Heterojunction tunnelled vanadium-based cathode materials for high-performance aqueous zinc ion batteries

Rechargeable aqueous zinc ion batteries (ZIBs) have emerged as a promising alternative to lithium-ion batteries due to their inherent safety, abundant availability, environmental friendliness and cost-effectiveness. However, the cathodes in ZIBs encounter challenges such as structural instability, low capacity, and sluggish kinetics. In this study, we constructed BiVO4@VO2 (BVO@VO) heterojunction cathode material with bismuth vanadate and vanadium dioxide phases for ZIBs, which demonstrate significant advancements in both aqueous and quasi-solid-state ZIBs. Benefitting from the heterojunction structure, the materials present a high capacity of 262 mAh g-1 at 0.1 A g-1, superb cyclic stability with 96% capacity retention after 1000 cycles at 2 A g-1, and outstanding rate property with a specific capacity of 218 mAh g-1 even at a high rate of 5.0 A g-1. Furthermore, the flexible quasi-solid-state ZIBs incorporating the BVO@VO cathode demonstrate prolonged cyclic life performance with a remarkable specific capacity of 234 mAh g-1 over 100 cycles at a current density of 0.1 A g-1. This study potentially paves the way for the utilization of heterointerface-enhanced zinc ion diffusion for vanadium-based materials in ZIBs, thereby providing a new approach for the design and investigation of high-performance zinc-ion systems.

Highly-exposed copper and ZIF-8 interface enables synthesis of hydrocarbons by electrocatalytic reduction of CO2

Electrochemical reduction of CO2 (CO2RR) to fuels and chemicals is a promising route to close the anthropogenic carbon cycle for sustainable society. The Cu-based catalysts in producing high-value hydrocarbons feature unique superiorities, yet challenges remain in achieving high selectivity. In this work, Cu@ZIF-8 NWs with highly-exposed Cu nanowires (Cu NWs) and ZIF-8 interface are synthesized via a surfactant-assisted method. Impressively, Cu@ZIF-8 NWs exhibit excellent stability and a high Faradaic efficiency of 57.5% toward hydrocarbons (CH4 and C2H4) at a potential of -0.7 V versus reversible hydrogen electrode. Computational calculations combining with experiments reveal the formation of Cu and ZIF-8 interface optimizes the adsorption of reaction intermediates, particularly stabilizing the formation of *CHO, thereby enabling efficient preference for hydrocarbons. This work highlights the potential of constructing metals and MOFs heterogeneous interfaces to enhance catalytic properties and offers valuable insights for the design of highly efficient CO2RR catalysts.

[Prevention and treatment of endometrial cancer]

Endometrial cancer is rising in incidence, especially in young women. This rise in incidence has implications for both primary prevention and screening in high-risk population. In the past several years, our understanding of the integration of clinically related genomic and pathologic data optimized the management of endometrial cancer. The updated 2023 FIGO staging includes the histological and molecular classification to better reflect the improved understanding of the heterogenous nature of endometrial carcinoma. Standard primary treatment is quite essential, however, selection of patients for adjuvant radiation or chemotherapy remains in controversy. Molecular characterization of endometrial cancer is becoming critical in directing treatment for advanced and recurrent disease, and the addition of immunotherapy to frontline chemotherapy is becoming the standard of care. More attention should be given to increase awareness of survivorship issues and improve patient quality-of-life.

Choline induced cardiac dysfunction by inhibiting the production of endogenous hydrogen sulfide in spontaneously hypertensive rats

To investigate the exact effects of dietary choline on hypertensive heart disease (HHD) and explore the potential mechanisms, male spontaneously hypertensive rats (SHR) and Wistar Kyoto rats (WKY) were randomly divided into five groups as follows: WKY group, WKY + Choline group, SHR group, SHR + Choline group, and SHR + Choline + NaHS group. In choline treatment groups, rats were fed with 1.3% (w/v) choline in the drinking water for 3 months. The rats in the SHR + Choline + NaHS group were intraperitoneally injected with NaHS (100 micromol/kg/day, a hydrogen sulfide (H2S) donor) for 3 months. After 3 months, left ventricular ejection fraction (LVEF) and fractional shortening (LVFS), the indicators of cardiac function measured by echocardiography, were increased significantly in SHR as compared to WKY, although there was no significant difference in collagen volumes and Bax/Bcl-2 ratio between the two groups, indicating the early stage of cardiac hypertrophy. There was a significant decrease in LVEF and LVFS and an increase in collagen volumes and Bax/Bcl-2 ratio in SHR fed with choline, meanwhile, plasma H2S levels were significantly decreased significantly in SHR fed with choline accompanying by the decrease of cystathionine-gamma-lyase (CSE) activity. Three months of NaHS significantly increased plasma H2S levels, ameliorated cardiac dysfunction and inhibited cardiac fibrosis and apoptosis in SHR fed with choline. In conclusion, choline aggravated cardiac dysfunction in HHD through inhibiting the production of endogenous H2S, which was reversed by supplementation of exogenous H2S donor.

Real world data on outcomes of anti-CD38 antibody treated, including triple class refractory, patients with multiple myeloma: a multi-institutional report from the Canadian Myeloma Research Group (CMRG) Database

Multiple myeloma (MM) remains incurable despite the availability of novel agents. This multi-center retrospective cohort study used the Canadian Myeloma Research Group Database to describe real-world outcomes of patients withanti-CD38 monoclonal antibody (mAb) refractory MM subsequently treated with standard of care (SoC) regimens. Patients with triple class refractory (TCR) disease (refractory to a proteasome inhibitor, immunomodulatory drug, and anti-CD38 mAb) were examined as a distinct cohort. Overall, 663 patients had disease progression on anti-CD38 mAb therapy, 466 received further treatment (346 with SoC regimens were included, 120 with investigational agents on clinical trial and were excluded). The median age at initiation of subsequent SoC therapy of 67.9 (range 39.6-89.6) years with a median of 3 prior lines (range 1-9). The median PFS and OS from the start of subsequent therapy was 4.6 (95% CI 4.1-5.6) months and 13.3 (95% CI 10.6-16.6) months, respectively. The median PFS and OS of patients with TCR disease (n = 199) was 4.4 (95% CI 3.6-5.3) months and 10.5 (95% CI 8.5-13.8) months. Our results reinforce that real-world patients with relapsed MM, particularly those with TCR disease, have dismal outcomes. There remains an urgent unmet need for the development of and access to effective therapeutics for these patients.

