Pharyngeal Constrictor-Sparing Salvage Stereotactic Body Radiation Therapy with Tongue-Out for In-Field Recurrence after Definitive Radiation Therapy for Head & Neck Cancer: Guide to Tongue-Out Radiation Therapy (TORT).

This report details a pharyngeal constrictor muscle (PCM)-sparing stereotactic body radiation therapy (SBRT) using our institutional technique of "Tongue-out" RT (TORT) for treating a local recurrent cancer in the uvula (GTVuvula) in a patient with history of a definitive chemo-RT (70 Gy with weekly cisplatin) for a locally advanced laryngeal cancer four years ago. TORT includes optimizing the patients' reproducible tongue-out position using readily available medicine cup (30 cc) followed by sculping the thermoplastic mask with tongue-out, and real-time visual monitoring of the tongue position during the CT-simulation scan, CBCT acquisition, and treatment. Between arcs during volumetric modulated arc therapy (VMAT), time for tongue relaxation and saliva swallowing can be given to the patient. Without TORT, the patient's GTVuvula abutted the medial aspect of superior PCM (medial-sPCM) and a substantial volume of the previously irradiated sPCM would have received high radiation dose from this salvage SBRT (32.5 Gy in 5 fractions). Compared to without TORT, the shortest distance between medial-sPCM-to-GTVuvula was increased by 13 mm with TORT, which reduced radiation dose to sPCM in salvage SBRT plan. The mean dose (Dmean) to sPCM was decreased from 20.5 Gy without TORT to 12.7 Gy with TORT. With TORT, minimal sPCM volumes fell within higher isodose line: volume receiving ≥ 60% prescription dose (V60%Rx), V80%Rx, and V100%Rx to sPCM was, 4.8 vs. 0.7 cc (without vs. with TORT, respectively), 2.9 vs. 0.19 cc, and 1.6 vs. 0.04 cc, respectively. Maximum dose (Dmax) to medial-sPCM was 34.6 Gy without TORT vs. 22.7 Gy with TORT. These high doses to the sPCM and intrafractional swallowing-related geographic misses of GTVuvula were avoided through the application of TORT in this salvage re-RT setting. The patient successfully finished salvage SBRT with TORT resulting no dysphagia or mucositis and maintained complete response at 12 months after treatment.

Continuous Positive Airway Pressure-Assisted Breathing With Supine Tangential Left Breast Radiation Therapy When Deep Inspiration Breath-Hold Radiation Therapy Was Ineffective or Unsuitable: Clinical Implications for an Affordable Heart-Sparing Breast Radiation Therapy to Reduce the Health Care Disparities in Low-Resource Settings.

Purpose: To report continuous positive airway pressure (CPAP)-assisted breathing with supine tangential left breast radiation therapy (CPAP-RT) when deep inspiration breath-hold RT (DIBH-RT) was ineffective or unsuitable. Methods and Materials: Ten patients with left breast cancer underwent computed tomography simulation scan (CT-sim) under DIBH followed by CPAP-assisted breathing (15 cm H2O) to create CPAP-RT plans in authors' institute. Reasons for CPAP-RT include inability to reproduce DIBH (n = 5), DIBH-RT plan exceeded dose limits to the heart (n = 2), and unable to proceed with planned DIBH-RT due to mechanical issues (n = 3). Radiation target volumes and organs at risk were contoured according to published atlas data. For dosimetric comparison, supine tangential fields for breast only RT (Breast-RT) and wide-tangential fields for breast + internal mammary nodal RT (Breast + IMN-RT) were used with prescription of 40 Gy in 15 fractions on each patients' CT-sim with free-breathing (FB), DIBH, and CPAP-assisted breathing, respectively. Results: Planning target volume (PTV) coverage was acceptable and comparable in all RT plans. Compared with FB, both DIBH and CPAP-assisted breathing inflated the thorax and increased left lung volume on average by 46% and 51%, respectively (FB: 1230 vs DIBH: 1802 vs CPAP-assisted breathing:1860 cc, P < .01), and increased the shortest distance between PTVeval-Breast to the heart by 5.6 ± 3.0 and 11.9 ± 3.6 mm (P < .01) and to LAD by 4.9 ± 2.9 and 10.8 ± 4.3 mm, respectively (P < .01). Compared with FB, both DIBH and CPAP significantly reduced radiation dose to the heart and LAD. A mean dose to the heart (HeartDmean) was FB: 2.3 ± 0.9, DIBH: 1.2 ± 0.7, and CPAP: 0.9 ± 0.4 Gy in Breast-RT (P < .01); FB: 3.2 ± 1.7, DIBH: 1.7 ± 0.8, and CPAP: 1.3 ± 0.5 Gy in Breast + IMN-RT (P < .01). LADDmean was FB: 11 ± 4.5, DIBH: 5.4 ± 3.2, and CPAP: 2.4 ± 0.9 Gy in Breast-RT (P < .01); FB: 15.5 ± 7.8, DIBH: 7.4 ± 4.1, and CPAP: 3.5 ± 1.4 Gy in Breast + IMN-RT (P < .01). A maximum dose to LAD (LADDmax) was FB: 35.8 ± 8.7, DIBH: 22.4 ± 15.4, and CPAP: 7.8 ± 5.3 Gy in Breast-RT (P < .01); FB: 38.7 ± 5.0, DIBH: 25.3 ± 15.2, and CPAP: 10.2 ± 6.8 Gy in Breast + IMN-RT (P < .01). All patients successfully completed CPAP-RT. Conclusions: CPAP-RT provides efficient and practical heart and LAD sparing RT using simple supine tangential fields for Breast-RT or wide-tangential fields for Breast + IMN-RT when DIBH-RT was ineffective or unsuitable. With its easy accessibility and low infrastructural requirement, CPAP-RT can provide affordable heart-sparing left breast RT to reduce the health care disparities in low-resource settings.

