Electrocardiogram Baseline Wander Suppression Based on the Combination of Morphological and Wavelet Transformation Based Filtering

One of the major noise components in electrocardiogram (ECG) is the baseline wander (BW). Effective methods for suppressing BW include the wavelet-based (WT) and the mathematical morphological filtering-based (MMF)algorithms. However, the T waveform distortions introduced by the WTand the rectangular/trapezoidal distortions introduced by MMF degrade the quality of the output signal. Hence, in this study, we introduce a method by combining the MMF and WTto overcome the shortcomings of both existing methods. To demonstrate the effectiveness of the proposed method, artificial ECG signals containing a clinicalBW are used for numerical simulation, and we also create a realistic model of baseline wander to compare the proposed method with other state-of-the-art methods commonly used in the literature. /e results show that the BW suppression effect of the proposed method is better than that of the others. Also, the new method is capable of preserving the outline of the BW and avoiding waveform distortions caused by the morphology filter, thereby obtaining an enhanced quality of ECG

Treatment of nonunions of humeral fractures with interlocking intramedullary nailing

ObjectiveTo introduce the experience of treating nonunions of humeral fractures with interlocking intramedullarynailing.MethodsTwelve patients with humeral nonunions were treated with interlocking intramedullary nailing. The time interval between trauma and surgery was 10.5 months on average. Open reduction with anterograde approach was performed. Axial compression was specially applied to the fracture site with humeral nail holder after insertion of distal locked screws. Iliac bone grafting was added.ResultsThe average follow-up period was 21 months (ranging 9-51 months). All patients achieved osseous union 5.8 months after treatment on average. Eleven patients had good functions of the shoulder joints and the upper extremities. No patient experienced any permanent neurological deficit. Refracture of the original ununited region occurred in one patient after removal of the internal fixator one year later, but union was achieved after closed re-intramedullarynailing fixation.ConclusionHumeral interlocking intramedullarynailing is an effective alternative treatment for humeral nonunion

Automated monitoring of early neurobehavioral changes in mice following traumatic brain injury

Traumatic brain injury often causes a variety of behavioral and emotional impairments that can develop into chronic disorders. Therefore, there is a need to shift towards identifying early symptoms that can aid in the prediction of traumatic brain injury outcomes and behavioral endpoints in patients with traumatic brain injury after early interventions. In this study, we used the SmartCage system, an automated quantitative approach to assess behavior alterations in mice during an early phase of traumatic brain injury in their home cages. Female C57BL/6 adult mice were subjected to moderate controlled cortical impact (CCI) injury. The mice then received a battery of behavioral assessments including neurological score, locomotor activity, sleep/wake states, and anxiety-like behaviors on days 1, 2, and 7 after CCI. Histological analysis was performed on day 7 after the last assessment. Spontaneous activities on days 1 and 2 after injury were significantly decreased in the CCI group. The average percentage of sleep time spent in both dark and light cycles were significantly higher in the CCI group than in the sham group. For anxiety-like behaviors, the time spent in a light compartment and the number of transitions between the dark/light compartments were all significantly reduced in the CCI group than in the sham group. In addition, the mice suffering from CCI exhibited a preference of staying in the dark compartment of a dark/light cage. The CCI mice showed reduced neurological score and histological abnormalities, which are well correlated to the automated behavioral assessments. Our findings demonstrate that the automated SmartCage system provides sensitive and objective measures for early behavior changes in mice following traumatic brain injury

Prognostic impact of H3K27me3 expression on locoregional progression after chemoradiotherapy in esophageal squamous cell carcinoma

