A high-speed C++/MEX solution for long-duration arterial blood pressure characteristic locations detection

The major concentration of this study is to describe the structure of a C++/MEX solution for robust detection and delineation of arterial blood pressure (ABP) signal events. Toward this objective, the original ABP signal was pre-processed by application of à trous discrete wavelet transform (DWT) to extract several dyadic scales. Then, a sliding window with fixed length was moved on the appropriately selected scale. In each slid, mean, variance, Skewness and Kurtosis values of the excerpted segment were superimposed to generate a newly defined multiple higher order moments (MHOM) metric to be used as the detection decision statistic (DS). Then, after application of an adaptive-nonlinear transformation for making the DS baseline static, the histogram parameters of the enhanced DS were used for regulation of the α-level Neyman–Pearson classifier aimed for false alarm probability (FAP)-bounded delineation of the ABP events. The proposed method was applied to all 18 subjects of the MIT-BIH Polysomnographic Database (359,000 beats). The end-systolic and end-diastolic locations of the ABP signal as well as the dicrotic notch pressure were extracted and values of sensitivity Se = 99.86% and positive predictivity P+ = 99.95% were obtained for the detection of all ABP events. This paper proves the proposed MHOM-based ABP events detection–delineation algorithm as an improvement because of its merits such as: high robustness against measurement noises, acceptable detection–delineation accuracy of the ABP events in the presence of severe heart valvular, arrhythmic dysfunctions within a tolerable computational burden (processing time) and having no parameters dependency on the acquisition sampling frequency.     

Spatial distribution of surface EMG on trapezius and lumbar muscles of violin and cello players in single note playing

Musicians activate their muscles in different patterns, depending on their posture, the instrument being played, and their experience level. Bipolar surface electrodes have been used in the past to monitor such activity, but this method is highly sensitive to the location of the electrode pair. In this work, the spatial distribution of surface EMG (sEMG) of the right trapezius and right and left erector spinae muscles were studied in 16 violin players and 11 cello players. Musicians played their instrument one string at a time in sitting position with/without backrest support. A 64 sEMG electrode (16 × 4) grid, 10 mm inter-electrode distance (IED), was placed over the middle and lower trapezius (MT and LT) of the bowing arm. Two 16 × 2 electrode grids (IED = 10 mm) were placed on the left and right erector spinae muscles. Subjects played each of the four strings of the instrument either in large (1 bow/s) or detaché tip/tail (8 bows/s) bowing in two sessions (two days). In each of two days, measurements were repeated after half an hour of exercise to see the effect of exercise on the muscle activity and signal stability. A “muscle activity index” (MAI) was defined as the spatial average of the segmented active region of the RMS map. Spatial maps were automatically segmented using the watershed algorithm and thresholding. Results showed that, for violin players, sliding the bow upward from the tip toward the tail results in a higher MAI for the trapezius muscle than a downward bow. On the contrary, in cello players, higher MAI is produced in the tail to tip movement. For both instruments, an increasing MAI in the trapezius was observed as the string position became increasingly lateral, from string 1 (most medial) toward string 4 (most lateral). Half an hour of performance did not cause significant differences between the signal quality and the MAI values measured before and after the exercise. The MAI of the left and right erector spinae was smaller in the case of backrest support, especially for violin players. Back muscles of violin and cello players were activated asymmetrically, specifically in fast movements (detaché tip/tail). These findings demonstrate the sensitivity and stability of the technique and justify more extensive investigation following this proof of concept.     

Sensitivity and stability of optically stimulated luminescence dosimeters with filled deep electron/hole traps under pre-irradiation and bleaching conditions

PurposeWe aimed to evaluate the characteristics of optically stimulated luminescence dosimeters (OSLDs) with fully filled deep electron/hole traps, and determine the optimal bleaching conditions for these OSLDs to minimize the changes in dose sensitivity or linearity according to the accumulated dose.MethodsInLight nanoDots were used as OSLDs. The OSLDs were first pre-irradiated at a dose greater than 5 kGy to fill the deep electron and hole traps, and then bleached (OSLD_full). OSLD_full characteristics were investigated in terms of the full bleaching, fading, regeneration of luminescence, dose linearity, and dose sensitivity with various bleaching conditions. For comparison, OSLDs with un-filled deep electron/hole traps (OSLD_empty) were investigated in the same manner.ResultsThe fading for OSLD_full exhibited stable signals after 10 min, for 1 and 10 Gy. The mean supra-linear index values for OSLD_full were 1.001 ± 0.001 for doses from 2 to 10 Gy. Small variations in dose sensitivity were obtained for OSLD_full within standard deviations of 0.85% and 0.71%, whereas those of OSLD_empty decreased by 2.3% and 4.2% per 10 Gy for unfiltered and filtered bleaching devices, respectively.ConclusionsUnder the bleaching conditions determined in this study, clinical dosimetry with OSLD_full is highly stable, minimizing the changes in dose sensitivity or linearity for the clinical dose.     