Quantum discriminator for binary classification.

Quantum computers have the unique ability to operate relatively quickly in high-dimensional spaces-this is sought to give them a competitive advantage over classical computers. In this work, we propose a novel quantum machine learning model called the Quantum Discriminator, which leverages the ability of quantum computers to operate in the high-dimensional spaces. The quantum discriminator is trained using a quantum-classical hybrid algorithm in [Formula: see text] time, and inferencing is performed on a universal quantum computer in [Formula: see text] time. The quantum discriminator takes as input the binary features extracted from a given datum along with a prediction qubit, and outputs the predicted label. We analyze its performance on the Iris and Bars and Stripes data sets, and show that it can attain 99% accuracy in simulation.

Pharmacist-led biometric screenings: A retrospective chart review in a community pharmacy.

BACKGROUND: Biometric screenings have gained popularity in employer-based wellness programs and are increasingly offered at community pharmacies. OBJECTIVE: This study aimed to analyze biometric screening data collected at a community pharmacy in North Alabama to examine the prevalence of risk factors and the role of pharmacist-led screenings in identifying at-risk individuals and facilitating referrals to primary care providers. METHODS: A retrospective chart review was conducted using biometric screening data collected between 2020 and 2021. Descriptive statistics were calculated to analyze the data. RESULTS: A total of 801 patients were included in the analysis. The mean age was 45.4 years, and 56.2 % were female. The mean systolic blood pressure was 132 mmHg, and the mean diastolic blood pressure was 84 mmHg. Mean total cholesterol was 174 mg/dL, and the mean blood glucose was 109 mg/dL. Mean BMI was 35.1 kg/m2. Among the screened patients, 22.5 % were referred to a primary care provider due to an elevated level of at least one of the measured variables, with BMI being the most common reason for referral. CONCLUSION: This study provides valuable insights into the prevalence of risk factors in a population undergoing pharmacist-led biometric screenings in a community pharmacy. The findings emphasize the important role of pharmacists in identifying at-risk individuals and facilitating appropriate referrals to primary care. Further research is needed to evaluate the long-term impact of these referrals and explore the feasibility of similar programs in diverse healthcare settings.

Concussion Education for Athletes: Symptom Reporting and Safe Return to Sport.

¼ Educational programs on concussion have been demonstrated to improve knowledge for athletes, families, athletic trainers, and coaches about concussion, with the goal of reducing concussion incidence, duration, severity, and complications.¼ Despite the widespread availability and often mandatory concussion education provided to high school and collegiate athletes, there has not been an adequate change in knowledge, attitudes, and self-reporting behavior in this population.¼ Recently published studies suggest improving concussion education by emphasizing athletes' symptom reporting behavior, to contrast with current emphasis on knowledge-based outcomes.¼ Future educational programs about concussions for athletes, families, athletic trainers, and coaches should aim to emphasize cultural and behavioral changes that demonstrate outcome changes rather than solely evaluating knowledge improvements to determine effective programming.

