Wall Lining Research Articles

Ablation of mitral annular flutter ablation utilizing a left atrial anterior line versus a lateral mitral isthmus line: a systematic review and meta-analysis

PurposeMitral annular flutter (MAF) is a common arrhythmia after atrial fibrillation ablation. We sought to compare the efficacy and safety of catheter ablation utilizing either a left atrial anterior wall (LAAW) line or a lateral mitral isthmus (LMI) line.MethodsWe performed a systematic review for all studies that compared LAAW versus LMI lines. Risk ratio (RR) and mean difference (MD) 95% confidence intervals were measured for dichotomous and continuous variables, respectively.ResultsFour studies with a total of 594 patients were included, one of which was a randomized control trial. In the LMI ablation group, 40% of patients required CS ablation. There were no significant differences in bidirectional block (RR 1.26; 95% CI, 0.94–1.69) or ablation time (MD −1.5; 95% CI, −6.11–3.11), but LAAW ablation was associated with longer ablation line length (MD 11.42; 95% CI, 10.69–12.14) and longer LAA activation delay (MD 67.68; 95% CI, 33.47–101.89.14) when compared to LMI. There was no significant difference in pericardial effusions (RR 0.36; 95% CI, 0.39–20.75) between groups and more patients were maintained sinus rhythm (RR 1.19; 95% CI, 1.03–1.37, p = 0.02) who underwent LAAW compared to LMI.ConclusionAblation of mitral annular flutter with a LAAW line compared to a LMI line showed no difference in rates of acute bidirectional block, ablation time, or pericardial effusion. However, LAAW ablation required a longer ablation line length, resulted in greater LAA activation delayed and was associated with more sinus rhythm maintenance, with the added advantage of avoiding ablation in the CS.

Randomized trials of housing interventions to prevent malaria and Aedes-transmitted diseases: A systematic review and meta-analysis.

BackgroundMosquito-borne diseases remain a significant public health problem in tropical regions. Housing improvements such as screening of doors and windows may be effective in reducing disease transmission, but the impact remains unclear.ObjectivesTo examine whether housing interventions were effective in reducing mosquito densities in homes and the impact on the incidence of mosquito-borne diseases.MethodsIn this systematic review and meta-analysis, we searched 16 online databases, including NIH PubMed, CINAHL Complete, LILACS, Ovid MEDLINE, and Cochrane Central Register of Controlled Trials for randomized trials published from database inception to June 30, 2020. The primary outcome was the incidence of any mosquito-borne diseases. Secondary outcomes encompassed entomological indicators of the disease transmission. I2 values were used to explore heterogeneity between studies. A random-effects meta-analysis was used to assess the primary and secondary outcomes, with sub-group analyses for type of interventions on home environment, study settings (rural, urban, or mixed), and overall house type (traditional or modern housing),ResultsThe literature search yielded 4,869 articles. After screening, 18 studies were included in the qualitative review, of which nine were included in the meta-analysis. The studies enrolled 7,200 households in Africa and South America, reporting on malaria or dengue only. The type of home environmental interventions included modification to ceilings and ribbons to close eaves, screening doors and windows with nets, insecticide-treated wall linings in homes, nettings over gables and eaves openings, mosquito trapping systems, metal-roofed houses with mosquito screening, gable windows and closed eaves, and prototype houses using southeast Asian designs. Pooled analysis depicted a lower risk of mosquito-borne diseases in the housing intervention group (OR = 0.68; 95% CI = 0.48 to 0.95; P = 0.03). Subgroup analysis depicted housing intervention reduced the risk of malaria in all settings (OR = 0.63; 95% CI = 0.39 to 1.01; P = 0.05). In urban environment, housing intervention was found to decrease the risk of both malaria and dengue infections (OR = 0.52; 95% CI = 0.27 to 0.99; P = 0.05).Meta-analysis of pooled odds ratio showed a significant benefit of improved housing in reducing indoor vector densities of both Aedes and Anopheles (OR = 0.35; 95% CI = 0.23 to 0.54; P<0.001).ConclusionsHousing intervention could reduce transmission of malaria and dengue among people living in the homes. Future research should evaluate the protective effect of specific house features and housing improvements associated with urban development.

