The hindbrain and cortico-reticular pathway in adolescent idiopathic scoliosis

AIM

To characterise the corticoreticular pathway (CRP) in a case-control cohort of adolescent idiopathic scoliosis (AIS) patients using high-resolution slice-accelerated readout-segmented echo-planar diffusion tensor imaging (DTI) to enhance the discrimination of small brainstem nuclei in comparison to automated whole-brain volumetry and tractography and their clinical correlates.

MATERIALS AND METHODS

Thirty-four participants (16 AIS patients, 18 healthy controls) underwent clinical and orthopaedic assessments and brain magnetic resonance imaging (MRI) on a 3 T MRI machine. Automated whole-brain volume-based morphometry, tract-based spatial statistics analysis, and manual CRP tractography by two independent raters were performed. Intra-rater and inter-rater agreement of DTI metrics from CRP tractography were assessed by intraclass correlation coefficient. Normalised structural brain volumes and DTI metrics were compared between groups using Student's t-tests. Linear correlation analysis between imaging parameters and clinical scores was also performed.

RESULTS

AIS patients demonstrated a significantly larger pons volume compared to controls (p=0.006). Significant inter-side CRP differences in mean (p=0.02) and axial diffusivity (p=0.01) were found in patients only. Asymmetry in CRP fractional anisotropy significantly correlated with the Cobb angle (p=0.03).

CONCLUSION

Relative pontine hypertrophy and asymmetry in CRP DTI metrics suggest central supranuclear inter-hemispheric imbalance in AIS, and support the role of the CRP in axial muscle tone. Longitudinal evaluation of CRP DTI metrics in the prediction of AIS progression may be clinically relevant.

Can growth in dichorionic twins be monitored with individualized growth assessment?

OBJECTIVE

To characterize fetal growth in dichorionic twins using individualized growth assessment (IGA), a method based on individual growth potential estimates.

METHODS

This secondary analysis included 286 fetuses/neonates from 143 dichorionic twin pregnancies that were part of the ESPRiT (Evaluation of Sonographic Predictors of Restricted Growth in Twins) study. The sample was subcategorized according to birth weight into appropriate-for-gestational-age (AGA) (n = 243) and small-for-gestational-age (SGA) (n = 43) cohorts. Serial biometric scans evaluating biparietal diameter, head circumference (HC), abdominal circumference, femur diaphysis length and estimated weight at 2-week intervals were used to evaluate fetal growth, while measurements of birth weight, crown-heel length and HC determined neonatal growth outcome. Six abnormalities (hypoxic ischemic encephalopathy, periventricular leukomalacia, necrotizing enterocolitis, respiratory distress, sepsis and death) constituted the evaluated adverse neonatal outcomes (ANO). IGA was used to: evaluate differences in second-trimester growth velocities between singletons (from a published dataset) and dichorionic twins (138 AGA twins with normal third-trimester growth); describe the degree to which actual third-trimester growth in twins followed expected growth (111 AGA twins, normal fetal growth and neonatal growth outcomes); determine if the fetal growth pathology score 1 (-FGPS1) could detect, quantify and classify twin growth pathology (224 AGA, 42 SGA); and assess the relationship between -FGPS1 and ANO (24 SGA twins with progressive growth restriction confirmed by abnormal neonatal growth outcome).

RESULTS

The differences in second-trimester growth velocity between singletons and twins (means and variances) were small and not statistically significant. Percent deviations from the expected third-trimester size trajectories were within the 95% reference ranges derived from singletons at 95.7% (1677/1752) of timepoints studied. Abnormal growth was detected in 37.9% of AGA twins and 85.7% of SGA twins. Growth restriction was more heterogeneous in AGA twins, while in SGA twins progressive growth restriction was the principal type (66.7%). -FGPS1 patterns previously defined in singletons classified 97.5% of pathological twin cases. In our most severe form of growth restriction (progressive), there were only three (12.5%) ANOs related to growth abnormalities, all in cases with -FGPS1 values more negative than -2.0%. Using these criteria, the frequency of ANO was 33%.

CONCLUSIONS

With respect to growth, dichorionic twins can be considered as two singletons in the same uterus. Normally growing dichorionic twins have the same growth potential as singletons with normal growth outcome. These twins also follow expected third-trimester growth trajectories with the same precision as do singletons. Third-trimester growth pathology can be detected, quantified and classified using -FGPS1 as in singletons. Limited evidence of a relationship between fetal growth abnormalities and adverse neonatal outcome was found. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

Artificial intelligence models for predicting calcium and magnesium removal by polyfunctional ketone using ensemble machine learners

Calcium (Ca2+) and magnesium (Mg2+) are the major scaling ions of reverse osmosis concentrate in zero-liquid discharge systems, causing performance decline. In this study, we predicted the removal of Ca2+ and Mg2+ from simulated reverse osmosis concentrate by functional polyketones (FPKs). Four amines, including 1,2-diaminopropane (DAP), 1-(2-aminoethyl) piperazine (AEP), 1-(3-aminopropyl) imidazole (API), and butyl amine (BA) used to synthesize FPKs. The effects of various factors such as the amount of adsorbent, feed water concentration, and pH were investigated for process optimization. In this study, ensemble learner artificial intelligence models, decision tree (DT), extreme gradient boost (XGB), and random forest (RF) were used to predict Ca2+ and Mg2+ removal by the FPKs. Datasets were collected experimentally using FPKs to remove Ca2+ and Mg2+ from the simulated reverse osmosis concentrate. The predictions were made by XGB, DT, and RF models for the first chosen amine for Ca2+ and then for Mg2+, subsequently, this process was repeated with each amine. The developed DT, RF, and XGB models demonstrated higher coefficients of determination for predicting Mg2+ removal by AEP and DAP (R2 = 0.841-0.935) than by API and BA (R2 = 0.774-0.801) except in the RF and XGB model results (R2 = 0.801-0.846). Overall, the XGB model displayed good results for both Ca2+ and Mg2+ removal but slight changes were observed in the AEP and BA predictions by DT and RF. Therefore, artificial intelligence models may be a viable alternative for further insight in predicting Ca2+ and Mg2+ removal by FPKs from simulated reverse osmosis concentrate.

Kondo screening in a Majorana metal

Kondo impurities provide a nontrivial probe to unravel the character of the excitations of a quantum spin liquid. In the S = 1/2 Kitaev model on the honeycomb lattice, Kondo impurities embedded in the spin-liquid host can be screened by itinerant Majorana fermions via gauge-flux binding. Here, we report experimental signatures of metallic-like Kondo screening at intermediate temperatures in the Kitaev honeycomb material α-RuCl3 with dilute Cr3+ (S = 3/2) impurities. The static magnetic susceptibility, the muon Knight shift, and the muon spin-relaxation rate all feature logarithmic divergences, a hallmark of a metallic Kondo effect. Concurrently, the linear coefficient of the magnetic specific heat is large in the same temperature regime, indicating the presence of a host Majorana metal. This observation opens new avenues for exploring uncharted Kondo physics in insulating quantum magnets.