DNA methylation profiles in African American prostate cancer patients in relation to disease progression

This study examined whether differential DNA methylation is associated with clinical features of more aggressive disease at diagnosis and prostate cancer recurrence in African American men, who are more likely to die from prostate cancer than other populations. Tumor tissues from 76 African Americans diagnosed with prostate cancer who had radical prostatectomy as their primary treatment were profiled for epigenome-wide DNA methylation levels. Long-term follow-up identified 19 patients with prostate cancer recurrence. Twenty-three CpGs were differentially methylated (FDR q ≤ 0.25, mean methylation difference ≥ 0.10) in patients with vs. without recurrence, including CpGs in GCK, CDKL2, PRDM13, and ZFR2. Methylation differences were also observed between men with metastatic-lethal prostate cancer vs. no recurrence (five CpGs), regional vs. local pathological stage (two CpGs), and higher vs. lower tumor aggressiveness (one CpG). These results indicate that differentially methylated CpG sites identified in tumor tissues of African American men may contribute to prostate cancer aggressiveness.     

Differential contributions of ankle plantarflexors during submaximal isometric muscle action: A PET and EMG study

The objective of this study was to investigate the relative contributions of superficial and deep ankle plantarflexors during repetitive submaximal isometric contractions using surface electromyography (SEMG) and positron emission tomography (PET). Myoelectric signals were obtained from twelve healthy volunteers (27.3 ± 4.2 yrs). A tracer ([¹⁸F]-FDG) was injected during the exercise and PET scanning was done immediately afterwards. The examined muscles included soleus (Sol), medial gastrocnemius (MG), lateral gastrocnemius (LG), and flexor hallucis longus (FHL). It was found that isometric maximal voluntary contraction (MVC) force, muscle glucose uptake (GU) rate, and SEMG of various plantarflexors were comparable bilaterally. In terms of %EMG MVC, FHL and MG displayed the highest activity (∼34%), while LG (∼21%) had the lowest activity. Cumulative SEMG from all parts of the triceps surae (TS) muscle accounted for ∼70% of the combined EMG signal of all four plantarflexors. As for GU, the highest quantity was observed in MG (2.4 ± 0.8 μmol * 100 g⁻¹ * min⁻¹), whereas FHL (1.8 ± 0.6 μmol * 100 g⁻¹ * min⁻¹) had the lowest uptake. Cumulative GU of TS constituted nearly 80% of the combined GU. The findings of this study provide valuable reference for studies where individual muscle contributions are estimated using models and simulations.     

Operation of a bioelectrochemical system as a polishing stage for the effluent from a two-stage biohydrogen and biomethane production process

Anaerobic bioenergy production processes including fermentative biohydrogen (BioH₂), anaerobic digestion (AD) and bioelectrochemical system have been investigated for converting municipal waste or various biomass feedstock to useful energy carriers. However, the performance of a microbial fuel cell (MFC) fed on the effluent from a two-stage biogas production process has not yet been investigated extensively in continuous reactor operation on complex substrates. In this study we have investigated the extent to which a microbial fuel cell (MFC) can reduce COD and recover further energy from the effluent of a two-stage biohydrogen and biomethane system. The performance of a four-module tubular MFC was determined at six different organic loadings (0.036–6.149 g sCOD L⁻¹ d⁻¹) in terms of power generation, COD removal efficiency, coulombic efficiency (CE) and energy conversion efficiency (ECE). A power density of 3.1 W m⁻³ was observed at the OLR = 0.572 g sCOD L⁻¹ d⁻¹, which resulted in the highest CE (60%) and ECE (0.8%), but the COD removal efficiency decreased at higher organic loading rates (35.1–4.4%). The energy recovery was 92.95 J L⁻¹ and the energy conversion efficiency, based on total influent COD was found to be 0.48–0.81% at 0.572 g sCOD L⁻¹ d⁻¹. However, the energy recovery by the MFC is only reported for a four-module reactor and improved performance can be expected with an extended module count, as chemical energy remained available for further electrogenesis.     

