Residual Functionality Research Articles

Coverage of radial forearm flap donor site with full thickness skin graft and Matriderm®: An alternative reliable solution?

After harvesting a radial forearm flap (RFF) an optimal aesthetic and functional restitution of the donor site is required. In order to cover the secondary defect of the donor site, several solutions are currently available, but there is still no real evidence of the most reliable option. A retrospective study was conducted in order to evaluate a new technique of forearm coverage with artificial dermis: the association of full thickness skin graft (FTSG) with Matriderm®. Our study included all RFF performed during a 34-month period. Forty-three forearm secondary defects after harvesting a RFF (16 men, 27 female) were included. Forearm donor site was covered using three techniques: a simple FTSG, split thickness skin graft (STSG) with Matriderm® or FTSG with Matriderm®. Clinical evaluations based on residual functionality, skin quality and aesthetic result were assessed using respectively the Disabilities of the Arm, Shoulder and Hand (DASH) score, the Vancouver Scar Scale (VSS) score and a blind panel questionnaire. FTSG with Matriderm® showed an improved DASH (10.6/100) and VSS score (5.5/13) if compared to the other techniques, mean surgeon satisfaction score was 3/5, mean patient satisfaction score was 3/5 in the FTSG with Matriderm® group. The results of this study revealed that the new association of FTSG with Matriderm® improves the DASH score and the aesthetic outcomes resulting to be a reliable solution in treating full thickness forearm skin defects after RFF harvesting.

A two-step lineage reprogramming strategy to generate functionally competent human hepatocytes from fibroblasts

Terminally differentiated cells can be generated by lineage reprogramming, which is, however, hindered by incomplete conversion with residual initial cell identity and partial functionality. Here, we demonstrate a new reprogramming strategy by mimicking the natural regeneration route, which permits generating expandable hepatic progenitor cells and functionally competent human hepatocytes. Fibroblasts were first induced into human hepatic progenitor-like cells (hHPLCs), which could robustly expand in vitro and efficiently engraft in vivo. Moreover, hHPLCs could be efficiently induced into mature human hepatocytes (hiHeps) in vitro, whose molecular identity highly resembles primary human hepatocytes (PHHs). Most importantly, hiHeps could be generated in large quantity and were functionally competent to replace PHHs for drug-metabolism estimation, toxicity prediction and hepatitis B virus infection modeling. Our results highlight the advantages of the progenitor stage for successful lineage reprogramming. This strategy is promising for generating other mature human cell types by lineage reprogramming.

Evaluation of the results of functional prosthetics in children with congenital defects of the hand and fingers

Background. Evaluation of the result of functional prosthetics in patients with different upper limb defects is a topical problem of modern prosthetics. Providing patients with non-functional hand stumps with functional prostheses is not wide-scale and refers to atypical and experimental prosthetics. While new functional prosthetic hands appear, there is no algorithm for evaluating the results of prosthetics.
 Aim. This study aimed to evaluate the result of functional prosthetics in children with congenital defects of the hand and fingers by active prostheses.
 Materials and methods. We observed 67 children with congenital hand defects, of which 22 were included in the experimental prosthetics group. Bench test station was used for an objective assessment of the residual function of the hand. The booth imitated the tasks of an international competition for the users of Cybathlon rehabilitation equipment and allowed users to perform a series of tests, for each of which a certain number of evaluation points were awarded. Samples at the stand were supplemented with a subjective assessment of the function of the hand using the DASH questionnaire validated in Russia.
 Results. The best subjective assessment of the supply of an active prosthetic hand was determined in the patients with underdeveloped hand similar to the truncation of the hand proximal to the metacarpophalangeal joints. The lowest functionality score of the active prosthetic hand was obtained in cases of ectrodactyly and hypoplasia of 1–5 fingers, which was associated with a high residual functionality of the hand.
 Conclusions. In addition to training functions, the developed bench test station serves a diagnostic function as it evaluates the results of functional prosthetics in patients with upper limb defects in different levels, including defects on the hand and fingers. The results of the study on the station correlate with the results of the DASH questionnaire.