Achieving High Performance of ZnSnO Thin-Film Transistor via Homojunction Strategy

The zinc-tin-oxide (ZTO) thin-film transistor (TFT) is one of the most promising candidates for advanced display applications, though its popularity is limited by its performances. In this work, a heterojunction channel strategy was adopted to regulate the electron transport behaviors and the TFT performances by manipulating the concentration and the distribution of oxygen vacancies, and a reasonable physical model was proposed based on experimental and simulation results. It is difficult to mediate the contradiction between mobility and threshold voltage for the single channel. Via a heterojunction channel strategy, desirable TFT performances, with mobility of 12.5 cm2/Vs, threshold voltage of 1.2 V and Ion/Ioff of 3 × 109, are achieved when the oxygen-vacancy-enriched layer gets close to the gate insulator (GI). The enhanced performances can be mainly attributed to the formation of two-dimensional electron gas (2DEG), the insensitive potential barrier and the reasonable distribution of oxygen vacancy. On the contrary, when the oxygen-vacancy-enriched layer stays away from GI, all the main performances degenerate due to the vulnerable potential well. The findings may facilitate the development and application of heterojunction channels for improving the performances of electronic devices.

Effects of Cold Rolling Reduction Rate on the Microstructure and Properties of Cu-1.16Ni-0.36Cr Alloy after Thermo-Mechanical Treatment

In this paper, a Cu-Ni-Cr alloy was prepared by adding a Ni-Cr intermediate alloy to copper. The effects of the cold rolling reduction rate on the microstructure and properties of the Cu-1.16Ni-0.36Cr alloy after thermo-mechanical treatment were studied. The results show that the tensile strength of the alloy increased while the electrical conductivity slightly decreased with an increase of the cold rolling reduction rate. At a rolling strain of 3.2, the tensile strength was 512.0 MPa and the conductivity was 45.5% IACS. At a rolling strain of 4.3, the strength further increased to 536.1 MPa and the conductivity decreased to 41.9% IACS. The grain size and dislocation density decreased with an increase of the reduction rate in the thermo-mechanical treatment. However, when the rolling strain reached 4.3, the recrystallization degree of the alloy increased due to an accumulation of the dislocation density and deformation energy, resulting in a slight increase in the grain size and a decrease in the dislocation density. The texture strength of the brass increased due to the induced shear band, with an increase of the cold rolling reduction rate. The reduction rate promoted a uniform distribution of nano-scale Cr precipitates and further enhanced the strength via precipitation strengthening.

Research Progress on Cu-15Ni-8Sn Alloys: The Effect of Microalloying and Heat Treatment on Microstructure and Properties

Cu-15Ni-8Sn alloy is the best choice to replace beryllium bronze alloy. This alloy has unparalleled application value in aerospace, ocean engineering, electronic information, equipment manufacturing, and other fields. However, the application of Cu-15Ni-8Sn alloy is challenged and limited because of a series of problems in its preparation and processing, such as easy segregation, difficult deformation, and discontinuous precipitation. It is an effective way to improve the comprehensive properties of Cu-15Ni-8Sn alloy using alloying design and process optimization to control the as-cast, deformed, and heat-treated microstructures. At present, it is a hot spot for scholars to study. In this paper, the grade generation, system evolution, and preparation technology development of Cu-15Ni-8Sn alloy are comprehensively reviewed. The phase transformation sequence of the Cu-15Ni-8Sn alloy is discussed. The influence of the type, amount, and existing form of alloying elements on the strength of Cu-15Ni-8Sn alloy and its mechanism are systematically summarized. Furthermore, the latest research progress on the effects of solid solution, cold deformation, and aging on the phase structure transformation and mechanical properties of Cu-15Ni-8Sn alloy is summarized. Finally, the future development trend of the Cu-15Ni-8Sn alloy is projected. The research results of this paper can provide a reference for the control of the microstructure and properties of high-performance Cu-15Ni-8Sn alloys used in key fields, as well as the optimization of the preparation process and alloy composition.

Reliability of synthetic diffusion-weighted imaging with a high b-value for paediatric abdominal MRI

AIM

To evaluate the reliability of synthetic diffusion-weighted imaging (DWI) using a high b-value in comparison to conventional DWI for paediatric abdominal MRI.

MATERIALS AND METHODS

Paediatric patients (<19 years old) who underwent liver or pancreatobiliary MRI with DWI using 10 b-values (b = 0, 25, 50, 75, 100, 200, 400, 600, 800, 1,500 s/mm2) from March to October 2021 were included in this retrospective study. Using the software, synthetic DWI using b = 1,500 s/mm2 was generated automatically by selecting the b-value required as output. Conventional and synthetic DWI values for b = 1,500 s/mm2 were measured at the liver, spleen, paraspinal muscle, and mass lesions, if present, and apparent diffusion coefficient (ADC) values were calculated using the mono-exponential model. Intraclass correlation coefficients (ICCs) were calculated to assess the reliability of conventional and synthetic DWI and ADC values with b = 1,500 s/mm2.

RESULTS

Thirty paediatric patients (M:F = 22:8, mean 10.8 ± 3.1 years old) were included and four had tumours on abdominal MRI. ICC values were 0.906-0.995 between conventional and synthetic DWI and ADC with b = 1,500 s/mm2 in the liver, spleen and muscle. For mass lesions, ICC values were 0.997-0.999 for both synthetic DWI and ADC images.

CONCLUSIONS

Synthetic DWI and ADC values obtained using a high b-value showed excellent agreement with conventional DWI for the liver, spleen, muscle, and mass in paediatric MRI.

Research Status of Manufacturing Technology of Tungsten Alloy Wire

In light of the fact that tungsten wire is gradually replacing high-carbon steel wire as a diamond cutting line, it is particularly important to study tungsten alloy wire with better strength and performance. According to this paper, in addition to various technological factors (powder preparation, press forming, sintering, rolling, rotary forging, annealing, wire drawing, etc.), the main factors affecting the properties of the tungsten alloy wire are the composition of the tungsten alloy, the shape and size of the powder, etc. Combined with the research results in recent years, this paper summarizes the effects of changing the composition of tungsten materials and improving the processing technology on the microstructure and mechanical properties of tungsten and its alloys and points out the development direction and trend of tungsten and its alloy wires in the future.