Study of the swelling pressure of coals and coal charges in the coking process

The maintenance of furnaces is one of the most important problems for by-product coke production. Swelling pressure is one of the least studied factors affecting the lining of coke furnace walls. The results of studies of the swelling pressure of PJSC “Koks” feedstock coal are presented in this paper. Research has been carried out to identify the dependence of the swelling pressure on the coal quality indicators, estimated during the incoming control of the central plant laboratory of PJSC “Koks”. The plastic properties of PJSC “Koks” feedstock coals were studied using Gieseler plastometer. The relationship between the swelling pressure and the maximum coal fluidity is revealed.

Ultra high performance concrete shear walls

The history of the development of Ultra-High Performance Concrete (UHPC) shear walls and the current status of today’s research as well as the future development prospects are comprehensively collated. The analysis process and conclusive results of the present-day domestic and international research on UHPC shear walls are highlighted. The load displacement curves, hysteresis curves and skeleton lines of ultra-high performance concrete shear walls under different experimental loads are collated and compared. Integrate the corresponding equations for shear bearing capacity and equations for the overall specimen load displacement curves. A finite element model of the ultra-high performance concrete shear wall is established to simulate and perform non-linear finite element analysis of its force process under unidirectional horizontal loading.

Faydhat Nayif Archaeological Site, AsSubbiyah, Kuwait: A Discovery of an Ancient Blacksmith Village along the North Shore of the Kuwait Bay, Kuwait

This paper is a report on a discovery of an ancient human settlement next to the Faydhat Nayif pond in the AsSubbiyah area, north of Kuwait Bay, Kuwait. It also presents a description of the site and its artefacts. The settlement, named by the author Faydhat Nayif Archaeological Site, is composed of two parts, the main cluster of gallery remains and a small satellite, the Sonna Village. The main site contains foundations of around fifty galleries. The state of preservation of the foundations varies from excellent to weak. The dominant architectural plan for the galleries is a rectangle. Infrastructural components associated with the foundations are iron smelters and iron tools. Artefacts include fabricated iron tools, fishhooks and fishnets, pottery fragments, glass shards, and animal bones. The craft of the inhabitants revolves around iron smelting and tool fabrication, and hence, the “blacksmith” status. The research method followed in the research is simple classical surveying techniques utilizing a Brunton compass and a measuring tape. Imaging of the galleries used digital cameras. The settlement displays three styles of construction. The first style is that of a faint triangle, seen mostly in the southern and western sides of the site. The second style shows as a rectangle, with most galleries containing two rooms and external bathrooms. The third style of construction is similar to the second style, except for the presence of wood vestiges and the gypsum lining of the gallery walls. These differences between the three styles suggest three episodes of occupancy. One of the occupancies was by the AsSubbah tribe. The site served repeatedly as a center of population and pilgrim rest area, as well as cultural exchanges in the last 1500 years.

New Refractory Lining Direction at Maringá Ferro-Liga Silico-Manganese Furnace #5

The Maringa Group operates 5 Submerged Arc Furnaces (SAF) in Itapeva, Brazil. The company is among the largest producers of manganese alloys in South America. Maringa #5 furnace is a 17 MVA furnace designed by DELP S.A. The original hearth design was made by Magnesita S.A. The furnace start-up was in 1993, and the current daily hot metal production is approximately 80 tons. The furnace has four tap holes, a rotating shell and a shell diameter of 8,5m. The grade produced is currently FeSiMn. After adding water shell cooling and changing the refractory philosophy, the latest furnace campaign started in May of 2019. In its first year, it has showed exceptional operational and lining performance. The wall and bottom lining temperatures are monitored by 72 single thermocouples. In addition, the cooling water temperature increase is monitored. This furnace was rebuilt incorporating the refractory freeze lining technology. Maringa expected that by making this critical change to their furnace they would accomplish a long and trouble-free campaign, with increased production by increased power and inner furnace volume. This well proven refractory concept is used today by several ferroalloy producers and the experiences from this together with the latest technical improvements made to the design will be discussed in this paper. Notable is that this furnace was originally installed using conventional rammed and insulated lining technology, resulting in a furnace campaign life of about 8 years. These experiences will also be described in this paper. It also elaborates on the details of the #5 furnace installation and describes the measures employed to ensure optimum furnace availability.