Robust closed-loop control of hypnosis with propofol using WAVCNS index as the controlled variable

This paper presents a robust closed-loop strategy for control of depth of hypnosis. The proposed method regulates the electroencephalogram (EEG)-derived WAV_CNS index as measure of hypnosis by manipulating intravenous propofol administration. In contrast to many existing closed-loop control methods for hypnosis drug delivery, the control design presented in this paper produces stability and robustness against uncertainty by explicitly accounting for the pharmacokinetic (PK) and pharmacodynamic (PD) variability between individuals, as well as the unexpected surgical stimulation and anesthetic–analgesic interaction that the closed-loop control is required to tolerate. This robust closed-loop controller was evaluated in comparison with a heuristically tuned proportional-derivative-integral (PID) controller using a simulated surgical procedure on 44 patients whose PK and PD models were identified using real clinical data. The results demonstrate that the robust control strategy can deliver propofol to yield consistent and acceptable closed-loop induction and maintenance phase responses over wide-ranging PK and PD differences (mean rise and settling times of 4 min and 7 min and mean overshoot of less than 8%, which meets anesthesiologists’ response specifications), whereas its PID control counterpart exhibits limitations in performance.     

Turbulent-flow chromatography coupled on-line to fast high-performance liquid chromatography and mass spectrometry for simultaneous determination of verticine,verticinone and isoverticine in rat plasma

A method based on the on-line turbulent-flow chromatography and fast high-performance liquid chromatography/mass spectrometry (TFC–LC/MS) was developed for sensitive and high throughput pharmacokinetic study of traditional Chinese medicines (TCMs). In this method, an on-line extraction column (Waters Oasis HLB) and a fast HPLC column with sub-2 μm particle size (Agilent Zorbax StableBond-C₁₈, 4.6 mm × 50 mm, 1.8 μm) in a column-switching set-up were utilized. HLB is a reversed-phase extraction column with hydrophilic–lipophilic balanced copolymer (2.1 mm × 20 mm, 25 μm particle size), which will exhibit some turbulent-flow properties at a high-flow rate. The method combines the speed and robustness of turbulent-flow extraction and the sensitivity and separation efficiency of fast HPLC–MS to analyze multiple and trace constituents of TCMs in plasma matrix. This method was successfully applied for pharmacokinetic study of verticine, verticinone and isoverticine, the chemical markers of Fritillaria thunbergii, after oral administration of total steroidal alkaloids extract of F. thunbergii to rats. Each plasma sample was analyzed within 7 min. The method demonstrated good linearity (R > 0.999) ranged from 0.505 to 96.0 ng/mL with satisfactory accuracy and precision, and the lower limit of quantifications of verticine, verticinone and isoverticine were estimated to be 0.120, 0.595 and 0.505 ng/mL, respectively. These results indicate that the proposed method is fast, sensitive, and feasible for pharmacokinetic study of TCMs.     

Design and development of a dedicated portable gamma camera system for intra-operative imaging

PurposeWe developed a high performance portable gamma camera platform dedicated to identification of sentinel lymph nodes (SLNs) and radio-guided surgery for cancer patients. In this work, we present the performance characteristics of SURGEOSIGHT-I, the first version of this platform that can intra-operatively provide high-resolution images of the surveyed areas.MethodsAt the heart of this camera, there is a 43 × 43 array of pixelated sodium-activated cesium iodide (CsI(Na)) scintillation crystal with 1 × 1 mm² pixel size and 5 mm thickness coupled to a Hamamatsu H8500 flat-panel multi-anode (64 channels) photomultiplier tube. The probe is equipped with a hexagonal parallel-hole lead collimator with 1.2 mm holes. The detector, collimator, and the associated front-end electronics are encapsulated in a common housing referred to as head.ResultsOur results show a count rate of ∼41 kcps for 20% count loss. The extrinsic energy resolution was measured as 20.6% at 140 keV. The spatial resolution and the sensitivity of the system on the collimator surface was measured as 2.2 mm and 142 cps/MBq, respectively. In addition, the integral and differential uniformity, after uniformity correction, in useful field-of-view (UFOV) were measured 4.5% and 4.6%, respectively.ConclusionsThis system can be used for a number of clinical applications including SLN biopsy and radiopharmaceutical-guided surgery.     