Phase I dose escalation and expansion study of golidocitinib, a highly selective JAK1 inhibitor, in relapsed or refractory peripheral T-cell lymphomas

BACKGROUND

Relapsed or refractory peripheral T-cell lymphomas (r/r PTCLs) are a group of rare and aggressive diseases that lack effective therapies. Constitutive activation of the Janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway is reported to be associated with PTCLs. Golidocitinib is an oral, potent JAK1 selective inhibitor evaluated in a phase I/II multinational study in patients with r/r PTCLs.

PATIENTS AND METHODS

Patients with r/r PTCLs were eligible. The primary objectives were to assess safety and tolerability of golidocitinib and to define its recommended phase II dose (RP2D). The secondary objectives were to evaluate its antitumor activity and pharmacokinetics (PK).

RESULTS

A total of 51 patients were enrolled and received golidocitinib treatment at 150 or 250 mg once daily (QD). The median prior lines of therapies were 2 (range: 1-8). Golidocitinib was tolerated at both doses tested, while a higher incidence of serious adverse events and dose modifications at 250 mg were observed. The most common grade ≥3 drug-related treatment-emergent adverse events were neutropenia (27.5%) and thrombocytopenia (11.8%). An objective response rate of 39.2% and a complete response rate of 21.6% were observed. With median follow-up time of 14.7 and 15.9 months, the median duration of response (DoR) and progression-free survival were 8.0 and 3.3 months, respectively. Based on these data, 150 mg QD was defined as the RP2D. Golidocitinib demonstrated a favorable PK profile as an oral agent. Biomarker analysis suggested a potential correlation between JAK/STAT pathway aberrations and clinical activity of golidocitinib.

CONCLUSIONS

In this phase I study, golidocitinib demonstrated an acceptable safety profile and encouraging antitumor efficacy in heavily pretreated patients with r/r PTCLs. These results support the initiation of the multinational pivotal study in patients with r/r PTCLs.

The Effects of Glypican-3 Deficiency on Radiosensitivity in Liver Cancer Cells

PURPOSE/OBJECTIVE(S)

Glypican-3 (GPC-3), a heparan sulfate proteoglycan involved in cellular proliferation, modulates signaling of FGF/FGFR, IGF/IGFR, HGF/Met, Wnt/Frizzled, among others and correlates with survival. GPC-3 is overexpressed in the majority of hepatocellular carcinoma and hepatoblastoma, but not in normal hepatocytes. Accordingly, it is being investigated as a liver cancer-selective target for radiopharmaceutical imaging and therapy. However, the potential linkage between GPC-3 expression and radiosensitivity has not yet been defined. In this study, we investigated the effects of GPC-3 deficiency on radiosensitivity in liver cancer cell lines.

MATERIALS/METHODS

CRISPR/Cas9 system was used to engineer GPC-3 knockout variants of liver cancer cell lines, HepG2 & Hep3B, both of which natively express GPC-3. Confirmation of knockout of GPC-3 was evaluated by RT-PCR, western blotting, flow cytometry, immunocytochemistry, and gDNA sequencing. Cell growth and migration were evaluated by BrdU insertion and wound-healing assays, respectively. In vitro radiosensitivity was examined by radiation-induced apoptosis/necrosis (Annexin V-APC and PI staining), cell cycle modification, γH2AX foci formation, and clonogenic assays (6 Gy). Wildtype and knockout lines were engrafted into athymic mice to assess tumor growth kinetics.

RESULTS

RT-PCR, western blotting, flow cytometry, and immunocytochemistry all confirmed GPC-3 knockout in both HepG2 and Hep3B cell lines. Nucleotide deletion at exon 3 of the GPC-3 gene was confirmed by gDNA sequencing in HepG2ΔGPC3 and Hep3BΔGPC3. GPC-3 deficiency reduced liver cancer cell proliferation (HepG2ΔGPC3, p = 0.027, and Hep3BΔGPC3, p = 0.031) and migration (HepG2ΔGPC3: 1.5-fold, p<0.001, and Hep3BΔGPC3: 2.3-fold, p<0.001) significantly when compared with wild type. GPC-3 deficiency reduced cell survival and clonogenicity (HepG2ΔGPC3: DEF = 1.23, Hep3BΔGPC3: DEF = 1.23) in liver cancer cells exposed to irradiation (6 Gy). The delayed repair of double-stranded DNA damage was observed in irradiated GPC-3 deficient liver cancer cells. Tumor growth was dramatically delayed by GPC-3 deficiency. Tumor weight measured at 50 (Hep3B) and 60 (HepG2) days after liver cancer cell inoculation corroborated these effects.

CONCLUSION

Knockout lines of HepG2 and Hep3B exhibited decreased cell proliferation, migration, and in vivo tumor growth compared to wildtype. GPC-3 deficiency was associated with increased sensitivity to radiation therapy. Studies identifying the pathways through which this radiosensitivity is mediated are ongoing.

Critical Factors to Understanding the Electrochemical Performance of All-Solid-State Batteries: Solid Interfaces and Non-Zero Lattice Strain

All-solid-state lithium batteries have been developed to secure safety by substituting a flammable liquid electrolyte with a non-flammable solid electrolyte. However, owing to the nature of solids, interfacial issues between cathode materials and solid electrolytes, including chemical incompatibility, electrochemo-mechanical behavior, and physical contact, pose significant challenges for commercialization. Herein, critical factors for understanding the performance of all-solid-state batteries in terms of solid interfaces and non-zero lattice strains are identified through a strategic approach. The initial battery capacity can be increased via surface coating and electrode-fabrication methods; however, the increased lattice strain causes significant stress to the solid interface, which degrades the battery cycle life. However, this seesaw effect can be alleviated using a more compacted electrode microstructure between the solid electrolyte and oxide cathode materials. The compact solid interfaces contribute to low charge-transfer resistance and a homogeneous reaction between particles, thereby leading to improved electrochemical performance. These findings demonstrate, for the first time, a correlation between the uniformity of the electrode microstructure and electrochemical performance through the investigation of the reaction homogeneity among particles. Additionally, this study furthers the understanding of the relationship between electrochemical performance, non-zero lattice strain, and solid interfaces.