An Integrated Ecological Approach to Mapping Variations in Collectivism Within China: Introducing the Triple-Line Framework

Measurable regional variations in collectivism have been found across the Chinese mainland, challenging the simple classification of China as a “collectivistic society” in cross-national studies. In previous studies, a small number of distal or proximal ecological factors have been used to explain these regional variations of collectivism. However, there has been little consensus on which ecological factors best predict regional collectivism. In this article, the authors propose the “triple-line framework,” an integrated perspective on regional variations in collectivism. This framework divides China into four regions using three lines—the Hu Huanyong Line, the Great Wall Line, and the Qinling–Huaihe Line—according to their ecological, historical, and social characteristics. A growing body of empirical research is largely consistent with this framework. The authors conclude by discussing the potential for this framework to generate new, testable hypotheses and consider some ways in which this approach to intranational variation could be used by cultural psychologists working in other parts of the world.

Static LiDAR Assisted UWB Anchor Nodes Localization

The paper presents an indoor mapping and UWB (ultra-wideband) anchor localization method. The method, unlike most of the solutions described it the literature uses a static LiDAR (Light Detection and Ranging) mounted on a tripod rather than a robotic platform. It can be used at an any place, where employing a robot would be difficult (e.g. private homes), but since it requires manual LiDAR placement it would be most efficient in spaces of moderate areas. The proposed concept consists in mapping the environment of system installation while performing ranging measurements with deployed UWB anchor nodes. The SLAM (Simultaneous Location and Mapping) algorithm used for map integration and device localization relies only on LiDAR results. The matching is performed in two steps by finding an initial match based on corresponding landmarks extracted from the scans (intersections of the detected wall lines) and refining the results using an Iterative Closest Point algorithm. The anchors are localized based on the ranging results and SLAM-derived device locations using a Least-Squares based optimizer. The experiments have shown that the algorithm allows to construct a comprehensive map of the environment and localize the anchors with a root mean square error of 0.34 m, which is at similar level to analogous methods described in other works. The impact of anchor localization error on the systems performance was not significant. In both static and dynamic scenarios the difference in median errors obtained using reference and mapped anchors’ locations was about 0.05 m.

Palynostratigraphy, Paleoenvironments and Kerogen Evaluation of the Campanian-Maastrichtian Enugu Shale, Anambra Basin, Nigeria

Palynological and palynofacies analyses were used to investigate the paleoenvironments and hydrocarbon potential of the Campanian-Maastrichtian Enugu Shale, Anambra Basin, Nigeria. The palynological analysis of twenty-three outcrop samples revealed diverse and abundant palynomorph assemblages, which consisted of pteridophyte spores 46.82%, angiosperms 36.9%, gymnosperms 1.48 %, algae 5.65%, dinoflagellate cysts 5.1%, fungal elements 1.17%, acritarchs 0.34%, microforaminiferal wall linings 0.01% and miscellaneous palynomorphs (Charred graminae cuticle, incertae sedis) 2.53%. Seven informal palynological assemblage zones (PAZ) with corresponding eustatic sea level changes were delineated. Palynofacies analysis revealed four palynofacies types I to IV based on the percentage relative abundances of the sedimentary organic matter (SOM). Palynofacies types P-I and P-II suggest proximal fluvio-deltaic setting, while P-III and P-IV reflect a heterolithic-oxic shelf (proximal shelf) environment, indicative of deposition in an oxidizing condition. Results of the Spore Colour Index (SCI) and Thermal Alteration Index (TAI) analyses indicate that the Enugu shales are thermally immature. Keywords: Enugu, Campanian, Maastrichtian, Palynomorphs, Phytoclasts