Continuous 2-keto-gluconic acid (2KGA) production from corn starch hydrolysate by Pseudomonas fluorescens AR4

A continuous fermentation process for 2-keto-gluconic acid (2KGA) production from cheap raw material corn starch hydrolysate was developed using the strain Pseudomonas fluorescens AR4. The dilution rate and feeding glucose concentration had a significant effect on the cell concentrations, glucose utilization and 2KGA production performance. The optimal operating factors were obtained as: 0.065 h⁻¹ of dilution rate, 180 g/L of feeding glucose concentration, and 16 h of batch fermentation time as the starting point. Under these conditions, the steady state had the 135.92 g/L of produced 2KGA concentration, 8.83 g/L.h of average volumetric productivity, and 0.9510 g/g of yield. In conclusion, the proposed efficient and stable continuous fermentation process for 2KGA production by the strain P. fluorescens AR4 is potentially competitive for industrial production from corn starch hydrolysate in terms of 2KGA productivity and yield.     

Endarterectomy patients with elevated levels of circulating IL-16 have fewer cardiovascular events during follow-up

Background and purposeIncreased interleukin 16 (IL-16) levels in carotid plaques have been associated with reduced incidence of cardiovascular (CV) events during follow-up in patients who underwent carotid endarterectomy (CEA). In the present study we aimed to determine whether high circulating levels of IL-16 also are associated with a decreased risk of CV events after CEA.MethodsPatients, who had their carotid plaques surgically removed (n = 473), were followed for a mean follow-up time of 3.1 years. Plasma levels of IL-16 the day before surgery were analyzed by proximity extension assay (PEA) and associated with the occurrence of CV events during follow-up (n = 98).ResultsHigh levels of circulating IL-16 were independently associated with a decreased risk of CV events when comparing the highest versus the lowest IL-16 tertile (hazard ratio [HR] 0.47; 95% CI 0.27–0.81; P = 0.007), as well as with CV deaths (HR 0.25; 95% CI 0.09–0.70; P = 0.008).ConclusionThese present findings indicate an association between IL-16 and less clinical complications of atherosclerosis in a population with known advanced carotid disease.     

Ilizarov method in combination with autologous mesenchymal stem cells from iliac crest shows improved outcome in tibial non-union

Autologous bone grafting and ilizarov technique are the preferred mode of treatment for bone nonunion, studies suggest that bone marrow derived mesenchymal stem cells can be effective in treatment of tibial non-union where there is length of bone defect. The current study investigates the beneficial clinical outcome of combining the ilizarov procedure with intraosseous injection of autologous mesenchymal stem cells. The open-label study enrolled 25 patients with infected tibial non-union at the Shanghai Fengxian District Central Hospital, Shanghai, China between April 2010 and July 2014. Patients were randomised to undergo the ilizarov procedure with (n = 11) or without (n = 13) intraosseous injection of bone marrow derived mesenchymal stem cells. All participants were followed prospectively until union was achieved (primary end point). The mean length of the bone defect in the Ilizarov group and Ilizarov group plus MSC group was 6.09 and 5.84 cm respectively. The mean time from the original injury to the time of the treatment for tibial non-union was 5–22 months (mean 13.5 months) for the Ilizarov group and 6–21 months (mean 13.5 months) for Ilizarov plus MSc group. All 24 patients were followed up for 12–34 months (mean 16 months). Both groups achieved the primary endpoint of stable union of the tibial fracture. No adverse events were observed in any of the group. Our study demonstrates that using autologous bone marrow derived mesenchymal stem cell as an add-on therapy to the ilizarov procedure shows significant clinical benefit in fixation of tibial non-union.     