[Mechanism study of platelet derived growth factor receptor alpha on the bidirectional differentiation regulation of glioma-associated oncogene homolog 1-positive mesenchymal stem cells in mice]

Objective: To investigate the role of platelet derived growth factor receptor alpha (PDGFRα) on bidirectional differentiation of glioma-associated oncogene homolog 1-positive mesenchymal stem cells (Gli1+-MSC). Methods: Breeding double reporter transgenic mice ROSAmT/mG/Gli1-Cre^ERt2/PDGFRα^fl (Experimental group) and ROSA^mT/mG/Gli1-Cre^ERt2 (Control group), 20 mice in each of the two groups at four weeks of age were selected, MSC were isolated from the mouse aortic epithelium. After tamoxifen inducement, the two groups of Gli1⁺-MSC were screened by green fluorescent protein (GFP) labeling and flow cytometry sorting. PDGFRα was conditionally knocked out in the experimental group, and the control group Gli1⁺-MSC expressed PDGFRα normally. The two groups of Gli1⁺-MSC were subjected to adipogenic induction and fibrogenic induction, the Western blotting was performed to detect PDGFRα, adipocyte markers [perilipin and CCAAT/enhancer binding protein alpha (C/EBPα)] and fibrogenic markers [alpha smooth muscle actin (α-SMA) and fibroblast-specific protein 1 (FSP-1)] and semi-quantitative analysis was performed. The degree of cellular adipose differentiation after bidirectional induction of Gli1+-MSC in both groups was observed by oil red O staining and analyzed semi-quantitatively. Results: After tamoxifen induction, Gli1⁺-MSC could be accurately isolated from flow cytometry by GFP labeling. Via adipogenic differentiation, the expression of PDGFRα in the experimental group (0.017±0.002) was significantly lower than that in the control group (0.184±0.012) (t=25.48，P=0.002). The protein expressions of perilipin (3.138±0.414) and C/EBPα (3.565±0.289) were significantly higher than those in the control group (2.312±0.218 and 2.179±0.103, respectively) (t=6.21，P=0.025；t=6.69，P=0.022). Thus, the knock-out of PDGFRα enhanced the adipogenic differentiation ability of Gli1⁺-MSC. After fibrogenesis induction, the protein expressions of PDGFRα, α-SMA and FSP-1 in the experimental group (0.030±0.001, 0.932±0.177 and 0.276±0.020, respectively) were significantly lower than those in the control group (0.439±0.006, 1.352±0.170 and 0.835±0.097, respectively) (t=149.40, P<0.001; t=66.38,P<0.001; t=11.41,P<0.08). This suggested that the knock-out of PDGFRα significantly inhibited Gli1⁺-MSC differentiation toward fibroblasts. After bidirectional induction, significantly less adipocyte formation was seen in the control group and more in the experimental group. Quantitative analysis showed that the amount of oil red O staining in the experimental group (0.461±0.042) was significantly higher than that in the control group (0.017±0.007) after bidirectional induction (t=23.20, P<0.01). Conclusions: PDGFRα plays an important role in the regulation of bidirectional differentiation of vascular adventitial Gli1+-MSC.

Study on Manufacturing Technology of Ultra-Thin/Narrow Bonding Cu Strip for Electronic Packaging

The performance of rolling parameters and annealing processes on the microstructure and properties of Cu strip were studied by High Precision Rolling Mill, FIB, SEM, Strength Tester, and Resistivity Tester. The results show that with the increase of the reduction rate, coarse grains in the bonding Cu strip are gradually broken and refined, and the grains are flattened when the reduction rate is 80%. The tensile strength increased from 248.0 MPa to 425.5 MPa, while the elongation decreased from 8.50% to 0.91%. The growth of lattice defects and grain boundary density results in an approximately linear increase in resistivity. With the increase of annealing temperature to 400 °C, the Cu strip recovers, and the strength decreased from 456.66 MPa to 220.36 MPa while the elongation rose from 1.09% to 24.73%. The tensile strength and elongation decreased to 192.2 MPa and 20.68%, respectively, when the annealing temperature was 550 °C. The trend of yield strength of the Cu strip was basically the same as that of tensile strength. The resistivity of the Cu strip decreased rapidly during a 200~300 °C annealing temperature, then the trend slowed, and the minimum resistivity was 3.60 × 10^-8 Ω·m. The optimum tension range annealing was 6-8 g; less or more than that will affect the quality of the Cu strip.

Analysis of the Safety and Pregnancy Outcomes of Fertility-sparing Surgery in Ovarian Malignant Sex Cord-stromal Tumours: A Multicentre Retrospective Study

AIMS

To assess the difference in survival between fertility-sparing surgery (FSS) and radical surgery and explore pregnancy outcomes after FSS in stage I malignant sex cord-stromal tumours (MSCSTs).

MATERIALS AND METHODS

We carried out a multicentre retrospective cohort study on patients who were diagnosed with MSCSTs and the tumour was confined to one ovary. The patients were divided into FSS and radical surgery groups. Inverse probability of treatment weighting (IPTW) was used to balance variables between the two groups. Kaplan-Meier analysis was used to compare the difference in disease-free survival (DFS). Univariate and multivariate Cox regression analysis was used to find risk factors of DFS. Univariate logistic regression analysis was used to assess risk factors of pregnancy.

RESULTS

In total, 107 patients were included, of whom 54 (50.5%) women underwent FSS and 53 (49.5%) received radical surgery. After IPTW, a pseudo-population of 208 was determined and all of the covariates were well balanced. After a median follow-up time of 50 months (range 7-156 months), 10 patients experienced recurrence and two died. There was no significant difference in DFS between the two groups, both in unweighted (P = 0.969) or weighted cohorts (P = 0.792). In the weighted cohort, stage IC (P = 0.014), tumour diameter >8 cm (P = 0.003), incomplete staging surgery (P = 0.003) and no adjuvant chemotherapy (P < 0.001) were the four high-risk factors associated with a shorter DFS. Among 14 patients who had pregnancy desire, 11 (78.6%) women conceived successfully; the live birth rate was 76.9%. In univariate analysis, only adjuvant chemotherapy (P = 0.009) was associated with infertility.

CONCLUSIONS

On the premise of complete staging surgery, FSS is safe and feasible in early stage MSCSTs with satisfactory reproductive outcomes.

Relationship between Social Support, Sarcopenia, and Cognitive Impairment in Chinese Community-Dwelling Older Adults

BACKGROUND

Cognitive impairment and sarcopenia have become important challenges for the growing aging population. Social support has been shown to protect against cognitive impairment, but its impact on sarcopenia remains unknown. The purpose of this study was to explore the correlation between social support, sarcopenia, and cognitive impairment in Chinese older adults.

METHOD

A multi-stage whole group sampling method was used to conduct a cross-sectional survey of 720 community-dwelling older people in Shanghai. The definition of sarcopenia was in accordance with the criteria of the Asian Working Group for Sarcopenia (AWGS) 2019. Cognitive impairment was evaluated using a computerized neuropsychological assessment device that had been previously validated. Social support was assessed using the Social Support Rate Scale. Logistic regression analyses were conducted to explore the relationship between social support cognitive impairment and sarcopenia, fully adjusting for all potential confounding factors.