Vertically distributed wall sources of buoyancy. Part 1. Unconfined

Abstract

Torsional Strength in Fused Filament Fabrication 3D Printing

Among robotics enthusiasts, fused filament fabrication (FFF) 3D printing has exploded in popularity. The ability to manufacture custom parts allows for a greater degree of freedom during the design phase. For example, mechanisms like the drivetrain, a hotbed of torsion forces, can be easily compressed to make room for additional functionality. However, such specific components are often unavailable for purchase. Therefore, the ability to manufacture custom torsionally resistant parts in an inexpensive manner is essential.&#x0D; The objective of this study is to determine the FFF 3D printer settings that contribute significantly to a part’s torsional strength. This will be accomplished by altering either infill percentage or wall line count during printing while keeping all other settings constant among 30 individual test parts. Each part will be tested in a custom testing machine that applies a 9:1 gear reduction to simulate the maximum output torque of most hobbyist drivetrains. By measuring the amount of time each test part lasts before snapping, the setting granting the greatest increase in torsional strength can be determined.

Abstract 16884: Evaluating the Effectiveness of Atrial Fibrillation Ablation Guided by Spatiotemporal Electrogram Dispersion

Introduction: Catheter ablation of atrial fibrillation (AF) guided by spatiotemporal dispersion (SD) of electrograms has been proposed as an ablation strategy to treat patients with persistent AF. However, external validation of this technique is lacking. Here we report a single center experience using ablation by SD. Hypothesis: Targeting regions with SD is associated with a high rate of termination and favorable freedom from AF among patients with persistent AF. Methods: Patients with persistent AF who underwent SD from November 2018 to January 2020 were included in this study. All patients underwent pulmonary vein isolation (PVI) in addition to targeting areas of SD. Lesions on areas of electrogram dispersion were anchored to the PVI or to mitral or posterior wall lines where appropriate. EKG, Holter, event monitors or device interrogations were obtained at 3 and 6 months to assess for arrhythmia recurrence. Results: 44 patients met the inclusion criteria and were included in the study. The patients had a mean age of 69±8 years and were 68 % male. The prevalence of comorbidities was as follows: hypertension (89%), diabetes (21%), OSA (37%) and CAD (26%). Average CHADSVASC score was 2.9±1.4, LVEF was 53±11% and left atrium (LA) diameter was 5.2±1 cm. The recurrence rate of AF at 6 months was 14% whereas the recurrence of atrial tachycardia was 20%. Acute AF termination was observed in 73% of the patients. Termination to sinus occurred in 38% of the patients and the remaining terminated to atrial tachycardia which was subsequently ablated to sinus. The mean procedure duration was 240±90 minutes. Univariate analysis showed recurrence was associated with LA diameter (r=.52; p&lt;.001). No recurrences were observed among patients with a LA diameter &lt; 5 cm. Termination rates were higher among patients with LA diameter &lt; 5 cm when compared to LA diameter ≥ 5 cm. However, it did not reach statistical significance (80% vs. 60%; p=.21). Conclusions: The target of electrograms with SD during AF ablation added to PVI was associated with a high termination rate and a good freedom from AF recurrence at 6 months. The ideal candidate for this procedure may be those with LA diameter &lt; 5 cm among persistent AF. The long-term efficacy of this technique merits further studies in larger populations.

