Protective role of Aloe vera against X‐ray induced testicular dysfunction

The present investigation was carried out to evaluate the possible radioprotective potential of an Aloe vera extract against whole‐body X‐ray irradiation‐induced testicular alterations in mice. Male balb/c mice were divided into four groups: control, A. vera, X‐ray and A. vera pre‐treated + X‐ray irradiated. Histopathological examination revealed significant structural alterations in testes after X‐ray exposure, which was also associated with the presence of apoptotic cells as assessed by TUNEL assay. X‐ray irradiation resulted in elevation in the levels of reactive oxygen species, lipid peroxidation, a reduction in glutathione concentration and enhanced activities of antioxidant enzymes such as glutathione reductase, glutathione peroxidase, catalase, superoxide dismutase and glutathione‐S‐transferase. Sperm count/motility and testosterone levels were significantly decreased in the irradiated group. Irradiated animals pre‐treated with A. vera extract revealed an improvement in antioxidant status, inhibition of lipid peroxides, apoptotic cell formation and enhanced testicular parameters when compared to the X‐ray‐exposed group. These findings suggest that A. vera extract could ameliorate X‐ray‐induced damage due to its free radical scavenging properties and its potential to boost cellular antioxidant defence machinery.     

Lung ultrasound compared with chest X‐ray in diagnosing postoperative pulmonary complications following cardiothoracic surgery: a prospective observational study

Postoperative pulmonary complications are common after cardiothoracic surgery and are associated with adverse outcomes. The ability to detect postoperative pulmonary complications using chest X‐rays is limited, and this technique requires radiation exposure. Little is known about the diagnostic accuracy of lung ultrasound for the detection of postoperative pulmonary complications after cardiothoracic surgery, and we therefore aimed to compare lung ultrasound with chest X‐ray to detect postoperative pulmonary complications in this group of patients. We performed this prospective, observational, single‐centre study in a tertiary intensive care unit treating adult patients who had undergone cardiothoracic surgery. We recorded chest X‐ray findings upon admission and on postoperative days 2 and 3, as well as rates of postoperative pulmonary complications and clinically‐relevant postoperative pulmonary complications that required therapy according to the treating physician as part of their standard clinical practice. Lung ultrasound was performed by an independent researcher at the time of chest X‐ray. We compared lung ultrasound with chest X‐ray for the detection of postoperative pulmonary complications and clinically‐relevant postoperative pulmonary complications. We also assessed inter‐observer agreement for lung ultrasound, and the time to perform both imaging techniques. Subgroup analyses were performed to compare the time to detection of clinically‐relevant postoperative pulmonary complications by both modalities. We recruited a total of 177 patients in whom both lung ultrasound and chest X‐ray imaging were performed. Lung ultrasound identified 159 (90%) postoperative pulmonary complications on the day of admission compared with 107 (61%) identified with chest X‐ray (p < 0.001). Lung ultrasound identified 11 out of 17 patients (65%) and chest X‐ray 7 out of 17 patients (41%) with clinically‐relevant postoperative pulmonary complications (p < 0.001). The clinically‐relevant postoperative pulmonary complications were detected earlier using lung ultrasound compared with chest X‐ray (p = 0.024). Overall inter‐observer agreement for lung ultrasound was excellent (κ = 0.907, p < 0.001). Following cardiothoracic surgery, lung ultrasound detected more postoperative pulmonary complications and clinically‐relevant postoperative pulmonary complications than chest X‐ray, and at an earlier time‐point. Our results suggest lung ultrasound may be used as the primary imaging technique to search for postoperative pulmonary complications after cardiothoracic surgery, and will enhance bedside decision making.     

System and path planning algorithm for low‐kV X‐ray free‐form surface irradiation

Objective: Intraoperative radiotherapy (IORT) after surgical resection using a low‐kV‐X‐ray source is a proven method used in cancer treatment. However, the shape and size of the targeted surface area are limited to the size of the available applicators. This can lead to nonconformal and therefore suboptimal treatment for many patients. Methods: A system is proposed comprising an X‐ray source with an applicator for surface irradiation mounted on a robotic arm. This is controlled by an algorithm designed for planning the required continuous path, enabling irradiation of any desired shape with a controlled dose distribution. Results: The system is shown to be capable of irradiating areas composed of rectangles on a flat surface with a homogeneity index of less than 7% inside the targeted area. Conclusion: The presented results demonstrate the potential of the proposed setup to eliminate the current limitations, leading to better treatment of patients.     

