Two-phase Protocol Research Articles

Development and psychometric testing of a pediatric chronic graft-versus-host disease symptom scale: protocol for a two-phase, mixed methods study.

Chronic graft-versus-host disease (cGVHD) is a debilitating late complication of hematopoietic stem cell transplantation. It is often accompanied by extensive symptom burden. No validated cGVHD patient-reported outcome (PRO) measure exists to evaluate cGVHD symptom bother in children and adolescents younger than 18 years. This paper presents the study protocol for a multi-center, two-phase protocol to develop a psychometrically valid pediatric cGVHD Symptom Scale (PCSS) and a companion caregiver-proxy measure to capture the symptom burden experienced by children with cGVHD. In the first phase of the study, our aim is to evaluate the comprehension, clarity and ease of response of the PCSS through cognitive interviewing and to iteratively refine the measure to optimize content validity. In the second phase of the study, we will quantitatively examine the measurement properties of the PCSS in children and their caregiver-proxies. Eligible participants are children/adolescents ages 5-17 with cGVHD who are receiving systemic immunosuppressive treatment or have recently tapered to discontinuation. In the first phase, we are enrolling 60 child and caregiver-proxy dyads in three child age strata (5-7, 8-12, and 13-17 years old). Semi-scripted cognitive debriefing interviews are conducted to assess comprehension, clarity, and ease of response of each PCSS item with the child alone, and then jointly with the caregiver-proxy to explore discordant ratings. In phase two, an age-stratified cohort of 120 child-caregiver dyads will be enrolled to evaluate test-retest reliability, construct validity, and responsiveness. Anchors for known-groups validity include the PedsQL module and clinical variables, including cGVHD clinician-rated severity scores. In participants ages 13-17, we will also compare responses on the PCSS with those from the Lee cGVHD Symptom Scale, to gauge the youngest age at which adolescent respondents can comprehend this adult measure. This study will yield a well-validated, counterpart measure to the Lee cGVHD Symptom Scale for use in children with cGVHD and their caregiver-proxies. This new patient-reported outcome measure can be integrated into clinical trials and care delivery for pediatric transplant survivors to improve the precision and accuracy with which their cGVHD symptom experience is captured. www.ClinicalTrials.gov, NCT04044365.

Two-phase optimized experimental design for fatigue limit testing

This study proposes an innovative Two-phase method, based on the Langlie method and the D-optimality criterion, to overcome the intrinsic shortcomings of the staircase method used in estimating the fatigue limit distribution. This paper identifies the current challenges and provides an overview of existing solutions, setting the goal of developing an efficient data collection protocol. It further explains the application of D-optimality criterion and describes the Two-phase protocol, accompanied by a relevant example. The most significant advantage of this approach is its minimal requirement for pre-test information. A simulation-based study was executed to analyze the sensitivity of the input parameters and compare the effectiveness of the proposed method with the traditional staircase and Bayesian optimized method. The numerical simulations reveal that the proposed method offers improved estimation performance for the mean and standard deviation of the fatigue limit distribution, even with minimal pre-test information.

Autism-associated gene shank3 is necessary for social contagion in zebrafish

BackgroundAnimal models enable targeting autism-associated genes, such as the shank3 gene, to assess their impact on behavioural phenotypes. However, this is often limited to simple behaviours relevant for social interaction. Social contagion is a complex phenotype forming the basis of human empathic behaviour and involves attention to the behaviour of others for recognizing and sharing their emotional or affective state. Thus, it is a form of social communication, which constitutes the most common developmental impairment across autism spectrum disorders (ASD).MethodsHere we describe the development of a zebrafish model that identifies the neurocognitive mechanisms by which shank3 mutation drives deficits in social contagion. We used a CRISPR-Cas9 technique to generate mutations to the shank3a gene, a zebrafish paralogue found to present greater orthology and functional conservation relative to the human gene. Mutants were first compared to wild types during a two-phase protocol that involves the observation of two conflicting states, distress and neutral, and the later recall and discrimination of others when no longer presenting such differences. Then, the whole-brain expression of different neuroplasticity markers was compared between genotypes and their contribution to cluster-specific phenotypic variation was assessed.ResultsThe shank3 mutation markedly reduced social contagion via deficits in attention contributing to difficulties in recognising affective states. Also, the mutation changed the expression of neuronal plasticity genes. However, only downregulated neuroligins clustered with shank3a expression under a combined synaptogenesis component that contributed specifically to variation in attention.LimitationsWhile zebrafish are extremely useful in identifying the role of shank3 mutations to composite social behaviour, they are unlikely to represent the full complexity of socio-cognitive and communication deficits presented by human ASD pathology. Moreover, zebrafish cannot represent the scaling up of these deficits to higher-order empathic and prosocial phenotypes seen in humans.ConclusionsWe demonstrate a causal link between the zebrafish orthologue of an ASD-associated gene and the attentional control of affect recognition and consequent social contagion. This models autistic affect-communication pathology in zebrafish and reveals a genetic attention-deficit mechanism, addressing the ongoing debate for such mechanisms accounting for emotion recognition difficulties in autistic individuals.