Methylphenidate-mediated motor control network enhancement in patients with traumatic brain injury

ABSTRACTPrimary Objective: To investigate functional improvement late (>6 months) after traumatic brain injury (TBI). To this end, we conducted a double-blind, placebo-controlled experimental medicine study to test the hypothesis that a widely used cognitive enhancer would benefit patients with TBI.Research Design: We focused on motor control function using a sequential finger opposition fMRI paradigm in both patients and age-matched controls.Methods and Procedures: Patients’ fMRI and DTI scans were obtained after randomised administration of methylphenidate or placebo. Controls were scanned without intervention. To assess differences in motor speed, we compared reaction times from the baseline condition of a sustained attention task.Main Outcomes and Results: Patients’ reaction times correlated with wide-spread motor-related white matter abnormalities. Administration of methylphenidate resulted in faster reaction times in patients, which were not significantly different from those achieved by controls. This was also reflected in the fMRI findings in that patients on methylphenidate activated the left inferior frontal gyrus significantly more than when on placebo. Furthermore, stronger functional connections between pre-/post-central cortices and cerebellum were noted for patients on methylphenidate.Conclusions: Our findings suggest that residual functionality in patients with TBI may be enhanced by a single dose of methylphenidate.

Post‐polymerization modification of bio‐based polymers: maximizing the high functionality of polymers derived from biomass

AbstractThe renaissance of the bio‐based chemical industry over the last 20 years has seen an ever growing interest in the synthesis of new bio‐based polymers. The building blocks of these new polymers, so called platform molecules, contain significantly more chemical functionality than their petrochemical counterparts (such as ethene, propene and para‐xylene). As a result bio‐based polymers often contain greater residual chemical functionality in their chains, with groups such as alkenes and hydroxyls commonly observed. These functional groups can act as sites for post‐polymerization modification (PPM), thus further extending the range of applications for bio‐based polymers by tailoring the polymers' final properties. This mini‐review highlights some of the most recent and compelling examples of how to make use of bio‐based polymers with residual functional groups for PPM. It also looks at how the emerging interdisciplinary field of enzymatic polymer synthesis allows for increased functionality in polymers by avoiding side‐reactions as a result of milder reaction conditions, and additionally offers an alternative means of polymer surface modification. © 2018 Society of Chemical Industry

Noisy vestibular stimulation improves vestibulospinal function in patients with bilateral vestibulopathy.

To examine the mechanism underlying previously reported ameliorating effects of noisy galvanic vestibular stimulation (GVS) on balance performance in patients with bilateral vestibulopathy (BVP) and determine those patients (incomplete versus complete vestibular loss) that might benefit from this intervention. Vestibulospinal reflex thresholds were determined in 12 patients with BVP [2 with complete loss (cBVP) and 10 with residual function (rBVP)]. Patients were stimulated with 1Hz sinusoidal GVS of increasing amplitudes (0-1.9mA). Coherence between GVS input and stimulation-induced body motion was determined and psychometric function fits were subsequently used to determine individual vestibulospinal reflex thresholds. The procedure was repeated with an additional application of imperceptible white noise GVS (nGVS). All patients with rBVP but none with cBVP exhibited stimulation-induced vestibulospinal reflex responses with a mean threshold level of 1.26 ± 0.08mA. Additional nGVS resulted in improved processing of weak subthreshold vestibular stimuli (p = 0.015) and thereby effectively decreased the vestibulospinal threshold in 90% of patients with rBVP (mean reduction 17.3 ± 3.9%; p < 0.001). The present findings allow to identify the mechanism by which nGVS appears to stabilize stance and gait performance in patients with BVP. Accordingly, nGVS effectively lowers the vestibular threshold to elicit balance-related reflexes that are required to adequately regulate postural equilibrium. This intervention is only effective in the presence of a residual vestibular functionality, which, however, applies for the majority of patients with BVP. Low-intensity noise stimulation thereby provides a non-invasive treatment option to optimize residual vestibular resources in BVP.

Reduced graphene oxide produced by chemical and hydrothermal methods

Reduced graphene oxide has attracted considerable interest due to its immense potential in developing a wide range of application devices. A key feature of the synthesis of reduced graphene oxide is that different methods of preparation result in materials with different properties which in turn affect their final performance. Here we depict two simple methods to synthesize reduced graphene oxide from graphite powder. Graphite oxide was prepared by the modified Hummer’s method through chemical oxidation of graphite powder. The reduction process was done by chemical and hydrothermal methods to attain minimum residual oxygen functionality. Both the samples were analyzed by characterization tools like XRD, confocal Raman, FTIR, and SEM which confirmed the formation of reduced graphene oxide. Even though hydrothermal reduction is cost effective and environmental friendly, the deoxygenation of graphene oxide by this method is found to be partial in comparison with chemical method.