Real‐time probe tracking using EM‐optical sensor for MRI‐guided cryoablation

Background

A method of real‐time, accurate probe tracking at the entrance of the MRI bore is developed, which, fused with pre‐procedural MR images, will enable clinicians to perform cryoablation efficiently in a large workspace with image guidance.

Methods

Electromagnetic (EM) tracking coupled with optical tracking is used to track the probe. EM tracking is achieved with an MRI‐safe EM sensor working under the scanner's magnetic field to compensate the line‐of‐sight issue of optical tracking. Unscented Kalman filter‐based probe tracking is developed to smooth the EM sensor measurements when occlusion occurs and to improve the tracking accuracy by fusing the measurements of two sensors.

Results

Experiments with a spine phantom show that the mean targeting errors using the EM sensor alone and using the proposed method are 2.21 mm and 1.80 mm, respectively.

Conclusion

The proposed method achieves more accurate probe tracking than using an EM sensor alone at the MRI scanner entrance.     

Manipulator‐driven selection of semi‐active MR‐visible markers

Background

A method for the identification of semi‐active fiducial magnetic resonance (MR) markers is presented based on selectively optically tuning and detuning them.

Methods

Four inductively coupled solenoid coils with photoresistors were connected to light sources. A microcontroller timed the optical tuning/detuning of coils and image collection. The markers were tested on an MR manipulator linking the microcontroller to the manipulator control to visibly select the marker subset according to the actuated joint.

Results

In closed‐loop control, the average and maximum were 0.76° ± 0.41° and 1.18° errors for a rotational joint, and 0.87 mm ± 0.26 mm and 1.13 mm for the prismatic joint.

Conclusions

This technique is suitable for MR‐compatible actuated devices that use semi‐active MR‐compatible markers.     

Direct detection and characterization of foot‐and‐mouth disease virus in East Africa using a field‐ready real‐time PCR platform

Effective control and monitoring of foot‐and‐mouth disease (FMD ) relies upon rapid and accurate disease confirmation. Currently, clinical samples are usually tested in reference laboratories using standardized assays recommended by The World Organisation for Animal Health (OIE ). However, the requirements for prompt and serotype‐specific diagnosis during FMD outbreaks, and the need to establish robust laboratory testing capacity in FMD ‐endemic countries have motivated the development of simple diagnostic platforms to support local decision‐making. Using a portable thermocycler, the T‐COR ™ 8, this study describes the laboratory and field evaluation of a commercially available, lyophilized pan‐serotype‐specific real‐time RT ‐PCR (rRT ‐PCR ) assay and a newly available FMD virus (FMDV) typing assay (East Africa‐specific for serotypes: O, A, Southern African Territories [SAT ] 1 and 2). Analytical sensitivity, diagnostic sensitivity and specificity of the pan‐serotype‐specific lyophilized assay were comparable to that of an OIE ‐recommended laboratory‐based rRT ‐PCR (determined using a panel of 57 FMDV ‐positive samples and six non‐FMDV vesicular disease samples for differential diagnosis). The FMDV ‐typing assay was able to correctly identify the serotype of 33/36 FMDV ‐positive samples (no cross‐reactivity between serotypes was evident). Furthermore, the assays were able to accurately detect and type FMDV RNA in multiple sample types, including epithelial tissue suspensions, serum, oesophageal–pharyngeal (OP ) fluid and oral swabs, both with and without the use of nucleic acid extraction. When deployed in laboratory and field settings in Tanzania, Kenya and Ethiopia, both assays reliably detected and serotyped FMDV RNA in samples (n  = 144) collected from pre‐clinical, clinical and clinically recovered cattle. These data support the use of field‐ready rRT ‐PCR platforms in endemic settings for simple, highly sensitive and rapid detection and/or characterization of FMDV.     

