early bolting of leaf lettuce, thereby reducing the yield and quality of leaf lettuce. Herein, we used two leaf lettuce (Lactuca sativa L.) cultivars (bolting-resistant ‘S24’ and bolting-sensitive ‘S39’) to investigate the key factors and molecular mechanism impacting bolting. We found that 14 MADS-box genes implicated in bolting and flowering, LsMADS54 (also referred to as L. sativa FRUITFULL, LsFUL), was significantly up-regulated 1000 times after 5-d HT treatment and that HT-induced up-regulation of LsFUL was higher in bolting-sensitive than in resistant cultivars. The overexpression lines of LsFUL exhibited an earlier bolting time than that in the non-transformed ‘S39’(CK). However, the RNA interference, and CRISPR-Cas9-mediated knockout lines of LsFUL exhibited a later bolting time than that in CK. In addition, we found that L. sativa SUPPRESSORS OF MEC-8 AND UNC-52 PROTEIN 2 (LsSMU2) and L. sativa CONSTANS-LIKE PROTEIN 5 (LsCOL5) interact with LsFUL, and these interactions could stimulate or prevent bolting. We observed that elevated temperature stimulated the abundance of LsSMU2 in the stem, which collaborated with LsFUL to accelerate bolting. Conversely, room temperature (RT) condition led to relatively more stable LsCOL5, which worked with LsFUL to postpone bolting. In summary, our findings demonstrate a molecular regulatory module of LsSMU2–LsFUL associated with HT-induced premature bolting, which serves as a reference for understanding HT-induced premature bolting phenomenon in leaf lettuce.

Value of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in predicting hospital mortality for postoperative brain tumor patients in intensive care units in Japan: A retrospective case-control study

ObjectiveAcute Physiology and Chronic Health Evaluation II (APACHE II) is based on the data of intensive care unit (ICU) patients and often correlates with disease severity and prognosis. However, no prognostic predictors exist based on ICU admission data for patients with brain tumors, and no studies have reported an association between APACHE II and prognosis in patients with brain tumors. The Japanese Intensive Care Patients Database (JIPAD) was established to improve the quality of care delivered in intensive care medicine in Japan. We used JIPAD to examine factors associated with in-hospital mortality based on available data of postoperative patients with brain tumors admitted to the ICU. MethodsPatients aged ≥16 years enrolled in JIPAD between April 2015 and March 2018 after surgical brain tumor resection or biopsy of brain tumors. We examined factors related to outcomes at discharge based on blood tests and medical procedures performed during ICU admission, tumor type, and APACHE II score. ResultsAmong the 1454 patients (male:female ratio: 1:1.1, mean age: 62 years) in the study, 32 (2.2 %) died during hospital stay. In multivariate analysis, male sex (odds ratio [OR] 2.70, [95 % confidence interval, CI 1.22–6.00]), malignant tumor (OR 2.51 [95 % CI 1.13–5.55]), and APACHE II score ≥15 (OR 2.51 [95 % CI 3.08–14.3]) were significantly associated with in-hospital mortality. ConclusionBy picking up cases with a high risk of in-hospital death at an early stage, it is possible to improve methods of treatment and support for the patient's family.

The effect of position on feeding performance in infants with cleft lip and palate: Quasiexperimental study.

This single-group, quasiexperimental study was conducted to determine the effect of feeding position on the physiological parameters and feeding performance of term-born infants with cleft lip and palate (CLP) in the preoperative period. The study sample consisted of 45 infants aged 0-6 months with CLP followed up preoperatively in our outpatient clinic between January 2021 and 2022. Infants who were being fed with a specialty bottle for babies with CLP and whose families consented to participate in the study were included. After 2 h of fasting, the infants were fed in the elevated supine (ESU) position for the first meal, then in the elevated side-lying (ESL) position for the second meal after another 2 h of fasting. The infants' heart rate and oxygen saturation values before, during, and after each feed and indicators of feeding performance were compared between the positions. There was no significant difference between the positions in terms of heart rate and oxygen saturation before, during, or after feeding (p > .05). There was no statistically significant difference in measures of feeding performance according to the infants' feeding position (p > .05). According to the findings obtained in this study, infants with CLP showed no statistically significant differences in heart rate, oxygen saturation, or feeding performance when fed in the ESLand ESU positions. However, despite the lack of statistical significance, both physiological values and feeding performance tended to be better when the infants were fed in the ESL position, nurses can practice ESL position according to the infant's opposite direction of the side of the cleft lip or palate.

