Purpose
The aim of this study was to determine inter- and intraobserver reliability of delta rod extension, and total rod length measured on digital x-rays in patients with early onset scoliosis ...(EOS) treated with magnetically controlled growing rods (MCGR). For the last decade, patients with EOS have been treated with MCGR. Replacement of MCGR relies heavily on the measurement done at every lengthening session. Only a few studies have looked at inter- and intraobserver reliability of rod lengthening, and none have used the delta extension before.
Methods
202 radiographs presented in random order were rated and measured twice with at least a 14-day interval and differing order of the radiographs. The measuring was done at both rods.
All x-rays came from 15 patients diagnosed with EOS and treated with MCGR from 2009 until 2019. The total extension length and the delta extension (the difference in total extension length between two lengthening in succession) were measured, and the intraclass correlation coefficient (ICC) calculated for both measurements
Results
Intrarater ICC scores varied from moderate to good, but non-significantly. Interrater reliability increased significantly from moderate (ICC 0.72 0.68; 0.76 and 0.73 0.69; 0.77 to excellent (ICC 0.91 0.88; 0.93 and 0.97 0.96: 0.98), when examining delta extension every sixth instead of every second month.
Conclusion
Measuring rod lengthening on x-rays can be done every 6 months, with an ample reliability. The ICC’s for the delta extension with 2–3 months interval were only moderately precise, compared to the near perfect ICC’s for the total extension length.
We measured current and luminosity at the channel bottom of 12 triggered lightning discharges including 44 return strokes, 23 M‐components, and 1 initial continuous current pulse. Combined current ...and luminosity data for impulse currents span a 10–90% risetime range from 0.15 to 192 µs. Current risetime and luminosity risetime at the channel bottom are roughly linearly correlated (τr,I = 0.71τr,L1.08). We observed a time delay between current and the resultant luminosity at the channel bottom, both measured at 20% of peak amplitude, that is approximately linearly related to both the luminosity 10–90% risetime (Δt20,b = 0.24τr,L1.12) and the current 10–90% risetime (Δt20,b = 0.35τr,I1.03). At the channel bottom, the peak current is roughly proportional to the square root of the peak luminosity (IP = 21.89LP0.57) over the full range of current and luminosity risetimes. For two return strokes we provide measurements of stroke luminosity vs. time for 11 increasing heights to 115 m altitude. We assume that measurements above the channel bottom behave similarly to those at the bottom and find that (1) one return stroke current peak decayed at 115 m to about 47% of its peak value at channel bottom, while the luminosity peak at 115 m decayed to about 20%, and for the second stroke 38% and 12%, respectively; and (2) measured upward return stroke luminosity speeds of the two strokes of 1.10 × 108 and 9.7 × 107 ms−1 correspond to current speeds about 30% faster. These results represent the first determination of return stroke current speed and current peak value above ground derived from measured return stroke luminosity data.
Key Points
A new experiment‐based measurement of return stroke current speed
At channel bottom, the peak impulse luminosity is roughly proportional to the peak current squared
At channel bottom, current‐luminosity sub to hundreds of microsecond risetimes correlate linearly
Progesterone can inhibit intestinal smooth muscle contraction; however, the specific mechanism remains unclear. Besides smooth muscle cells, smooth muscle has two important mesenchymal cells, namely ...interstitial cells of Cajal (ICC) and PDGFRα+ cells, which induce the contraction and relaxation of smooth muscles. We aimed to explore the regulation of PDGFRα+ cells and ICC in progesterone-mediated colon slow transit in pregnant mice.
Colon transit experiments were performed in vivo and in vitro to observe slow colon transit. The expression of PDGFRα and c-KIT was detected by Western blot, RT-PCR, and immunofluorescence. An isometric tension experiment was performed to investigate smooth muscle contractions.
