Detailed analysis of allergic cutaneous reactions to spinal cord stimulator devices

The use of spinal cord stimulation (SCS) devices to treat chronic, refractory neuropathic pain continues to expand in application. While device-related complications have been well described, inflammatory reactions to the components of these devices remain underreported. In contrast, hypersensitivity reactions associated with other implanted therapies, such as endovascular and cardiac rhythm devices, have been detailed. The purpose of this case series is to describe the clinical presentation and course of inflammatory reactions as well as the histology of these reactions. All patients required removal of the entire device after developing inflammatory reactions over a time course of 1–3 months. Two patients developed a foreign body reaction in the lead insertion wound as well as at the implantable pulse generator site, with histology positive for giant cells. One patient developed an inflammatory dermatitis on the flank and abdomen that resolved with topical hydrocortisone. “In vivo” testing with a lead extension fragment placed in the buttock resulted in a negative reaction followed by successful reimplantation of an SCS device. Inflammatory reactions to SCS devices can manifest as contact dermatitis, granuloma formation, or foreign body reactions with giant cell formation. Tissue diagnosis is essential, and is helpful to differentiate an inflammatory reaction from infection. The role of skin patch testing for 96 hours may not be suited to detect inflammatory giant cell reactions that manifest several weeks post implantation

Agriculture Irrigation and Water Use

The 17 Western States, plus Arkansas, Florida, and Louisiana, account for 91 percent of all U.S. irrigated acreage, with the Western States alone contributing over 85 percent. This report integrates data on the distribution, characteristics, uses, and management of water resources from a wide variety of data sources. The report includes charts and tables on water use in irrigation; farm data comparing selected characteristics of irrigated and nonirrigated farms; and data on water application systems, sources of water, pump energy expenses by energy type, values of irrigated and nonirrigated land, and cash rents

The diverse molecular profiles of lynch syndrome-associated colorectal cancers are (highly) dependent on underlying germline mismatch repair mutations

Lynch syndrome (LS) is a hereditary cancer syndrome that accounts for 3% of all new colorectal cancer (CRC) cases. Patients carry a germline pathogenic variant in one of the mismatch repair (MMR) genes (MLH1, MSH2, MSH6 or PMS2), which encode proteins involved in a post-replicative proofreading and editing mechanism. The clinical presentation of LS is highly heterogeneous, showing high variability in age at onset and penetrance of cancer, which may be partly attributable to the molecular profiles of carcinomas. This review discusses the frequency of alterations in the WNT/B-CATENIN, RAF/MEK/ERK and PI3K/PTEN/AKT pathways identified in all four LS subgroups and how these changes may relate to the 'three pathway model' of carcinogenesis, in which LS CRCs develop from MMR-proficient adenomas, MMR-deficient adenomas or directly from MMR-deficient crypts. Understanding the specific differences in carcinogenesis for each LS subgroup will aid in the further optimization of guidelines for diagnosis, surveillance and treatment.Molecular tumour pathology - and tumour geneticsMTG2 - Moleculaire genetica van gastrointestinale tumore

Experimental Analysis and Modeling for Reciprocating Wear Behavior of Nanocomposite Coatings

This paper presents the study of wear responses of nanocomposite coatings with a steel ball under oscillatingreciprocating state. Nanocomposite coatings for this study include: Nickel-Alumina (Ni/Al2O3), Nickel-Silicon Carbide (Ni/SiC), Nickel-Zirconia (Ni/ZrO2) and Ni/Graphene. Ni/ZrO2 exhibited maximum wear rate followed by Ni/SiC, Ni/Al2O3 and Ni/Graphene respectively which was also assured by Scanning Electron Microscopy (SEM) micrographs, grain sizes, hardness, porosity, surface stresses, frictional coefficients behaviours and “Ushaped" wear depth profiles. The “U-shaped” profiles were utilised to calculate the energy distribution (Archard factor density) along the interface. A novel mechano-wear model incorporating the energy distribution equations with the mechanics equations was developed for analysing the effects of intrinsic mechanical properties (such as grain sizes, hardness, porosity, surface stresses of the nanocomposite coatings) on the wear response. The predictions showed close agreement with the experimental results. In conclusion Ni/Graphene exhibited better anti-wear properties compared to other nanocomposite coatings. The high anti-wear behaviour of Ni/Graphene composite is due to enhanced strengthening effects in the presence of graphene. The importance of this work is evident from various industrial applications which require reliable modelling techniques to predict coatings failures due to wear. This work will bring significant impact to precision manufacturing, wind turbine industries, automotive, locomotive and aerospace in overcoming critical wear failures