Real‐time electromagnetic navigation for breast‐conserving surgery using NaviKnife technology: A matched case‐control study

Breast‐conserving surgery (BCS) is a mainstay in breast cancer treatment. For nonpalpable breast cancers, current strategies have limited accuracy, contributing to high positive margin rates. We developed NaviKnife, a surgical navigation system based on real‐time electromagnetic (EM) tracking. The goal of this study was to confirm the feasibility of intraoperative EM navigation in patients with nonpalpable breast cancer and to assess the potential value of surgical navigation. We recruited 40 patients with ultrasound visible, single, nonpalpable lesions, undergoing BCS. Feasibility was assessed by equipment functionality and sterility, acceptable duration of the operation, and surgeon feedback. Secondary outcomes included specimen volume, positive margin rate, and reoperation outcomes. Study patients were compared to a control group by a matched case‐control analysis. There was no equipment failure or breach of sterility. The median operative time was 66 (44‐119) minutes with NaviKnife vs 65 (34‐158) minutes for the control (P = .64). NaviKnife contouring time was 3.2 (1.6‐9) minutes. Surgeons rated navigation as easy to setup, easy to use, and useful in guiding nonpalpable tumor excision. The mean specimen volume was 95.4 ± 73.5 cm³ with NaviKnife and 140.7 ± 100.3 cm³ for the control (P = .01). The positive margin rate was 22.5% with NaviKnife and 28.7% for the control (P = .52). The re‐excision specimen contained residual disease in 14.3% for NaviKnife and 50% for the control (P = .28). Our results demonstrate that real‐time EM navigation is feasible in the operating room for BCS. Excisions performed with navigation result in the removal of less breast tissue without compromising postive margin rates.     

Intensity‐based 2D‐3D registration for an ACL reconstruction navigation system

To improve the positioning accuracy of tunnels for anterior cruciate ligament (ACL) reconstruction, we proposed an intensity‐based 2D‐3D registration method for an ACL reconstruction navigation system. Methods for digitally reconstructed radiograph (DRR) generation, similarity measurement, and optimization are crucial to 2D‐3D registration. We evaluated the accuracy, success rate, and processing time of different methods: (a) ray‐casting and splating were compared for DRR generation; (b) normalized mutual information (NMI), Mattes mutual information (MMI), and Spearman's rank correlation coefficient (SRC) were assessed for similarity between registrations; and (c) gradient descent (GD) and downhill simplex (DS) were compared for optimization. The combination of splating, SRC, and GD provided the best composite performance and was applied in an augmented reality (AR) ACL reconstruction navigation system. The accuracy of the navigation system could fulfill the clinical needs of ACL reconstruction, with an end pose error of 2.50 mm and an angle error of 2.74°.     

Three‐dimensional knee joint kinematics during golf swing and stationary cycling after total knee arthroplasty

The expectation of returning to sports activities after total knee arthroplasty (TKA) has become more important to patients than ever. To our knowledge, no studies have been published evaluating the three‐dimensional knee joint kinematics during sports activity after TKA. Continuous X‐ray images of the golf swing and stationary cycling were taken using a large flat panel detector for four and eight post‐arthroplasty knees, respectively. The implant flexion and axial rotation angles were determined using a radiographic‐based, image‐matching technique. Both the golf swing from the set‐up position to the top of the backswing, and the stationary cycling from the top position of the crank to the bottom position of the crank, produced progressive axial rotational motions (p = 0.73). However, the golf swing from the top of the backswing to the end of the follow‐through produced significantly larger magnitudes of rotational motions in comparison to stationary cycling (p < 0.01). Excessive internal–external rotations generated from the top of the backswing to the end of the follow‐through could contribute to accelerated polyethylene wear. However, gradual rotational movements were consistently demonstrated during the stationary cycling. Therefore, stationary cycling is recommended rather than playing golf for patients following a TKA who wish to remain physically active. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res     

Use of high resolution dual‐energy x‐ray absorptiometry‐region free analysis (DXA‐RFA) to detect local periprosthetic bone remodeling events

Dual‐energy x‐ray absorptiometry (DXA) is the gold standard method for measuring periprosthetic bone remodeling, but relies on a region of interest (ROI) analysis approach. While this addresses issues of anatomic variability, it is insensitive to bone remodeling events at the sub‐ROI level. We have validated a high‐spatial resolution tool, termed DXA‐region free analysis (DXA‐RFA) that uses advanced image processing approaches to allow quantitation of bone mineral density (BMD) at the individual pixel (data‐point) level. Here we compared the resolution of bone remodeling measurements made around a stemless femoral prosthesis in 18 subjects over 24 months using ROI‐based analysis versus that made using DXA‐RFA. Using the ROI approach the regional pattern of BMD change varied by region, with greatest loss in ROI5 (20%, p < 0.001), and largest gain in ROI4 (6%, p < 0.05). Analysis using DXA‐RFA showed a focal zone of increased BMD localized to the prosthesis–bone interface (30–40%, p < 0.001) that was not resolved using conventional DXA analysis. The 20% bone loss observed in ROI5 with conventional DXA was resolved to a focal area adjacent to the cut surface of the infero‐medial femoral neck (up to 40%, p < 0.0001). DXA‐RFA enables high resolution analysis of DXA datasets without the limitations incurred using ROI‐based approaches. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:712–716, 2015.     