Survival time and prognostic factors in canine leishmaniosis in a non-endemic country treated with a two-phase protocol including initial allopurinol monotherapy

BackgroundLeishmania infantum is an intracellular protozoan parasite which is endemic in countries of the Mediterranean Basin. Leishmaniosis is increasingly diagnosed in non-endemic areas due to the relocation of dogs from endemic areas and the travel of dogs to and from these areas. The prognosis of leishmaniosis in these dogs may differ from that of those in endemic areas. The aims of this study were (1) to determine the Kaplan–Meier estimated survival time for dogs with leishmaniosis in the Netherlands (a non-endemic country), (2) to determine if clinicopathological variables at the time of diagnosis predicted the survival of these dogs, and (3) to evaluate the effect of a two-phase therapy protocol of allopurinol monotherapy followed by meglumine antimoniate and/or miltefosine in the case of incomplete remission or relapse.MethodsThe database of the Department of Clinical Sciences of Companion Animals of the Faculty of Veterinary Medicine, Utrecht University was investigated for leishmaniosis patients. Patient records were reviewed for signalment and clinicopathological data at the time of diagnosis. Only treatment-naive patients were included. Follow-up was performed during the study by phone contact and included treatment received and date and cause of death. Univariate analysis was performed using the Cox proportional hazards regression model.ResultsThe estimated median Kaplan–Meier survival time was 6.4 years. In the univariate analysis, increases in monocyte, plasma urea and creatinine concentrations, and urine protein to creatinine ratio were all significantly associated with decreased survival time. The majority of patients only received allopurinol monotherapy.ConclusionsCanine leishmaniosis patients in our study population in the Netherlands, which is non-endemic for the disease, had an estimated Kaplan–Meier median survival time of 6.4 years, which is comparable to the outcome of other reported therapy protocols. Increased plasma urea and creatinine concentrations and monocyte concentration were statistically associated with an increased risk of death. We conclude that initial allopurinol monotherapy for 3 months should be effective in more than half of canine leishmaniosis cases, provided there is adequate follow-up, and that meglumine antimoniate or miltefosine therapy should be started as the second phase of the protocol in cases where remission is incomplete or there is a relapse.Graphical

Generation of Natural Killer Cells from Human Expanded Potential Stem Cells.

The differentiation of natural killer (NK) cells from human pluripotent stem cells allows for research on and the manufacture of clinical-grade cellular products for immunotherapy. Described here is a two-phase protocol that uses a serum-free commercial medium and a cocktail of cytokines (interleukin [IL]-3, IL-7, IL-15, stem cell factor [SCF], and FMS-like tyrosine kinase 3 ligand [Ftl3L]) to differentiate human expanded potential stem cells (hEPSCs) into cells that possess NK cell properties in vitro with both 3-dimensional (3D) and 2-dimensional (2D) culture technology. Following this protocol, CD3-CD56+ or CD45+CD56+ NK cells are consistently generated. When cocultured with tumor targets for 3 h, the differentiated products display mild cytotoxicity as compared to an IL-2-independent permanent cell line, NK92mi cells. The protocol preserves the complexity of the differentiation microenvironment by the generation of 3D structures, thus facilitating the study of the spatial relationships between immune cells and their niches. Meanwhile, the 2D culture system enables the routine phenotypical validation of cell differentiation without harming the delicate differentiation niche.