Multimodal information improves the rapid detection of mental fatigue

One of the major challenge in the detection of mental states is improving the accuracy of brain activity-based detectors with additional information from extracranial signals. We assessed the suitability, for real-time mental fatigue detection, of EEG, EOG and ECG measurements, taken separately or together. Thirteen subjects performed six blocks of switching tasks. For each participant, the block with the lowest error rate from the first two blocks and the block with the highest error rate from the last three blocks were discriminated with a machine learning algorithm (support vector machine). The classification scores obtained with ECG or EOG were greater than would be expected by chance (>50%) for time windows of at least 8 s. EEG was the best single mode of detection, with classification scores ranging from 80 ± 3% with a 4 s time window to 94 ± 2% with a 30 s time window. The addition of ECG and EOG features to EEG features significantly increased classification scores for short time windows (e.g., to 86 ± 3% with a 4 s time window, p < 0.001). For short time windows (up to 12 s), ECG significantly increased the discriminatory power of EEG, whereas EOG did not. These results demonstrate that mental state detection on the basis of extracerebral measurements is feasible and that a combination of EEG and ECG is particularly appropriate for the rapid detection of mental fatigue.     

Selective inhibition of human acetylcholinesterase by xanthine derivatives: In vitro inhibition and molecular modeling investigations

The commonly used beverage and psychostimulant caffeine is known to inhibit human acetylcholinesterase enzyme. This pharmacological activity of caffeine is partly responsible for its cognition enhancing properties. However, the exact mechanisms of its binding to human cholinesterases (acetyl and butyrylcholinesterase; hAChE and hBuChE) are not well known. In this study, we investigated the cholinesterase inhibition by the xanthine derivatives caffeine, pentoxifylline, and propentofylline. Among them, propentofylline was the most potent AChE inhibitor (hAChE IC₅₀ = 6.40 μM). The hAChE inhibitory potency was of the order: caffeine (hAChE IC₅₀ = 7.25 μM) < pentoxifylline (hAChE IC₅₀ = 6.60 μM) ? propentofylline (hAChE IC₅₀ = 6.40 μM). These compounds were less potent relative to the reference agent donepezil (hAChE IC₅₀ = 0.04 μM). Moreover, they all exhibited selective inhibition of hAChE with no inhibition of hBuChE (IC₅₀ > 50 μM) relative to the reference agent donepezil (hBuChE IC₅₀ = 13.60 μM). Molecular modeling investigations indicate that caffeine binds primarily in the catalytic site (Ser203, Glu334 and His447) region of hAChE whereas pentoxifylline and propentofylline are able to bind to both the catalytic site and peripheral anionic site due to their increased bulk/size, thereby exhibiting superior AChE inhibition relative to caffeine. In contrast, their lack of hBuChE inhibition is due to a larger binding site and lack of key aromatic amino acids. In summary, our study has important implications in the development of novel caffeine derivatives as selective AChE inhibitors with potential application as cognitive enhancers and to treat various forms of dementia.     

The therapeutic responses to I-131 ablation in patients of differentiated thyroid carcinoma complicated with nodular goiter

IntroductionWe applied the response to therapy reclassification system (RTRS) to evaluate the disease status after surgery and I-131 therapy in differentiated thyroid carcinoma (DTC) patients with nodular goiter (NG).Materials and methodsA total of 268 DTC complicated with NG patients who underwent the I-131 treatment and thyroidectomy between 2010 and 2018 were analyzed. The RTRS were classified into excellent (ER), indeterminate (IDR), biochemical incomplete (BIR) and structural incomplete response (SIR). Logistic regression analysis were performed to evaluate the relevant clinicopathologic and laboratory variables in the prediction of non-ER (IDR, BIR and SIR).ResultsIn the logistic analysis, gender (OR: 3.543, P = 0.01), lateral cervical lymph node metastases (N1b) (OR: 6.646, P = 0.005), pre-ablation stimulated thyroglobulin (Ps-Tg) (OR: 0.859, P = 0.000), and anti-Tg antibody (TgAb) (OR: 64.546, P = 0.000) were predictor of non-ER. The cut-off value of ps-Tg for predicting the ER was 19.98 ng/mL with a sensitivity of 92.6% and specificity of 83.2%. The non-ER rate of N1b group was significantly higher than the central cervical LNM (N1a) group.ConclusionFor patients with DTC complicated with NG, the cut-off value of ps-Tg for predicting the ER was 19.98 ng/mL. N1b patients showed inferior responses to I-131 therapy compared to N1a patients.     

Evaluation of cysteine ethyl ester as efficient inducer for glutathione overproduction in Saccharomyces spp.