RESULTS

Our study found that 230 (31.94%) of the participants had cognitive impairment and 97 (13.47%) of the participants had sarcopenia. The mean social support score was 35.10 ± 7.54. Besides, the results showed that cognitive impairment was associated with sarcopenia (OR:1.650, 95% CI: 1.048, 2.596, P=0.030) after adjusting for confounding factors. Older adults with high level social support had the lowest risk of cognitive impairment (OR: 0.297, 95% CI: 0.115, 0.680, P=0.021) and sarcopenia (OR: 0.113, 95% CI: 0.031, 0.407, P=0.001), respectively.

CONCLUSION

Our analysis revealed that high level social support was negatively associated with sarcopenia and cognitive impairment. These findings provide strong support for the health promotion effect of social networks against sarcopenia and cognitive impairment in Chinese community-dwelling older adults, with important implications for healthcare policy makers.

Injectable carbon nanotube-functionalized hydrogel as a tool for cardiac tissue engineering

Background/Introduction

Heart failure (HF) is an expensive major public health problem in the United States and around the world (1). The current treatments for HF are aimed at reducing symptoms, slowing disease progression, and reducing mortality and not aimed at repairing heart muscle or restoring function. Furthermore, even with these treatments, approximately half of patients with HF will die within 5 years of diagnosis (2). Cardiac transplantation remains the only definitive treatment for those affected with end-stage HF, but availability of donor hearts remains a major limitation (3).

Purpose

The ability of the adult heart to regenerate cardiomyocytes (CMs) lost after injury is limited, generating interest in developing tissue engineering therapies to avoid progression towards HF. Rigid carbon nanotubes (CNTs) scaffolds have been used to improve CMs viability, proliferation, and maturation (4), but require undesirable invasive surgeries for implantation. To overcome this limitation, we engineered an injectable reverse thermal gel (RTG) functionalized with CNTs (RTG-CNT) that transitions from a liquid-solution to a gel-based matrix shortly after reaching body temperature allowing for a liquid-based delivery rapidly followed by a stable-gel localization (5).

Methods and results

Here we show experimental evidences the RTG-CNT hydrogel, used as a three-dimensional (3D) niche to culture human induced pluripotent stem cells (hiPSC)-CMs, promotes hiPSC-CMs alignment and elongation with increased Cx43 localization and improved contraction function when compared with traditional two-dimensional (2D) fibronectin controls and plain 3D RTG system without CNTs. Moreover, the short-term (4-week) biocompatibility of the RTG-CNT hydrogel was also assessed in a mouse model (intracardial injection). The results confirmed that the RTG-CNT hydrogel is well tolerated by the cardiac tissue.

Conclusion

Our results indicated that the injectable RTG-CNT hydrogel has the potential to be used as a minimally invasive tool for cardiac tissue engineering efforts.

Funding Acknowledgement

Type of funding sources: Other. Main funding source(s): NATIONAL HEART, LUNG, AND BLOOD (NHLBI) INSTITUTE

In Situ Investigation of Microstructural Evolution and Intermetallic Compounds Formation at Liquid Al/Solid Cu Interface by Synchrotron X-ray Radiography

Synchrotron radiation dynamic imaging technology combined with the static characterization method was used to study the microstructural evolution and the growth kinetics of intermetallic compounds (IMCs) at the liquid Al/solid Cu interface. The results show that the interfacial microstructure can be divided into layered solid diffusion microstructures (AlCu₃, Al₄Cu₉, Al₂Cu₃ and AlCu) and solidification microstructures (Al₃Cu₄, AlCu and Al₂Cu) from the Cu side to the Al side. Meanwhile, the growth of bubbles formed during the melting, holding and solidification of an Al/Cu sample was also discussed, which can be divided into three modes: diffusion, coalescence and engulfment. Moreover, the growth of AlCu₃ and (Al₄Cu₉ + Al₂Cu₃) near the Cu side is all controlled by both interfacial reaction and volume diffusion. The growth of Al₃Cu₄ adjacent to the melt is mainly controlled by the interfacial reaction, which plays a major role in the growth of the total IMCs.

[Prognosis and fertility outcomes of patients with borderline ovarian tumors after fertility-sparing surgery]

Objective: To explore the clinical prognosis and fertility outcomes in patients with borderline ovarian tumors (BOT) who underwent fertility-sparing surgery, and evaluate the related risk factors. Methods: The study examined the clinicopathological characteristics of 280 patients diagnosed with BOT from Qilu Hospital of Shandong University between January 2009 and December 2019. According to the surgery plan, the patients were divided into the fertility-sparing group (167 cases) and the radical surgery group (113 cases). The information of the patients' age, preoperative serum CA-125 level, surgery method, pathological type, FIGO stage (2014), tumor location, and whether focal canceration combined were collected. The Kaplan-Meier method was used to compare disease-free survival (DFS) between the fertility-sparing surgery group and the radical surgery group. The univariate and multivariate Cox proportional hazard regression analysis was used to explore high-risk factors associated with DFS. Results: A total of 280 BOT patients were identified in the study, with a median age of 35.0 (26.0, 51.0) years old. The median follow-up time was 55.2 (34.7, 79.3)months. 25 patients (15.0%) developed recurrence in the fertility-sparing surgery group, 11 patients (8.7%) developed recurrence in the radical surgery group. There was no significant difference in 5-year DFS rate between the two groups (84.4% vs 90.1%, P=0.223). Only FIGO stage was found to be related to DFS through the univariable and multivariable Cox proportional hazard regression analysis, and patients with FIGO Ⅱ/Ⅲ had higher risk of recurrence [HR (95%CI) 2.872(1.283-6.431)] (P=0.010); Fertility-sparing surgery does not increase the recurrence risk of BOT patients (P=0.116). Pregnancies were reported in 39 patients (54.2%), among whom 37 patients gave birth successfully, and 2 patients selected to terminate pregnancy. Conclusions: The fertility-sparing surgery does not increase the risk of recurrence in BOT patients, and patients who underwent the fertility-sparing surgery have a favorable outcome. FIGO stage is the independent risk factor of DFS in BOT patients.

Hierarchical twinning governed by defective twin boundary in metallic materials

Dense networks of deformation twins endow metals and alloys with unprecedented mechanical properties. However, the formation mechanism of these hierarchical twin structures remains under debate, especially their relations with the imperfect nature of twin boundaries (TBs). Here, we investigate the intrinsic deformability of defective TBs in face-centered cubic metallic materials, where the inherent kinks on a set of primary TBs are demonstrated to facilitate the formation of secondary and hierarchical nanotwins. This defect-driven hierarchical twinning propensity is critically dependent on the kink height, which proves to be generally applicable in a variety of metals and alloys with low stacking fault energies. As a geometric extreme, a fivefold twin can be constructed via this self-activated hierarchical twinning mechanism. These findings differ from the conventional twinning mechanisms, enriching our understanding of twinning-mediated plasticity in metallic materials.

