Critical Care Ultrasonography and Its Application for COVID-19

Ultrasound has developed as an invaluable tool in diagnosis and proper management in the intensive care unit (ICU). Application of critical care ultrasonography is quite distinct from the routine comprehensive diagnostic ultrasound exam, because the urgent setting mandates a goal-directed approach. Performing accurate and efficient critical care ultrasound requires ultrasound providers to first understand the pathophysiology of the disease and related imaging findings, and then follow the protocols to perform a focused ultrasound exam. In the ongoing coronavirus disease 2019 (COVID-19) pandemic, ultrasound plays an essential role in diagnosing and monitoring critically ill COVID-19 patients in the ICU. Our review focuses on the basics and clinical application of critical care ultrasound in diagnosing common lung disease, COVID-19 pulmonary lesions, pediatric COVID-19, and cardiovascular dysfunction as well as its role in ECMO and interventional ultrasonography

Chinese Expert Consensus on Critical Care Ultrasound Applications at COVID-19 Pandemic

The spread of new coronavirus (SARS-Cov-2) follows a different pattern than previous respiratory viruses, posing a serious public health risk worldwide. World Health Organization (WHO) named the disease as COVID-19 and declared it a pandemic. COVID-19 is characterized by highly contagious nature, rapid transmission, swift clinical course, profound worldwide impact, and high mortality among critically ill patients. Chest X-ray, computerized tomography (CT), and ultrasound are commonly used imaging modalities. Among them, ultrasound, due to its portability and non-invasiveness, can be easily moved to the bedside for examination at any time. In addition, with use of 4G or 5G networks, remote ultrasound consultation can also be performed, which allows ultrasound to be used in isolated medial areas. Besides, the contact surface of ultrasound probe with patients is small and easy to be disinfected. Therefore, ultrasound has gotten lots of positive feedbacks from the frontline healthcare workers, and it has played an indispensable role in the course of COVID-19 diagnosis and follow up

Dissociation Between the Growing Opioid Demands and Drug Policy Directions Among the U.S. Older Adults with Degenerative Joint Diseases

We aim to examine temporal trends of orthopedic operations and opioid-related hospital stays among seniors in the nation and states of Oregon and Washington where marijuana legalization was accepted earlier than any others. As aging society advances in the United States (U.S.), orthopedic operations and opioid-related hospital stays among seniors increase in the nation. A serial cross-sectional cohort study using the healthcare cost and utilization project fast stats from 2006 through 2015 measured annual rate per 100,000 populations of orthopedic operations by age groups (45–64 vs 65 and older) as well as annual rate per 100,000 populations of opioid-related hospital stays among 65 and older in the nation, Oregon and Washington states from 2008 through 2017. Orthopedic operations (knee arthroplasty, total or partial hip replacement, spinal fusion or laminectomy) and opioid-related hospital stays were measured. The compound annual growth rate (CAGR) was used to quantify temporal trends of orthopedic operations by age groups as well as opioid-related hospital stays and was tested by Rao–Scott correction of χ2 for categorical variables. The CAGR (4.06%) of orthopedic operations among age 65 and older increased (P...) (See full abstract in article

Trans-lymphatic Contrast-Enhanced Ultrasound in Combination with Blue Dye Injection is Feasible for Detection and Biopsy of Sentinel Lymph Nodes in Breast Cancer