<p>Abstract</p> <p>Background</p> <p>Trimethylation of lysine 27 on histone H3 (H3K27me3) by enhancer of zeste homolog 2 (EZH2) is an epigenetic mark that mediates gene silencing. EZH2 is overexpressed and correlates with poor prognosis in many cancers. However, the clinical implication of H3K27me3 in human malignancies has not been well established. We wished to ascertain whether a correlation exists between the expression of H3K27me3 and clinical outcome in a group of patients with esophageal squamous cell carcinoma (ESCC) treated with definitive chemoradiotherapy (CRT).</p> <p>Methods</p> <p>The method of immunohistochemistry (IHC) was utilized to examine the protein expression of H3K27me3 in 98 pretreatment biopsy specimens of ESCC and in 30 samples of normal esophageal mucosa. The clinical/prognostic significance of H3K27me3 expression was statistically analyzed.</p> <p>Results</p> <p>The expression frequency and expression levels of H3K27me3 were significantly higher in ESCCs than in normal tissues. There was a positive correlation between H3K27me3 expression and WHO grade (<it>P </it>= 0.016), tumor size (<it>P </it>= 0.019), T status (<it>P </it>= 0.024), locoregional progression (<it>P </it>= 0.009) and EZH2 expression (<it>P </it>= 0.036). High H3K27me3 expression was associated with poor locoregional progression-free survival (LPFS) (<it>P </it>= 0.010) in ESCC. Further analysis demonstrated that H3K27me3 could stratify patient outcome in T2-3 (<it>P </it>= 0.048), N0 (<it>P </it>= 0.005) and M0 (<it>P </it>= 0.018) stages as well as in CRT effective group (<it>P </it>= 0.022).</p> <p>Conclusions</p> <p>Our data suggests that H3K27me3 expression examined by IHC might be useful for stratifying LPFS for different subsets of ESCC patients treated with definitive CRT.</p

Coexistence of aneurysmal subarachnoid hemorrhage and surgically identified pituitary apoplexy: a case report and review of the literature

INTRODUCTION: A ruptured aneurysm associated with a pituitary apoplexy is rare. We present the first case report of the coexistence of a ruptured posterior communicating aneurysm with a surgically discovered pituitary apoplexy where the pituitary apoplexy had not been diagnosed by a pre-operative computerized tomography scan. CASE PRESENTATION: A 31-year-old right-handed Chinese woman began to experience severe headache, vomiting and blurred vision which continued for two days. On admission to the hospital, a brain computerized tomography scan demonstrated a small amount of increased signal in the basal cisterns; no evidence of intrasellar and suprasellar lesions was seen. The appearance of her brain suggested aneurysmal subarachnoid hemorrhage. She had nuchal rigidity and reduced vision. There was no extra-ocular palsy and no other neurological deficit. Our patient had no stigmata of Cushing’s syndrome or acromegaly. During an interview for further history, she reported normal menses and denied reduced vision. Cerebral digital subtraction angiography was subsequently performed, which revealed a 6mm left posterior communicating aneurysm. Urgent left pterional craniotomy was performed. The left ruptured posterior communicating artery aneurysm was completely dissected prior to clipping. At surgery, a suprasellar mass was discovered, the tumor bulging the diaphragma sella and projecting anteriorly under the chiasm raising suspicion of a pituitary tumor. The anterior part of the tumor capsule was opened and a necrotic tumor mixed with dark old blood was removed. The appearance suggested pituitary apoplexy. Histopathology revealed pituitary adenoma with evidence of hemorrhagic necrosis. Our patient made a good recovery. CONCLUSION: Our case report proves that pituitary apoplexy can be coexistent with the rupture of a posterior communicating aneurysm. This association should be considered when evaluating any case of aneurysm. A normal computerized tomography scan does not exclude pituitary apoplexy. Pre-operative magnetic resonance imaging interpretation is required if a pituitary apoplexy is suspected. Craniotomy allows a coexisting aneurysm and pituitary apoplexy to be simultaneously treated

Experimental test of the Jarzynski equality in a single spin-1 system using high-fidelity single-shot readouts

The Jarzynski equality (JE), which connects the equilibrium free energy with non-equilibrium work statistics, plays a crucial role in quantum thermodynamics. Although practical quantum systems are usually multi-level systems, most tests of the JE were executed in two-level systems. A rigorous test of the JE by directly measuring the work distribution of a physical process in a high-dimensional quantum system remains elusive. Here, we report an experimental test of the JE in a single spin-1 system. We realized nondemolition projective measurement of this three-level system via cascading high-fidelity single-shot readouts and directly measured the work distribution utilizing the two-point measurement protocol. The validity of the JE was verified from the non-adiabatic to adiabatic zone and under different effective temperatures. Our work puts the JE on a solid experimental foundation and makes the NV center system a mature toolbox to perform advanced experiments of stochastic quantum thermodynamics