Stepwise control of reduction of graphene oxide and quantitative real-time evaluation of residual oxygen content using EC-SPR for a label-free electrochemical immunosensor

Abstract The aim of this study was to develop an electrochemical surface plasmon resonance (EC-SPR) method for the stepwise reduction of graphene oxide (GO) by monitoring the real-time refractive index in an effort to control the residual oxygen functionality and conductivity in GO sheets, and then to enhance sensitivity to detect immunoaffinity. The EC-SPR technique acts as a real-time operating system to be used for the observation of oxygen chemical element on the surface of GO. Experimental results demonstrated that EC-SPR signals could quantitatively detect real-time changes in the refractive index of GO films during the stepwise removal of oxygen functional groups. Cyclic voltammetry (CV) in the initial cycles of the electrochemical reduction of GO showed that the oxygen content of the GO film declined by approximately 60%. The SPR angle shifts during the electrochemical reduction for 10, 50 and 100 CV cycles were 164, 218 and 223 mdeg, and the corresponding X-ray photoelectron spectroscopy (XPS) spectra carbon-to-oxygen (C/O) ratios were 17.35, 21.07 and 30.95, respectively. The obtained electrochemically-reduced graphene oxide (ERGO) film chip had a very high sensitivity to detect anti-BSA, and this electrochemical immunosensor was more sensitive than an SPR immunosensor. Our results confirm that this EC-SPR technique could be used to develop electrochemical biosensors with immediate modification of GO film surfaces.

Flood impacts on a water distribution network

Abstract. Floods cause damage to people, buildings and infrastructures. Water distribution systems are particularly exposed, since water treatment plants are often located next to the rivers. Failure of the system leads to both direct losses, for instance damage to equipment and pipework contamination, and indirect impact, since it may lead to service disruption and thus affect populations far from the event through the functional dependencies of the network. In this work, we present an analysis of direct and indirect damages on a drinking water supply system, considering the hazard of riverine flooding as well as the exposure and vulnerability of active system components. The method is based on interweaving, through a semi-automated GIS procedure, a flood model and an EPANET-based pipe network model with a pressure-driven demand approach, which is needed when modelling water distribution networks in highly off-design conditions. Impact measures are defined and estimated so as to quantify service outage and potential pipe contamination. The method is applied to the water supply system of the city of Florence, Italy, serving approximately 380 000 inhabitants. The evaluation of flood impact on the water distribution network is carried out for different events with assigned recurrence intervals. Vulnerable elements exposed to the flood are identified and analysed in order to estimate their residual functionality and to simulate failure scenarios. Results show that in the worst failure scenario (no residual functionality of the lifting station and a 500-year flood), 420 km of pipework would require disinfection with an estimated cost of EUR 21 million, which is about 0.5 % of the direct flood losses evaluated for buildings and contents. Moreover, if flood impacts on the water distribution network are considered, the population affected by the flood is up to 3 times the population directly flooded.

Mid-Term Outcomes After Open Reduction Internal Fixation of Proximal Interphalangeal Joint Dorsal Fracture-Dislocations Through a Volar, Shotgun Approach and a Review of the Literature.

Background:Proximal interphalangeal (PIP) fracture dislocations remain a complex injury pattern to treat. There are several treatment methods available aimed to restore stability, preserve range of motion, and reconstitute the articular surface. This study looked at the mid-term clinical and radiographic results of open reduction internal fixation through a shotgun approach of comminuted PIP fracture dislocations.Methods:A retrospective review was conducted of all PIP fracture dislocations treated through a volar, shotgun approach at a single institution over a 15-year period. Patients identified were contacted and asked to return to the office for clinical and radiographic evaluation. Patient reported outcomes were assessed with the Michigan hand questionnaire (MHQ) and visual analog scale (VAS) for pain.Results:5 patients returned to the office for further evaluation with average follow-up of 69 months (range, 33-133 months). 3 patients were found to have post traumatic arthritis on radiographs. 1 case had recurrent instability and one case had a deep infection, both necessitating further surgical intervention. Average PIP arc of motion was found to be 79°. Average VAS score of 0 and MHQ result of 95 (out of a possible score of 100) indicating no residual pain and excellent functionality of the affected hand.Conclusion:Open reduction internal fixation of comminuted PIP fracture dislocations utilizing the volar, shotgun approach provides excellent mid-term functional results despite the high incidence of post traumatic arthritis.