The colon transit time in pregnant mice was longer than that in non-pregnant mice. Progesterone significantly blocks colonic smooth muscle contractions. However, when the relaxation and contraction of PDGFRα+ cells and ICC are blocked, progesterone cannot inhibit smooth muscle contraction. When the function of only PDGFRα+ cells are blocked, progesterone has a more obvious inhibitory effect on smooth muscle in the non-pregnant group than that in the pregnant group. However, when ICC alone was blocked, progesterone inhibited smooth muscle contractions more clearly in pregnant mice. The protein and mRNA expression of PDGFRα was higher and c-KIT was lower in pregnant mice. PDGFRα+ cells and ICC from smooth muscle all co-localize progesterone receptors.
Under the regulation of progesterone, the relaxation function of PDGFRα+ cells is enhanced and the contraction function of ICC is weakened, leading to the slow colon transit of pregnant mice.
Aim
To report the multicenter retrospective experience on combination of balloon-occluded MWA(b-MWA) followed by balloon-occluded TACE(b-TACE) in patients with liver malignancies > 3 cm, focusing on ...appearance and volume of necrotic area, safety profile and oncological results.
Materials and Methods
Twenty-three patients with liver primary malignancies (hepatocellular carcinoma,HCC = 18; intrahepatic cholangiocarcinoma,iCC = 2) and metastasis (colorectal cancer metastasis = 1;sarcoma metastasis = 1;breast metastasis = 1) were treated. Maximum mean diameter of lesions was 4.4 cm (± 1 cm). Treatments were performed using a single-step approach:b-MWA was performed after balloon-microcatheter inflation, followed by b-TACE (with epirubicin or irinotecan). Necrotic area shape and discrepancy with the expected volume of necrosis suggested by vendor’s ablation chart were assessed at post-procedural CT. Complications were categorized according to CIRSE classification. Oncological results at 1 and 3–6 months were evaluated using m-RECIST(HCC) and RECISTv1.1(metastasis/iCC).
Results
Mean volume of necrotic area was 75 cm
3
(± 36). Discrepancy with vendor chart consisted in a medium percentage of volumetric incrementation of necrotic area of 103.2% (± 99.8). Non-spherical shape was observed in 22/23 patients (95.7%). No complications occurred; Post-embolization syndrome occurred in 12/23patients. Complete response and partial response were, respectively, 91, 3% (21/23) and 8.7% (2/23) at 1 month, 85.7% (18/21) and 9.5% (2/21) at 3–6 months. Progression of disease was 4.7% (1/21) at 3–6 months for extra-hepatic progression. Among partial responders, average percentage of tumor volume debulking was 78.8% (± 9.8%).
Conclusion
b-MWA followed by b-TACE in a single-step procedure led to larger necrotic areas than the proposed by vendors ablation chart, non-spherical in shape and corresponded to the vascular segment occluded during ablation. This permitted to safely achieve promising oncological results in patients with > 3 cm tumors.
For the digestion of food, it is important for the gut to be differentiated regionally and to have proper motor control. However, the number of transcription factors that regulate its development is ...still limited. Meanwhile, the interstitial cells of the gastrointestinal (GI) tract are necessary for intestinal motility in addition to the enteric nervous system. There are Anoctamine1 (Ano1)-positive and Platelet-derived growth factor receptor alpha (Pdgfra)-positive interstitial cells in mammal, but Pdgfra-positive cells have not been reported in the zebrafish. To identify new transcription factors involved in GI tract development, we used RNA-sequencing comparing between larval and adult gut. We isolated 40 transcription factors that were more highly expressed in the larval gut. We demonstrated expression patterns of the 13 genes, 7 of which were newly found to be expressed in the zebrafish larval gut. Six of the 13 genes encode nuclear receptors. The osr2 is expressed in the anterior part, while foxP4, in its distal part. Also, we reported the expression pattern of pdgfra for the first time in the larval zebrafish gut. Our data would provide fundamental knowledge for studying vertebrate gut regionalization and motility by live-imaging using zebrafish. This article is protected by copyright. All rights reserved.