Genome-wide gene expression responses to experimental manipulation of Saccharomyces cerevisiae repressor activator protein 1 (Rap1) expression level

Precise regulation of transcription in gene expression is critical for all aspects of normal organism form, fitness, and function and even minor alterations in the level, location, and timing of gene expression can result in phenotypic variation within and between species including evolutionary innovations and human disease states. Eukaryotic transcription is regulated by a complex interplay of multiple factors working both at a physical and molecular levels influencing this process. In Saccharomyces cerevisiae, the TF with the greatest number of putative regulatory targets is the essential gene Repressor Activator Protein 1 (RAP1). While much is known about the roles of Rap1 in gene regulation and numerous cellular processes, the response of Rap1 target genes to systematic titration of RAP1 expression level remains unknown. To fill this knowledge gap, we used a strain with a tetracycline-titratable promoter replacing wild-type regulatory sequences of RAP1 to systematically reduce the expression level of RAP1 and followed this with RNA sequencing (RNA-seq) to measure genome-wide gene expression responses. Previous research indicated that Rap1 plays a significant regulatory role in particular groups of genes including telomere-proximal genes, homothallic mating (HM) loci, glycolytic genes, DNA repair genes, and ribosomal protein genes; therefore, we focused our analyses on these groups and downstream targets to determine how they respond to reductions in RAP1 expression level. Overall, despite being known as both an activator and as a repressor of its target genes, we found that Rap1 acts as an activator for more target genes than as a repressor. Additionally, we found that Rap1 functions as an activator of ribosomal protein genes and a repressor of the silent mating locus genes consistent with predictions from the literature. Unexpectedly, we found that Rap1 functions as a repressor of glycolytic enzyme genes contrary to prior reports of it having the opposite effect. We also compared the expression of RAP1 to five different genes related to DNA repair pathway and found that decreasing RAP1 downregulated four of those five genes. Finally, we found no effect of RAP1 depletion on telomere-proximal genes despite its functioning to silence telomeric repeat-containing RNAs. Together our results enrich our understanding of this important transcriptional regulator. The graphical abstract is provided as a supplementary fig. (S-Fig 1).

Achieving structural stability and enhanced electrochemical performance through Nb-doping into Li- and Mn-rich layered cathode for lithium-ion batteries

Although Li- and Mn-rich layered oxides are attractive cathode materials possessing high energy densities, they have not been commercialized owing to voltage decay, low rate capability, poor capacity retention, and high irreversible capacity in the first cycle. To circumvent these issues, we propose a Li_1.2Ni_0.13Co_0.13Mn_0.53Nb_0.01O₂ (Nb-LNCM) cathode material, wherein Nb doping strengthens the transition metal oxide (TM-O) bond and alleviates the anisotropic lattice distortion while stabilizing the layered structure. During long-term cycling, maintaining a wider LiO₆ interslab thickness in Nb-LNCM creates a favorable Li⁺ diffusion path, which improves the rate capability. Moreover, Nb doping can decrease oxygen loss, suppress the phase transition from layered to spinel and rock-salt structures, and relieve structural degradation. Nb doping results in less capacity contributions of Mn and Co and more reversible Ni and O redox reactions compared to pristine Li_1.2Ni_0.133Co_0.133Mn_0.533O₂ (LNCM), which significantly mitigates the voltage decay (Δ0.289 and Δ0.516 V for Nb-LNCM and LNCM, respectively) and ensures stable capacity retention (82.7 and 70.3% for Nb-LNCM and LNCM, respectively) during the initial 100 cycles. Our study demonstrates that Nb doping is an effective and practical strategy to enhance the structural and electrochemical integrity of Li- and Mn-rich layered oxides. This promotes the development of stable cathode materials for high-energy-density lithium-ion batteries.

Development and evaluation of photon-counting Cd0.875Zn0.125Te0.98Se0.02 detector for measuring bone mineral density

Cadmium zinc telluride (CZT) has been actively researched and developed by researchers in various fields. In medical applications, especially photon-counting, CZT enables improved image quality, multi-material decomposition, and improved dose efficiency. Moreover, band gap engineering and selenium addition on CZT improved electrical, spectroscopic and structural properties, thereby supporting performance of CZT as a photon-counting detector. In this study, it is shown that Cd_0.875Zn_0.125Te_0.98Se_0.02 (CZTS) shows sufficient performance without loss of detection efficiency. We carried out a study involving the application of this CZTS on calculating bone mineral density (BMD) values, because this application has a novelty of new material for BMD sensor which follows the CdTe- or CdZnTe- based BMD detector. Anatomical images from different energy bins contained different information of attenuation although the images were taken in the same region at the same time. Moreover, calculated BMD values had a proper tendency depending on the amount of bone in that region. The final BMD value was 1.1972 g/cm², which is close to the real value of 1.2 g/cm². The introduction with a bone filter and a smaller pixel size will improve the accuracy and precision of photon-counting CZTS detectors for measuring BMD values. However, in this study the CZTS showed the feasibility that a photon-counting CZTS detector can help the measurement of BMD values and the diagnosis of osteoporosis.

Ultrasoft edge-labelled hydrogel sensors reveal internal tissue stress patterns in invasive engineered tumors

Measuring internal mechanical stresses within 3D tissues can provide important insights into drivers of morphogenesis and disease progression. Cell-sized hydrogel microspheres have recently emerged as a powerful technique to probe tissue mechanobiology, as they can be sufficiently soft as to deform within remodelling tissues, and optically imaged to measure internal stresses. However, measuring stresses at resolutions of ∼10 Pa requires ultrasoft, low-polymer content hydrogel formulations that are challenging to label with sufficiently fluorescent materials to support repeated measurements, particularly in optically dense tissues over 100 μm thick, as required in cancer tumor models. Here, we leverage thermodynamic partitioning of hydrogel components to create "edge-labelled" ultrasoft hydrogel microdroplets, in a single polymerization step. Bright and stable fluorescent nanoparticles preferentially polymerize at the hydrogel droplet interface, and can be used to repeatedly track sensor surfaces over long-term experiments, even when embedded deep in light-scattering tissues. We utilize these edge-labelled microspherical stress gauges (eMSGs) in inducible breast cancer tumor models of invasion, and demonstrate distinctive internal stress patterns that arise from cell-matrix interactions at different stages of breast cancer progression. Our studies demonstrate a long-term macroscale compaction of the tumor during matrix encapsulation, but only a short-term increase in local stress as non-invasive tumors rapidly make small internal reorganizations that reduce the mechanical stress to baseline levels. In contrast, once invasion programs are initiated, internal stress throughout the tumor is negligible. These findings suggest that internal tumor stresses may initially prime the cells to invade, but are lost once invasion occurs. Together, this work demonstrates that mapping internal mechanical stress in tumors may have utility in advancing cancer prognostic strategies, and that eMSGs can have broad utility in understanding dynamic mechanical processes of disease and development.