Efficacy of Two-phase Treatment Regimen for Rhino-facial Entomophthoromycosis: Our Experience and Review of Literature

This paper reviews our institutional experience in the management of rhino-facial entomophthoromycosis, a rare subcutaneous fungal infection. We adopt a fixed two-phase protocol comprising an initial 'intensive phase' (two-drug regimen) followed by an 'eradication phase' (monotherapy). We present five patients treated between May 2013 and May 2020 in our institution who were subjected to the mentioned protocol. All five patients received six months of supersaturated potassium iodide solution and itraconazole, followed by four months of monotherapy with only supersaturated potassium iodide solution. All patients responded well to the treatment and were disease-free on follow-up of a minimum two years post-treatment. We recommend this procedure for all typical cases of entomophthoromycosis and suggest avoiding surgical intervention which may disseminate the fungus and delay response to treatment.

Performance Analysis and Optimization in Two-Way Cooperative NOMA Under Two-Phase Transmission Protocol

In this article, a novel two-phase transmission protocol is proposed to help the bidirectional transmission in a user-aid two-way cooperative nonorthogonal multiple access system, where superposition coding, bit-level Exclusive-Or operation, and successive interference cancellation (SIC) techniques are employed for improving the spectrum efficiency and throughput. Considering the residual interference generated in the practice process of decoding, both the perfect SIC and the imperfect SIC scenarios are discussed. Besides, the power allocation factor <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$\alpha _{1}$</tex-math></inline-formula> and <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$\alpha _{2}$</tex-math></inline-formula> are optimized under the perfect SIC to reduce the total outage probability, whose closed-form expression is derived and verified by simulations. Also, the approximated outage performance is derived in imperfect SIC scenario. Furthermore, two other conventional two-phase protocols and one three-phase protocol are provided as the benchmark to compare the outage probability and throughput with the proposed protocol, which shows the superiority of the proposed two-phase protocol and power allocation.

A Protocol to Assess Adult Outcomes at 30 Years Following Preterm Birth.

Among the most intense adversity experiences for infants is premature birth. Early birth marks the beginning of a life course that broadly affects families, healthcare, education, social systems, and the survivors themselves. For many, the transition to adulthood is challenging and often hampered by cognitive, physical and mental health, and motor and independence difficulties. The aim of this study was to share a comprehensive protocol of a 10th follow-up study of premature infants in their 30s. The protocol accounts for stress during the neonatal period, the cumulative context (risk and protection) of development, biological and epigenetic mechanisms, and individual resilience. The prospective, five-group longitudinal design includes 215 term-born and preterm-born individuals with various neonatal morbidities at ages 30-35 years. Adult outcomes include health, adaptive, executive function, work, and social competence. Novel measures are four system indicators of allostatic load (AL) and epigenetics. Contextual measures include socioeconomic risk and individual resilience. All measures were selected based on coherence with constructs of the scientific aims, strong psychometrics, continuity for repeated measures, and minimal subject burden. Objective assessments include body composition imaging, exercise testing, blood and saliva collection, and actigraphy. The two-phase protocol takes approximately 8 hours. After an 11-month COVID-19 pause, participant response has been strong. As of May 2022, 75 participants have completed the full protocol, and 99 have consented to participate. When socioeconomic risk is controlled, we hypothesize that life course trajectories in physical and psychological health, adaptive function, and executive function will differ between term and preterm neonatal morbidity groups. AL will vary across groups and contribute to outcomes. We expect proximal protection and resilience to mediate the cumulative medical and socioeconomic risk and AL. Epigenome-wide DNA methylation, with estimates of age acceleration, will be examined across groups and explored in longitudinal associations with medical risk, socioeconomic status, and protection. To our knowledge, this is the only U.S. study of premature infants aged 30-35 years. With millions of preterm-born individuals reaching adulthood, the protocol incorporates molecular and genetic biomarkers in a life course developmental examination to inform the timing and content of interventions.