Seismic out-of-plane retrofit of URM walls using timber strong-backs

Inadequate seismic performance of unreinforced masonry (URM) buildings is frequently encountered in earthquake prone countries such as Italy and New Zealand and consequently, effective and economical retrofit strategies need to be adopted in order to guarantee safety and the preservation of the URM building stock. The retrofit technique studied herein consisted of connecting vertical timber elements (strong-backs), to the interior surface of the walls of a building using mechanical screws or bolts. The vertical timber framing is typically a non-structural support for the inner wall lining of URM buildings and its use, as a part of the retrofits, resulted in being a cost effective and low impact solution. The out-of-plane behaviour of as-built and retrofitted masonry walls was investigated by conducting full scale static airbag tests. The walls were subjected to semi-cyclic out-of-plane loading through the application of uniformly distributed loads, using inflated airbags in order to simulate the self-weight inertia force induced by an earthquake. Five different wall specimens were tested in the as-built and retrofitted conditions, the improvement of out-of-plane seismic capacity was recorded and the performances of different retrofit configurations were investigated. A simplified numerical model to predict the response of the masonry wall retrofitted using timber strong-backs was developed using the finite element software SAP2000. Its effectiveness was validated by means of a comparison between the experimental and the numerical results as well as a sensitivity analysis of the model on parameter variations, and further considerations on the retrofit solution were drawn.

S0085 Technical Feasibility and Diagnostic Yield of EUS-Guided Through-the-Needle Biopsy Forceps for Pancreatic Cystic Lesions: Experience of a Tertiary Referral Center

INTRODUCTION: Current management of pancreatic cystic lesions (PCLs) is based on clinical presentation, imaging, and cyst fluid analysis. Nevertheless, a PCL may remain a diagnostic challenge after completion of all standard investigations. Recently, through-the-needle biopsy (TTNB) sampling was added to the armamentarium for PCL evaluation during endoscopic ultrasound (EUS). METHODS: We carried out a prospective cohort study to evaluate the feasibility, diagnostic yield and safety of EUS-TTNB. Technical success was defined as visible specimen present after TTNB sampling. Clinical success was determined by the pathology results whenever the cyst wall lining was present, and a histologic diagnosis could be established. RESULTS: A total of 20 patients (mean age 62.0 ± 11 years; 14 (61%) females) were included. The median cyst diameter was 29.5 mm (IQR 21.3–56.8 mm, range 15–75 mm). The procedure was technically successful in 19 patients (95%). TTNB allowed a histologic diagnosis in 15 out of 19 cases (clinical success: 78.9%). Fine-needle aspiration (FNA) cytology was performed in 19/20 patients but was nondiagnostic in 9 cases (45%). The combination of fluid cytology with TTNB resulted in an increased overall diagnostic yield (17/20 cases, 85%), providing additional information in 2 cases in which TTNB results were inconclusive. While cyst fluid carcinoembryonic antigen CEA >192 ng/mL was found in 5/20 cases, TTNB allowed the diagnosis of 12 mucinous lesions. Based on histological features and immunochemical mucin expression on TTNB samples, we were able to determine the predominant phenotype of IPMN in 8/10 cases. Surgical specimens were available in 9 cases with a diagnostic concordance rate of 66.7% (6/9 cases) when compared with TTNB specimens. Overall, in 7 cases, TTNB provided the diagnosis otherwise not suggested by cytology. Also, the histologic features of TTNB specimens changed the presumable diagnosis of the PCL in 5/20 cases and changed management in 8/20 patients (40%). Adverse events occurred in one patient who developed self-limited intracystic bleeding. CONCLUSION: EUS-TTNB was associated with high technical and clinical success and low adverse events rate. It was found superior to FNA cytology and cyst fluid CEA. The addition of TTNB to the current standard approach may provide an incremental benefit for PCLs diagnosis and risk stratification. Also, the possibility for IPMN subtyping can become an important feature for patient management.

Study of scull and lining in the hearth of blast furnace No. 2 of JSC EVRAZ ZSMK (Report 3)