Synthesis of heated aluminum oxide particles impregnated with Prussian blue for cesium and natural organic matter adsorption: Experimental and machine learning modeling

Heated aluminum oxide particles impregnated with Prussian blue (HAOPs-PB) are synthesized for the first time using different molar ratios of aluminum sulfate and PB to improve the adsorption of cesium (¹³³Cs⁺) and natural organic matter (NOM) from an aqueous solution. The Cs⁺ adsorption from various aqueous solutions, including surface, tap and deionized water by synthesized HAOPs-PB, is investigated. The influencing factors such as HAOPs-PB mixing ratio, pH and dosage are studied. In addition, pseudo 1st and 2nd order is tested for adsorption kinetics study. A machine learning model is developed using gene expression programming (GEP) to evaluate and optimize the adsorption process for Cs⁺ and NOM removal. Synthesized adsorbent showed maximum adsorption at a 1:1 M ratio of aluminum sulfate and PB in DI, tap, and surface water. The pseudo 2nd order kinetics model described the Cs ⁺ adsorption by HAOPs-PB more accurately that indicating physiochemical adsorption. Adsorption of Cs⁺ showed an increasing trend with higher HAOPs-PB concentration, while high pH also favored the adsorption. Maximum NOM adsorption is found at a higher HAOPs-PB dosage and a neutral pH value. Furthermore, the proposed GEP model shows outstanding performance for Cs⁺ adsorption modeling, whereas a modified-GEP model presents promising results for NOM adsorption prediction for testing dataset by learning the relationship between inputs and output with R² values of 0.9348 and 0.889, respectively.

Second-trimester growth velocities in twin and singleton pregnancies

OBJECTIVE

Previous small studies used individualized growth assessment (IGA) to characterize prenatal growth velocities of singletons and twins. We aimed to compare second-trimester growth velocities of individual anatomical parameters between monochorionic diamniotic (MCDA) twins, dichorionic diamniotic (DCDA) twins and singleton fetuses in a larger study.

METHODS

This was a study of a novel cohort of 222 MCDA twins and previously published cohorts of 40 DCDA twins and 118 singletons with serial ultrasound data. Fetal biometric measurements of biparietal diameter, head circumference, abdominal circumference and femur diaphysis length from prenatal ultrasound examinations were used to calculate second-trimester growth velocities using direct calculation or linear regression analysis. Linear fit was assessed based on the coefficient of determination (R² ). Mean growth velocities and variances were compared among the three groups.

RESULTS

The majority of cases underwent three second-trimester ultrasound examinations with fetal biometry available. All fetuses had linear growth, with R² > 99% for all parameters. Only 1-2% of all MCDA and DCDA anatomical parameters had abnormal growth velocity scores outside the 95% reference range for singletons. There were no significant differences in mean growth velocity for any parameter between MCDA twins and singletons. Femur diaphysis length growth velocity was significantly lower in DCDA twins than in both MCDA twins and singletons. There were no other significant differences among the groups.

CONCLUSIONS

Expanding on prior work using IGA, we found that second-trimester growth velocity of the four major anatomical parameters overall was similar between twins and singletons and between MCDA and DCDA twins, supporting the use of singleton-derived growth standards for IGA in twins. Twin growth potential appears to be similar to that of singletons in the second trimester, suggesting that subsequent growth divergence may be due to third-trimester physiological or pathological changes in twin pregnancies. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

Predictive modeling of pharmaceutical product removal by a managed aquifer recharge system: Comparison and optimization of models using ensemble learners

Pharmaceutical products (PPs) are emerging water pollutants with adverse environmental and health-related impacts, owing to their toxic, persistent, and undetectable microscopic nature. Globally, increasing scientific knowledge and advanced technologies have allowed researchers to study PP-associated problems and their removal for water reuse. Experimental modeling methods require laborious, lengthy, expensive, and environmentally hazardous lab-work to optimize the process. On the other hand, predictive machine learning (ML) models can trace the complex input-output relationship of a process using available datasets. In this study, ensemble ML techniques, including decision tree (DT), random forest (RF), and Xtreme gradient boost (XGB), were used to explore PP (diclofenac, iopromide, propranolol, and trimethoprim) removal by a managed aquifer recharge (MAR) system. The model input parameters included characteristics of reclaimed water and soil used in the columns, pH, dissolved organic carbon, operating time, nitrogen dioxide, sulfate, nitrate, electrical conductivity, manganese, and iron. The selected PP removal was the model output. Datasets were collected through a one-year experimental study of continuous MAR system operation to predict the removal of PPs. DT, RF, and XGB models were then developed for one of the selected compounds and tested for the others to check the reliability of the ML model results. The developed models were assessed using statistical performance matrices. The experimental results showed >80% removal of propranolol and trimethoprim; however, removal of diclofenac and iopromide was only ≈50% by the MAR system. The proposed DT and RF models presented higher coefficients of determination (R² ≥ 0.92) for diclofenac, propranolol, and trimethoprim than for iopromide (R² ≤ 0.63). In contrast, the XGB model showed better results for diclofenac, iopromide, propranolol, and trimethoprim, with R² values of 0.92, 0.72, 0.96, and 0.97, respectively. Therefore, XGB could be the best predictive model to provide insight into the adaptation of ML models to predict PP removal by the MAR system, thereby minimizing experimental work.

Treating reverse osmosis concentrate to address scaling and fouling problems in zero-liquid discharge systems: A scientometric review of global trends

Currently, reverse osmosis concentrate (ROC) treatment is one of the most promising techniques for its disposal because it produces freshwater with high recovery and valuable materials such as salts and reduces waste volume and environmental pollution. Public attention to the severe consequences of water pollution and strict environmental regulations on wastewater discharge has pushed water-polluting industries toward zero-liquid discharge (ZLD). However, scaling and fouling problems increase energy consumption and limit permeate flux at high salt concentrations, mainly due to calcium, magnesium, and silica precipitation, ultimately decreasing ZLD performance. Therefore, this study discusses drivers and ROC pretreatment technologies to improve ZLD efficiency and presents a scientometric review of global trends. The advantages, disadvantages, and economic and environmental aspects of conventional and emerging pre-treatment technologies were studied. Traditional treatment of chemical processes combined with precipitation removes a large amount of scaling ions; however, high operation and maintenance costs and limited full-scale plant experience are the main drawbacks. Softening and coagulation are most commonly applied to treat large volumes at a moderate cost; however, substantial sludge production and increased conductivity are major operational issues. Moreover, emerging technologies efficiently remove scale-forming ions with high capital and operating costs. New variations in standard reverse osmosis technologies have improved ZLD efficiency; nonetheless, scaling and fouling are of concern. Therefore, this review presents the studies on ROC pre-treatment technologies for removing scaling ions to enhance ZLD efficiency, which can help in future research.

Impact of dementia and drug compliance on patients with acute myocardial infarction

Background

There has been a worrying rise in the number of people with dementia, especially with many of them also suffering from acute myocardial infarction (AMI), a disease with a high mortality rate.

Purpose

We evaluated the impact of dementia on the mortality of patients with AMI and how drug compliance affects this relationship.

Methods

The data were derived from National Health Insurance Service-Senior. The total number of patients diagnosed with AMI for the first time between 2007 and 2013 was 16,835, among whom 2,021 had dementia. Medication possession ratio (MPR) was used to assess medication adherence.