Polyethyleneimine stabilized silver nanoparticles as an efficient and selective colorimetric assay for promethazine

Development of simple, facile, and on-spot colorimetric assays for drugs and pesticides based on metal nanoparticles is an emerging field of modern scientific research. Herein, a branched polyethyleneimine (PEI) is used to stabilize silver nanoparticles (AgNPs) through a simple one-pot, two-phase protocol. As the primary goal of the research, the synthesized PEI-AgNPs are employed for an efficient and selective quantitative detection of promethazine (PRO). The typical yellow color of PEI-AgNPs changed to orangish-brown as soon as PRO is added which is further endorsed by an increase in the intensity of the SPR band. The electrostatic forces are responsible for the steric stabilization of silver ions in the micro-domains of the PEI. PRO addition in PEI-AgNPs decreased the average hydrodynamic size and increased apparent positive charge of AgNPs. These changes might be attributed to the presence of the sulfur group in PRO. The limit of detection, the limit of quantification, and the dynamic range of detection of PRO through PEI-AgNPs are found to be 0.003 μM, 0.1 μM, and 0.1–200 μM, respectively. Moreover, PEI-AgNPs allowed reliable, efficient, selective, and quick quantitative detection of PRO in environmental, biological, and commercial drug samples in the presence of other interfering drugs and metal salts. The proposed PRO sensor renders an excellent platform for its quick and on-spot detection without requiring a well-equipped lab setup. Up to the best of our knowledge, the proposed PRO sensor is the first of its kind (colorimetric) in the list of proposed instrumental methods for determination of PRO. The quantitation of PRO as obtained by proposed sensor is compared with UV–Vis spectroscopy and UPLC. Finally, excellent performance of PEI-AgNPs based sensor for biological, environmental, and commercial samples is demonstrated in comparison to UV–Vis spectroscopy and UPLC.

Two-Phase MDCT Protocol for the Screening of Small Hepatocellular Carcinoma.

Screening programmes for cirrhotic patients are based on ultrasound (US) examinations at 6-month intervals, but a US sensitivity of 47% has recently been reported. The aim of this study was to evaluate a two-phase MDCT protocol in terms of hepatic nodule detection within a hepatocellular carcinoma (HCC) screening situation and to evaluate a reduction in irradiation dose for the 6-monthly checks compared to the classic four-phase protocol. In total, 373 patients with 498 nodules that were suspected to be HCC and ranged from 10 to 30 mm in size were prospectively included. All patients underwent four-phase MDCT with an unenhanced phase, arterial phase (AP), portal phase (PP) and delayed phase (DP). The cumulative irradiation from the repeated 6-monthly MDCT protocol was calculated. Of the 498 nodules, only 4 (0.008%) were only seen in the PP and not in the AP or AP. Of the 319 HCC nodules, 270 (84.6%) had AP hyperenhancement, while 115 had washout in the PP and 224 had washout in the DP. Overall, 222 of the 224 (99.1%) HCC nodules with typical features were seen in the AP and DP. The dose reduction was estimated at 55.4% when using the two-phase protocol (AP and DP). The cumulative irradiation of the two-phase protocol, which was performed every 6 months over 5 years, was 96.5 mSv. MDCT with the two-phase protocol could offer an alternative to ultrasound screening with an interesting risk–benefit trade-off.

Distributed Quantization for Partially Cooperating Sensors Using the Information Bottleneck Method.

This paper addresses the optimization of distributed compression in a sensor network with partial cooperation among sensors. The widely known Chief Executive Officer (CEO) problem, where each sensor has to compress its measurements locally in order to forward them over capacity limited links to a common receiver is extended by allowing sensors to mutually communicate. This extension comes along with modified statistical dependencies among involved random variables compared to the original CEO problem, such that well-known outer and inner bounds do not hold anymore. Three different inter-sensor communication protocols are investigated. The successive broadcast approach allows each sensor to exploit instantaneous side-information of all previously transmitting sensors. As this leads to dimensionality problems for larger networks, a sequential point-to-point communication scheme is considered forwarding instantaneous side-information to only one successor. Thirdly, a two-phase transmission protocol separates the information exchange between sensors and the communication with the common receiver. Inspired by algorithmic solutions for the original CEO problem, the sensors are optimized in a greedy manner. It turns out that partial communication among sensors improves the performance significantly. In particular, the two-phase transmission can reach the performance of a fully cooperative CEO scenario, where each sensor has access to all measurements and the knowledge about all channel conditions. Moreover, exchanging instantaneous side-information increases the robustness against bad Wyner–Ziv coding strategies, which can lead to significant performance losses in the original CEO problem.