Factors influencing the effective management of diabetes during humanitarian crises in low- and middle-income countries: a systematic review

OBJECTIVES

The management of non-communicable chronic diseases such as diabetes mellitus is often poor in humanitarian crisis settings. Poor disease management can have serious long-term consequences. This review sought to identify studies that explored the effectiveness of interventions and the determinants that may improve the management of diabetes in the humanitarian context.

STUDY DESIGN

A systematic review was conducted of all types of studies that implemented diabetes programmes in humanitarian settings.

METHODS

MEDLINE, Embase, CINAHL and Web of Science were searched for relevant articles using multiple search terms for relevant studies published in English between 2000 and June 2020. Quality assessments using valid tools, were conducted. A narrative synthesis of the findings was then performed.

RESULTS

The search yielded 550 citations. After de-duplicating and screening, 19 studies were eligible for inclusion. Most studies were conducted in the Middle East (74%), Asia (16%) and Africa (10%). The interventions reported to improved diabetes care included the mHealth tool, intensive lifestyle intervention, task-shifting, psychosocial support, distribution of glucometers and comprehensive care. Insufficient drug supply, out-of-pocket cost, the complexity of insulin therapy and low adherence to guidelines were identified as barriers.

CONCLUSION

There is a paucity of evidence on optimal diabetes care in acute crisis and natural disaster settings. The review was constrained by the low quality of the studies included. Nevertheless, it is likely that mHealth can be feasibly utilised, as educational SMS messages are cost-effective and electronic medical records can enhance disease monitoring. In addition, a multidisciplinary approach to care improves glycaemic control and is desirable due to the multifaceted nature of the disease and management required. Several key barriers have been identified that need to be tackled. Overall, the evidence base for diabetes care in humanitarian settings remains sparse, and further research is needed.

Effect of Ceramic Capillary Parameters on Bonded Morphology and Strength

The effects of the geometry parameters of a ceramic cleaver on the morphology of ball and second bonded points were studied using an automatic wire bonder, push pull tester, scanning electron microscope, ceramic capillary with different geometric parameters and φ25.4 μmAg-5Au bonding alloy wire, etc. The result shows that when the inner hole diameter (IHD) of the ceramic capillary is 1.3 times the diameter of the alloy wire (33 μm), the neck morphology of the ball bonded point (first bonded point) meet the requirements. The neck of the ball bonded point appeared to fracture when the IHD is 26 μm; The neck of the ball bonded point appeared as an irregular shape when the IHD is 41 μm. When the inner cutting angle diameter (ICAD) is 64 μm, the size of the mashed ball diameter (MBD) is qualified. When the ICAD is 51 μm, the MBD is too large and mashed ball overflows the pad. When the ICAD is 76 μm, the ball bonded point is too high. When the inner cutting bevel angle (ICBA) is 100°, the MBD size meets the requirements of the pad. When the ICBA was reduced to 70°, the ball bonded point is eccentric. When the ICBA was increased to 120°, the MBD is too large and is connected to the adjacent pad contact. The size of the fish tail of the second bonded point (second bonded point) changed in the same direction as the tip diameter (TD) changes. When the TD is 178 μm, the fish tail shape is regular and symmetrical. When the working face angle (WFA) is 8° and the outer circular radius (OCR) is equal to the diameter of the alloy wire (25.4 μm), the fish tail shape is regular. When the WFA is higher than 11° or the OCR is higher than 30 μm, the fish tail will appear as virtual welding, and when the WFA is less than 4°, the fish tail of the second bonded point will break due to thinning. When the OCR is less than 20 μm, the fish tail of the second bonded point is too long and causes a short circuit.

De-escalation strategy with half-dose prasugrel or ticagrelor on pharmacodynamics and outcome in East Asians patients with acute coronary syndrome

Background

East Asians treated with potent P2Y12 inhibitors (prasugrel or ticagrelor) are exposed to more potent platelet inhibitory response. Whether half-dose de-escalation strategy would be benefit for chronic antiplatelet strategy in East Asian patients with acute coronary syndrome (ACS) remain uncertain.

Method

In half-dose de-escalation strategy, 129 Korean ACS patients were assigned to receive standard-dose potent P2Y12 inhibitors (n=86, prasugrel [n=38], ticagrelor [n=48]), followed by half-dose reduction at 1 month for maintenance, and was compared to clopidogrel (n=43) as control. The primary safety outcome was any clinically significant bleeding according to BARC (Bleeding Academic Research Consortium) criteria at 12 months. The pharmacodynamic response is accessed by VerifyNow P2Y12 reaction unit (PRU) at 1 month and 3 months post PCI.

Results

Ticagrelor achieved significantly lower PRU (7 [4–32] vs. 11 [5–76] vs. 167 [97–212]) than prasugrel and clopidogrel, resulting OPR rate 0% vs. 21.6% vs. 58.5%, respectively at 1 month post PCI. Similar results were observed at 3 months (PRU 12 [6–43] in ticagrelor vs. 88 [58–148] in prasugrel vs. 169 [107–199] in clopidogrel), with OPR rate 7.1% vs. 51.5% vs. 65.9%, respectively. At 12 months, the incidence of BARC type-1 or -2 bleeding was significantly higher in potent P2Y12 inhibitors (37.5% in ticagrelor, 34.2% in prasugrel) than in clopidogrel (36.0 vs. 14.0%; HR, 2.86; 95% CI, 1.19–6.87; p=0.018).

Conclusion

In Korean ACS patients, pharmacodynamic response (OPR rate) with half-dose prasugrel appears comparable to that with clopidogrel, whereas ticagrelor still exhibit potent platelet inhibition either standard or half doses. De-escalation strategy with half-dose potent P2Y12 inhibitor was associated with higher incidence of clinically insignificant bleeding compared with clopidogrel. Optimal dose reduction strategies in potent P2Y12 inhibitors to balance safety and effectiveness remain uncertain, and require further studies.

Pharmcodynamics to oral P2Y12 inhibitors

Funding Acknowledgement

Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): National Research Foundation of Korea

Pharmacodynamic comparison of optimal platelet reactivity by multiple platelet function tests in Korean acute coronary syndrome patients with half-dose ticagrelor or prasugrel treatment

Background

East Asians treated with potent P2Y12 inhibitors, prasugrel or ticagrelor exhibit more potent platelet inhibition than clopidogrel. Whether half-dose de-escalation strategy would improve optimal platelet reactivity at maintenance in East Asian patients with acute coronary syndrome (ACS) remains uncertain.