Modern blast furnaces have operation life of 15-20 years. Such a duration of their operation to a great extent reached due to the resistance of lining of hearth and hearth bottom. To study the processes, effecting the rate of its erosion, a study of composition and structure of the scull on the lining of walls of a blast furnace hearth and hearth bottom was accomplished. For the study the No. 2 blast furnace of EVRAZ ZSMK was chosen after its stoppage for overhaul. Results of visual examination of the state of the lining of lower part of the hearth and hearth bottom presented. Macro-structure of the picked out samples presented, general view of lump samples and polished section briquettes shown. Mineral composition of the samples and chemical composition of their separate mineral phases studied. It was determined, that the samples density, picked out lower the iron notch, was considerably higher. By authors opinion, it is stipulated by the increase of metal phase content in the scull along the hearth height in the direction from tuyere level to the hearth bottom, as well as considerable change of the scull porosity along both the horizontal section and the hearth height. The porosity of the samples, picked out lower the iron notch, was not high - at the level of 2.73-3.73%. The gases (oxygen, nitrogen, hydrogen) contained in the BF melts, lead to the forming of scull porous structure of insignificant thickness in the upper horizons of the hearth and in the notch channel. It was determined, that a building-up of zinc can be observed on the hearth bottom, as well as its alloys with iron and lead. The samples macro-structure was clear laminated. The zinc in the sample exists in the form of two mineral phases: an oxide phase (zinc oxide) and a metal phase, often with iron contaminant and rarely - with iron and lead. The results obtained, apart from the studies carried out earlier on the scull and BF hearth lining state, will be base of a theoretical analysis of scull forming mechanism and lining properties change, effecting the blast furnaces campaign duration.

Design optimization of moderately thick hexagonal honeycomb sandwich plate with modified multi-objective particle swarm optimization by genetic algorithm (MOPSOGA)

Design optimization of moderately thick hexagonal honeycomb sandwich plate has been investigated via employing an improved multi-objective particle swarm optimization with genetic algorithm (MOPSOGA). Based on the first-order shear deformation theory (FSDT), governing equations of the plate are obtained. The equations are solved analytically. Total weight and maximum deflection of the plate under static gravity loads are considered to be objective functions of the problem. Core height, faces thickness, cell walls thickness, vertical and inclined cell wall length and the angle between inclined cell wall and horizontal line are set to be design variables of the problem. The geometrical and failure constrains are chosen to have desirable performance and stability of the sandwich plate. In the used multi-objective optimization technique, the optimum velocity parameter, inertia weight and acceleration coefficients for next iteration of the MOPSO are obtained by employing the genetic algorithm via minimizing generational distance between the sets of dominated and non-dominated particles in the previous iteration. Efficiency and accuracy of the proposed solution procedure are demonstrated and effects of different parameters on design optimization of the plate are studied. Also, TOPSIS multi-criteria decision-making method has been selected to report appreciate results from the Pareto-front curve of the MOPSOGA.

“House Plasmodial Prevalence Index” Another Relevant Indicator of Evaluating a Malaria Vector Control Operations, Example of Capango Village (Benguela Province, Angola)

The WHO fascicule “Information systems for the evaluation of malaria control programmes” identified as outcome target “the proportion of households targeted for use of nets using at least one impregnated bednet” [1].&#x0D; The parasitological evaluation of the efficacy of vector control programme is mainly based on the plasmodial prevalence rate evaluated by cross sectional or longitudinal surveys on representative sample of the human population targeted.&#x0D; For the new “House plasmodial” index we decided to combine the 2 indicators: the classical human plasmodial prevalence and house considering as positive any house with “at least one symptomless inhabitant having at least one positive thick film during the survey”. We used this new indicator when analyzing data gained during 24 regularly done parasitological surveys during 5 years in Capango village where a vector control (VC) programme was implemented using both Long Lasting Nets PermaNet© 2.0 and deltamethrin treated wall lining called ZeroFly© inside every house. Surveys were done during 2 years before VC and 3 years after.&#x0D; It appeared that the House Plasmodial positive index showed the same trends and level as the classical human plasmodial prevalence and clearly indicated the impact of vector control in reducing the overall plasmodial prevalence in the targeted village.&#x0D; On the other hand it appeared repeating surveys identified “frequently positive houses” (=found positive in some 50% of surveys) and therefore to be prioritized for control and those “scarcely positive” (20% of surveys).&#x0D; The House Plasmodial Prevalence index appeared relevant and reliable, interesting to be used in vector control programme while easy to get and should be considered in other epidemiological situation.