Asynchronous Wrapper-Based Low-Power GALS Structural QDMA

The design of System-on-Chip systems using synchronous circuits involves complex clock distribution strategies, which envisage challenges for designers to integrate large-scale systems. Globally Asynchronous Locally Synchronous architectures containing asynchronous port controllers encapsulated in the self-timed wrapper have been adopted in this work. These port controllers communicate through Asynchronous Finite State Machines defined by Signal Transition Graphs are implemented adopting the C element. This GALS architecture implemented for the point-to-point interface can also be modified for the multipoint interface. The proposed methodology uses a two-phase handshake protocol to communicate between two Locally Synchronous modules as it has fewer signal transitions, which, in turn, reduces latency. In this paper, the Queue Direct Memory Access subsystem is implemented using the Vivado simulator on UltraScale+™ device at a maximum frequency of 257.4MHz, and various parameters are reported. A comparison shows that the proposed wrapper has improved latency time of 53%, with a reduction in power dissipated by 27% and an increase in gate count by 13%.

Biodegradable Poly-ε-Caprolactone Scaffolds with ECFCs and iMSCs for Tissue-Engineered Heart Valves.

Clinically used heart valve prostheses, despite their progress, are still associated with limitations. Biodegradable poly-ε-caprolactone (PCL) nanofiber scaffolds, as a matrix, were seeded with human endothelial colony-forming cells (ECFCs) and human induced-pluripotent stem cells-derived MSCs (iMSCs) for the generation of tissue-engineered heart valves. Cell adhesion, proliferation, and distribution, as well as the effects of coating PCL nanofibers, were analyzed by fluorescence microscopy and SEM. Mechanical properties of seeded PCL scaffolds were investigated under uniaxial loading. iPSCs were used to differentiate into iMSCs via mesoderm. The obtained iMSCs exhibited a comparable phenotype and surface marker expression to adult human MSCs and were capable of multilineage differentiation. EFCFs and MSCs showed good adhesion and distribution on PCL fibers, forming a closed cell cover. Coating of the fibers resulted in an increased cell number only at an early time point; from day 7 of colonization, there was no difference between cell numbers on coated and uncoated PCL fibers. The mechanical properties of PCL scaffolds under uniaxial loading were compared with native porcine pulmonary valve leaflets. The Young’s modulus and mean elongation at Fmax of unseeded PCL scaffolds were comparable to those of native leaflets (p = ns.). Colonization of PCL scaffolds with human ECFCs or iMSCs did not alter these properties (p = ns.). However, the native heart valves exhibited a maximum tensile stress at a force of 1.2 ± 0.5 N, whereas it was lower in the unseeded PCL scaffolds (0.6 ± 0.0 N, p < 0.05). A closed cell layer on PCL tissues did not change the values of Fmax (ECFCs: 0.6 ± 0.1 N; iMSCs: 0.7 ± 0.1 N). Here, a successful two-phase protocol, based on the timed use of differentiation factors for efficient differentiation of human iPSCs into iMSCs, was developed. Furthermore, we demonstrated the successful colonization of a biodegradable PCL nanofiber matrix with human ECFCs and iMSCs suitable for the generation of tissue-engineered heart valves. A closed cell cover was already evident after 14 days for ECFCs and 21 days for MSCs. The PCL tissue did not show major mechanical differences compared to native heart valves, which was not altered by short-term surface colonization with human cells in the absence of an extracellular matrix.

Double-blind cross-over pilot trial protocol to evaluate the safety and preliminary efficacy of long-term adaptive deep brain stimulation in patients with Parkinson’s disease

IntroductionAfter several years of brain-sensing technology development and proof-of-concept studies, adaptive deep brain stimulation (aDBS) is ready to better treat Parkinson’s disease (PD) using aDBS-capable implantable pulse generators (IPGs). New...