Development and Validation of a Preprocedural Risk Score to Predict Access Site Complications After Peripheral Vascular Interventions Based on the Vascular Quality Initiative Database

Purpose: Access site complications following peripheral vascular intervention (PVI) are associated with prolonged hospitalization and increased mortality. Prediction of access site complication risk may optimize PVI care; however, there is no tool designed for this. We aimed to create a clinical scoring tool to stratify patients according to their risk of developing access site complications after PVI. Methods: The Society for Vascular Surgery’s Vascular Quality Initiative database yielded 27,997 patients who had undergone PVI at 131 North American centers. Clinically and statistically significant preprocedural risk factors associated with in-hospital, post-PVI access site complications were included in a multivariate logistic regression model, with access site complications as the outcome variable. A predictive model was developed with a random sample of 19,683 (70%) PVI procedures and validated in 8,314 (30%). Results: Access site complications occurred in 939 (3.4%) patients. The risk tool predictors are female gender, age > 70 years, white race, bedridden ambulatory status, insulin-treated diabetes mellitus, prior minor amputation, procedural indication of claudication, and nonfemoral arterial access site (model c-statistic = 0.638). Of these predictors, insulin-treated diabetes mellitus and prior minor amputation were protective of access site complications. The discriminatory power of the risk model was confirmed by the validation dataset (c-statistic = 0.6139). Higher risk scores correlated with increased frequency of access site complications: 1.9% for low risk, 3.4% for moderate risk and 5.1% for high risk. Conclusions: The proposed clinical risk score based on eight preprocedural characteristics is a tool to stratify patients at risk for post-PVI access site complications. The risk score may assist physicians in identifying patients at risk for access site complications and selection of patients who may benefit from bleeding avoidance strategies

Cornerstones of Sampling of Operator Theory

This paper reviews some results on the identifiability of classes of operators whose Kohn-Nirenberg symbols are band-limited (called band-limited operators), which we refer to as sampling of operators. We trace the motivation and history of the subject back to the original work of the third-named author in the late 1950s and early 1960s, and to the innovations in spread-spectrum communications that preceded that work. We give a brief overview of the NOMAC (Noise Modulation and Correlation) and Rake receivers, which were early implementations of spread-spectrum multi-path wireless communication systems. We examine in detail the original proof of the third-named author characterizing identifiability of channels in terms of the maximum time and Doppler spread of the channel, and do the same for the subsequent generalization of that work by Bello. The mathematical limitations inherent in the proofs of Bello and the third author are removed by using mathematical tools unavailable at the time. We survey more recent advances in sampling of operators and discuss the implications of the use of periodically-weighted delta-trains as identifiers for operator classes that satisfy Bello's criterion for identifiability, leading to new insights into the theory of finite-dimensional Gabor systems. We present novel results on operator sampling in higher dimensions, and review implications and generalizations of the results to stochastic operators, MIMO systems, and operators with unknown spreading domains

Effect of IoT capabilities and energy consumption behavior on green supply chain integration

The Internet of Things (IoT) is the next generation of internet-connected information communication technologies (ICT). IoT typically integrates supply chain activities to enhance green supply chain performance (GSCP). Since every organization has different IoT capabilities in comparison with other organizations, GSCP can enable supply chain integration activities for enhanced performance. The implementation of an IoT system can reduce the consumption of organizational resources like energy, electricity, and time and can increase the operational speed to gain better logistics and, ultimately, improved supply chain performance. This study has developed and empirically tested the relationship between IoT capabilities, energy consumption behavior (ECB), supply chain integration, green training (GT), and supply chain practices. Such a multidisciplinary relationship has not previously been established in the literature. The proposed study can fulfill the literature gap and opens new horizons for interdisciplinary research. Data used in this study are collected through offline and online survey methods. A total number of 250 out of 400 respondents participated in the survey. Data has been analyzed through partial least square-structure equation modeling (PLS-SEM) technique. The results of this study empirically test the developed model. IoT has a positive effect on supplier integration (SI), and customer integration (CI). Furthermore, SI and CI have a mediating role between IoT and GSCP, and GT has a positive impact on GSCP. It is concluded that the implementation of IoT can integrate CI and SI to increase GSCP. GT and ECB can ultimately improve GSCP. Additionally, the use of technology and GT can motivate employees to save energy and protect the environment to increase GSCP