Objective: The best method for sentinel lymph node biopsy (SLNB) in early-staged breast cancer (EBC) remains controversial. This study aimed to evaluate a novel method by combining trans-lymphatic contrast-enhanced ultrasound (TLCEUS) with blue dye injection as a guidance of SLNB. Methods: TLCEUS was performed in 88 patients with newly diagnosed EBC. Methylene blue dye was percutaneously injected into enhanced sentinel lymph nodes (SLNs) under ultrasound guidance, followed by standard SLNB and axillary lymph node dissection. Enhancement patterns and the arriving time (AT) of contrast agent within SLNs were evaluated. Histopathological examination of dissected nodes was performed to confirm metastasis. Results: A total of 95 enhanced SLNs were identified and biopsied in 86 of 88 patients with identification rate of 97.7%. The specificity was 75.0%, sensitivity was 83.3%, and false-negative rate was 16.7%. Contrast-enhanced SLNs with type I, type II, and type III patterns had a metastatic positive rate of 11.4% (5/44), 57.1% (12/21) and 80.0% (24/30), respectively. Metastatic positive SLNs showed a mean AT of 61.6 ± 58.7 s while metastatic negative SLNs showed a mean AT of 41.3 ± 19.9 s, which was statistically significantly different. Conclusion: The TLCEUS/blue dye method can be used as an alternative to the radioisotope/blue dye method for its feasibility and accuracy

Advances in Modern Clinical Ultrasound

Advances in modern clinical ultrasound include developments in ultrasound signal processing, imaging techniques and clinical applications. Improvements in ultrasound processing include contrast and high-fidelity ultrasound imaging to expand B-mode imaging and microvascular (or microluminal) discrimination. Similarly, volumetric sonography, automated or intelligent ultrasound, and fusion imaging developed from the innate limitations of planar ultrasound, including user-operator technical dependencies and complex anatomic spatial prerequisites. Additionally, ultrasound techniques and instrumentation have evolved towards expanding access amongst clinicians and patients. To that end, portability of ultrasound systems has become paramount. This has afforded growth into the point-of-care ultrasound and remote or tele-ultrasound arenas. In parallel, advanced applications of ultrasound imaging have arisen. These include high frequency superficial sonograms to diagnose dermatologic pathologies as well as various intra-cavitary or lesional interrogations by contrast-enhanced ultrasound. Properties such as real­time definition and ease-of-access have spumed procedural and interventional applications for vascular access. This narrative review provides an overview of these advances and potential future directions of ultrasound

Found: High Surface Brightness Compact Galaxies

We are using the 2dF spectrograph to make a survey of all objects (`stars' and `galaxies') in a 12 sq.deg region towards the Fornax cluster. We have discovered a population of compact emission-line galaxies unresolved on photographic sky survey plates and therefore missing in most galaxy surveys based on such material. These galaxies are as luminous as normal field galaxies. Using H-alpha to estimate star formation they contribute at least an additional 5 per cent to the local star formation rate.Comment: To appear in "The Low Surface Brightness Universe", IAU Coll 171, eds. J.I. Davies et al., A.S.P. Conference Series. 3 pages, LaTex, 1 encapsulated ps-figure, requires paspconf.st

Learning and Communications Co-Design for Remote Inference Systems: Feature Length Selection and Transmission Scheduling

In this paper, we consider a remote inference system, where a neural network is used to infer a time-varying target (e.g., robot movement), based on features (e.g., video clips) that are progressively received from a sensing node (e.g., a camera). Each feature is a temporal sequence of sensory data. The learning performance of the system is determined by (i) the timeliness and (ii) the temporal sequence length of the features, where we use Age of Information (AoI) as a metric for timeliness. While a longer feature can typically provide better learning performance, it often requires more channel resources for sending the feature. To minimize the time-averaged inference error, we study a learning and communication co-design problem that jointly optimizes feature length selection and transmission scheduling. When there is a single sensor-predictor pair and a single channel, we develop low-complexity optimal co-designs for both the cases of time-invariant and time-variant feature length. When there are multiple sensor-predictor pairs and multiple channels, the co-design problem becomes a restless multi-arm multi-action bandit problem that is PSPACE-hard. For this setting, we design a low-complexity algorithm to solve the problem. Trace-driven evaluations suggest that the proposed co-designs can significantly reduce the time-averaged inference error of remote inference systems.Comment: 41 pages, 8 figures. The manuscript has been submitted to IEEE Journal on Selected Areas in Information Theor

Hit and run versus long-term activation of PARP-1 by its different domains fine-tunes nuclear processes.