Double-Layer Energy Efficient Synchronous-Asynchronous Circuit-Switched NoC

A network-on-chip (NoC) offers high performance, flexibility and scalability in communication infrastructure within multi-core platforms. However, NoCs contribute significantly to the overall system’s power consumption. The double-layer energy efficient synchronous-asynchronous circuit-switched NoC (CS-NoC) is proposed to enhance the power utilization. To reduce the dynamic power consumption, single-rail asynchronous protocols are utilized. The two-phase and four-phase encoding algorithms are analyzed to determine the most efficient technique. For the data layer, the two asynchronous protocols reduced the power consumption by 80%, with an increase in latency when compared with the fully synchronous protocol. However, the two-phase single-rail protocol had better performance compared with the four-phase protocol by 38%, with the same power consumption and a slight increase in area of 5%. Based on this conducted analysis, the asynchronous two-phase layer had significant power reduction yet operated at a moderate frequency. Therefore, the proposed NoC is divided into two data transfer layers with a single control layer. The data transfer layers are designed using synchronous and asynchronous protocols. The synchronous layer is designated to high-frequency loads, and the asynchronous layer is confined to low-frequency loads. The switching between the layers creates a trade-off between the maximum allowed frequency and the power consumption. The proposed NoC reduces the overall power consumption by 23% when compared with recent previous work. The NoC maintains the same system performance with an 8% area increase over the fully synchronous double-layer in the literature.

A High Performance Concurrency Protocol for Smart Contracts of Permissioned Blockchain

Although the emergence of the programmable smart contract makes blockchain systems easily embrace a wide range of industrial services, how to execute smart contracts efficiently becomes a big challenge nowadays. Due to the existence of Byzantine nodes, existing mature concurrency control protocols in database cannot be employed directly, since the mechanism of executing smart contracts varies a lot. Furthermore, even though smart contract execution follows a two-phase style, i.e., the primary node executes a batch of smart contracts in the first phase and the validators replay them in the second phase, existing parallel solutions merely focus on the optimization for the first phase, rather than the second phase. In this paper, we propose a novel two-phase concurrency control protocol to optimize both phases for the first time. First, the primary executes transactions in parallel and generates a transaction dependency graph with high parallelism for validators. Then, a graph partition algorithm is devised to divide the original graph into several sub-graphs to preserve parallelism and reduce communication cost remarkably. Finally, we propose a deterministic replay protocol to re-execute the primary’s parallel schedule concurrently. Moreover, this two-phase protocol is further optimized by integrating with PBFT. Theoretical analysis and extensive experimental results illustrate that the proposed scheme outperforms state-of-art solutions significantly.

Full-face skin resurfacing using a combination of fractional and full spot ablative 2940nm erbium laser.

Full-field deep ablative laser resurfacing is a popular method for skin rejuvenation due to maximum improvement in a single treatment. However, it is associated with disadvantages such as pain, prolonged erythema, swelling, crusting, infections, pigmentary changes, and scarring. Patients are increasingly seeking less invasive options with comparable effect. The aim of this retrospective study was to evaluate the safety and efficacy of full-face resurfacing using a combination of full spot and fractional erbium (Er:YAG) laser resurfacing. About 109 patients, mostly females over 50years old, were treated with a two-phase protocol: full spot ablation (5J/cm2 , three passes) and fractional ablation (132J/cm2 , 5% coverage, three passes). We recorded time to re-epithelization and duration of post-treatment erythema. Any side effects observed at follow-up or reported by the patient were recorded. Patient satisfaction questionnaire and blinded evaluation of pre- and post-treatment photographs were used to assess efficacy. A single session was performed in 96% of cases. Postoperative re-epithelization lasted on average 6.4±2.9days. Post-treatment erythema lasted on average 13.8±15.2days. One patient had hyperpigmentation, one infection, one hypo-pigmentation, and one ulcer. All side effects resolved without complications. According to the blinded assessment of photographs, 78% of patients showed improvement. About 97% of patients were satisfied with the results of the treatment. A combination of fractional and full spot ablative Er:YAG laser is a safe and effective option for full-face resurfacing.