The value of extensive catheter linear ablation on persistent atrial fibrillation (the CLEAR-AF Study)

BackgroundThe ablation therapy for persistent atrial fibrillation (PerAF) is still a challenge due to the high recurrence rate. This study was aimed to investigate the value of extensive linear ablation with contact force sensing techniques for PerAF. MethodsA total of 214 patients with PerAF were enrolled in five centers. The patients were randomly assigned to Group I (PVI + LA roof line+ LA anterior wall line) and Group II (PVI + LA roof line), mitral valve isthmus lines were added in both groups if the atrial fibrillation (AF) could not be terminated after all approaches above. ResultsAcute success rate of AF termination during the ablation procedure in Group I was significantly higher than Group II (P = 0.028). Two-years follow-up showed no significant difference in the sinus rhythm maintenance rate between the two groups (63.4% in group I vs. 57.2% in group II, P = 0.218). More patients in Group I recurred as organized atrial tachycardia (AT) and can be precisely mapped during repeat ablation procedures (15 vs. 2, P = 0.001). The Kaplan–Meier estimates of AF/AT-free survival after repeat ablation procedures were 76.2% in Group I and 47.1% in Group II (P = 0.039). ConclusionsExtensive linear ablation with contact force monitoring did not improve the long-term outcomes for PerAF patients. Repeat ablation procedure showed a possible higher chance of sinus rhythm restoration during follow-up.

Reconstruction of Intrapelvic Defects Using the Free Anterolateral Thigh Flap: Expanding the Traditional Algorithm.

Reconstruction of intrapelvic soft tissue defects traditionally relies on regional pedicled myocutaneous flaps. However, there remain situations in which local options are unavailable. We review our experience treating intrapelvic defects with the anterolateral thigh (ALT) microvascular free flap. A retrospective, institutional review was conducted from 2014 to 2018 of patients undergoing microvascular ALT flap reconstruction of intrapelvic defects. Four patients were identified in this cohort out of 92 total pelvic reconstruction cases. All patients underwent abdominoperineal resection (APR) for rectal cancer treatment. In the two male patients, pelvic abscesses and bladder leak necessitated soft tissue reconstruction after radiation and APR. In both, regional tissue options were unavailable, and a buried ALT free flap was used for soft tissue reconstruction. Both female patients developed rectovaginal fistulas secondary to their tumor burden, necessitating posterior vaginal wall resections. Prior surgical scars and ostomies made abdominal wall tissue unavailable; thus, free ALTs were used to eliminate intrapelvic dead space and reconstruct the posterior vaginal wall. In all cases, recipient vessels were the deep inferior epigastric artery and vein. Flap survival was 100%. Pelvic reconstruction has traditionally been addressed with local/regional pedicled flaps. In cases where these are unavailable, the free ALT flap is a versatile option when buried for intrapelvic reconstruction or posterior vaginal wall lining. We also propose updating Cordeiro et al.'s classic vaginal defect reconstruction algorithm to include the free ALT flap for type IB cases in which the rectus abdominis is unavailable.

Human primary endothelial label-free biochip assay reveals unpredicted functions of plasma serine proteases

Tissue-on-a-chip technologies are more and more important in the investigation of cellular function and in the development of novel drugs by allowing the direct screening of substances on human cells. Constituting the inner lining of vessel walls, endothelial cells are the key players in various physiological processes, moreover, they are the first to be exposed to most drugs currently used. However, to date, there is still no appropriate technology for the label-free, real-time and high-throughput monitoring of endothelial function. To this end, we developed an optical biosensor-based endothelial label-free biochip (EnLaB) assay that meets all the above requirements. Using our EnLaB platform, we screened a set of plasma serine proteases as possible endothelial cell activators, and first identified the endothelial cell activating function of three important serine proteases – namely kallikrein, C1r and mannan-binding lectin-associated serine-protease 2 (MASP-2) – and verified these results in well-established functional assays. EnLaB proved to be an effective tool for revealing novel cellular mechanisms as well as for the high-throughput screening of various compounds on endothelial cells.