Economical yeast based glutathione (GSH) production is a process that is influenced by several factors like raw material and production costs, biomass production and efficient biotransformation of adequate precursors into the final product GSH. Nowadays the usage of cysteine for the microbial conversion into GSH is industrial state of practice. In the following study, the potential of different inducers to increase the GSH content was evaluated by means of design of experiments methodology. Investigations were executed in three natural Saccharomyces strains, S. cerevisiae, S. bayanus and S. boulardii, in a well suited 50 ml shake tube system. Results of shake tube experiments were confirmed in traditional baffled shake flasks and finally via batch cultivation in lab-scale bioreactors under controlled conditions. Comprehensive studies showed that the usage of cysteine ethyl ester (CEE) for the batch-wise biotransformation into GSH led up to a more than 2.2 times higher yield compared to cysteine as inducer. Additionally, the intracellular GSH content could be significantly increased for all strains in terms of 2.29 ± 0.29% for cysteine to 3.65 ± 0.23% for CEE, respectively, in bioreactors. Thus, the usage of CEE provides a highly attractive inducing strategy for the GSH overproduction.     

Endovenous laser treatment of the great saphenous vein: Measurement of the pullback speed of the fiber by magnetic tracking

Endovenous laser treatment (ELT) is a minimally invasive technique used to treat varicose veins. In this technique, an optical fiber is inserted into the vein to be treated and the laser lights while the optical is slowly withdrawn. The average linear endovenous energy density (LEED) delivered during the procedure is determinant in the success of this therapy. Recanalization and side effects are energy-dependent. Thus, the success of the therapy is mainly related to the pullback speed of the fiber. Ideally this speed has to be 1 mm/s. The purpose of this investigation was to evaluate in real time the fiber pullback speed. In order to measure in real time the motion of the fiber inside the saphenous vein, magnetic tracking was used. The system was evaluated during the treatment procedures for 18 patients. The mean pullback speed was 1.02 ± 0.15 mm/s similar to the speed the physician wanted to obtain. Based on quality control, safety standards, and regulations official documents for medical lasers, where a 20% accuracy is admitted; only one patient was treated with an average pullback speed inferior to 0.8 mm/s (0.77 cm/s) and two patients were treated with an average pullback speed superior to 1.2 mm/s (1.26 mm/s and 1.32 mm/s). Consequently, even for a well-trained physician, variations can be observed. These variations could easily explain why complications (too low speed and consequently too high LEED) or recurrences (too fast speed and consequently too low LEED) are sometimes reported in clinical studies. A standardized or an automatic withdrawal of the fiber could possibly improve this technique but remains to be carefully evaluated.     

Bacteriocidal effects of brevetoxin on natural microbial communities

The sensitivity of bacteria to the marine neurotoxins, brevetoxins, produced by the dinoflagellate Karenia brevis and raphidophytes Chattonella spp. remains an open question. We investigated the bacteriocidal effects of brevetoxin (PbTx-2) on the abundance and community composition of natural microbial communities by adding it to microbes from three coastal marine locations that have varying degrees of historical brevetoxin exposure: (1) Great Bay, New Jersey, (2) Rehoboth Bay, Delaware and (3) Sarasota Bay, Florida. The populations with limited or no documented exposure were more susceptible to the effects of PbTx-2 than the Gulf of Mexico populations which are frequently exposed to brevetoxins. The community with no prior documented exposure to brevetoxins showed significant (p = 0.03) changes in bacterial abundance occurring with additions greater than 2.5 μg PbTx-2 L⁻¹. Brevetoxin concentrations during K. brevis blooms range from ∼2.5 to nearly 100 μg L⁻¹ with typical concentrations of ∼10–30 μg L⁻¹. In contrast to the unexposed populations, there was no significant decrease in bacterial cell number for the microbial community that was frequently exposed to brevetoxins, which implies variable sensitivity in natural communities. The diversity in the bacterial communities that were sensitive to PbTx-2 declined upon exposure. This suggests that the PbTx-2 was selecting for or against specific species. Mortality was much higher in the 200 μg PbTx-2 L⁻¹ treatment after 48 h and >37% of the species disappeared in the bacterial communities with no documented exposure. These results suggest that toxic red tides may play a role in structuring bacterial communities.