Objective: Our objective is to create a blood pressure measurement device, which may provide a way to easily acquire frequent measurements. Common techniques to measure blood pressure include an ...arterial catheter, an oscillometric pressure cuff, or an auscultatory pressure cuff. Methods: The approach takes as input ultrasound images of an artery and contact force between the ultrasound array and subject. A subject may perform the self-measurements. Image and force data is analyzed for its quality and used to provide guidance or reject poor measurements. Tissue motions, due to probe contact forces and pulsing blood pressure, are estimated from the ultrasound image. Tissues elasticities and blood pressure are found by optimally fitting the observed tissue motion versus applied forces to a table of predicted motion-pre-generated with a finite element tissue deformation model. The output of the optimization is an estimate of systolic and diastolic blood pressure, arterial stiffness, and surrounding tissue stiffness. Results: The real-time implementation of the algorithm was validated on a cohort of 21 single-visit volunteers and on four volunteers self-monitored longitudinally. The systolic and diastolic pressures were compared to oscillometric cuff readings. Regression and Bland-Altman analyses were performed. Conclusion: Systolic pressure and diastolic pressure can be estimated in real-time and by the subject using this novel non-invasive ultrasound-based method (systolic accuracy/precision: -5.2 mmHg/10.7 mmHg; diastolic accuracy/precision: -3.9/8.0 mmHg). Significance: The method occupies a middle ground between the arterial catheter and cuff-based techniques. It has the potential to give calibration-free results.
This paper follows the call of Lusch and Vargo (2010) expressed in their influential paper for a new science of the market to transcend the various sub-disciplines of Marketing, including B2B ...Marketing. The paper applies and expands the multidisciplinary components of this new science in the transitional context of Poland. The authors suggest that this new science, in the context of Poland's transition, is best reflected in the innovative term ‘Curative International Marketing’. The authors conclude that still existing transitional gaps in Poland can be the result of neglecting the micro internal and meso B2B relationships. Macro factor development can be partially seen as a success story but also negatively affected B2B and internal relationships. The unconsidered concept of identity is regarded center stage to explain the relationship related phenomena. Based on the philosophy of Curative International Marketing, a future focus on B2B and internal relationships is regarded to be on the top of the agenda to improve value co-creation, and provide for a better health level of market systems as a whole.
Objective:
Leucopatch is a leukocyte and platelet-rich fibrin patch that provides concentrated blood cells and signal substances to the surface of an ulcer. It is produced by centrifugation of the ...patient's own venous blood. The aim of this pilot multicentre cohort study was to evaluate effects of the leucocyte patch in patients with hard-to-heal diabetic foot ulcers (DFUs).
Method:
Non-ischaemic Wagner grade 1 or 2 DFUs with a duration of more than 6 weeks and a maximal area of 10cm2 were included. Patients with >40% ulcer area change during a two-week run-in period were excluded. The treatment was applied once a week for up to 19 treatments or until the foot ulcer was completely epithelialised. The primary endpoint was healing within 20 weeks.
Results:
Of the 60 patients who gave consent 16 were excluded during run-in period, 44 patients initiated study treatment and 39 were included in the per-protocol analysis. Complete epithelisation was achieved in 34% (per-protocol analysis 36%) at 12 weeks and 52% (59%) at 20 weeks. In patients with ulcer duration less than 6 months, 73% of ulcers healed within 20 weeks. Patients with healed ulcers had larger ulcer area reduction during the first two treatment weeks compared to non-healers. Adverse events were mild and rare.
Conclusion:
The leucocyte patch is well-tolerated, easy to use and has potential in the armamentarium of the DFU treatment, provided this outcome is confirmed in an appropriately powered randomised clinical trial.
Declaration of interest:
M.L and L.T have received consultation fees from Reapplix A/S. R.L. is co-inventor of the Leucopatch technology. All other authors declare no duality of interest associated with this manuscript. This study was financed by Reapplix A/S. Time to data analysis and manuscript preparations have been financed by Medical Faculty (ALF), Lund University, Lund Sweden.
Hip reconstruction is often necessary in children with cerebral palsy (CP) but is associated with high failure rates. Over-containment deeply seats the hip within the acetabulum at the time surgical ...reconstruction. The goal of this study is to evaluate the effect of over-containment on radiographic outcomes and failure rates in children with CP undergoing hip reconstruction.