The effectiveness of a low implant density in Scheurmann kyphosis in correcting the lumbar lordosis -pelvic incidence mismatch

Purpose To evaluate the effectiveness of using a low implant density in surgical treatment of Scheurmann Kyphosis (SK) in correcting the lumbar lordosis (LL)- Pelvic incidence (PI) mismatch. Methods Patients that were surgically treated for SK by a low screw density with multiple Ponte osteotomies at two institutions from January 2021 to January 2022 were identified and included in the study. Preoperative/postoperative/1- and 2-year follow-up measurements were analyzed from full-spine standing radiographs. Results Thirty patients were enrolled in our study, mean age 20.5 (13–37) years, mean preoperative kyphosis was 85.9 (75–108), a mean preoperative lumbar lordosis-pelvic LL-PI mismatch was 25.9 (23–28). The maximum kyphosis was corrected to 46.2 (37–63) and the LL-PI mismatch was reduced to 7.7. The correction was maintained at 1- and 2-years follow-up with no statistical change in the sagittal angles. Conclusion Surgical correction of SK using low-density implants and multiple Ponte osteotomies is an effective method of correcting the kyphotic deformity and reducing the LL-PI mismatch to normal physiological values.

Multiphase patient-specific simulations to study fibrillation-induced thrombosis in the left atrial appendage

Thrombosis commonly develops in the left atrial appendage of patients with atrial fibrillation. The formation of blood clots in atrial appendage is a complex process, which depends on the shape of the appendage, the velocity of blood flow, the concentrations of red blood cells, platelets, and coagulation, among other factors. In this work, we present a new methodology to identify the key factors contributing to clot formation in the left atrial appendage during atrial fibrillation. The new methodology combines computed tomography imaging, computational fluid dynamics, mesh processing, and multiphase thrombosis modeling. We begin by running simulations to investigate flow patterns inside the left atrial appendages with realistic geometries. Our simulations suggest that at the entrance of the left atrial appendage, the flow forms vortices, which can intrude inside the appendage depending on the phases of the cardiac cycle. Next, we introduce blood coagulation and consider different scenarios corresponding to physiological values of blood flow velocity, geometry of the left atrial appendage, and hematocrit values. Numerical results suggest that the chances of clot formation are higher in the “cactus” geometry than in the “chicken-wing” one, in agreement with the literature. Furthermore, they suggest that slower flow circulation facilitates the development of a clot in the depth of the left atrial appendage. Slower blood movement also favors the procoagulant activity of platelets, while faster flow circulation enhances the procoagulant effect from erythrocytes. Finally, our simulations show that increased hematocrit upregulates the generation of fibrin polymer, regardless of flow velocity.

A discrete-to-continuum model for the human cornea with application to keratoconus.

We introduce a discrete mathematical model for the mechanical behaviour of a planar slice of human corneal tissue, in equilibrium under the action of physiological intraocular pressure (IOP). The model considers a regular (two-dimensional) network of structural elements mimicking a discrete number of parallel collagen lamellae connected by proteoglycan-based chemical bonds (crosslinks). Since the thickness of each collagen lamella is small compared to the overall corneal thickness, we upscale the discrete force balance into a continuum system of partial differential equations and deduce the corresponding macroscopic stress tensor and strain energy function for the micro-structured corneal tissue. We demonstrate that, for physiological values of the IOP, the predictions of the discrete model converge to those of the continuum model. We use the continuum model to simulate the progression of the degenerative disease known as keratoconus, characterized by a localized bulging of the corneal shell. We assign a spatial distribution of damage (i.e. reduction of the stiffness) to the mechanical properties of the structural elements and predict the resulting macroscopic shape of the cornea, showing that a large reduction in the element stiffness results in substantial corneal thinning and a significant increase in the curvature of both the anterior and posterior surfaces.

Medidas eletrocardiográficas em ovinos Santa Inês

The absence of physiological normal values and electrocardiographic standards for clinically healthy sheep can hinder the detection of various conditions that might affect the transmission of cardiac impulses. This study aimed to determine the values of electrocardiographic measurements in leads D1, D2, D3, aVR, aVL, aVF, V1, V2, V3, and V4 and its correlation with the weight and age of sheep. The study was conducted with 39 nonpregnant and healthy Santa Inês sheep. They were categorized into four groups according to body weight: 7 sheep (20–30 kg), 14 sheep (30–40 kg), 11 sheep (40–50 kg), and 7 sheep (over 50 kg). They were also categorized into three groups according to age: 6 sheep (10–12 months), 28 sheep (16 and 17 months), and five sheep (2–4 years). Sheep aged 16 and 17 months showed a significant increase in P-wave time compared with sheep of other ages. There was no significant variation in terms of weight among the animals studied (P &gt; 0.05). The reference intervals of electrocardiogram parameters did not show considerable variation in relation to weight and the age range from 10 months to 4 years. This corroborates the standardization of electrocardiographic normality values of non-sedated Santa Inês sheep.