Survivability Modeling and Resource Planning for Self-Repairing Reconfigurable Device Fabrics.

A resilient system design problem is formulated as the quantification of uncommitted reconfigurable resources required for a system of components to survive its lifetime within mission availability specifications. We show that this survivability metric can be calculated according to the residual functionality obtained from pools of dynamically configurable elements constituting the amorphous resource pool (ARP). The ARP is depleted based on the failure rate to replenish the functionality lost in a reconfigurable fabric due to the occurrence of permanent faults during the mission lifetime. While genetic algorithms are selected for the reparation method, any probabilistic or deterministic active repair strategy is covered without loss of generality. Parameters of this model are correlated with reliability specifications of Xilinx Virtex-4 field programmable gate array devices, which are then utilized for MCNC benchmark circuits along with a realistic space mission. Calculation of the spare fabric resources which must be budgeted for a mission, maximum mission lifetime, and repair policy parameters are realized using the proposed probabilistic survivability model for soft computing-based repair strategies.

Evaluation of functional resilience in urban drainage and flood management systems using a global analysis approach

Enhancing resilience in urban drainage systems (UDSs) requires new evaluation approaches that explicitly consider vital interactions between threats, system performance and resulting failure impacts during both normal and unexpected (exceptional) loading conditions. However, current reliability-based approaches only focus on prevention of functional (hydraulic) failures resulting from a specified design storm. In this study, the global resilience analysis (GRA) approach is further extended for evaluation of UDS performance when subject to a wide range of random functional failure scenarios (extreme rainfall) with varying magnitude, duration, and spatial distribution. The resulting loss of system functionality during the simulated failure scenarios is quantified using total flood volume and mean flood duration. System residual functionality for each considered rainfall block loading scenario is quantified using the functional resilience index. The developed approach has been successfully applied to test and characterise the functional resilience to extreme rainfall of an existing UDS in Kampala city, Uganda. The study concluded that: (1) UDS functional resilience is significantly influenced by both occurrence of short duration, high intensity rainfall events and spatial rainfall variation during extreme rainfall conditions and (2) future planning and design of resilience enhancement strategies should apply spatially distributed rainfall inputs to facilitate effective sizing of potential adaptation strategies.

Do you see me? The role of visual fixation in chronic disorders of consciousness differential diagnosis

Visual fixation (VF) of a target is a possible, although atypical, feature of the Unresponsive Wakefulness Syndrome (UWS). Whether VF may indicate residual awareness in these patients is debatable, since it may simply subtend a series of reflex processes. Objective tools should therefore be used to identify aware VF, which depends on the integrity of visuomotor networks encompassing frontal-parietal-occipital areas. The aim of our study was to detect residual visuomotor network functionality potentially sustaining aware VF. To this end, we evaluated the visuomotor integration (VMI) and visual P300 patterns in a chronic Disorder of Consciousness (DOC) sample and a control group of healthy individuals (HC), using an associative stimulation protocol combining transcranial magnetic stimulation (TMS) with visual stimulation through transorbital alternating current stimulation. The Minimally Conscious State (MCS) patients showed preserved patterns of VMI and P300, whereas nearly all the UWS patients showed no significant VMI. Notably, the electrophysiological findings were correlated with the visual domain of the Coma Recovery Scale-Revised. Nonetheless, two fixating UWS individuals had a VMI similar to MCS patients. Our data suggest that some UWS patients showing VF could be aware, but unable to manifest it clearly, probably because of a severe motor output impairment, which is a condition compatible with the Functional Locked-In Syndrome.

