Evacuation of the Pleural Cavity With an Infant Feeding Catheter Following en Bloc Resection of Hepatocellular Carcinoma and Involved Diaphragm–an Institutional Experience

En bloc resection of hepatocellular carcinoma and the involved diaphragm will, towards the end of operation, require evacuation of the pleural cavity, usually with a chest drain. We describe our method and experience of evacuating the pleural cavity, at the time of diaphragmatic repair, with an infant feeding catheter without the need of a chest drain. We have found the method safe and efficacious

Alterations in Leg Extensor Muscle-Tendon Unit Biomechanical Properties With Ageing and Mechanical Loading.

Tendons transfer forces produced by muscle to the skeletal system and can therefore have a large influence on movement effectiveness and safety. Tendons are mechanosensitive, meaning that they adapt their material, morphological and hence their mechanical properties in response to mechanical loading. Therefore, unloading due to immobilization or inactivity could lead to changes in tendon mechanical properties. Additionally, ageing may influence tendon biomechanical properties directly, as a result of biological changes in the tendon, and indirectly, due to reduced muscle strength and physical activity. This review aimed to examine age-related differences in human leg extensor (triceps surae and quadriceps femoris) muscle-tendon unit biomechanical properties. Additionally, this review aimed to assess if, and to what extent mechanical loading interventions could counteract these changes in older adults. There appear to be consistent reductions in human triceps surae and quadriceps femoris muscle strength, accompanied by similar reductions in tendon stiffness and elastic modulus with ageing, whereas the effect on tendon cross sectional area is unclear. Therefore, the observed age-related changes in tendon stiffness are predominantly due to changes in tendon material rather than size with age. However, human tendons appear to retain their mechanosensitivity with age, as intervention studies report alterations in tendon biomechanical properties in older adults of similar magnitudes to younger adults over 12-14 weeks of training. Interventions should implement tendon strains corresponding to high mechanical loads (i.e., 80-90% MVC) with repetitive loading for up to 3-4 months to successfully counteract age-related changes in leg extensor muscle-tendon unit biomechanical properties. CM was funded by the Kootstra Talent Fellowship awarded by the Centre for Research Innovation, Support and Policy (CRISP) and by the NUTRIM Graduate Programme, both of Maastricht University Medical Center+. MK was supported by the German Social Accident Insurance (Deutsche Gesetzliche Unfallversicherung, Postgraduate Scholarship)

Compact circularly polarized truncated square ring slot antenna with suppressed higher resonances

This paper presents a compact circularly polarized (CP) antenna with an integrated higher order harmonic rejection filter. The proposed design operates within the ISM band of 2.32 GHz± 2.63 GHz and is suitable for example for wireless power transfer applications. Asymmetrical truncated edges on a square ring create a defected ground structure to excite the CP property, simultaneously realizing compactness. It offers a 50.5% reduced patch area compared to a conventional design. Novel stubs and slot shapes are integrated in the transmission line to reduce higher (up to the third) order harmonics. The proposed prototype yields a -10 dB reflection coefficient (S11) impedance bandwidth of 12.53%, a 3 dB axial ratio bandwidth of 3.27%, and a gain of 5.64 dBi. Measurements also show good agreement with simulations. © 2017 Sabran et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Patient-Specific Prosthetic Fingers by Remote Collaboration - A Case Study

The concealment of amputation through prosthesis usage can shield an amputee from social stigma and help improve the emotional healing process especially at the early stages of hand or finger loss. However, the traditional techniques in prosthesis fabrication defy this as the patients need numerous visits to the clinics for measurements, fitting and follow-ups. This paper presents a method for constructing a prosthetic finger through online collaboration with the designer. The main input from the amputee comes from the Computer Tomography (CT) data in the region of the affected and the non-affected fingers. These data are sent over the internet and the prosthesis is constructed using visualization, computer-aided design and manufacturing tools. The finished product is then shipped to the patient. A case study with a single patient having an amputated ring finger at the proximal interphalangeal joint shows that the proposed method has a potential to address the patient's psychosocial concerns and minimize the exposure of the finger loss to the public.Comment: Open Access articl

Prognostic value of abdominal aortic calcification: A systematic review and meta‐analysis of observational studies