Updating and pre-existing semantic associations: testing can enhance or impair new learning.

We often need to update what we have learned, building on older information by adding newer information. When updating, is it better to review the older information by retrieving it (testing) or restudying it? In other words, do tests result in enhanced updating or impaired updating compared to restudying? Past research has obtained divergent conclusions to this question. The present study used a paired associates updating paradigm in which participants studied a cue and the older response (A-B). They later reviewed the older response by restudying (A-B) or testing (A-?; A-B) and immediately after learned a newer response (-D) that updated the original pair into a trio (A-B-D). In eight experiments, we demonstrated that different patterns of pre-existing semantic associations between the cue, older response, and newer response resulted in all possible outcomes: test enhanced new learning, test impaired new learning, and no difference. The results were most consistent with a family of updating theories that propose the metacognitive processes that occur after reviewing determine whether testing enhances, impairs, or has no impact on new learning. The results suggest that theories should consider the impact of the newer response in updating in addition to performance on the initial test.

Effects of roughage type on particle separation, rumination, fiber mat characteristics, in situ degradation, and ruminal fermentation parameters in beef steers.

Six ruminally cannulated steers (average BW = 791 ± 71 kg) were used in a replicated 3 × 3 Latin square experiment to determine the effects of roughage type on rumination, fiber mat characteristics, and rumen fermentation variables. Three roughages were included at 7% (DM basis) in a steam flaked corn-based diet: cotton burrs (CB), wheat silage (WS), or corn stalks (CS). Steers were fitted with a sensory collar to record rumination behaviors in 2-h intervals at the beginning of the experiment. Each 30-d period consisted of 7 d of recovery, 14 d of diet adaptation, 7 d of rumination data collection (daily and bi-hourly average rumination), 1 d of rumen fluid collection, and 1 d of rumen evacuations. In situ degradation of individual roughages was determined for 4 d after period 3 evacuations. During rumen evacuations, ruminal contents were removed; the rumen fiber mat (RF) was separated from the liquid portion with a 2-mm sieve, weighed, and a subsample was dried. Data were analyzed using the MIXED procedure of SAS with steer as the experimental unit and roughage (CB, WS, and CS) as the main effect. Dry matter intake (DMI) was not different for CB and WS (P = 0.25) and greatest for steers consuming CS diet (P ≤ 0.01). Roughage type did not influence the weight of the RF dry matter (%; DM; P = 0.92), RF weight (P = 0.69), or RF:DMI ratio (P = 0.29). Daily rumination (min/d) did not differ among roughages (P = 0.40), but min of rumination/kg of DMI was greatest for CS (18.0 min), min/kg of NDF was greatest for WS (89.8 min; P = 0.02), and min/kg of peNDF was greatest for CS (132.4 min; P ≤ 0.01). Wheat silage had the greatest percentage of soluble and degradable DM. Rumen fiber mat did not differ for roughages, although rumination min/kg of DMI and peNDF was greatest for steers consuming CS and WS. In situ degradation determined that CB-R and CS-R had the greatest percentage of ruminal undegraded DM. Based on the objective of the experiment, roughage type did not influence daily rumination or fiber mat characteristics.

Comparison of monensin sodium sources for finishing beef cattle.

The objective of this study was to evaluate the ruminal fermentation characteristics of ruminally fistulated beef steers consuming a steam-flaked corn (SFC) or dry-rolled corn (DRC) based diet containing either Rumensin 90 (RUM; Elanco, Greenfield, IN), or Monovet 90 (MV; Huvepharma, Peachtree City, GA). Six ruminally fistulated steers (657.7 kg ± 72.6) housed individually were used in a 6 × 6 Latin square design with 2 × 3 factorial treatment arrangement. Each of the 6 periods were 15 d with 14 d for diet adaptation and 1 d of rumen fluid collections. Dietary treatments were DRC without monensin sodium (DRC-C), SFC without monensin sodium (SFC-C), DRC with Rumensin 90 (DRC-R), DRC with Monovet 90 (DRC-MV), SFC with Rumensin 90 (SFC-R), and SFC with Monovet 90 (SFC-MV). Rumen contents and fluid were collected through the fistula of each animal at 0, 3, 6, 12, and 24 h on d 15 of each period. Rumen fluid collected at 6 h post-feeding each period was used for in vitro analyses. Steer was the experimental unit and the model included fixed effects of grain processing, additive, and grain processing × additive. Total gas produced was composited from each in vitro bottle into a gas collection bag for the 48-h determination of methane concentration. No differences were detected for DMI (P = 0.81). Ruminal pH did not differ for the control or additive treatments (P = 0.33). However, ruminal pH was lower (P < 0.01) with SFC compared to DRC. There was a significant difference in acetate to propionate ratio for grain type (P = 0.01) and a tendency for additive inclusion (P = 0.06). Additive inclusion reduced methane proportion of total gas compared to control treatments (P ≤ 0.01). Overall, monensin sodium reduced methane concentration though source had no effect on DMI or ruminal pH.