The Effect of Listening to White Noise and Heart Sound on Pain During Sternum Dressing in Newborn

The research was conducted to determine the effect of listening to white noise and heart sounds during the sternum dressing process on the pain felt by newborns who had congenital heart surgery. The research sample consisted of 48 newborns who underwent cardiac surgery in a training and research hospital in Istanbul and met the sample selection criteria. Newborn Pain Scale (NIPS) was used to assess pain. It was seen that there was a statistically significant difference in terms of physiological parameter values evaluated between the groups during the sternum dressing procedure (p

Radioprotective ingredients of a composite dairy product

Food products that have an anti-radiation effect and can be used in conditions of increased radiation are of particular interest. Scientifically based rationing of such products in the daily diet will make it possible to effectively use them to adapt the body to increased radiation and eliminate the effects of radiation exposure during treatment or examination. The purpose of the research presented in the paper is to analyze the nutritional and physiological causes of chronic nutrient deficiency of radioprotective microelements in the diet, to study the qualitative and biological characteristics of radioprotective ingredients to create a milk-based anti-radiation composition. The experimental part of the study has related to researching the mineral composition of selected ingredients and their antioxidant activity. The data obtained indicate that milk thistle flour contains a large amount of calcium, and sunflower meal contains potassium. In terms of potassium content, sunflower meal exceeds the microelement content in milk thistle by 50 %. The amount of calcium in milk thistle is 67 % higher compared to sunflower meal. In addition, plant raw materials are a source of magnesium, iron, zinc, copper, phosphorus and have pronounced antioxidant activity. As a result a scientific substantiation of the addition of ingredients for the production of radioprotective fermented milk product and its use in therapeutic and prophylactic nutrition for adults has been carried out in order to prevent radiation complications and remove radionuclides from the body. The normalized amount of ingredients for consumption per day has been calculated according to recommended diets, nutritional, physiological value, and physiological activity. Standards have been established for enriching micronutrients in the production of a radioprotective dairy product designed to increase the body's resistance to the action of free radical processes and enhance antioxidant capacity under conditions of radiation exposure.

Isothiocyanate-Corticosteroid Conjugates against asthma: Unity makes strength

Asthma is a major noncommunicable disease, affecting both children and adults, and represents one of the major causes leading to high health care costs due to the need for chronic pharmacological treatments. The standard gold therapy of inflammation in asthmatic patients involves the use of glucocorticoids even if their chronic use is often related to serious adverse effects. Growing evidence suggests the biological relevance of hydrogen sulfide (H2S) in the pathogenesis of airway diseases. Hence, aiming to associate the beneficial effects of steroidal anti-inflammatory drugs (SAIDs) to H2S biological activity, we designed and synthesized novel multi-target molecules by chemically combining a group of glucocorticoids, usually employed in asthma treatment, with an isothiocyanate moiety, well-known for its H2S releasing properties. Firstly, the synthesized compounds have been screened for their H2S-releasing profile using an amperometric approach and for their in vitro effects on the degranulation process, using RBL-2H3 cell line. The physicochemical profile, in terms of solubility, chemical and enzymatic stability of the newly hybrid molecules, has been assessed at different physiological pH values and in esterase-rich medium (bovine serum albumin, BSA). The selected compound 5c, through both its corticosteroid and H2S releasing component, has been evaluated in vivo in experimental model of asthma. The compound 5c inhibited in vivo all asthma features with a significative effect on the restoration of pulmonary structure and reduction of lung inflammation.