Poly(ADP-ribose) polymerase 1 (PARP-1) is a multidomain multifunctional nuclear enzyme involved in the regulation of the chromatin structure and transcription. PARP-1 consists of three functional domains: the N-terminal DNA-binding domain (DBD) containing three zinc fingers, the automodification domain (A), and the C-terminal domain, which includes the protein interacting WGR domain (W) and the catalytic (Cat) subdomain responsible for the poly(ADP ribosyl)ating reaction. The mechanisms coordinating the functions of these domains and determining the positioning of PARP-1 in chromatin remain unknown. Using multiple deletional isoforms of PARP-1, lacking one or another of its three domains, as well as consisting of only one of those domains, we demonstrate that different functions of PARP-1 are coordinated by interactions among these domains and their targets. Interaction between the DBD and damaged DNA leads to a short-term binding and activation of PARP-1. This hit and run activation of PARP-1 initiates the DNA repair pathway at a specific point. The long-term chromatin loosening required to sustain transcription takes place when the C-terminal domain of PARP-1 binds to chromatin by interacting with histone H4 in the nucleosome. This long-term activation of PARP-1 results in a continuous accumulation of pADPr, which maintains chromatin in the loosened state around a certain locus so that the transcription machinery has continuous access to DNA. Cooperation between the DBD and C-terminal domain occurs in response to heat shock (HS), allowing PARP-1 to scan chromatin for specific binding sites

Complete mitochondrial genome sequence of the Indian pipistrelle Pipistrellus coromandra (Vespertilioninae)

We characterized the complete mitogenome of Pipistrellus coromandra (Indian pipistrelle) for comparative analysis of mitogenomes and for resolving the phylogenetic relationship of four tribes in the subfamily Vespertilioninae. The mitogenome size of P. coromandra was 17,153 bp, with a control region and a typical set of 37 mitochondrial genes. The nucleotide composition of the P. coromandra mitogenome showed an AT bias with a nucleotide composition of 33.5% A, 30.7% T, 13.3% G, and 22.5% C. The mitochondrial protein-coding genes in P. coromandra use the standard start codon (ATN), two stop codons (TAA and AGA), and two incomplete stop codons (TA- and T--). The intertribal relationship of four tribes was highly resolved from the phylogenetic analysis of mitogenome sequences

Revisit the intrinsic features of flip-flopping flow behind side-by-side circular cylinders

As one of the most intriguing wake patterns of two side-by-side circular cylinders at an intermediate gap spacing, the flip-flopping (FF) flow has attracted great attention of fundamental research interest. This FF flow is featured by the intermittently and randomly switching gap flow with correspondingly changing forces of the two cylinders. In this paper, we first present a partition map of the wake patterns behind two side-by-side circular cylinders and briefly introduce intrinsic features of each flow pattern. We focus on the FF flow aiming to explain: (i) the origin of the FF flow between laminar and turbulent regimes, (ii) their connections in different flow regimes, and (iii) mechanisms of the significantly varying flip-over time scale of the FF flows. In the laminar regime, we further divide the FF flow into the sub-classed I (FF1) and II (FF2), based on their different origins from the in-phase and anti-phase synchronized vortex shedding instabilities, respectively. By exploring the vortex interactions, we show that the FF flow in the turbulent regime has the same origin and similar vortex dynamics as the FF2 wake in the laminar regime, despite some minor disparities. Thus, a connection is established between the FF2 pattern in the laminar flow and the FF pattern in the turbulent flow. For the FF flow in the laminar regime (Re < 150-200), the mildly decreasing switching time, is several vortex shedding periods. However, for the FF flow in the weak turbulence regime (150-200 < Re < 1000-1700), the switching time scale increases significantly with Re owing to the increased vortex formation length. The FF in the strong turbulence regime (Re > 1000-1700) has a switching time scale of several orders of magnitude longer than the vortex shedding period, where the switching scale decreases gradually with Re due to the stronger Kelvin-Helmholtz vortices