Impact of increasing levels of fumonisin on performance, liver toxicity, and tissue histopathology of finishing beef steers.

To address the gaps in current scientific knowledge, the objective of the present study was to investigate the impact of fumonisin exposure on feedlot cattle intake and performance. Fifty steers were received (day 0; 361 ± 6.4 kg), housed individually and fed once daily at 0800 hours. All steers were transitioned to a dry-rolled corn-based finishing diet from days 0 to 21 and then were fed the control finishing diet until day 50. Treatment diets were formulated to achieve ≤5 (CON), 15 (15PPM), 30 (30PPM), 60 (60PPM), or 90 ppm (90PPM) of total dietary fumonisin. Steers were fed the fumonisin treatment diets from day 50 until harvest on day 160; individual animal body weights (BW) were measured on days 0, 50, 100, 150, 159, and 160. Liver, kidney, and skeletal muscle tissue samples were collected at harvest for histopathological analyses, and liver samples were further analyzed for sphinganine (SA) and sphingosine (SO) concentration. Animal performance, carcass data, and liver enzyme concentration were analyzed using a mixed model; categorical data were analyzed via nonparametric models. Contrasts were used to test for linear and quadratic responses. Throughout the study, there was no effect of treatment (P > 0.60), or a linear response (P > 0.16) from increasing fumonisin levels, on BW or dry matter intake (DMI). However, CON tended to have a lower average daily gain (ADG) than the fumonisin treatments during the fumonisin treatment period (P = 0.10), and there was a positive linear response (P = 0.02) of ADG to fumonisin during the treatment period. There were no treatment differences in hot carcass weight, dressing percentage, marbling score, ribeye area, or yield grade. There were no effects of treatment on either liver abscesses (P = 0.95) or telangiectasis (P = 0.13). We observed a treatment difference for SA and SA:SO (P < 0.01), as well as a quadratic response (P < 0.02); both SA and SA:SO increased as dietary fumonisin increased. There were no observed differences between treatments for histopathology scores of kidney (P = 0.16), liver (P = 0.25), or skeletal muscle (P = 0.59) tissue. No adverse effects were observed in steers fed increasing dietary levels of fumonisin for 110 d prior to harvest. While elevated liver amino alcohol concentration did occur, negative effects on growth and carcass characters were not observed.

What can directed forgetting tell us about clinical populations?

This paper reviews and critically assesses the implications of directed forgetting (DF) research on clinical populations. We begin by reviewing the typical methods and results of the item method and list method directed forgetting procedures and provide best practice recommendations for future studies using clinical populations. Next, we note that DF was often interpreted as being due to inhibition, and when clinical populations showed impaired directed forgetting, it was treated as evidence in inhibitory control difficulties. However, inhibition may not be the cause of DF effects, based on current understanding of these cognitive tasks. We instead suggest that item method DF is tied to attentional control, which might include inhibitory mechanisms (or might not). In contrast, list method DF is tied to two forms of memory control: control of mental context (indicated by effective forgetting of List 1), and changes in the strategies used to remember (indicated by better learning of List 2). We review the current state of the clinical DF literature, assess its strength based on our best practice recommendations, and call for more research when warranted.

Associations of mucosal disaccharidase kinetics and expression in the jejunum of steers with divergent average daily gain.