Post-quake urban road network functionality assessment for seismic emergency management in historical centres

In this paper, a procedure for the evaluation of the interaction between existing buildings and urban roadway networks after a seismic event is proposed. This question is relevant in historical urban centres, where urbanisation typology has evidenced, in the past, lack of road networks’ residual connectivity in post-earthquake conditions. The present study proposes a method for the evaluation of the residual functionality in urban context, moving from the execution of building surveys, the application of probabilistic concepts and fuzzy logic with the aim to define probable urban road network damage scenarios. The methodology is applied to the Municipality of Conegliano (northeastern Italy) evaluating the potential seismic damage scenario to the historical urban centre and highlighting criticisms in the post-earthquake rescue operations.

Degradable Amine-Reactive Coatings Fabricated by the Covalent Layer-by-Layer Assembly of Poly(2-vinyl-4,4-dimethylazlactone) with Degradable Polyamine Building Blocks.

We report the fabrication of reactive and degradable cross-linked polymer multilayers by the reactive/covalent layer-by-layer assembly of a non-degradable azlactone-functionalized polymer [poly(2-vinyl-4,4-dimethylazlactone), PVDMA] with hydrolytically or enzymatically degradable polyamine building blocks. Fabrication of multilayers using PVDMA and a hydrolytically degradable poly(β-amino ester) (PBAE) containing primary amine side chains yielded multilayers (∼100 nm thick) that degraded over ∼12 days in physiologically relevant media. Physicochemical characterization and studies on stable films fabricated using PVDMA and an analogous non-degradable poly(amidoamine) suggested that erosion occurred by chemical hydrolysis of backbone esters in the PBAE components of these assemblies. These degradable assemblies also contained residual amine-reactive azlactone functionality that could be used to impart new functionality to the coatings post-fabrication. Cross-linked multilayers fabricated using PVDMA and the enzymatically degradable polymer poly(l-lysine) were structurally stable for prolonged periods in physiological media, but degraded over ∼24 h when the enzyme trypsin was added. Past studies demonstrate that multilayers fabricated using PVDMA and non-degradable polyamines [e.g., poly(ethylenimine)] enable the design and patterning of useful nano/biointerfaces and other materials that are structurally stable in physiological media. The introduction of degradable functionality into PVDMA-based multilayers creates opportunities to exploit the reactivity of azlactone groups for the design of reactive materials and functional coatings that degrade or erode in environments that are relevant in biomedical, biotechnological, and environmental contexts. This "degradable building block" strategy should be general; we anticipate that this approach can also be extended to the design of amine-reactive multilayers that degrade upon exposure to specific chemical triggers, selective enzymes, or contact with cells by judicious design of the degradable polyamine building blocks used to fabricate the coatings.

Interaction between Building Collapse and Road Serviceability during Seismic Emergency Operations in Urban Centers

In this paper a procedure for the evaluation of the interaction between existing buildings’ seismic damage and residual roads’ serviceability is proposed. The problem of the interaction between jutting buildings and roads is relevant in the seismic assessment of the residual functionality of roadway networks belonging to urban centres, where, in general, the urbanization has shown lack of road networks’ residual connectivity in the past quake experiences. The study proposes a comprehensive approach for the probabilistic assessment of the residual functionality of the urban network links, moving from the execution of the buildings external surveys, the application of probabilistic concepts and the use of fuzzy logic with the final aim to outline the potential urban network damage scenarios. The methodology is applied to the municipality of Conegliano (North-Eastern Italy) evaluating the potential seismic damage scenarios to the historical urban centre and highlighting the potential criticalities in the post-earthquake rescue operations.

Residual symptoms and functionality in depressed outpatients: A one-year observational study in Switzerland with escitalopram

BackgroundResidual depressive symptoms are associated with a poor prognosis for relapse or recurrence and are recognized as impeding factors of functionality. Recovery to the pre-depression level of functioning should be the goal of treatment. AimTo evaluate outcomes in depressed outpatients treated with escitalopram regarding response, recovery, residual symptoms, functionality and ability to work over 48 weeks. Method3278 outpatients were evaluated at weeks 8, 24 and 48. A simple questionnaire was used to rate severity of illness, impairment of functionality, treatment response, tolerability, presence and severity of residual symptoms, whether remission with residual symptoms or recovery was achieved, and to what degree the patient was able to work. ResultsData over the full 48-week period were available for 75.8% of patients, for whom treatment response was rated as “very good” or “good” in 81%. However, only 42% of the completing patients achieved recovery without residual symptoms, while 41% were rated as remitters with residual symptoms. Lack of energy/motivation was the most common reported residual symptom and was present in 23.5% of patients at study end. Concentration difficulties were present in 15.8% and impaired sleep in 13.9% of patients. Complete inability to work decreased from 36% at baseline to 9% at week 48, while full-time working capacity increased from 37% to 62%. LimitationsNon-controlled observational real life study using simple ratings rather than established rating scales. Conclusion<50% of patients completing a one-year antidepressant treatment regimen were rated as being symptomatically fully recovered, and ≈50% still reported functional deficits.