Results

AMI patients with dementia had unfavorable baseline characteristics; they had significantly higher risk of all-cause mortality (Hazard ratio [HR]: 2.49; 95% confidence interval (CI): 2.34–2.66; P&lt;0.001) and lower MPR (aspirin: 21.9% vs. 42.8%; P&lt;0.001). AMI patients were stratified by presence of dementia and medication adherence, and the survival rate was the highest among those with no dementia and good adherence. followed by those with no dementia and poor adherence, those with dementia and good adherence, and those with dementia and poor adherence. The multivariable analysis revealed that dementia (HR: 1.64; 95% CI: 1.53–1.75; P&lt;0.001) and poor adherence to medication (HR: 1.60; 95% CI: 1.49–1.71; P&lt;0.001) had a significant association with all-cause mortality in AMI patients.

Conclusions

AMI patients with dementia have a higher mortality rate. Patients with dementia have poorer medication adherence than those without, negatively affecting their prognosis.

Funding Acknowledgement

Type of funding sources: None.

Very long-term outcomes of patients undergoing catheter ablation of atrial fibrillation: a systematic review and meta-analysis

Background

The efficacy of catheter ablation of atrial fibrillation (AF) is reported to stabilise at 5-year, but most studies report up to 3-year-outcomes only.

Objective

To perform a systematic review and meta-analysis of outcomes at 5-years following AF ablation.

Methods

We searched PubMed and Embase for studies reporting on ≥5-year outcomes following AF ablation, including freedom from atrial arrhythmia, all-cause death, stroke, and major bleeding. All meta-analyses were performed using the “meta” package in R with pooled incidence calculated using log transformation.

Results

Among 5,764 studies screened, 58 (n=41,344 patients) were included for analysis. The pooled mean age was 60.3y, 68.7% male, 78.4% paroxysmal AF, and radiofrequency was the most common ablation energy (72.4%). Most (51.5%) patients had hypertension, but the pooled rates of other comorbidities were low (heart failure: 9.0%, coronary artery disease: 12.8%, diabetes: 11.0%, and previous stroke: 8.5%). Pooled incidence of freedom from atrial arrhythmia at 5-years was 47.6% (95% CI 43.8%-51.6%, I2=98.4%) after a single procedure and increased to 64.3% (95% CI 59.6%-69.3%, I2=98.3%) after multiple procedures (Figure 1). The incidence was higher among patients with paroxysmal compared with non paroxysmal AF (55.9% vs. 28.7% and 82.2% vs. 47.6% after single and multiple procedures respectively). Retrospective studies reported slightly higher incidence of arrhythmia freedom (single procedure: 51.2% vs. 46.7%; multiple procedures: 66.9% vs. 61.9%) than did prospective studies. Few studies reported outcomes other than atrial arrhythmia free survival at 5-years (n=14) and incidences of these outcomes could only be pooled for multiple procedures. Pooled incidences of death, stroke, and major bleeding at 5-years were 8.0% (95% CI 4.2%-15.2%, I2=95.8%), 2.3% (95% CI 1.4%-3.6%, I2=72.9%), and 1.1% (95% CI 0.6%-1.8%, I2=32.5%), respectively (Figure 2).

Conclusion

At five-years, only up to 65% of patients undergoing AF ablations remained free from atrial arrhythmia although there was significant heterogeneity among individual studies. Encouragingly, these patients had low risk of dying, experiencing a stroke or major bleeding (all incidences&lt;10%).

Funding Acknowledgement

Type of funding sources: None.

Social status mediated variation in hypothalamic transcriptional profiles of male mice

Animals of different social status exhibit variation in aggression, territorial and reproductive behavior as well as activity patterns, feeding, drinking and status signaling. This behavioral and physiological plasticity is coordinated by underlying changes in brain gene transcription. Using Tag-based RNA sequencing (Tag-seq), we explore RNA transcriptomes from the medial preoptic area (mPOA) and ventral hypothalamus (vHYP) of male mice of different social ranks in a dominance hierarchy and detect candidate genes and cellular pathways that underlie status-related plasticity. Within the mPOA, oxytocin (Oxt) and vasopressin (Avp) are more highly expressed in subdominant mice compared to other ranks, while nitric oxide synthase (Nos1) has lower expression in subdominant mice. Within the vHYP, we find that both orexigenic and anorexigenic genes involved in feeding behavior, including agouti-related peptide (Agrp), neuropeptide-Y (Npy), galanin (Gal), proopiomelanocortin (Pomc), and Cocaine- and Amphetamine-Regulated Transcript Protein prepropeptide (Cartpt), are less expressed in dominant animals compared to more subordinate ranks. We suggest that this may represent a reshaping of feeding circuits in dominant compared to subdominant and subordinate animals. Furthermore, we determine several genes that are positively and negatively associated with the level of despotism (aggression) in dominant males. Ultimately, we identify hypothalamic genes controlling feeding and social behaviors that are differentially transcribed across animals of varying social status. These changes in brain transcriptomics likely support phenotypic variation that enable animals to adapt to their current social status.

POS0197 SARS-CoV-2 INFECTION CAUSED THROMBOSIS IN THE LUPUS MODEL WITH ANTIPHOSPHOLIPID ANTIBODY, WHEREAS COVID-19 ASSOCIATED THROMBOSIS WAS IRRELEVANT IN PATIENTS WITH POSITIVE ANTIPHOSPHOLIPID ANTIBODY

Background

Thrombosis is a unique complication in coronavirus disease 2019 (COVID-19). We have reported that elevated ferritin and D-dimer on admission were the risk factors of thromboses by analyzing the patients sequentially admitted to our hospital due to COVID-19 (1). However, we have not analyzed thrombotic complications in the view of the antiphospholipid antibodies (aPLs), which are frequently detected in the COVID-19 patients.

Objectives

To elucidate the thrombogenic effects of aPLs in COVID-19, we analyzed the development of thrombosis in three lupus models after SARS-CoV-2 infection. Additionally, we evaluated the association of thrombotic events and the serum profile of aPLs in Japanese patients with COVID-19.

Methods

Three animal models of lupus (MRL-lpr/lpr, NZBxNZW F1 and NZW×BXSB F1) were evaluated in this study. NZW×BXSB F1 was also considered as a model of antiphospholipid syndrome (APS) since aPLs were detected with a high titer (2). Experimental SARS-CoV-2 infection was induced using mouse-passaged virus strain (3). The incidence of thromboses in the lungs and kidneys were identified by evaluating H&E staining and PTAH staining of paraffin-embedded sections. We have experienced 44 thrombotic events in 34 out of 594 patients admitted to our institute. As a non-thrombotic COVID-19, 68 patients were selected to make a 1 to 2 matched-pair based on the propensity score. In total 102 patients, seven types of aPLs (anti-cardiolipin (CL) IgG/IgM, anti-β2GP1 IgG/IgA/IgM, and anti-phosphatidyl serine/prothrombin complex (PS/PT) IgG/IgM) were measured using specific ELISA kits. The patients’ clinical characteristics and serological profile of aPLs were further evaluated.

Results

We identified the development of thromboses in the lungs or kidneys in 6 out of 12 (50%) NZW×BXSB F1 mice after the SARS-CoV-2 infection, whereas no thrombosis was observed in non-infected mice. Further, there was no thrombosis in the other lupus models (0%) after the infection. These findings might suggest the pathogenic role of aPLs under the SARS-CoV-2 infection.