The objective of this study was to quantify the differences in the activity of jejunal maltase and isomaltase between two groups of steers with average dry matter intake (DMI) and differing average daily gain (ADG). DMI and ADG were measured in crossbred steers (n = 69; initial body weight = 456 ± 5.0 kg) consuming a finishing diet containing 67.8% dry-rolled corn, 20.0% wet distillers grains with solubles, 8.0% alfalfa hay, and 4.2% vitamin/mineral supplement on a dry matter basis for 84 d. Jejunal mucosal samples were collected from eight steers with the greatest (high) or least (low) ADG and average DMI (± 0.55 standard deviation). Homogenates of jejunal mucosa were incubated with increasing amounts of maltose and isomaltose to determine the disaccharidase kinetics. Total mucosal protein concentration (mg protein/g tissue; P = 0.45) of the mucosa and small intestinal weights (P = 0.69) did not differ between the groups. Neither the Michaelis-Menten constant (Km) of isomaltase (P = 0.15) nor maltase (P = 0.21) differed between groups. The isomaltase maximum velocity (Vmax) expressed per gram of protein tended to differ (P = 0.10) between groups of steers but did not differ (P = 0.13) when expressed on a tissue basis. Similarly, neither the maltase Vmax expressed per gram of protein (P = 0.31) nor tissue (P = 0.32) differed between groups. While previous studies have indicated that disaccharidase expression is associated with differences in ADG, data presented here indicate that differences in enzyme activity at the end of the finishing period are minimal.

Quantifying the biochemical state of knee cartilage in response to running using T1rho magnetic resonance imaging.

Roughly 20% of Americans run annually, yet how this exercise influences knee cartilage health is poorly understood. To address this question, quantitative magnetic resonance imaging (MRI) can be used to infer the biochemical state of cartilage. Specifically, T1rho relaxation times are inversely related to the proteoglycan concentration in cartilage. In this study, T1rho MRI was performed on the dominant knee of eight asymptomatic, male runners before, immediately after, and 24 hours after running 3 and 10 miles. Overall, (mean ± SEM) patellar, tibial, and femoral cartilage T1rho relaxation times significantly decreased immediately after running 3 (65 ± 3 ms to 62 ± 3 ms; p = 0.04) and 10 (69 ± 4 ms to 62 ± 3 ms; p < 0.001) miles. No significant differences between pre-exercise and recovery T1rho values were observed for either distance (3 mile: p = 0.8; 10 mile: p = 0.08). Percent decreases in T1rho relaxation times were significantly larger following 10 mile runs as compared to 3 mile runs (11 ± 1% vs. 4 ± 1%; p = 0.02). This data suggests that alterations to the relative proteoglycan concentration of knee cartilage due to water flow are mitigated within 24 hours of running up to 10 miles. This information may inform safe exercise and recovery protocols in asymptomatic male runners by characterizing running-induced changes in knee cartilage composition.

In Vivo Anterior Cruciate Ligament Deformation During a Single-Legged Jump Measured by Magnetic Resonance Imaging and High-Speed Biplanar Radiography.

BACKGROUND: The in vivo mechanics of the anterior cruciate ligament (ACL) and its bundles during dynamic activities are not completely understood. An improved understanding of how the ACL stabilizes the knee is likely to aid in the identification and prevention of injurious maneuvers. PURPOSE/HYPOTHESIS: The purpose was to measure in vivo ACL strain during a single-legged jump through use of magnetic resonance imaging (MRI) and high-speed biplanar radiography. We hypothesized that ACL strain would increase with the knee near extension, and a peak in ACL strain would occur just before landing from the jump, potentially due to quadriceps contraction in anticipation of landing. STUDY DESIGN: Descriptive laboratory study. METHODS: Models of the femur, tibia, and ACL attachment sites of 8 male participants were generated from MRI scans through use of solid modeling. High-speed biplanar radiographs were obtained from these participants as they performed a single-legged jump. The bone models were registered to the biplanar radiographs, thereby reproducing the in vivo positions of the joint throughout the jump. ACL and bundle elongations were defined as the centroid to centroid distances between attachment sites for each knee position. ACL strain was defined as ACL length normalized to its length measured in the position of the knee at the time of MRI. RESULTS: Peaks in ACL strain were observed before toe-off and 55 ± 35 milliseconds before initial ground contact. These peaks were associated with the knee positioned at low flexion angles. Mean ACL strain was inversely related to mean flexion angle (rho = -0.73, P < .001), such that ACL strain generally increased with knee extension throughout the jumping motion. ACL bundle lengths were significantly (rho > 0.85, P < .001) correlated with overall ACL length. CONCLUSION: These findings provide insight into how landing in extension can increase the risk of ACL injury. Specifically, this study shows that peak ACL strain can occur just before landing from a single-legged jump. Thus, when an individual lands on an extended knee, the ACL is relatively taut, which may make it particularly vulnerable to injury, especially in the presence of a movement perturbation or unanticipated change in landing strategy. CLINICAL RELEVANCE: This study provides a novel measurement of dynamic ACL strain during an athletic maneuver and lends insight into how landing in extension can increase the likelihood of ACL failure.