Method

In de-escalation strategy single center study, eligible Korean ACS patients (n=96) were assigned to receive standard-dose ticagrelor (n=33), prasugrel (n=28), followed by half-dose reduction at 1 month for maintenance, and clopidogrel (n=35) as control. Platelet reactivity was measured by VerifyNow, light transmittance aggregometry (LTA) and multiple electrode aggregometry (MEA). The investigators aim to compare optimal platelet reactivity status (OPR, defined as 85–208 P2Y12 reaction unit [PRU] for VerifyNow (VN), 16%–47% for LTA and 19–46 U for MEA) among 3 different platelet function tests at 3 months post PCI.

Results

At 3 months, ticagrelor achieved significantly lower PRU (17 [6–51] vs. 95 [61–151] vs. 172 [111–204]) than prasugrel and clopidogrel, resulting OPR rate 10% vs. 57.7% vs. 60.0%, respectively. Similar results were observed at LTA method (2% [0–12] in ticagrelor vs. 18% [13–22] in prasugrel vs. 18% [11–30] in clopidogrel), with OPR rate 11.8% vs. 69.2% vs. 50.0%, respectively. However, platelet reactivity was similar by MEA method (16 [13–20] in ticagrelor vs. 17 [13–22] in prasugrel vs. 19 [14–28] in clopidogrel), with OPR rate 33.3% vs. 40.0% vs. 42.0%, respectively (all p&gt;0.005). Among the three tests, resulting higher correlation between VN and LTA (r=0.745), MEA and LTA vs. MEA and VN showed lower correlations (r=0.412 and r=0.303). (Fig.)

Conclusion

In Korean ACS patients with half-dose de-escalation strategy after 1 month, OPR rate in ticagrelor is still rare during 3-month treatment by VN and LTA methods, however, prasugrel appears comparable to clopidogrel. VN/LTA might overestimate platelet function than MEA or MEA underestimate OPR rate than VN/LTA.

Funding Acknowledgement

Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): National Research Foundation of Korea

Canadian perspective on managing multiple myeloma during the COVID-19 pandemic: lessons learned and future considerations

The coronavirus disease 2019 (covid-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 has necessitated changes to the way patients with chronic diseases are managed. Given that patients with multiple myeloma are at increased risk of covid-19 infection and related complications, national bodies and experts around the globe have made recommendations for risk mitigation strategies for those vulnerable patients. Understandably, because of the novelty of the virus, many of the proposed risk mitigation strategies have thus far been reactionary and cannot be supported by strong evidence. In this editorial, we highlight some of the risk mitigation strategies implemented at our institutions across Canada during the first wave of covid-19, and we discuss the considerations that should be made when managing patients during the second wave and beyond.

Controlling spin current polarization through non-collinear antiferromagnetism

The interconversion of charge and spin currents via spin-Hall effect is essential for spintronics. Energy-efficient and deterministic switching of magnetization can be achieved when spin polarizations of these spin currents are collinear with the magnetization. However, symmetry conditions generally restrict spin polarizations to be orthogonal to both the charge and spin flows. Spin polarizations can deviate from such direction in nonmagnetic materials only when the crystalline symmetry is reduced. Here, we show control of the spin polarization direction by using a non-collinear antiferromagnet Mn₃GaN, in which the triangular spin structure creates a low magnetic symmetry while maintaining a high crystalline symmetry. We demonstrate that epitaxial Mn₃GaN/permalloy heterostructures can generate unconventional spin-orbit torques at room temperature corresponding to out-of-plane and Dresselhaus-like spin polarizations which are forbidden in any sample with two-fold rotational symmetry. Our results demonstrate an approach based on spin-structure design for controlling spin-orbit torque, enabling high-efficient antiferromagnetic spintronics.

In the typical spin-hall effect, spin-current, charge current, and spin polarisation are all mutually perpendicular, a feature enforced by symmetry. Here, using an anti-ferromagnet with a triangular spin structure, the authors demonstrate a spin-hall effect without a perpendicular spin alignment.

Effects of Bonding Parameters on Free Air Ball Properties and Bonded Strength of Ag-10Au-3.6Pd Alloy Bonding Wire

Free air ball (FAB) and bonded strength were performed on an Ag-10Au-3.6Pd alloy bonding wire (diameter of 0.025 mm) for different electronic flame-off (EFO) currents, times and bonding parameters. The effects of the EFO and bonding parameters on the characteristics of the FAB as well as the bonded strength were investigated using scanning electron microscopy. The results showed that, for a constant EFO time, the FAB of the Ag-10Au-3.6Pd alloy bonding wire transitioned from a pointed defined ball to an oval one, then to a perfectly shaped one, and finally to a golf ball with an increase in the EFO current. On the other hand, when the EFO current was constant and the EFO time was increased, the FAB changed from a small ball to a perfect one, then to a large one, and finally to a golf ball. The FAB exhibited the optimal geometry at an EFO current of 0.030 A and EFO time of 0.8 ms. Further, in the case of the Ag-10Au-3.6Pd alloy bonding wire, for an EFO current of 0.030 A, the FAB diameter exhibited a nonlinear relationship with the EFO time, which could be expressed by a quadratic function. Finally, the bonded strength decreased when the bonding power and force were excessively high, causing the ball bond to overflow. This led to the formation of neck cracks and decrease in the bonded strength. On the other hand, the bonded strength was insufficiently when the bonding power and force were small. The bonded strength was of the desired level when the bonding power and force were 70 mW and 0.60 N (for the ball bonded) and 95 mW and 0.85 N (for the wedge bonded), respectively.

Influence of the Anisotropy on the Microstructure and Mechanical Properties of Ti/Al Laminated Composites

Anisotropy is the difference in the microstructure or mechanical properties of materials in different directions. Anisotropic behavior occurs in rolled sheets, and this anisotropy is very obvious in laminated composites. In this work, the influence of anisotropy on the microstructure and mechanical properties of Ti/Al laminated composites fabricated by rolling was investigated. The results show that the microstructure and mechanical properties of the Ti/Al laminated composites were obviously anisotropic. The grains in the Al layer of the composites were elongated along the rolling direction and were compressed perpendicular to the rolling direction. The grains in the Ti layer of the composites had no obvious preferential orientation and comprised mainly twins. With the rolling direction as 0°, the mechanical properties of the Ti/Al laminated composites varied greatly as the angle of the composites increased. The tensile strength, elongation and bond strength of the Ti/Al laminated composites decreased with increasing angle of the composites. In addition, the microhardness of the Ti/Al laminated composites increased with increasing angle of the composites.