Among our COVID-19 patients, 39 out of 102 (38%) were tested positive for one or more aPLs. The positive ratios of any aPLs were statistically indifferent between the patients with or without thrombosis; anti-CL IgG (8.8% vs 5.9%)/IgM (0% vs 5.9%), anti-β2GP1 IgG (21% vs 12%)/IgA (8.8% vs 15%)/IgM (0% vs 1.5%), and anti-PS/PT IgG (0% vs 2.9%)/IgM (12% vs 13%), respectively. In addition, their titers were relatively lower than those observed in APS patients. The patients’ characteristics and the prognosis of COVID-19 were comparable regardless of the detection of any aPLs. These findings suggested that COVID-19 associated aPLs were irrelevant to thrombotic complications.

Conclusion

Thromboses were induced after the infection of SARS-CoV-2 only in the APS model. However, aPLs detected in COVID-19 patients have little impact on the development of thrombosis. SARS-CoV-2 infection might have a high risk of thrombosis, especially in APS patients, as shown in the case report (4). The discrepancy of its thrombogenic effects of aPLs might be explained by the low titer of the antibody or the diversity of antibody epitope. Further analyses are required to clarify the mechanisms of aPLs production and the development of thrombosis in COVID-19.

References

[1]Oba S, et al. Arterial and Venous Thrombosis Complicated in COVID-19: A Retrospective Single-Center Analysis in Japan. Front Cardiovasc Med. 2021 Nov 19;8:767074.

[2]Hashimoto Y, et al. Anticardiolipin antibodies in NZW x BXSB F1 mice. A model of antiphospholipid syndrome. J Immunol. 1992 Aug 1;149(3):1063-8.

[3]Iwata-Yoshikawa N, et al. A lethal mouse model for evaluating vaccine-associated enhanced respiratory disease during SARS-CoV-2 infection. Sci Adv. 2022 Jan 7;8(1):eabh3827.

[4]Chidharla A, et al. A Case Report of COVID-Associated Catastrophic Antiphospholipid Syndrome Successfully Treated with Eculizumab. J Blood Med. 2021 Oct 30;12:929-933.

Disclosure of Interests

Seiya Oba: None declared, Tadashi Hosoya Speakers bureau: Janssen Pharmaceutical K.K.

Daiichi Sankyo Company, limited

Asahi Kasei Corporation

Ono pharmaceuticals

Eisai

Eli Lilly, Daisuke Kawata: None declared, Wenshi Lee: None declared, Mari Kamiya: None declared, Yoji Komiya: None declared, Hideyuki Iwai: None declared, Yuko Nukui: None declared, Shuji Tohda: None declared, Shinsuke Yasuda Speakers bureau: Abbvie,

Asahi Kasei Pharma,

Chugai Pharmaceutical,

Eisai, Eli Lilly,

GlaxoSmithKline,

Mitsubishi Tanabe Pharma,

Ono pharmaceutical,

Pfizer., Consultant of: ImmunoForge, Grant/research support from: Abbvie,

Asahi Kasei Pharma,

Chugai Pharmaceutical,

CSL Behring,

Eisai,

ImmunoForge,

Mitsubishi Tanabe Pharma,

Ono pharmaceutical

Behavioural and physiological plasticity in social hierarchies

Individuals occupying dominant and subordinate positions in social hierarchies exhibit divergent behaviours, physiology and neural functioning. Dominant animals express higher levels of dominance behaviours such as aggression, territorial defence and mate-guarding. Dominants also signal their status via auditory, visual or chemical cues. Moreover, dominant animals typically increase reproductive behaviours and show enhanced spatial and social cognition as well as elevated arousal. These biobehavioural changes increase energetic demands that are met via shifting both energy intake and metabolism and are supported by coordinated changes in physiological systems including the hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes as well as altered gene expression and sensitivity of neural circuits that regulate these behaviours. Conversely, subordinate animals inhibit dominance and often reproductive behaviours and exhibit physiological changes adapted to socially stressful contexts. Phenotypic changes in both dominant and subordinate individuals may be beneficial in the short-term but lead to long-term challenges to health. Further, rapid changes in social ranks occur as dominant animals socially ascend or descend and are associated with dynamic modulations in the brain and periphery. In this paper, we provide a broad overview of how behavioural and phenotypic changes associated with social dominance and subordination are expressed in neural and physiological plasticity. This article is part of the theme issue 'The centennial of the pecking order: current state and future prospects for the study of dominance hierarchies'.

Third-trimester growth diversity in small fetuses classified as appropriate-for-gestational age or small-for-gestational age at birth

OBJECTIVE

We have shown previously that third-trimester growth in small fetuses (estimated fetal weight (EFW) < 10^th percentile) with birth weight (BW) < 10^th percentile is heterogeneous using individualized growth assessment (IGA). We aimed to test our hypothesis that individual growth patterns in small fetuses with BW > 10^th percentile are also variable but in different ways.

METHODS

This was a study of 191 cases with EFW < 10^th percentile and BW > 10^th percentile (appropriate-for-gestational-age (AGA) cohort), derived from the PORTO study. Composite size parameters were used to quantify growth pathology at individual third-trimester timepoints (individual composite prenatal growth assessment score (-icPGAS)). The fetal growth pathology score 1 (-FGPS1), calculated cumulatively from serial -icPGAS values, was used to characterize third-trimester growth patterns. Vascular-system evaluation included umbilical artery (UA) and middle cerebral artery (MCA) Doppler velocimetry. Outcome variables were birth age (preterm/term delivery) and BW (expressed as growth potential realization index for weight (GPRI_WT ) and percentile). The findings from the AGA cohort were compared with those from small fetuses (EFW < 10^th percentile) with BW < 10^th percentile (small-for-gestational-age (SGA) cohort).

RESULTS

The AGA cohort was found to have 134 fetuses (70%) with normal growth pattern and 57 (30%) with growth restriction based on IGA criteria. Seven growth-restriction -FGPS1 patterns were observed, including the previously defined progressive, late, adaptive and recovering types. The recovering type was the most common growth pattern in the AGA cohort (50.9%). About one-third of fetuses without any evidence of growth restriction had significant unexplained abnormalities in the UA (34%) and MCA (31%) and elevated mean GPRI_WT values (113 ± 12.5%). Comparison of the AGA and SGA cohorts indicated a significant difference in the distribution of -FGPS1 growth patterns (P = 0.0001). Compared with the SGA cohort, the AGA cohort had more fetuses with a normal growth pattern (70% vs 38%) and fewer cases with growth restriction (30% vs 62%). While the recovering type was the most common growth-restriction pattern in the AGA cohort (51%), the progressive type was the primary growth-restriction pattern in the SGA cohort (44%). No difference in the incidence of MCA or UA abnormality was found between the SGA and AGA cohorts when comparing subgroups of more than 10 fetuses.