This study is a retrospective chart review of children with CP that underwent hip reconstruction between 2010 and 2019 with at least 2 years of radiographic follow-up. Migration percentage (MP), acetabular index (AI), and neck shaft angle (NSA) were recorded preoperatively, postoperatively and throughout follow-up. Failures were defined as a MP at latest follow-up ≥30% or need for revision hip reconstruction. Hips were divided into groups based on postoperative MP-group 1 (over-containment group) had a MP≤0% and group 2 had an MP>0%. Radiographic parameters and failure rates were compared across Gross Motor Functional Classification Score (GMFCS) level, age at the time of surgery, and degree of preoperative subluxation.
A cohort of 108 patients (197 hips) with an average age of 7.3±3.2 years met inclusion criteria with an average follow-up of 49.6 months (range: 24 to 118 mo). There were 147 hips in group 1 and 50 hips in group 2. At latest follow-up, group 1 demonstrated lower MP, AI, and NSA in comparison to group 2. The overall failure rate in our cohort was 8.1% (16 hips). Failure rates trended lowest in hips that were over-contained (6.1% v. 14.0%) although not statistically significant. Over-containment resulted in significantly lower failure rates in GMFCS IV/V hips, children under age 6 at the time of surgery and those with a higher degree of preoperative hip displacement (MP>50%).
Over-containment at the time of hip reconstruction can positively affect radiographic outcomes and failure rates in children with CP. Over-containment should be considered in hips at high risk of failure, especially non ambulatory children with significant hip subluxation at an early age.
Level III-retrospective comparative study.
•We performed next generation metagenomic sequencing on soil samples.•Several genes for chitin and chitosan modifying enzymes were identified.•A novel sequence coding for chitinase was ...codon-optimized and synthesized.•Expression studies and dot assays revealed the chitinase to be active.•Metagenomic sequencing can be used as tool for novel enzymes.
Chitin and its derivative chitosan are abundant natural polysaccharides with many potential industrial applications. Metagenomic analysis of chitin-enriched soil samples using the Roche Genome Sequencer FLX platform led to the identification of several novel genes for chitin and chitosan modifying enzymes (CCMEs) which may be used to produce novel chitosans. The sequencing approach yielded 2,281,090 reads with an average length of 378bp amounting to a total sequence information of approximately 851Mb. Assembly of the obtained sequences comprised 699,710 reads representing 30.68% of all reads. A total of 6625 contigs larger than 500bp containing 16,289 predicted genes are included in the assembly. Taxonomic profiling of the indigenous microbial community by applying the software CARMA revealed that 96.1% of the reads were of bacterial origin including 17% assigned to the family Xanthomonadaceae. Several putative genes encoding CCMEs were identified by comparison against the GenBank database, inclusive a full-length chitinase gene which was codon optimized for Escherichia coli and heterologously synthesized as a Strep-tagged protein in E. coli Rosetta 2 using the pET vector system. Approximately 5mg of the novel active chitinase was purified as demonstrated by dot assay analysis using glycol chitin as a substrate. Next generation metagenomic sequencing, thus, emerges as a new and powerful tool for the identification of potentially novel biocatalysts of biotechnological value.
Proximal femoral screw hemiepiphysiodesis (PFSH) is a promising technique for treatment of hip subluxation in children with cerebral palsy (CP). The aim of this study is to report radiographic ...outcomes of PFSH and to evaluate its role in changing the natural history of hip displacement in children with CP.
This is a single center retrospective chart review of children with CP that underwent PFSH with at least 2 years of radiographic follow-up. Demographic information, surgical details, complications, additional surgical procedures, and need for screw exchange were recorded. Radiographs were assessed for migration percentage (MP), neck shaft angle (NSA), head shaft angle (HSA), and articular trochanter distance preoperatively as well as at 6 months, 1 year, 2 year, and latest follow-up postoperatively. Hips were divided into group 1 (no previous hip surgery) and group 2 (PFSH performed after hip reconstruction). Hips with 2 years of preoperative radiographic data were included in the natural history cohort.
Twenty-three patients (44 hips) met inclusion criteria with an average age of 7.3±1.7 years and a mean follow-up of 33.5 months. Group 1 and group 2 had 32 and 12 hips, respectively. Group 1 had significant improvement in all parameters (ΔMP=5%, ΔNSA=13 degrees, ΔHSA=15 degrees) group 2 showed improvements in NSA and HSA (ΔNSA=4 degrees ΔHSA=8 degrees) with only HSA reaching significance and MP remaining unchanged. All radiographic measurements worsened in the 2 years before surgery (N=25, natural history group) and improved after PFSH. Screw exchange occurred in 12 hips (27.2%) at an average of 33 months (range 27 to 42 mo) with 2 hips also undergoing pelvic osteotomy at that time. Three hips had a MP >50% at follow-up with 2 hips in group 1 undergoing hip reconstruction. No complications were noted.