How changes in intracranial compliance (ICC), resistance to cerebrospinal fluid (CSF)-outflow (Rout), and pressure-volume index (PVI) can play a prominent role in clarifying the complexities in the ...biomechanism and treatment outcomes of hydrocephalus. This study aims to provide a comprehensive review to find the correlation between ICC, Rout, and PVI with intracranial pressure (ICP) characteristics, as well as morphometric parameters, in hydrocephalus patients.
Electronic searches were conducted using the PubMed/MEDLINE, Scopus, Google Scholar, Ovid, Cochrane, and EMBASE databases from their dates of inception to December 2022 using filters for English-language articles. The article selection and data collection were conducted in accordance with PRISMA guidelines and recommendations. We assigned a quality score for each study to evaluate the information and selection bias. The certainty of the pooled data for all articles was assessed based on GRADE criteria. The Funnel plot asymmetry study was used to evaluate publication bias.
The overall pre-treatment ICC, Rout, and PVI were 0.45 ml/mmHg (95% CI, 0.33-0.57; I2=99.7%; P<0.001), 14.93 mmHg/(ml/min) (95% CI, 13.65-16.21; I2= 99.7%; P<0.001) and 19.26 ml (95% CI, 15.63-22.89; I2=98.7%; P<0.001), respectively. The pooled Rout was observed to be higher in adult hydrocephalus compared to pediatric hydrocephalus, whereas the opposite trend was found for PVI. Patients with normal pressure hydrocephalus (NPH) exhibited a higher pooled Rout compared to communicating hydrocephalus. Patients with unimproved outcomes demonstrated a decrease in the effect size of the pooled Rout. The results also showed significant correlations were observed between all ICP characteristics and both the ICC and Rout. The correlation between ICC and the ventricular score was significant. Rout had a significant correlation with the third ventricle index. PVI had significant correlations with Evan's ratio, inverse cella media, and ventricular score.
The results indicate the possible reason for publication bias in some subgroups may be related to methodological heterogeneity in the measurement of pressure-volume parameters. This finding motivates researchers to investigate the effects of different invasive and non-invasive methods on the measurement results of ICC, Rout, and PVI.
•Rout was higher in adult hydrocephalus compared to pediatric, opposite trend for PVI.•NPH patients had a higher Rout compared to communicating hydrocephalus.•All ICP characteristics correlated with both the ICC and Rout.•ICC correlated with ventricular score and Rout correlated with third ventricle index.
We present a study focused on pulses superimposed on the initial continuous current of upward negative discharges. The study is based on experimental data consisting of correlated lightning current ...waveforms recorded at the instrumented Säntis Tower in Switzerland and electric fields recorded at a distance of 14.7 km from the tower. Two different types of pulses superimposed on the initial continuous current were identified: (1) M‐component‐type pulses, for which the microsecond‐scale electric field pulse occurs significantly earlier than the onset of the current pulse, and (2) fast pulses, for which the onset of the field matches that of the current pulse. We analyze the currents and fields associated with these fast pulses (return‐stroke type (RS‐type) initial continuous current (ICC) pulses) and compare their characteristics with those of return strokes. A total of nine flashes containing 44 RS‐type ICC pulses and 24 return strokes were analyzed. The median current peaks associated with RS‐type ICC pulses and return strokes are, respectively, 3.4 kA and 8 kA. The associated median E‐field peaks normalized to 100 km are 1.5 V/m and 4.4 V/m, respectively. On the other hand, the electric field peaks versus current peaks for the two data sets (RS‐type ICC pulses and return strokes) are characterized by very similar linear regression slopes, namely, 3.67 V/(m kA) for the ICC pulses and 3.77 V/(m kA) for the return strokes. Assuming the field‐current relation based on the transmission line model, we estimated the apparent speed of both the RS‐type ICC pulses and return strokes to be about 1.4 × 108 m/s. A strong linear correlation is observed between the E‐field risetime and the current risetime for the ICC pulses, similar to the relation observed between the E‐field risetime and current risetime for return strokes. The similarity of the RS‐type ICC pulses with return strokes suggests that these pulses are associated with the mixed mode of charge transfer to ground.