The coding microsatellite mutation profile of PMS2-deficient colorectal cancer

Lynch syndrome (LS) is caused by a pathogenic heterozygous germline variant in one of the DNA mismatch repair (MMR) genes: MLH1, MSH2, MSH6 or PMS2. LS-associated colorectal carcinomas (CRCs) are characterized by MMR deficiency and by accumulation of multiple insertions/deletions at coding microsatellites (cMS). MMR deficiency-induced variants at defined cMS loci have a driver function and promote tumorigenesis. Notably, PMS2 variant carriers face only a slightly increased risk of developing CRC. Here, we investigate whether this lower penetrance is also reflected by differences in molecular features and cMS variant patterns. Tumor DNA was extracted from formalin-fixed paraffin-embedded (FFPE) tissue cores or sections (n = 90). Tumors originated from genetically proven germline pathogenic MMR variant carriers (including 14 PMS2-deficient tumors). The mutational spectrum was analyzed using fluorescently labeled primers specific for 18 cMS previously described as mutational targets in MMR-deficient tumors. Immune cell infiltration was analyzed by immunohistochemical detection of T-cells on FFPE tissue sections. The cMS spectrum of PMS2-deficient CRCs did not show any sig-nificant differences from MLH1/MSH2-deficient CRCs. PMS2-deficient tumors, however, displayed lower CD3-positive T-cell infiltration compared to other MMR-deficient cancers (28.00 vs. 55.00 per 0.1 mm(2), p = 0.0025). Our study demonstrates that the spectrum of potentially immunogenic cMS variants in CRCs from PMS2 gene variant carriers is similar to that observed in CRCs from other MMR gene variant carriers. Lower immune cell infiltration observed in PMS2-deficient CRCs could be the result of alternative mechanisms of immune evasion or immune cell exclusion, similar to those seen in MMR-proficient tumors.Hereditary cancer genetic

Hydromulches suppress weeds and maintain fruit production in organically managed strawberry systems

Polyethylene (PE) mulches are widely used in strawberry (Fragaria×ananassa Duch) production for weed suppression and crop growth optimization. However, PE mulches are not biodegradable and contribute to plastic pollution. Our objective was to develop and test biodegradable liquid-applied ‘hydromulches’ (HMs) as a sustainable alternative to PE mulch. HM weed suppression efficacy, strawberry plant growth, and yield were evaluated. HM formulations consisted of shredded newsprint paper (NP), water, and a tackifier, either guar gum (GG) or psyllium husk (PH) added at 2 or 6%. Experiments were conducted at two environmentally distinct locations: northwest Washington (WA) and eastern North Dakota (ND). Five HM formulations were compared to black PE mulch within a randomized complete block design with four replications. PE mulch suppressed weeds completely at peak weed emergence and peak weed vegetative growth at both locations. Formulations of HM containing GG provided superior weed suppression compared to other HM formulations at peak weed emergence (4–6 vs. 18–22 plants m-2, respectively). At peak vegetative growth, HM formulations containing GG had the lowest weed density compared to other HMs in ND (1 vs. 9–12 plants m-2), whereas these differences were not observed in WA. Total weed biomass did not differ among HMs across both locations. GG HM formulations deteriorated similarly to PE mulch (3–5% vs. 2%, respectively) in ND, whereas other HMs deteriorated more substantially. In WA, all HMs deteriorated more than PE mulch (6–12% vs. 1%, respectively). Fruit yield did not differ among treatments in weedy and weed-free subplots (194–254 g plant-1) in WA. In ND, yield was greater in all HM treatments compared to PE mulch in both weedy and weed-free subplots. Across both locations, strawberry canopy cover was greater in PE mulch (56.1% canopy cover) compared to 2%GG and NP (42.4 and 39.8% canopy cover). Strawberry plant biomass was similar among mulch treatments. However, strawberry leaf and crown biomass were slightly lower in 2%PH compared to other mulch treatments. Results demonstrate HMs with GG tackifier are a promising alternative to PE mulch in organic strawberry systems based on ability to suppress weeds, enhance strawberry growth, and maintain yield