Mild COVID‐19 in a pediatric renal transplant recipient

As of mid‐April 2020, the coronavirus disease of 2019 (COVID‐19) pandemic has affected more than 2 million people and caused 135 000 deaths worldwide. Not much is known about the effect of this disease in immunosuppressed children with renal transplantation (RT). Here we report a 13‐year‐old child with multiple comorbidities who acquired COVID‐19 5 years post‐RT in the United States. Maintenance immunosuppression (IS) consisted of sirolimus and mycophenolate. There was no history of travel or exposure to sick contacts. The presenting features were fever, cough, rhinorrhea, and hypoxemia. Diarrhea was the only extrapulmonary manifestation. Chest X‐ray was normal. He did not require intensive care unit care or ventilation. There was a transient rise in his serum creatinine without change in urine output; dialysis was not required. Slight reduction in IS was done. He had an excellent clinical recovery within 4 days and was able to be discharged home. His respiratory symptoms resolved but the diarrhea persisted during a 4‐week follow‐up period. This report provides a brief perspective on the short‐term COVID‐19 clinical course in an immunosuppressed child. More reports will add valuable information on the potential variety of spectrum of the illness in this subset of children.     

Difference in outcomes after antibody‐mediated rejection between abo‐incompatible and positive cross‐match transplantations

Graft survival seems to be worse in positive cross‐match (HLAi) than in ABO‐incompatible (ABOi) transplantation. However, it is not entirely clear why these differences exist. Sixty‐nine ABOi, 27 HLAi and 10 combined ABOi+HLAi patients were included in this retrospective study, to determine whether the frequency, severity and the outcome of active antibody‐mediated rejection (AMR) were different. Five‐year death‐censored graft survival was better in ABOi than in HLAi and ABOi+HLAi patients (99%, 69% and 64%, respectively, P = 0.0002). Features of AMR were found in 38%, 95% and 100% of ABOi, HLAi and ABOi+HLAi patients that had a biopsy, respectively (P = 0.0001 and P = 0.001). After active AMR, a declining eGFR and graft loss were observed more frequently in HLAi and HLAi+ABOi than in ABOi patients. The poorer prognosis after AMR in HLAi and ABOi+HLAi transplantations was not explained by a higher severity of histological lesions or by a less aggressive treatment. In conclusion, ABOi transplantation offers better results than HLAi transplantation, partly because AMR occurs less frequently but also because outcome after AMR is distinctly better. HLAi and combined ABOi+HLAi transplantations appear to have the same outcome, suggesting there is no synergistic effect between anti‐A/B and anti‐HLA antibodies.     

Evaluating the feasibility and uptake of a community‐led HIV testing and multi‐disease health campaign in rural Uganda

Introduction: Multi‐disease community health campaigns can be effective for population‐wide HIV testing in a research setting (SEARCH: NCT01864603). We sought to evaluate feasibility and uptake of a community‐led health campaign (CLHC) planned and implemented by village leaders and local clinic workers in Uganda. Methods: Over five months in 2014, locally elected village leaders and Ministry of Health (MoH) clinic staff in a rural parish in Uganda planned a census followed by a CLHC, after training by two SEARCH trial consultants and by leaders from a neighbouring parish that had previously participated in a SEARCH health campaign. We defined feasibility as: (1) elected leaders’ participation in training and implementation of pre‐campaign census and mobilization activities; (2) implementation of all campaign activities by MoH‐funded, local clinic staff; and (3) community participation in the campaign, including point‐of‐care screening for HIV, malaria, hypertension and diabetes, and same‐day referral for male circumcision and family planning (FP). Costing of all salaries and supplies was conducted. Results: Elected leaders from all eight villages in the parish participated in CLHC training. They and local clinic staff met monthly to select and plan CLHC services. Village leaders then leveraged existing volunteer health teams to perform a door‐to‐door census, enumerating 5,202 parish residents over 2 weeks. 2,753 (53%) residents participated in the 6‐day CLHC. Of 1,584 adult participants, 1,474 (93%) tested for HIV: 105/1,474 (7.1%) tested HIV positive. 27% (751/2,753) of participants reported fever and underwent malaria rapid diagnostic testing: 5.3% (40/751) tested positive. Among adults screened, 19% (271/1,452) were hypertensive, and 3% (18/637) had a random blood sugar >11.1 mmol/L. Of 805 men and boys (>10 years), 91 (11%) accepted same‐day clinic referral and underwent medical circumcision. Of 900 women offered same‐day long‐term FP referrals, 25 accepted. The CLHC cost, including census, mobilization and testing services, was $23,597 ($8.57/participant). C onclusions: Elected village leaders successfully planned and conducted a 6‐day multi‐disease health campaign with service provision by local clinic staff that reached over half of a rural Ugandan community. These data suggest it is feasible for local leaders and clinics to adopt a multi‐disease health campaign approach to scale‐up HIV testing in rural Africa.     

