Surgical repair of large muscular defects requires the use of autologous graft transfer or prosthetic material. Naturally derived matrices are biocompatible materials obtained by tissue ...decellularization and are commonly used in clinical practice. Despite promising applications described in the literature, the use of acellular matrices to repair large defects has been only partially successful, highlighting the need for more efficient constructs. Scaffold recellularization by means of tissue engineering may improve not only the structure of the matrix, but also its ability to functionally interact with the host. The development of such a complex construct is challenging, due to the complexity of the native organ architecture and the difficulties in recreating the cellular niche with both proliferative and differentiating potential during growth or after damage. In this study, we tested a mouse decellularized diaphragmatic extracellular matrix (ECM) previously described by our group, for the generation of a cellular skeletal muscle construct with functional features. The decellularized matrix was stored using different conditions to mimic the off‐the‐shelf clinical need. Pediatric human muscle precursors were seeded into the decellularized scaffold, demonstrating proliferation and differentiation capability, giving rise to a functioning three‐dimensional skeletal muscle structure. Furthermore, we exposed the engineered construct to cardiotoxin injury and demonstrated its ability to activate a regenerative response in vitro promoting cell self‐renewal and a positive ECM remodeling. Functional reconstruction of an engineered skeletal muscle with maintenance of a stem cell pool makes this a promising tool toward future clinical applications in diaphragmatic regeneration. Stem Cells Translational Medicine 2019;8:858&869
Schematic depiction of diaphragmatic construct generation.
This study examined whether measuring myocardial blood flow (MBF) in the sub-endocardial (SEN) and sub-epicardial (SEP) layers of the left ventricular myocardium using 13NH3 positron emission ...tomography (PET) and an automated procedure gives reasonable results in patients with known or suspected coronary artery disease (CAD).
Resting and stress 13NH3 dynamic PET were performed in 70 patients. Using ≥ 70% diameter stenosis in invasive coronary angiography (ICA) to identify significant CAD, we examined the diagnostic value of SEN- and SEP-MBF, and coronary flow reserve (CFR) vs. the corresponding conventional data averaged on the whole wall thickness.
ICA demonstrated 36 patients with significant CAD. Their global stress average 1.61 (1.26, 1.87) mL·min−1·g−1, SEN 1.39 (1.2, 1.59) mL·min−1·g−1 and SEP 1.22 (0.96, 1.44) mL·min−1·g−1 MBF were significantly lower than in the 34 no-CAD patients: 2.05 (1.76, 2.52), 1.72 (1.53, 1.89) and 1.46 (1.23, 1.89) mL·min−1·g−1, respectively, all P < .005. In the 60 CAD vs. the 150 non-CAD territories, stress average MBF was 1.52 (1.10, 1.83) vs. 2.06 (1.69, 2.48) mL·min−1·g−1, SEN-MBF 1.33 (1.02, 1.58) vs. 1.66 (1.35, 1.93) mL·min−1·g−1, and SEP-MBF 1.07 (0.80, 1.29) vs. 1.40 (1.12, 1.69) mL·min−1·g−1, respectively, all P < .05. Using receiver operating characteristics analysis for the presence of significant CAD, the areas under the curve (AUC) were all significant (P < .0001 vs. AUC = 0.5) and similar: stress average MBF = 0.79, SEN-MBF = 0.75, and SEP-MBF = 0.73. AUC was 0.77 for the average CFR, 0.75 for SEN, and 0.70 for SEP CFR. The stress transmural perfusion gradient (TPG) AUC (0.51) was not significant. However, stress TPG was significantly lower in segments subtended by totally occluded arteries vs. those subtended by sub-total stenoses: 1.10 (0.86, 1.33) vs. 1.24 (0.98, 1.56), respectively, P < .005.
Automatic assessment of SEN- and SEP-MBF (and CFR) using 13NH3 PET gives reasonable results that are in good agreement with the conventional average whole wall thickness data. Further studies are needed to examine the utility of layer measurements such as in patients with hibernating myocardium or microvascular disease.
A laser beam is the light that is subject to the laws of physics. Surface roughness can cause that the light can be reflected in different angles. Therefore, the surface roughness may influence the ...amount of light to be reflected so the power of the laser could be lowered. Present paper analyses the influence of different surface roughness on porosity and geometry of weld joint using design of experiment. Surface roughness monitored during the experiment was in the range from Ra 0.8 to Ra 15 achieved and by machining on aluminium-lithium alloy AW2099. In order to keep the same condition for welding the bead on plate welds were realised. Porosity was analysed using computer tomography. Surface roughness proved to have minor influence on porosity as well as the shape of the weld joint.
Previous studies showed that quarantine for pandemic diseases is associated with several psychological and medical effects. The consequences of quarantine for COVID-19 pandemic in patients with ...dementia are unknown. We investigated the clinical changes in patients with Alzheimer's disease and other dementias, and evaluated caregivers' distress during COVID-19 quarantine.
The study involved 87 Italian Dementia Centers. Patients with Alzheimer's Disease (AD), Dementia with Lewy Bodies (DLB), Frontotemporal Dementia (FTD), and Vascular Dementia (VD) were eligible for the study. Family caregivers of patients with dementia were interviewed by phone in April 2020, 45 days after quarantine declaration. Main outcomes were patients' changes in cognitive, behavioral, and motor symptoms. Secondary outcomes were effects on caregivers' psychological features.