Reminders can enhance or impair episodic memory updating: a memory-for-change perspective.

The Memory-for-Change framework proposes that retrieving episodic memories can facilitate new learning when changes between existing memories and new information are integrated during encoding and later recollected. Four experiments examined whether reminders could improve memory updating and enhance new learning. Participants studied two study lists of word pairs and were given a cued recall test on responses from both lists. Reminders of List 1 words pairs (A-B) appeared immediately before List 2 words pairs that included repeated cues and changed responses (A-D). Across experiments, we varied the types of reminders to determine whether differences in their effectiveness as retrieval cues would influence memory for the list membership of responses. We found that presenting intact reminders (cue-response) enhanced the memory benefits associated with recollection-based retrieval of changes relative to when no reminders appeared and when partial reminders (cue-only) appeared with and without feedback. Importantly, cue-response reminders benefitted memory when they were recognised in List 2 and when changes were later recollected. This suggests that integrative encoding can be facilitated when substantial environmental support is available to cue retrieval of existing memories. These findings have practical implications for understanding which reminders best aid the correction of memories for inaccurate information.

Get the Basics Right: A Description of the Key Priorities for Establishing a Neonatal Service in a Resource-Limited Setting in Cambodia.

BACKGROUND: Worldwide, reduction in under-five mortality has not sufficiently included neonates, who represent 45% of deaths in children of age under five years. The least progress has been observed in resource-limited settings. METHODS: This mixed methods study conducted at a Cambodian non-governmental paediatric hospital described the key priorities of the ongoing neonatal service. Routinely collected data from the hospital and microbiology databases included the number of admissions, discharges and deaths and the number of cases of bacteraemias (2011-2016). Semi-structured interviews with the management staff explored the essential features of the service. RESULTS: There were 2127 neonatal admissions and 247 deaths. The incidence of facility-based neonatal mortality decreased by 81%. Bacteraemic healthcare-associated infections decreased by 68%. A dedicated area for neonatal care was perceived as crucial, allowing better infection control and delivery of staff training. CONCLUSIONS: In this hospital, the neonatal service prioritized basic measures, particularly, having a dedicated neonatal area. Facility-based mortality and bacteraemic healthcare-associated infections decreased.

Obesity alters the in vivo mechanical response and biochemical properties of cartilage as measured by MRI.

BACKGROUND: Obesity is a primary risk factor for the development of knee osteoarthritis (OA). However, there remains a lack of in vivo data on the influence of obesity on knee cartilage mechanics and composition. The purpose of this study was to determine the relationship between obesity and tibiofemoral cartilage properties. METHODS: Magnetic resonance images (3T) of cartilage geometry (double-echo steady-state) and T1rho relaxation of the knee were obtained in healthy subjects with a normal (n = 8) or high (n = 7) body mass index (BMI) before and immediately after treadmill walking. Subjects had no history of lower limb injury or surgery. Bone and cartilage surfaces were segmented and three-dimensional models were created to measure cartilage thickness and strain. T1rho relaxation times were measured before exercise in both the tibial and femoral cartilage in order to characterize biochemical composition. Body fat composition was also measured. RESULTS: Subjects with a high BMI exhibited significantly increased tibiofemoral cartilage strain and T1rho relaxation times (P <0.05). Tibial pre-exercise cartilage thickness was also affected by BMI (P <0.05). Correlational analyses revealed that pre-exercise tibial cartilage thickness decreased with increasing BMI (R2 = 0.43, P <0.01) and body fat percentage (R2 = 0.58, P <0.01). Tibial and femoral cartilage strain increased with increasing BMI (R2 = 0.45, P <0.01; R2 = 0.51, P <0.01, respectively) and increasing body fat percentage (R2 = 0.40, P <0.05; R2 = 0.38, P <0.05, respectively). Additionally, tibial T1rho was positively correlated with BMI (R2 = 0.39, P <0.05) and body fat percentage (R2 = 0.47, P <0.01). CONCLUSIONS: Strains and T1rho relaxation times in the tibiofemoral cartilage were increased in high BMI subjects compared with normal BMI subjects. Additionally, pre-exercise tibial cartilage thickness decreased with obesity. Reduced proteoglycan content may be indicative of pre-symptomatic osteoarthritic degeneration, resulting in reduced cartilage thickness and increased deformation of cartilage in response to loading.