Reactivity in the periphery of functionalised multiple bonds of heavier group 14 elements.

Heavier group 14 multiple bonds have intrigued chemists since more than a century. The synthesis of stable compounds with double and triple bonds with silicon, germanium, tin and lead had considerable impact on modern ideas of chemical bonding. These developments were made possible by the use of bulky substituents that provide kinetic and thermodynamic protection. Since about a decade the compatibility of heavier multiple bonds with various functional groups has moved into focus. This review covers multiply bonded group 14 species with at least one additional reactive site. The vinylic functionalities of groups 1 and 17, resulting in nucleophilic and electrophilic disila vinyl groups, respectively, are the most prevalent and well-studied. They have been employed repeatedly for the transfer of heavier multiple bonds to yield low-valent group 14 compounds with novel structural motifs. Vinylic functionalities of groups 2 to 16 and a few σ-bonded transition metal complexes are experimentally known, but their reactivity has been studied to a lesser extent. Donor-coordinated multiple bonds are a relatively new field of research, but the large degree of unsaturation as isomers of alkynes (as well as residual functionality in some cases) offers considerable possibility for further manipulation, e.g. for the incorporation into more extended systems. Heavier allyl halides constitute the major part of heavier multiple bonds with a functional group in allylic position and some examples of successful transformations are given. At present, remote functionalities are basically limited to para-phenylene functionalised disilenes. The reported use of the latter for further derivatisation might encourage investigations in this direction. In summary, the study of peripherally functionalised multiple bonds with heavier group 14 elements is already well beyond its infancy and may be an instrumental factor in awakening the potential of group 14 chemistry for applications in polymers and other materials.

Seismic resilience of concrete structures under corrosion

SummaryA probabilistic approach to lifetime assessment of seismic resilience of deteriorating concrete structures is presented. The effects of environmental damage on the seismic performance are evaluated by means of a methodology for lifetime assessment of concrete structures in aggressive environment under uncertainty. The time‐variant seismic capacity associated with different limit states, from damage limitation up to collapse, is assumed as functionality indicator. The role of the deterioration process on seismic resilience is then investigated over the structural lifetime by evaluating the post‐event residual functionality and recovery of the deteriorating system as a function of the time of occurrence of the seismic event. The proposed approach is applied to a three‐story concrete frame building and a four‐span continuous concrete bridge under corrosion. The results show the combined effects of structural deterioration and seismic damage on the time‐variant system functionality and resilience and indicate the importance of a multi‐hazard life‐cycle‐oriented approach to seismic design of resilient structure and infrastructure systems. Copyright © 2015 John Wiley &amp; Sons, Ltd.

A global analysis approach for investigating structural resilience in urban drainage systems

Building resilience in urban drainage systems requires consideration of a wide range of threats that contribute to urban flooding. Existing hydraulic reliability based approaches have focused on quantifying functional failure caused by extreme rainfall or increase in dry weather flows that lead to hydraulic overloading of the system. Such approaches however, do not fully explore the full system failure scenario space due to exclusion of crucial threats such as equipment malfunction, pipe collapse and blockage that can also lead to urban flooding. In this research, a new analytical approach based on global resilience analysis is investigated and applied to systematically evaluate the performance of an urban drainage system when subjected to a wide range of structural failure scenarios resulting from random cumulative link failure. Link failure envelopes, which represent the resulting loss of system functionality (impacts) are determined by computing the upper and lower limits of the simulation results for total flood volume (failure magnitude) and average flood duration (failure duration) at each link failure level. A new resilience index that combines the failure magnitude and duration into a single metric is applied to quantify system residual functionality at each considered link failure level. With this approach, resilience has been tested and characterised for an existing urban drainage system in Kampala city, Uganda. In addition, the effectiveness of potential adaptation strategies in enhancing its resilience to cumulative link failure has been tested.