CONCLUSIONS

Both normal-growth and growth-restriction patterns were observed in the AGA cohort using IGA, as seen previously in the SGA cohort. The seven types of growth restriction defined in the SGA cohort were also identified in AGA cases, but their distribution was significantly different. In one-third of cases without evidence of growth pathology in the AGA cohort, Doppler abnormalities in the UA and MCA were seen. This heterogeneity underscores the difficulty of accurate classification of fetal and neonatal growth status using conventional population-based methods. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Adsorptive removal of dyes from wastewater using a metal-organic framework: A review

Water pollution from synthetic dyes is a growing environmental concern because many dyes have carcinogenic effects on humans and aquatic life. Adsorption is a widely used technology for the separation and removal of dyes from wastewater. However, the dye removal process using conventional adsorbents is not sufficiently efficient for industrial wastewater. Metal-organic frameworks (MOFs) addresses these drawbacks. MOF showed excellent dye removal and degradation capacity owing to its multifunctionality, water-stability, large surface area, tunable pore size and recyclability. Magnetic MOFs retained excellent performance up to several consecutive cycles. Modified MOFs performed as Fenton-like catalysis process which generated abundant reactive radicals that degraded complex organic dyes into simple and less toxic forms which were further adsorbed onto the MOF. This review systematically compiles in-depth studies on the adsorptive removal of dyes from wastewater, MOF adsorption mechanisms, major influencing factors, to adsorption efficiency of MOFs. While all MOFs adsorb dyes through electrostatic attraction, the type of MOF, presence of functional groups, ligands, and pH significantly control the adsorption mechanism. Before developing an MOF, optimization and upgradation of factors and interaction between available adsorption site and adsorbate is needed. Finally, the prospects and new frontiers of MOFs in sustainable water treatment is discussed.

Prediction of endogenous thrombolytic activity in patients with coronary artery disease

Background

Endogenous thrombolytic activity (ETA) has been suggested as an essential factor related to the acute coronary syndrome. However, there have been little data regarding clinical characteristics of ETA in East Asians.

Method

As an interim study of the entire cohort (n=2,000), we analyzed a total of 278 patients who underwent percutaneous coronary intervention (PCI) due to coronary artery disease (CAD). Informed consent was obtained from all research subjects. Blood samples of patients were brought before the procedure. The Global Thrombosis Test (GTT, Thromboquest, UK), a novel test for examining ETA, was used. Lysis time (LT), which means the time interval between blood flow occlusion and restart, was used as an indicator for ETA. Clinical, laboratory and angiographic characteristics were obtained. LT=3000 seconds was used as a cut-off value to divide patients into two groups. P value&lt;0.05 was regarded as significant.

Results

LT of Korean CAD patients showed bimodal distribution. Median value was 1695 [IQR: 1099, 5932] and it was higher than previous data from Europeans (Figure 1). Patients with impaired ETA (LT&gt;3000) were older and more diabetic. They showed higher creatinine, aPTT, fibrinogen, D-dimer, c-reactive protein, and proBNP values. Moreover, they had lower hemoglobin and platelet levels. Intracoronary thrombus was more frequently observed in LT&gt;3000 group. In the multivariable regression analysis, hemoglobin (per g/dL, odds ratio 0.766, 95% confidence interval (CI) 0.632–0.928) and fibrinogen level(per 10mg/L, odds ratio 1.054, 95% CI 1.015–1.095) could significantly predict impaired ETA.

Conclusion

East Asian patients showed a right-shifted distribution of ETA compared to that of Europeans. Patients with impaired ETA had different clinical, laboratory and angiographic characteristics from those with intact ETA. Hemoglobin and fibrinogen level were significantly associated with impaired ETA. Further studies are warranted to confirm causal relationship among these factors.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Research Foundation, Republic of Korea

Safety and Efficacy of Stent-Assisted Coiling of Unruptured Intracranial Aneurysms Using Low-Profile Stents in Small Parent Arteries

BACKGROUND AND PURPOSE

Stent-assisted coiling of intracranial aneurysms arising from small vessels (≤ 2.0 mm) is a common procedure. However, data regarding its treatment outcomes are scarce. This study evaluated the clinical and radiologic outcomes of stent-assisted coiling using low-profile stents for aneurysms of small parent arteries.

MATERIALS AND METHODS

From November 2015 to October 2020, sixty-four patients with 66 aneurysms arising from parent arteries of ≤2.0 mm were treated with stent-assisted coiling using a Low-Profile Visualized Intraluminal Support Junior (LVIS Jr) or the Neuroform Atlas stent in a single institution. The clinical and radiologic data were retrospectively reviewed, and the risk factors for procedure-related complications were evaluated.

RESULTS

The LVIS Jr and Neuroform Atlas stents were used in 22 (33.3%) and 44 (66.7%) cases, respectively. Technical success was achieved in 66 cases (100%). Immediate postprocedural aneurysm occlusion grades assessed by the Raymond-Roy occlusion classification were I (57.6%), II (19.7%), and III (22.7%), respectively. Procedure-related complications occurred in 10 cases (15.2%), with 8 thromboembolic complications (12.1%) and 2 hemorrhagic complications (3.0%). Procedure-related morbidity was 4.5% without mortality. On multivariate analysis, current smoking (odds ratio = 7.1, P = .021) had a statistically significant effect on procedure-related complications.

CONCLUSIONS

Stent-assisted coiling of intracranial aneurysms with low-profile stents in small vessels (≤ 2.0 mm) had a 100% success rate and a 15.2% overall complication rate with 4.5% morbidity. Current smoking was a significant risk factor associated with procedure-related complications.

Longitudinal evaluation of motor function in patients who underwent prenatal or postnatal neural tube defect repair

OBJECTIVE

To compare the evolution of motor function from mid-gestation to 12 months of age between prenatally and postnatally repaired cases of open neural tube defect (ONTD).

METHODS

This was a retrospective cohort study of all fetuses that underwent prenatal (fetoscopic or open hysterotomy) or postnatal ONTD repair at a single institution between November 2011 and December 2018. The anatomical level of the lesion was defined as the upper bony spinal defect at initial magnetic resonance imaging assessment. Prenatal motor function of the lower extremities was evaluated by ultrasound according to the metameric level of the neurological lesion, based on the methodology of Carreras et al. Fetal motor function was assessed at referral, at 6 weeks after surgery in prenatally repaired cases or 6 weeks after referral in postnatally repaired cases (6-week follow-up) and at the last scan before delivery. In addition, motor function was assessed by a detailed neurological examination at birth and 12 months of age. First sacral (S1) neurological level of the lesion was considered as intact motor function. For statistical comparisons, we attributed numerical scores to each neurological level and motor function was expressed as median (range) neurological level. Motor function (as numerical score) and the proportion of cases with intact motor function and with motor function two or more levels better than expected based on the anatomical level of the lesion were compared between the prenatal- and postnatal-repair groups. Fetal motor function was compared to the anatomical level of the lesion at referral and a better motor function was defined when it was two or more levels better than the anatomical level of the lesion. To assess the evolution of motor function, we compared motor function at referral with that at each follow-up assessment using paired t-tests.