Background The prognostic importance of abdominal aortic calcification (AAC) viewed on noninvasive imaging modalities remains uncertain. Methods and Results We searched electronic databases (MEDLINE and Embase) until March 2018. Multiple reviewers identified prospective studies reporting AAC and incident cardiovascular events or all‐cause mortality. Two independent reviewers assessed eligibility and risk of bias and extracted data. Summary risk ratios (RRs) were estimated using random‐effects models comparing the higher AAC groups combined (any or more advanced AAC) to the lowest reported AAC group. We identified 52 studies (46 cohorts, 36 092 participants); only studies of patients with chronic kidney disease (57%) and the general older‐elderly (median, 68 years; range, 60–80 years) populations (26%) had sufficient data to meta‐analyze. People with any or more advanced AAC had higher risk of cardiovascular events (RR, 1.83; 95% CI, 1.40–2.39), fatal cardiovascular events (RR, 1.85; 95% CI, 1.44–2.39), and all‐cause mortality (RR, 1.98; 95% CI, 1.55–2.53). Patients with chronic kidney disease with any or more advanced AAC had a higher risk of cardiovascular events (RR, 3.47; 95% CI, 2.21–5.45), fatal cardiovascular events (RR, 3.68; 95% CI, 2.32–5.84), and all‐cause mortality (RR, 2.40; 95% CI, 1.95–2.97). Conclusions Higher‐risk populations, such as the elderly and those with chronic kidney disease with AAC have substantially greater risk of future cardiovascular events and poorer prognosis. Providing information on AAC may help clinicians understand and manage patients\u27 cardiovascular risk better

Anti-cancer effects and mechanism of actions of aspirin analogues in the treatment of glioma cancer

INTRODUCTION: In the past 25 years only modest advancements in glioma treatment have been made, with patient prognosis and median survival time following diagnosis only increasing from 3 to 7 months. A substantial body of clinical and preclinical evidence has suggested a role for aspirin in the treatment of cancer with multiple mechanisms of action proposed including COX 2 inhibition, down regulation of EGFR expression, and NF-κB signaling affecting Bcl-2 expression. However, with serious side effects such as stroke and gastrointestinal bleeding, aspirin analogues with improved potency and side effect profiles are being developed. METHOD: Effects on cell viability following 24 hr incubation of four aspirin derivatives (PN508, 517, 526 and 529) were compared to cisplatin, aspirin and di-aspirin in four glioma cell lines (U87 MG, SVG P12, GOS – 3, and 1321N1), using the PrestoBlue assay, establishing IC50 and examining the time course of drug effects. RESULTS: All compounds were found to decrease cell viability in a concentration and time dependant manner. Significantly, the analogue PN517 (IC50 2mM) showed approximately a twofold increase in potency when compared to aspirin (3.7mM) and cisplatin (4.3mM) in U87 cells, with similar increased potency in SVG P12 cells. Other analogues demonstrated similar potency to aspirin and cisplatin. CONCLUSION: These results support the further development and characterization of novel NSAID derivatives for the treatment of glioma

3-D Super-Resolution Ultrasound Imaging with a 2-D Sparse Array

High frame rate 3-D ultrasound imaging technology combined with super-resolution processing method can visualize 3-D microvascular structures by overcoming the diffraction limited resolution in every spatial direction. However, 3-D super-resolution ultrasound imaging using a full 2-D array requires a system with large number of independent channels, the design of which might be impractical due to the high cost, complexity, and volume of data produced. In this study, a 2-D sparse array was designed and fabricated with 512 elements chosen from a density-tapered 2-D spiral layout. High frame rate volumetric imaging was performed using two synchronized ULA-OP 256 research scanners. Volumetric images were constructed by coherently compounding 9-angle plane waves acquired at a pulse repetition frequency of 4500 Hz. Localization-based 3-D super-resolution images of two touching sub-wavelength tubes were generated from 6000 volumes acquired in 12 seconds. In conclusion, this work demonstrates the feasibility of 3-D super-resolution imaging and super-resolved velocity mapping using a customized 2-D sparse array transducer

Game theory framework for MAC parameter optimization in energy-delay constrained sensor networks

Optimizing energy consumption and end-to-end (e2e) packet delay in energy-constrained, delay-sensitive wireless sensor networks is a conflicting multiobjective optimization problem. We investigate the problem from a game theory perspective, where the two optimization objectives are considered as game players. The cost model of each player is mapped through a generalized optimization framework onto protocol-specific MAC parameters. From the optimization framework, a game is first defined by the Nash bargaining solution (NBS) to assure energy consumption and e2e delay balancing. Secondy, the Kalai-Smorodinsky bargaining solution (KSBS) is used to find an equal proportion of gain between players. Both methods offer a bargaining solution to the duty-cycle MAC protocol under different axioms. As a result, given the two performance requirements (i.e., the maximum latency tolerated by the application and the initial energy budget of nodes), the proposed framework allows to set tunable system parameters to reach a fair equilibrium point that dually minimizes the system latency and energy consumption. For illustration, this formulation is applied to six state-of-the-art wireless sensor network (WSN) MAC protocols: B-MAC, X-MAC, RI-MAC, SMAC, DMAC, and LMAC. The article shows the effectiveness and scalability of such a framework in optimizing protocol parameters that achieve a fair energy-delay performance trade-off under the application requirements