4913 patients (2934 females, 1979 males) fulfilled the inclusion criteria. Caregivers reported a worsening in cognitive functions in 55.1% of patients, mainly in subjects with DLB and AD. Aggravation of behavioral symptoms was observed in 51.9% of patients. In logistic regression analysis, previous physical independence was associated with both cognitive and behavioral worsening (odds ratio 1.85 95% CI 1.42-2.39, 1.84 95% CI 1.43-2.38, respectively). On the contrary, pandemic awareness was a protective factor for the worsening of cognitive and behavioral symptoms (odds ratio 0.74 95% CI 0.65-0.85; and 0.72 95% CI 0.63-0.82, respectively). Approximately 25.9% of patients showed the onset of new behavioral symptoms. A worsening in motor function was reported by 36.7% of patients. Finally, caregivers reported a high increase in anxiety, depression, and distress.
Our study shows that quarantine for COVID-19 is associated with an acute worsening of clinical symptoms in patients with dementia as well as increase of caregivers' burden. Our findings emphasize the importance to implement new strategies to mitigate the effects of quarantine in patients with dementia.
The costs and benefits of full lockdown measures are debated. Neurologically impaired children are a vulnerable population with specific needs in terms of protection against infection and access to ...health services.
We investigated the effects of lockdown on the health of children with neurological disorders and on their access to care during lockdown.
Data from 514 children (282 males – 232 females) were collected through physician-administered interviews to investigate: the occurrence of viral-like physical symptoms, the correlation between the risk of developing such symptoms and several demographic and clinical variables, the occurrence of any worsening of the children's neurological conditions during lockdown, and their access to care services during this period.
49.1% experienced at least one symptom during the study period, but no child developed severe complications. The prevalence of symptoms was significantly lower during lockdown than during the previous two months. The underlying neurological condition worsened in 11.5% of the patients. Children who regularly left the home during lockdown were greater risk of exhibiting symptoms. During lockdown, 67.7% had a specialist appointment cancelled, 52.6% contacted their paediatrician, and 30.9% contacted their child neuropsychiatrist. Among patients who usually receive rehabilitation, 49.5% continued remotely.
Lockdown protected children from infections. Telemedicine and telerehabilitation constituted a valid alternative for the care and treatment of these children, but they should not become a widespread and definitive model of care. COVID-19 and other emergency response plans must take into account the specific needs of children with disabilities.
Background
Trichophyton rubrum and Trichophyton mentagrophytes variant interdigitalis are the most frequent etiologic agents of onychomycosis. Diagnosis of certainty requires mycological examination, ...which often results unfeasible.
Objectives
The aim of our study is to describe pathogen specific dermoscopic features, allowing a differential diagnosis without the need for cultural examination, in order to prescribe the most appropriate treatment anyway.
Patients and methods
We conducted an observational retrospective study on 54 patients with a culture proven diagnosis of distal subungual onychomycosis of the toenail, caused by Trichophyton rubrum or Trichophyton mentagrophytes variant interdigitalis. Using a videodermatoscope we collected data on nail colour (white, yellow, orange, brown, dark) and on dermoscopic patterns (aurora, spikes, jagged, ruin, linear edge, dots, striae).
Results
Fifty‐four patients, with a total of 72 nails, were eligible for this study. Analysing the association between discoloration of the nail plate and type of infection (T. rubrum or T. interdigitalis), no correlation turned out to be statistically significant. Instead, significant associations between spikes and T. rubrum infection and striae and infection from T. interdigitalis were identified. Finally, a 100% specificity was identified for white colour and ruin pattern for T. rubrum infection, and brown colour, jagged border and aurora pattern for T. interdigitalis.
Conclusions
Trying to find relationships between specific pathogens and dermoscopic patterns, we found out an association between spikes and striae and T. rubrum and T. interdigitalis respectively. Further larger studies are however necessary to evaluate our preliminary findings.
Satellite cells (SCs) represent a distinct lineage of myogenic progenitors responsible for the postnatal growth, repair and maintenance of skeletal muscle. Distinguished on the basis of their unique ...position in mature skeletal muscle, SCs were considered unipotent stem cells with the ability of generating a unique specialized phenotype. Subsequently, it was demonstrated in mice that opposite differentiation towards osteogenic and adipogenic pathways was also possible. Even though the pool of SCs is accepted as the major, and possibly the only, source of myonuclei in postnatal muscle, it is likely that SCs are not all multipotent stem cells and evidences for diversities within the myogenic compartment have been described both in vitro and in vivo. Here, by isolating single fibers from rat flexor digitorum brevis (FDB) muscle we were able to identify and clonally characterize two main subpopulations of SCs: the low proliferative clones (LPC) present in major proportion (approximately 75%) and the high proliferative clones (HPC), present instead in minor amount (approximately 25%). LPC spontaneously generate myotubes whilst HPC differentiate into adipocytes even though they may skip the adipogenic program if co-cultured with LPC. LPC and HPC differ also for mitochondrial membrane potential (DeltaPsi(m)), ATP balance and Reactive Oxygen Species (ROS) generation underlying diversities in metabolism that precede differentiation. Notably, SCs heterogeneity is retained in vivo. SCs may therefore be comprised of two distinct, though not irreversibly committed, populations of cells distinguishable for prominent differences in basal biological features such as proliferation, metabolism and differentiation. By these means, novel insights on SCs heterogeneity are provided and evidences for biological readouts potentially relevant for diagnostic purposes described.
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