Oral administration of alendronate and vitamin D3 for the treatment of chronic non-bacterial osteomyelitis of the jaw

Chronic non-bacterial osteomyelitis (CNO) is a rare and difficult-to-diagnose disease, especially when limited to the jaws. We report the case of a 5-year-old girl with spontaneous jaw pain and a large pre-auricular facial swelling overlying the angle of the mandible that was non-responsive to previous antibiotic and non-steroidal anti-inflammatory treatment. The diagnosis was confirmed as CNO following evaluation and workup by a multidisciplinary team. The patient exhibited a favourable response to oral alendronate sodium plus vitamin D3 combination treatment. We believe that alendronate sodium is an effective second-line drug for CNO.

Microstructure Evolution in Cu-Ni-Co-Si-Cr Alloy During Hot Compression by Ce Addition

Cu-Ni-Si alloys are widely used in lead frames and vacuum devices due to their high electrical conductivity and strength. In this paper, a Cu-Ni-Co-Si-Cr-(Ce) alloy was prepared by vacuum induction melting. Hot compression tests of the Cu-Ni-Co-Si-Cr and Cu-Ni-Co-Si-Cr-Ce alloys were carried out using a Gleeble-1500 simulator at 500-900 °C deformation temperatures and 0.001-10 s-1 strain rates. The texture change was analyzed by electron backscatter diffraction. The <110> fiber component dominated the texture after compression, and the texture intensity was reduced during recrystallization. Moreover, the average misorientation angle φ for Cu-Ni-Co-Si-Cr-Ce (11°) was lower than that of Cu-Ni-Co-Si-Cr (16°) under the same conditions. Processing maps were developed to determine the optimal processing window. The microstructure and precipitates of the Cu-Ni-Co-Si-Cr and Cu-Ni-Co-Si-Cr-Ce alloys were also analyzed. The average grain size of the Cu-Ni-Co-Si-Cr-Ce alloy (48 μm) was finer than that of the Cu-Ni-Co-Si-Cr alloy (80 μm). The average size of precipitates in the Cu-Ni-Co-Si-Cr alloy was 73 nm, while that of the Cu-Ni-Co-Si-Cr-Ce alloy was 27 nm. The addition of Ce delayed the occurrence of dynamic recrystallization.

[Association between tooth missing and non-alcoholic fatty liver disease]

Objective: To evaluate the association between the number of teeth missed and the prevalence of non-alcoholic fatty liver disease (NAFLD) in adults. Methods: A cross-sectional study was carried out in 26 983 adults from Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study. The number of teeth missed (excluding third molars) was recorded and classified into four categories: 0, 1-, 3- and ≥6. NAFLD was diagnosed by at least two liver ultrasonography examinations. Adjusted multivariable logistic regression analysis was used to access the association between the number of missed teeth and NAFLD in adults. Results: The overall prevalence of NAFLD was 7 270 and the number of the subjects with at least one tooth missed was 9 667. The multivariable-adjusted ORs (95%CI) of NAFLD across the categories of tooth missing (0, 1-, 3- and ≥6) were as follows: 1.00, 1.04 (0.93-1.15), 1.08 (0.93-1.26) and 1.38 (1.09-1.76) (trend test P=0.030) in males; 1.00, 0.96 (0.82-1.12), 1.11 (0.91-1.35) and 1.22 (0.90-1.64) (trend test P=0.450) in females. Conclusion: The number of missed teeth was positively associated with a higher prevalence rate of NAFLD in males with over 6 teeth missed, but not in females.

Predictors and Barriers to Condom Use in the African Cohort Study

Consistent condom use is an inexpensive and efficacious HIV prevention strategy. Understanding factors associated with condom use and barriers to use can inform strategies to increase condom uptake. The ongoing African Cohort Study prospectively enrolls adults at 12 clinical sites in Uganda, Kenya, Tanzania, and Nigeria. At enrollment, participants are asked about condom use at last sex with a regular partner. Robust Poisson regression models were used to evaluate predictors of self-reported condom use. Participants who reported not using condoms were asked to provide reasons. From January 2013 to September 2019, 2482 participants reported having at least one regular sexual partner in the preceding 6 months. Of those, 1577 (63.5%) reported using a condom at last sex. Condom use was more common among older participants, males, HIV-infected participants, and those with an HIV-infected partner. Married participants, those with a partner of unknown HIV status, and those reporting alcohol use were less likely to report condom use at last sex. Condom use at last sex also varied significantly by clinical site. Partner disapproval or refusal to use a condom was a consistent driver of disparities in condom use among participants who were HIV infected, female, and aged 18-24 years. Effective HIV prevention programs should integrate condom education with the tools necessary to negotiate condom use with regular partners.

Genetic diversity and differentiation among Korean-Holstein, Hanwoo, and Uganda-Holstein breeds

The aim of this research was to assess genetic diversity of Korean-Holstein, Korean Hanwoo, and Ugandan-Holstein dairy cattle. DNA was extracted from either blood or hair of Korean-Holstein (n=74), Korean-Hanwoo (n=75) and Ugandan-Holstein (N=77) using AccuPrep® PCR purification kit. The DNA samples were amplified by multiplex polymerase chain reaction, using GeneTrackTM Hanwoo genotyping kit and assayed using ABI genetic analyser 3130XL. Number of alleles, expected heterozygosity (He), observed heterozygosity (Ho), and the polymorphism information content (PIC) were estimated from 10 microsatellite loci in the three breeds. In addition, F-statistics for each of the 10 microsatellites in the three cattle breeds were estimated using fstat version 2.9.3.2 computer program. GENETIX (v.4.02) was used to perform factorial correspondence analysis (FCA) from the allele frequencies and multi-locus clustering was done using STRUCTURE analyses. A total of 124 alleles were detected. The number of alleles per locus varied from eight (TGLA126) to 22 (TGLA122), with an overall mean of 12.2. Expected heterozygosity ranged from 0.617 (SPS115) to 0.854 (TGLA53) and averaged 0.761. Observed heterozygosity ranged from 0.6 (SPS115) to 0.859 (TGLA53); and averaged 0.761. The mean PIC was 0.723; and means of the F-statistics FIT, FST and FIS were 0.077, 0.076 and 0.001 respectively. Although FCA revealed clear differentiation of Uganda-Holstein, Korean-Holstein, and Hanwoo, clustering assignments showed genetic admixture between Ugandan dairy cattle (Uganda-Holstein) and Hanwoo. In conclusion, the allelic variation present at the 10 loci was sufficient to categorize these cattle into distinct breed groups. Keywords: dairy cattle, genetic differentiation, F-statistics, heterozygosity, microsatellite