Key Points
The median current peaks associated with RS‐type ICC pulses and return strokes are, respectively, 3.4 kA and 8 kA
The associated median radiation E‐field peaks normalized to 100 km are 1.5 V/m and 4.4 V/m, for ICC pulses and return strokes, respectively
Comparison of RS‐type ICC pulses and return strokes suggests that the former are associated with the mixed mode of charge transfer to ground
Purpose
The consulting team intervenes in the integrated construction consulting (ICC) network structure centered on “client-contractor-consultant.” Team boundary-spanning behavior (TBB) driven by ...the network structure is crucial to project performance. This article investigated how to stimulate the consulting project performance (CPP) improvement by considering the interactive effect of network structure and TBB. To be specific, this paper explored the configuration between structural characteristics of project networks, the dimension of TBB, and project performance in ICC projects.
Design/methodology/approach
Network density and centrality were used to reflect network structure. This study collected 216 valid responses from construction professionals (including project managers, department managers, and project engineers) via a questionnaire survey and analyzed the data using fsQCA.
Findings
Combining with the corresponding typical project case and analysis, the results concluded four types of configurations for achieving high performance in the ICC projects. Meanwhile, network centrality, density, ambassadorial behavior, coordination behavior, and detection behavior significantly impact high consulting project performance. Matching ICC network characteristics with the TBB is important. There are also three low performance configurations for the ICC projects. Low performance state also occurs when network centrality or density and coordination behavior is simultaneously low. Only the right match between the network characteristics and TBB can produce high consulting project performance.
Research limitations/implications
The network centrality and density, the implementation of TBB vary, and the paths to achieve high consulting project performance are different. Clients, ICC projects, and consulting teams should choose the appropriate development paths according to the actual situation. (1) Clients should commit to applying the ICC project model with high network centrality, density, and coordination behavior of ICC enterprises to promote project performance. (2) Consulting enterprises should carry out ICC business based on detecting behavior and coordinating behavior. (3) The market should cultivate head consulting enterprises with independence and integration, and bring into play the effectiveness of consulting team ambassadorial behavior.
Practical implications
Comparing the results of the four high CPP configurations, the network structure characteristics are essential, which means that in the Chinese consulting practice between the owner and the consulting firm pay attention to the use of appropriate ICC organizational structure model and arrange the degree of centralization of authorized responsibilities. Coordination behavior is necessary to achieve high CPP. Therefore, Chinese consulting firms should pay attention to effective communication and exchange with project contractors in order to get high CPP in conducting business; meanwhile, enabling behavior can achieve high CPP both in the presence and absence of configuration H1 and H4, which indicates that enabling behavior has substitution effect. Comparing the three low CPP configurations also contrarily confirms the indispensability of coordinating behavior. Comparing the results of high and low CPP configurations, the TBB is seriously missing and not properly applied in CPP enhancement. In detail, Chinese consulting firms have been regarded as independent third parties providing services, and less attention has been paid to the TBB of Chinese consulting firms in past practice, thus leading to the dilemma of inadequate empowerment of consulting firms due to their unclear status. To solve this dilemma, the findings of this paper offer a solution at the micro level to change the previous perception of consulting and demonstrate that Chinese consulting practice needs to pay attention to TBB with owners and contractors, and apply it well to enhance the reputation, management consulting level and capability, and experience and expertise of consulting firms to achieve high CPP.
Originality/value
The research results changed from the previous bilateral project governance to a new perspective of network embedding. It provided a theoretical basis for the improvement path of high consulting project performance, as well as providing ideas for clients on the organizational design of ICC projects. On the other hand, it provided a practical reference for TBB positioning of ICC enterprises for transformation and upgrading development.
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