Integrative approach for improved dofetilide solubility using β-cyclodextrin and two its substituted derivatives: Solutions and solid dispersions

The complexation an anti-arrhythmia drug dofetilide (DFT) with β-cyclodextrin (β-CD), 2-hydroxypropyl-β-cyclodextrin (HP-β-CD) and sulfobutylether-β-cyclodextrin (SBE-β-CD) were studied using two main approaches: phase solubility diagrams and solid dispersions technique. The phase solubility diagrams were constructed in buffer solutions with physiological values рН 2.0 и 7.4. In accordance with the protolytic properties of the drug, the solubilizing effect of cyclodextrins turned out to be more effective in a neutral environment (buffer pH 7.4): the solubility improvement of DFT in the presence of β-CD, HP-β-CD and SBE-β-CD was 3.6, 11.8 and 18.1 times, respectively. In buffer pH 2.0, the tendency for an increase in the solubilizing effect, depending on the chemical nature of the CDs used, is maintained, but the solubility of the drug almost does not grow. The binding constants for the DFT/HP-β-CD and DFT/SBE-β-CD complexes equal to 344 L·mol−1 and 429 L·mol−1 in buffer pH 7.4 indicate the formation of stable inclusion complexes and belong to the optimal range for refinement bioavailability and stability of hydrophobic drugs. Amorphous solid dispersions DFT/β-CD, DFT/HP-β-CD and DFT/SBE-β-CD with stoichiometry 1:1 were obtained by grinding method. The combination FTIR, PXRD, DSC, TGA and SEM methods confirmed the inclusion complexes formation of the drug with cyclodextrins used. Dissolution profiles of solid dispersions DFT/β-CD, DFT/HP-β-CD and DFT/SBE-β-CD were graphing in buffer solutions рН 2.0 and 7.4. Enlargement factor of DFT solubility in the composition of solid dispersions DFT/β-CD, DFT/HP-β-CD and DFT/SBE-β-CD in the neutral medium are 3.4, 4.1 and 5.2, respectively. Whereas the formation of solid inclusion complexes DFT/CDs in an acidic buffer has virtually no effect on the increase in the equilibrium concentration of the active substance in the solution. Findings have demonstrated that the use of SBE-β-CD shows the best solubilization potential for DFT both in solution and as a solid dispersion.

Effects of kinematic hardening of mucus polymers in an airway closure model

The formation of a liquid plug inside a human airway, known as airway closure, is computationally studied by considering the elastoviscoplastic (EVP) properties of the pulmonary mucus covering the airway walls for a range of liquid film thicknesses and Laplace numbers. The airway is modeled as a rigid tube lined with a single layer of an EVP liquid. The Saramito–Herschel–Bulkley (Saramito-HB) model is coupled with an Isotropic Kinematic Hardening model (Saramito-HB-IKH) to allow energy dissipation at low strain rates. The rheological model is fitted to the experimental data under healthy and cystic fibrosis (CF) conditions. Yielded/unyielded regions and stresses on the airway wall are examined throughout the closure process. Yielding is found to begin near the closure in the Saramito-HB model, whereas it occurs noticeably earlier in the Saramito-HB-IKH model. The kinematic hardening is seen to have a notable effect on the closure time, especially for the CF case, with the effect being more pronounced at low Laplace numbers and initial film thicknesses. Finally, standalone effects of rheological properties on wall stresses are examined considering their physiological values as baseline.

Evaluation of the Tibial Plateau-Patella Angle (TPPA) in Dogs.

Estimating a dog's patellar position involves various methods, which categorize it as norma, alta (high), or baja (low). However, they require various calculations. We aimed to evaluate the clinical applicability of a new method, the tibial plateau-patella angle (TPPA). This could aid in planning patella luxation surgery, estimating the patella position after TPLO and various osteotomies. We conducted a two-step study: first, on 15 stifles without pathologies from nine canine cadavers, and second, using 100 patient X-rays from the archive. Three stifle angle positions (45 ± 5°, 90 ± 5°, and 135 ± 5°) and three weight groups (S, M, and L) were evaluated in the first part of this study. Based on these results, the second part of this study was conducted using 100 pathology-free radiographs at the optimal stifle angle (90 ± 5°) from the archive. All radiographs were measured by three observers with varying levels of experience. Our results indicate that the stifle angle significantly impacted the TPPA, whereby lower values were detected with higher stifle angles, which remained consistent within the weight groups. High inter- and intra-observer agreement was achieved. The physiological TPPA values ranged from 26.7° to 48.8°, remaining consistent within the various weight groups. Observer 3 in Group S exhibited a 20% (insignificant) deviation, possibly due to challenges in determining the caudal point of the tibial plateau. In contrast with humans, TPPA values in dogs are negatively correlated with stifle angles, independent of weight. Our reliable and reproducible protocol suggests the potential benefits of training on small-breed dogs stifles.