RESULTS

We included 127 patients with ONTD, of whom 93 underwent prenatal (51 fetoscopic and 42 open hysterotomy) and 34 postnatal repair. At the time of referral, cases in the prenatal- and postnatal-repair groups presented with a similar anatomical level of lesion (L3 (T9-S1) vs L3 (T7-S1); P = 0.52), similar motor function (S1 (L1-S1) vs S1 (L1-S1); P = 0.52) and a similar proportion of cases with intact motor function (81% vs 79%; P = 0.88) and with motor function two or more levels better than expected based on the anatomical level of the lesion (62% vs 74%; P = 0.24). When compared with prenatally repaired cases, postnatally repaired cases showed worse motor function at birth (S1 (L1-S1) vs L4 (L1-S1); P < 0.01) and at 12 months of age (S1 (L1-S1) vs L4 (L1-S1); P < 0.01). In the prenatal-repair group, motor function remained stable from the time of referral to 12 months of age (P = 0.26). Furthermore, the proportion of patients with intact motor function at referral (81% (75/93)) was similar to that at the 6-week follow-up (74% (64/87)), at the last scan before birth (74% (42/57)), at birth (68% (63/93)) and at 12 months of age (67% (39/58)) in the prenatal-repair group. In the postnatal-repair group, worse motor function, starting from the third trimester to 12 months of age, was observed. The proportion of patients with intact motor function at referral (79% (27/34)) was similar to that at 6-week follow-up (80% (12/15); P = 0.92), but was lower at the last assessment before birth (25% (2/8); P < 0.01), at birth (24% (8/34); P < 0.01) and at 12 months of age (28% (7/25); P < 0.01). Similar findings were noted when assessing the evolution of the proportion of cases with motor function two or more levels better than expected based on the anatomical level of the lesion in each group.

CONCLUSIONS

Infants with ONTD that underwent postnatal repair had worse motor function at birth and at 12 months of age than at mid-gestation and when compared with infants that underwent prenatal ONTD repair. Prenatal motor function assessment by ultrasound is an adequate tool to identify those infants who should have a good clinical motor function after delivery. Information obtained by fetal motor function assessment can have an important role for patient counseling and case selection for surgery. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.

Osteoconductivity of Porous Titanium Structure on Implants in Osteoporosis

In compromised bone conditions such as osteoporosis, developments of the implant surface are necessary to secure the stability of implants. This study investigated the effect of the surface porous titanium structure (PS) on the osseointegration of implants in osteoporotic bone. Bilateral ovariectomy (OVX) was performed in 4 female beagle dogs to induce osteoporosis for 32 wk. Success of induction was based on the evaluation of bone mineral density by Hounsfield units (HU) in computed tomography images. Posterior teeth in both mandibles were extracted 1 wk after OVX, and a total of 30 implants (15 implants in each group) were placed after 32 wk of osteoporosis induction. The control group implant underwent resorbable blast media (RBM) surface treatment, whereas the test group underwent RBM surface treatment in the coronal two-thirds and a PS added to the apical 3-mm portion. HU values in the mandibular trabecular bone, lumbar, and femoral head significantly decreased 32 wk after OVX, confirming osteoporotic condition after induction. Resonance frequency analysis and removal torque test showed comparable values between the 2 groups at 4 wk after implant placement. The surface topography of the implant after removal showed hard tissue integration at the PS in the test group. Bone-to-implant contact length was greater in the apical portion of the test group, although statistical significance was not found between the groups. Interthread bone area in the apical portion of the test group showed a significant increase compared to the control group (control: 0.059 ± 0.041 mm², test: 0.121 ± 0.060 mm², P = 0.028) with the histological feature of bone ingrowth at the PS. The findings of the study demonstrated that the surface PS could improve osteoconductivity in the osteoporotic trabecular bone by bone ingrowth at the pore space, thereby enhancing the osseointegration and stability of the implants.

The burden of heat-related mortality attributable to recent human-induced climate change

Climate change affects human health; however, there have been no large-scale, systematic efforts to quantify the heat-related human health impacts that have already occurred due to climate change. Here, we use empirical data from 732 locations in 43 countries to estimate the mortality burdens associated with the additional heat exposure that has resulted from recent human-induced warming, during the period 1991-2018. Across all study countries, we find that 37.0% (range 20.5-76.3%) of warm-season heat-related deaths can be attributed to anthropogenic climate change and that increased mortality is evident on every continent. Burdens varied geographically but were of the order of dozens to hundreds of deaths per year in many locations. Our findings support the urgent need for more ambitious mitigation and adaptation strategies to minimize the public health impacts of climate change.

An optomechanogram for assessment of the structural and mechanical properties of tissues

The structural and mechanical properties of tissue and the interplay between them play a critical role in tissue function. We introduce the optomechanogram, a combined quantitative and qualitative visualization of spatially co-registered measurements of the microstructural and micromechanical properties of any tissue. Our approach relies on the co-registration of two independent platforms, second-harmonic generation (SHG) microscopy for quantitative assessment of 3D collagen-fiber microstructural organization, and nanoindentation (NI) for local micromechanical properties. We experimentally validate our method by applying to uterine cervix tissue, which exhibits structural and mechanical complexity. We find statistically significant agreement between the micromechanical and microstructural data, and confirm that the distinct tissue regions are distinguishable using either the SHG or NI measurements. Our method could potentially be used for research in pregnancy maintenance, mechanobiological studies of tissues and their constitutive modeling and more generally for the optomechanical metrology of materials.

Semimetal to semiconductor transition in Bi/TiO2 core/shell nanowires

We demonstrate the full thermoelectric and structural characterization of individual bismuth-based (Bi-based) core/shell nanowires. The influence of strain on the temperature dependence of the electrical conductivity, the absolute Seebeck coefficient and the thermal conductivity of bismuth/titanium dioxide (Bi/TiO₂) nanowires with different diameters is investigated and compared to bismuth (Bi) and bismuth/tellurium (Bi/Te) nanowires and bismuth bulk. Scattering at surfaces, crystal defects and interfaces between the core and the shell reduces the electrical conductivity to less than 5% and the thermal conductivity to less than 25% to 50% of the bulk value at room temperature. On behalf of a compressive strain, Bi/TiO₂ core/shell nanowires show a decreasing electrical conductivity with decreasing temperature opposed to that of Bi and Bi/Te nanowires. We find that the compressive strain induced by the TiO₂ shell can lead to a band opening of bismuth increasing the absolute Seebeck coefficient by 10% to 30% compared to bulk at room temperature. In the semiconducting state, the activation energy is determined to |41.3 ± 0.2| meV. We show that if the strain exceeds the elastic limit the semimetallic state is recovered due to the lattice relaxation.