Quantitative Measurement of Muscle Atrophy and Fat Infiltration of the Supraspinatus Muscle Using Ultrasonography After Arthroscopic Rotator Cuff Repair

ObjectiveTo investigate the utility of ultrasonography to objectively examine morphological changes (i.e., muscle atrophy and fatty infiltration) of the supraspinatus muscle.MethodsThirty-four patients were prospectively enrolled in this study. The degrees of muscle atrophy and fat infiltration were measured using ultrasonography 3–4 months after arthroscopic supraspinatus tendon repair. Shoulder function (i.e., shoulder active range of motion, visual analogue scale, and constant score) was examined. Using the symmetricity of the muscles in the human body, the degrees of morphological changes of the supraspinatus muscle were quantitatively measured. The associations between the morphological changes of the supraspinatus muscle and shoulder function were identified.ResultsThere were statistically significant differences in the cross-sectional area (CSA) and echogenicity between the surgery and non-surgery sides (p<0.001). The CSA ratio, which represents the degree of muscle atrophy, was associated with shoulder forward flexion, external rotation, and constant score; however, the echogenicity ratio, which represents the degree of fat infiltration, was not associated with shoulder function after surgery.ConclusionThis study demonstrated that shoulder function could be predicted by evaluating the morphological changes of the supraspinatus muscle using ultrasonography and that objective evaluation is possible through quantitative measurement using the symmetricity of the human body

Pan-cancer analysis of whole genomes

Cancer is driven by genetic change, and the advent of massively parallel sequencing has enabled systematic documentation of this variation at the whole-genome scale(1-3). Here we report the integrative analysis of 2,658 whole-cancer genomes and their matching normal tissues across 38 tumour types from the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium of the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA). We describe the generation of the PCAWG resource, facilitated by international data sharing using compute clouds. On average, cancer genomes contained 4-5 driver mutations when combining coding and non-coding genomic elements; however, in around 5% of cases no drivers were identified, suggesting that cancer driver discovery is not yet complete. Chromothripsis, in which many clustered structural variants arise in a single catastrophic event, is frequently an early event in tumour evolution; in acral melanoma, for example, these events precede most somatic point mutations and affect several cancer-associated genes simultaneously. Cancers with abnormal telomere maintenance often originate from tissues with low replicative activity and show several mechanisms of preventing telomere attrition to critical levels. Common and rare germline variants affect patterns of somatic mutation, including point mutations, structural variants and somatic retrotransposition. A collection of papers from the PCAWG Consortium describes non-coding mutations that drive cancer beyond those in the TERT promoter(4); identifies new signatures of mutational processes that cause base substitutions, small insertions and deletions and structural variation(5,6); analyses timings and patterns of tumour evolution(7); describes the diverse transcriptional consequences of somatic mutation on splicing, expression levels, fusion genes and promoter activity(8,9); and evaluates a range of more-specialized features of cancer genomes(8,10-18).Peer reviewe

Five insights from the Global Burden of Disease Study 2019

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3.5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers.Peer reviewe

Realization of Signal-Injection Sensorless Control of SMPMSM by Modification of Current Trajectory

In this paper, the feasibility of signal injection sensorless control (SISC) in surface mounted permanent-magnet synchronous motors (SMPMSMs) is discussed. At first, dynamic inductances of a target SMPMSM according to rotor position and dq-axes currents are measured from an experimental test. Based on the measured inductances, current response induced by the injected voltage is calculated. The induced current signal in every operable dq-axes current point is analyzed with an index variable. An optimal current trajectory for the SISC is proposed after the analysis. By adopting optimal trajectory control (OTC) instead of maximum torque per ampere (MTPA) control, the performance of the conventional SISC of the SMPMSM can be conspicuously improved at the cost of slightly increased copper loss. The proposed method is verified with experimental results.N

Realization of Signal-Injection Sensorless Control of SMPMSM With Saturation-Induced Saliency by Modification of Current Trajectory

This article discusses the feasibility of signal-injec- tion sensorless control (SISC) in low saliency surface-mounted permanent-magnet synchronous motors (SMPMSMs). At first, dynamic inductances of a target SMPMSM according to rotor position and dq-axes currents are measured from an experiment. The current response induced by the injected voltage is theoretically calculated based on the inductances. The induced current signal in every operable point on dq current plane is evaluated with a newly defined index variable. An optimal current trajectory for the SISC is proposed after the evaluation. By adopting optimal trajectory control instead of maximum torque per ampere control, the performance of the SISC in the SMPMSM can be conspicuously improved at the cost of slightly increased electrical loss. The proposed method is verified with experimental results.N

Improved Signal-Injection Sensorless Control Robust to Inverter Nonlinearity Effects by Prediction of Voltage Disturbance

In signal-injection sensorless control, the estimated rotor position includes considerable error induced by the inverter nonlinearity effects. It would degrade overall performances of the sensorless drive, and it could even result in the failure of the position tracking. In this paper, an improved signal-injection sensorless control thanks to the compensation of the voltage error is proposed. The compensation depends on a precise calculation method of the voltage error induced by the inverter nonlinearity. The proposed method effectively reduces the voltage disturbance especially under the switching frequency injection for sensorless control. The performance of the proposed method is verified by computer simulations and experimental results.N

Analysis of Position Estimation Error in Signal-Injection Sensorless Control Induced by Inverter dvdt-Based Current Measurement Noise

This article discusses position estimation error in signal-injection sensorless control (SISC) induced by the current measurement noise of closed-loop Hall effect current sensor, when it is installed in an inverter system. For the first step, an equivalent circuit modeling of the current sensor in the inverter system is proposed, which includes the parasitic capacitances between the inverter and sensor. The presented modeling can explain how the high dv/dt of the inverter switching generates the leakage current through the parasitic capacitances, resulting in the measurement noise. The noise is sampled with analog to digital conversion, and it affects the rotor position estimation signal with the SISC algorithm. As a result, it is revealed that considerable position estimation error occurs from the noise. The experimental results are provided to verify the proposed theory and confirm the noise effects on the SISC performance.N

Suppression of Torque Ripple on MTPA Operation of IPMSM with Voltage Feedforwarding Control

Interior permanent-magnet synchronous motor (IPMSM) has been used as the traction motor because of its higher torque density and higher efficiency. Maximum torque per ampere (MTPA) control that minimizes motor copper loss is widely applied to enhance the efficiency of IPMSM drive. However, the conventional MTPA control inevitably generates torque ripple because of the spatial harmonics of IPMSM. This paper proposes a voltage feedforwarding control to suppress the torque ripple. As the rotating speed increases, the feedforwarding voltage gets larger. Over a certain speed, the feedforwarding voltage is large enough to be over the inverter voltage limitation. And the torque ripple reduction performance is significantly degraded. Even, the average torque cannot match the torque command, since the fundamental frequency voltage is also affected by the voltage saturation. This study proposes a novel technique that can apply the voltage feedforwarding control up to medium speed range. By preventing the saturation of the inverter&apos;s output voltage, it is possible to reduce the torque ripple effectively in the speed range where the conventional method cannot reduce the torque ripple. The proposed method is verified through simulations and experimental results with 45 kW IPMSM for Hybrid Electric Vehicle (HEV) drive system.N