Ectopic parathyroid adenoma in the submandibular region: a case report

Ectopic parathyroid adenomas that affect the submandibular region have not been widely reported. We describe a 34-year-old man who presented with a painless swelling of the submandibular region. The identification of hypercalcaemia encouraged us to engage a multidisciplinary team to evaluate further serum changes. Parathyroid hormone analysis, ^99mTc-methoxy-isobutyl-isonitrile (^99mTc-MIBI) scintigraphy, and single-photon emission computed tomography (SPECT-CT) were done to rule out hyperparathyroidism. Raised parathyroid hormone together with ^99mTc-MIBI and SPECT-CT examination were consistent with a tumour caused by the hyperparathyroidism. Removal of the lesion resulted in rapid improvement in serum calcium and parathyroid hormone, and the normalisation of the serum creatinine, concentrations. Histopathological analysis confirmed a parathyroid adenoma. We conclude that ectopic parathyroid adenomas should be considered as part of a differential diagnosis for tumours of the submandibular region.

Excessive daytime sleepiness with snoring or witnessed apnea is associated with handgrip strength: a population-based study

BACKGROUND

Sarcopenia is emerging as an important public health problem, and evidences have determined that poor sleep is associated with muscle strength, but the potential effects of excessive daytime sleepiness (EDS), snoring and witnessed apnea on handgrip strength have not been evaluated.

AIM

We aimed to examine the association between EDS, snoring, witnessed apnea and muscle strength in an adult population.

DESIGN

Cross-sectional study.

METHODS

This cross-sectional study comprised 19 434 adults. Handgrip strength was measured using a handheld digital dynamometer. EDS was assessed by Epworth Sleepiness Scale, snoring and witnessed apnea during sleep were reported through simple yes/no questions. Analysis of covariance was carried out to determine the association between EDS with snoring or witnessed apnea and muscle strength.

RESULTS

The means (95% confidence interval) for average handgrip strength/body weight (kg/kg) across symptoms categories were 0.396 (0.333-0.472), 0.393 (0.330-0.467), 0.396 (0.333-0.471) and 0.386 (0.325-0.460) (P < 0.0001), respectively. Similar results were observed with maximal handgrip strength/body weight (kg/kg).

CONCLUSIONS

Self-reported EDS accompanied with snoring or apnea is associated with lowest handgrip strength, independently of confounding factors. Whether improvement of EDS, snoring and apnea, can ameliorate age-associated decline in muscle strength warrants further studies.

Updates from the 2019 American Society of Clinical Oncology and European Hematology Association annual meetings: a Canadian perspective on high-risk cytogenetics in multiple myeloma

The 2019 annual meetings of the American Society of Clinical Oncology and the European Hematology Association took place, respectively, in Chicago, Illinois, 31 May-4 June, and in Amsterdam, Netherlands, 13-16 June. At the meetings, results from key studies on the treatment of patients with relapsed or refractory multiple myeloma with high-risk cytogenetics were presented. Our meeting report describes those studies and includes interviews with investigators and commentaries by Canadian hematologists about the potential impact on Canadian practice.

Liver kinase B1 suppresses the metastasis and angiogenesis of lung cancer: involvement of the Shh signaling pathway

Liver kinase B1 (LKB1) is revealed to have a close relationship with cancers. However, the underlying mechanism remains unclear. This study aimed to reveal the mechanism through which LKB1 performed its role in lung cancer. LKB1 shRNA and overexpression plasmid were employed to investigate the role of LKB1 in lung cancer in vitro and in vivo. The involvement of Shh signaling pathway was assessed by western blot. Silence of LKB1 promoted, while overexpression of LKB1 inhibited the migration, invasion and angiogenesis of lung cancer cells. Further study showed that Shh signaling pathway was suppressed by LKB1. Cyclopamine, a Shh signaling pathway inhibitor, reduced the effects of LKB1 silence, indicating that LKB1 inhibits the migration, invasion and angiogenesis through suppressing the Shh signaling pathway. In vivo study also showed that Shh signaling pathway was involved in the modulation of LKB1 on the metastasis and angiogenesis of lung cancer. Our study demonstrates that LKB1 inhibits the metastasis and angiogenesis of lung cancer through suppressing the Shh signaling pathway.

T1ρ MRI of the talar articular cartilage is increased in those with chronic ankle instability

OBJECTIVE

To determine if individuals with chronic ankle instability (CAI) demonstrate different talar cartilage T1ρ relaxation times compared to uninjured controls.

DESIGN

Fifteen CAI (21.13 ± 1.81 years, 4.00 ± 2.07 previous ankle sprains) and fifteen controls (21.07 ± 2.55 years, no previous ankle sprains) participated. CAI inclusion criteria was in accordance with the International Ankle Consortium guidelines. Greater T1ρ relaxation times were interpreted as greater degenerative changes. Participants were non-weight bearing for 30-minutes prior to scanning to unload the cartilage. Voxel by voxel T1ρ relaxation times were calculated from a five image sequence. Segmentation of the talar cartilage was performed manually using ITK-SNAP software. T1ρ relaxation time means and variability across the entire talus and in the anteromeidal, anterolateral, posteromedial, and posterolateral regions of interest (ROIs) were compared between groups using mean differences and effect sizes (ES) with their corresponding 95% confidence intervals (95%CI).

RESULTS

Individuals with CAI demonstrated higher T1ρ relaxation times (mean ± standard deviation) across the entire talus (CAI: 65.97 ± 10.45 ms, Control: 58.84 ± 7.68 ms; ES = 0.76, 95%CI = 0.02-1.50), in the anterolateral (ES = 1.00, 95%CI = 0.24-1.48), posteromedial (ES = 0.74, 95%CI = 0.01-1.49), and posterolateral region of interest (ES = 3.84, 95%CI = 2.63-5.04). The T1ρ relaxation time variability (mean ± standard deviation) also differed across the overall talus (CAI: 32.78 ± 4.06 ms, Control: 28.23 ± 4.45 ms; ES = 1.04, 95%CI = 0.28-1.80), in the anteriolateral, (ES = 1.07, 95%CI = 0.31, 1.84) and posteriolateral (ES = 1.00, 95%CI = 0.24-1.75) ROIs.

CONCLUSIONS

Individuals with CAI demonstrate greater T1ρ relaxation times and higher T1ρ variability compared to uninjured controls. This finding supports the existing literature illustrating early degenerative joint tissue changes consistent with early onset posttraumatic osteoarthritis in individuals with CAI.