Increasing the rate of datasets amenable to CTFFR and quantitative plaque analysis: Value of software for reducing stair-step artifacts demonstrated in photon-counting detector CT

PurposeTo determine the value of an algorithm for reducing stair-step artifacts for advanced coronary analyses in sequential mode coronary CT angiography (CCTA). MethodsForty patients undergoing sequential mode photon-counting detector CCTA with at least one stair-step artifact were included. Twenty patients (14 males; mean age 57±17years) with 45 segments showing stair-step artifacts and without atherosclerosis were included for CTFFR analysis. Twenty patients (20 males; mean age 74±13years) with 22 segments showing stair-step artifacts crossing an atherosclerotic plaque were included for quantitative plaque analysis. Artifacts were graded, and CTFFR and quantitative coronary plaque analyses were performed in standard reconstructions and in those reconstructed with a software (entitled ZeeFree) for artifact reduction. ResultsStair-step artifacts were significantly reduced in ZeeFree compared to standard reconstructions (p<0.05). In standard reconstructions, CTFFR was not feasible in 3/45 (7 %) segments but was feasible in all ZeeFree reconstructions. In 9/45 (20 %) segments without atherosclerosis, the ZeeFree algorithm led to a change of CTFFR values from pathologic in standard to physiologic values in ZeeFree reconstructions. In one segment (1/22, 5 %), quantitative plaque analysis was not feasible in standard but only in ZeeFree reconstruction. The mean overall plaque volume (111±60 mm3), the calcific (77±47 mm3), fibrotic (31±28 mm3), and lipidic (4±3 mm3) plaque components were higher in standard than in ZeeFree reconstructions (overall 75±50 mm3, p<0.001; calcific 51±42 mm3, p<0.001; fibrotic 22±19 mm3, p<0.05; lipidic 3±3 mm3, p=0.055). ConclusionDespite the lack of reference standard modalities for CTFFR and coronary plaque analysis, initial evidence indicates that an algorithm for reducing stair-step artifacts in sequential mode CCTA increases the rate and quality of datasets amenable to advanced coronary artery analysis, hereby potentially improving patient management.

Work of Breathing: Physiology, Measurement, and Diagnostic Value in Childhood Pneumonia.

In clinical practice, increased "work of breathing" (WOB) is used to rapidly identify the acutely ill child in need of immediate clinical care, and is commonly used to support a clinical diagnosis of pneumonia. However, this key clinical sign is poorly understood and inconsistently defined. This review discusses the physiology, measurement, and clinical assessment of WOB, highlighting its utility in the recognition of pneumonia in under-resourced settings, where access to diagnostic imaging may be limited.

Soft tissue material properties based on human abdominal in vivo macro-indenter measurements

Simulations of human-technology interaction in the context of product development require comprehensive knowledge of biomechanical in vivo behavior. To obtain this knowledge for the abdomen, we measured the continuous mechanical responses of the abdominal soft tissue of ten healthy participants in different lying positions anteriorly, laterally, and posteriorly under local compression depths of up to 30 mm. An experimental setup consisting of a mechatronic indenter with hemispherical tip and two time-of-flight (ToF) sensors for optical 3D displacement measurement of the surface was developed for this purpose. To account for the impact of muscle tone, experiments were conducted with both controlled activation and relaxation of the trunk muscles. Surface electromyography (sEMG) was used to monitor muscle activation levels. The obtained data sets comprise the continuous force-displacement data of six abdominal measurement regions, each synchronized with the local surface displacements resulting from the macro-indentation, and the bipolar sEMG signals at three key trunk muscles. We used inverse finite element analysis (FEA), to derive sets of nonlinear material parameters that numerically approximate the experimentally determined soft tissue behaviors. The physiological standard values obtained for all participants after data processing served as reference data. The mean stiffness of the abdomen was significantly different when the trunk muscles were activated or relaxed. No significant differences were found between the anterior-lateral measurement regions, with exception of those centered on the linea alba and centered on the muscle belly of the rectus abdominis below the intertubercular plane. The shapes and areas of deformation of the skin depended on the region and muscle activity. Using the hyperelastic Ogden model, we identified unique material parameter sets for all regions. Our findings confirmed that, in addition to the indenter force-displacement data, knowledge about tissue deformation is necessary to reliably determine unique material parameter sets using inverse FEA. The presented results can be used for finite element (FE) models of the abdomen, for example, in the context of orthopedic or biomedical product developments.