Prospects for the reduction of the patient doses based on the optimization of the CT abdomen protocols for the different types of malignancies

Reducing radiation exposure in computed tomography is a relevant medical task due to the growing number of studies and the lack of generally accepted approaches to their conduct in the radiological community. One way to reduce the effective dose in contrast-enhanced computed tomography of the abdomen is to optimize the protocol of examination, which can include four scans: in the native, arterial, venous and delayed phases. However while providing repeated studies in patients with oncological diseases, it is possible to confine one or two phases, which will allow the radiologist to visualize observed pathological changes and to evaluate the response to the treatment, as well as detect the recurrence in case of the monitoring of the patients. In the present study, two groups were formed on the basis of a sample of 514 patients. In group 1 (control), CTB was performed according to a three- or four-phase protocol. In group 2, the same patients with an interval from 1 to 5.5 months were performed with computed tomography -OBP according to a single or two-phase protocol depending on the degree of vascularization of the tumor tissue and the clinical situation. At the same time, a decrease in the average effective dose in patients in group 2 compared with group 1 was demonstrated by 63% (p&lt;0.05). In all cases, the various pathological changes that characterize the oncological process and were diagnosed with a three- or four-phase protocol were visualized with a single- or two-phase protocol. Thus, the informative value of computed tomography examination did not decrease.

Phosphorous acid promoted isomerization of propargyl alcohols to α,β-unsaturated carbonyl compounds

A metal-free and two-phase protocol for the Meyer-Schuster isomerization of propargyl alcohols to the corresponding α,β-unsaturated carbonyl compounds has been achieved in the presence of stoichiometric phosphorous acid aqueous solution, which produces the desired products in high yields with excellent stereoselectivity. Compared with the traditional methods, the procedure features broad scope of the substrates, mild conditions, and easy separation, providing an appealing alternative to the Meyer-Schuster reaction.

Development of a training paradigm for voluntary control of the peri-auricular muscles: a feasibility study

BackgroundSpinal cord injury (SCI) can lead to severe and permanent functional deficits. In humans, peri-auricular muscles (PAMs) do not serve any physiological function, though their innervation is preserved in even high level SCI. Auricular control systems provide a good example of leveraging contemporary technologies (e.g., sEMG controlled computer games) to enable those with disabilities. Our primary objective is to develop and test the effectiveness of an auricular muscle training protocol to facilitate isolated and coordinated, bilateral voluntary control that could be used in individuals without volitional control of the vestigial PAMs.MethodsSeventeen non-disabled persons were screened; 13 were eligible and 10 completed the entire protocol. The facilitation phase, included one session of sub-motor threshold, sensory electrical stimulation followed by neuromuscular electrical stimulation paired with ear movement feedback for up to 8 additional sessions. Participants progressed to the skill acquisition phase where they dawned an auricular control device that used sEMG signals to control movements of a cursor through three levels of computer games, each requiring increasingly more complex PAM coordination.ResultsThe 10 who completed the protocol, finished the facilitation phase in 3 to 9 sessions and achieved some level of voluntary auricle movement that ranged between 1 and 5 mm. Qualitative analysis of longitudinal post-session auricular movement, revealed two subgroups of learners. Six successfully completed all 3 games—the “Learners”. Two were partially successful in game completion and two were unable to complete a single game--“Poor/Non-Learners”. Quantitative analysis revealed a significant group difference in auricular amplitude for both facilitation and skill phases (p < .05), and a significant relationship between performance in the two phases (R2 = 0.84, p = 0.004).ConclusionSixty percent of those who completed the facilitation phase were able to learn and demonstrate functional voluntary control of the vestigial PAMs. Those who progressed the fastest through facilitation were also those who were most proficient in skill acquisition with the device. There was considerable variability in progression through the two-phase protocol, with 20% deemed Poor/Non-Learners and unable to complete even the most basic game following training. There were no serious adverse events.Trial registrationClinicalTrials.gov Identifier: NCT02358915, first posted February 9, 2015.