PFSH effectively alters proximal femoral growth and can improve hip subluxation in children with CP. Screws often need to be exchanged and hips should be carefully monitored.
Level III-retrospective comparative study.
BACKGROUND:The utility of routine follow-up radiographs for the treatment of nondisplaced pediatric supracondylar humerus fractures has not been established. The purpose of this study is to (1) ...determine the frequency that postcast removal x-rays change patient management and (2) determine the role of routine follow-up for range of motion evaluation after cast removal in the treatment of nondisplaced supracondylar humerus fractures.
METHODS:We conducted a single center retrospective chart review of patients under the age of 18 years old that sustained nondisplaced supracondylar humerus fractures between January 1, 2010 and July 1, 2018. Demographic information, fracture characteristics, time to follow-up and each appointment outcome were recorded. A change in patient management after postcast removal x-ray was defined as a need for an additional period of immobilization, a delay in initiation of range of motion exercises, or need for operative intervention. In addition, the appointment for range of motion evaluation was considered to alter management if further activity restriction was required, a formal physical therapy program was recommended or an additional office visit required. Unscheduled appointments were also noted.
RESULTS:A total of 489 patients met inclusion criteria. The average age was 4.90±2.68 years and 51.8% were female. A total of 487 patients had routine follow-up x-rays after cast removal. No patient had a change of management based on postcast removal radiographs. In all, 290 patients returned for range of motion follow-up with 94.8% of patients being discharged from care. There were 14 patients whose management changed based on this evaluation (4.8%). The most common reason was an additional appointment for range of motion evaluation (12/14 patients, 86%). There were 13 patients with unscheduled evaluation after discharge from care, 77% were secondary to repeat injury.
CONCLUSION:This study suggests that postcast removal x-rays and routine follow-up after cast removal rarely change patient management and may not be necessary in the treatment of nondisplaced pediatric supracondylar humerus fractures.
LEVEL OF EVIDENCE:Level IV—case series.
We propose a new method for strain field estimation in quasi-static ultrasound elastography based on matching RF data frames of compressed tissues. The method benefits from using a handheld ...force-controlled ultrasound probe, which provides the contact force magnitude and therefore improves repeatability of displacement field estimation. The displacement field is estimated in a two-phase manner using triplets of RF data frames consisting of a pre-compression image and two post-compression images obtained with lower and higher compression ratios. First, a reliable displacement field estimate is calculated for the first post-compression frame. Second, we use this displacement estimate to warp the second post-compression frame while using linear elasticity to obtain an initial approximation. Final displacement estimation is refined using the warped image. The two-phase displacement estimation allows for higher compression ratios, thus increasing the practical resolution of the strain estimates. The strain field is computed from a displacement field using a smoothness- regularized energy functional, which takes into consideration local displacement estimation quality. The minimization is performed using an efficient primal-dual hybrid gradient algorithm, which can leverage the architecture of a graphical processing unit. The method is quantitatively evaluated using finite element simulations. We compute strain estimates for tissue-mimicking phantoms with known elastic properties and finally perform a qualitative validation using in vivo patient data.
Due to low production costs, lignite is an important component of energy mixes of countries in its possession. However, high moisture content undermines its applicability as fuel for power ...generation. Drying in superheated steam is a prospective method of upgrading quality of lignite. The study aimed to validate the drying model of lignite from Belchatow mine in Poland. The experimental investigation on superheated steam drying of lignite was previously conducted. Spheres of 10 mm in diameter were exposed to the drying medium at the temperature range of 110-170oC. The drying behaviour was described in the form of moisture content, drying rate and temperature profile curves against time. With the application of basic coal properties (e.g. density, water percentage, specific heat) as well as the mechanisms of heat and mass transfer in subsequent stages of the process, the numerical model of drying was constructed. It was tentatively verified with reference to experimental results both in terms of drying parameters and temperature. The model illustrated drying behaviour in the entire range of conditions. Nevertheless, further development of numerical model is desirable regarding accuracy of the process parameters.
Catalytic properties of monometallic Ni and bimetallic Ru–Ni supported on Al
2
O
3
, CaO–Al
2
O
3
, and MgO–Al
2
O
3
have been studied in mixed reforming of methane. Physicochemical properties of the ...catalytic systems have been studied by X-ray diffraction, scanning electron microscopy with energy dispersive spectroscope and temperature-programmed reduction by hydrogen. It has been shown that, of all the studied samples, the highest conversion of methane and carbon dioxide is achieved in the presence of the Ru−Ni/MgO–Al
2
O
3
bimetallic catalyst. Temperature-programmed reduction has confirmed the effect of hydrogen spillower from ruthenium to NiO. The formation of Ru–Ni alloy has also been found.
PDF