Characterization of Distributed Microfabricated Strain Gauges on Stretchable Sensor Networks for Structural Applications.

Smart structures mimic biological systems by using thousands of sensors serving as a nervous system analog. One approach to give structures this sensing ability is to develop a multifunctional sensor network. Previous work has demonstrated stretchable sensor networks consisting of temperature sensors and impact detectors for monitoring external environments and interacting with other objects. The objective of this work is to develop distributed, robust and reliable strain gauges for obtaining the strain distribution of a designated region on the target structure. Here, we report a stretchable network that has 27 rosette strain gauges, 6 resistive temperature devices and 8 piezoelectric transducers symmetrically distributed over an area of 150 × 150 mm to map and quantify multiple physical stimuli with a spatial resolution of 2.5 × 2.5 mm. We performed computational modeling of the network stretching process to improve measurement accuracy and conducted experimental characterizations of the microfabricated strain gauges to verify their gauge factor and temperature coefficient. Collectively, the results represent a robust and reliable sensing system that is able to generate a distributed strain profile of a common structure. The reported strain gauge network may find a wide range of applications in morphing wings, smart buildings, autonomous cars and intelligent robots.

Utilization of the methoxymalonyl-acyl carrier protein biosynthesis locus for cloning the oxazolomycin biosynthetic gene cluster from Streptomyces albus JA3453.

Oxazolomycin (OZM), a hybrid peptide-polyketide antibiotic, exhibits potent antitumor and antiviral activities. Using degenerate primers to clone genes encoding methoxymalonyl-acyl carrier protein (ACP) biosynthesis as probes, a 135-kb DNA region from Streptomyces albus JA3453 was cloned and found to cover the entire OZM biosynthetic gene cluster. The involvement of the cloned genes in OZM biosynthesis was confirmed by deletion of a 12-kb DNA fragment containing six genes for methoxymalonyl-ACP biosynthesis from the specific region of the chromosome, as well as deletion of the ozmC gene within this region, to generate OZM-nonproducing mutants.

Predicting obstructive coronary artery disease with serum sphingosine-1-phosphate.

BACKGROUND: Sphingolipids are emerging as important signaling molecules that may be produced by cardiac tissue during ischemic stress or as a consequence of inflammation. Because both inflammation and myocardial ischemia are associated with coronary artery disease (CAD), a study was designed to test the ability of serum sphingolipids to predict obstructive CAD. METHODS: The study consisted of 308 consecutive patients undergoing coronary angiography for all indications. The primary data points were the assessment of coronary artery stenosis with angiography and the measurements of serum sphingolipids. RESULTS: In this diverse population, serum sphingosine-1-phosphate (S1P) was a significant predictor of CAD (P <.001). Multivariate analysis with logistic regression demonstrated that serum S1P was more predictive of obstructive CAD (odds ratio = 7.61) than the traditional risk factors (age, sex, family history of CAD, diabetes mellitus, lipid profile, hypertension, etc.). A 3-variable S1PC composite score was derived by combining the power of the S1P marker with the 2 most important risk factors, age and sex. The relationship between the S1PC and CAD scores was continuous and progressive, such that patients with elevated S1PC scores had higher occurrences of obstructive CAD. S1PC was also predictive of disease severity; 53.2% of patients in the fourth S1PC quartile had 2 to 3 vessel CAD, whereas only 5.2% of patients in the first S1PC quartile had 2 to 3 vessel disease (RR = 10.2 for severity). CONCLUSIONS: Serum S1P is a remarkably strong and robust predictor of both the occurrence and severity of coronary stenosis. An S1P-based composite score may be useful as a novel, non-invasive indicator of obstructive CAD.

C-O bond formation by polyketide synthases.

Polyketide synthases (PKSs) assemble the polyketide carbon backbone by sequential decarboxylative condensation of acyl coenzyme A (CoA) precursors, and the C-C bond-forming step in this process is catalyzed by the beta-ketoacyl synthase (KS) domain or subunit. Genetic and biochemical characterization of the nonactin biosynthesis gene cluster from Streptomyces griseus revealed two KSs, NonJ and NonK, that are highly homologous to known KSs but catalyze sequential condensation of the acyl CoA substrates by forming C-O rather than C-C bonds. This chemistry can be used in PKS engineering to increase the scope and diversity of polyketide biosynthesis.