When patients fail UNAIDS’ last 90 ‐ the “failure cascade” beyond 90‐90‐90 in rural Lesotho,Southern Africa: a prospective cohort study

Introduction : HIV‐infected individuals on first‐line antiretroviral therapy (ART) in resource‐limited settings who do not achieve the last “90” (viral suppression) enter a complex care cascade: enhanced adherence counselling (EAC), repetition of viral load (VL) and switch to second‐line ART aiming to achieve resuppression. This study describes the “failure cascade” in patients in Lesotho. Methods : Patients aged ≥16 years on first‐line ART at 10 facilities in rural Lesotho received a first‐time VL in June 2014. Those with VL ≥80 copies/mL were included in a cohort. The care cascade was assessed at four points: attendance of EAC, result of follow‐up VL after EAC, switch to second‐line in case of sustained unsuppressed VL and outcome 18 months after the initial unsuppressed VL. Multivariate logistic regression was used to assess predictors of being retained in care with viral resuppression at follow‐up. Results : Out of 1563 patients who underwent first‐time VL, 138 (8.8%) had unsuppressed VL in June 2014. Out of these, 124 (90%) attended EAC and 116 (84%) had follow‐up VL (4 died, 2 transferred out, 11 lost, 5 switched to second‐line before follow‐up VL). Among the 116 with follow‐up VL, 36 (31%) achieved resuppression. Out of the 80 with sustained unsuppressed VL, 58 were switched to second‐line, the remaining continued first line. At 18 months’ follow‐up in December 2015, out of the initially 138 with unsuppressed VL, 56 (41%) were in care and virally suppressed, 37 (27%) were in care with unsuppressed VL and the remaining 45 (33%) were lost, dead, transferred to another clinic or without documented VL. Achieving viral resuppression after EAC (adjusted odds ratio (aOR): 5.02; 95% confidence interval: 1.14–22.09; p = 0.033) and being switched to second‐line in case of sustained viremia after EAC (aOR: 7.17; 1.90–27.04; p = 0.004) were associated with being retained in care and virally suppressed at 18 months of follow‐up. Age, gender, education, time on ART and level of VL were not associated. Conclusions : In this study in rural Lesotho, outcomes along the “failure cascade” were poor. To improve outcomes in this vulnerable patient group who fails the last “90”, programmes need to focus on timely EAC and switch to second line for cases with continuous viremia despite EAC.     

BK virus viremia in a well‐HLA‐matched kidney transplant population mainly on low‐dose cyclosporine‐based immunosuppression

The incidence and clinical course of polyomavirus‐associated nephropathy (PyVAN) in our well‐HLA‐matched kidney transplant population mainly on low‐dose cyclosporine‐based triple‐drug immunosuppression has not been described in detail. We aimed to characterize our patients with PyVAN and BK virus (BKV) viremia. Among 166 kidney transplantations between January 2007 and February 2011 followed up at Helsinki University Hospital nephrology clinic, 136 were screened for BKV viremia by quantitative analysis of BKV DNA in plasma. PyVAN was diagnosed by biopsy histopathology and SV40 T‐antigen detection. BKV viremia or PyVAN were treated by reducing immunosuppression. BKV viremia was detected in 12 (9%) patients. PyVAN was diagnosed in six patients (4%). In the six patients with no PyVAN, four had low‐level viremia (<10 000 copies/mL) of short duration (<2 months), one had high‐level viremia, and one had sustained low‐level viremia. After reduction of immunosuppression, all except one patient were able to clear viremia. No grafts were lost due to PyVAN. Even in a low‐risk population, BKV viremia and PyVAN occur, highlighting the importance of monitoring viral loads. Reduction of immunosuppression was successful, and no grafts were lost due to PyVAN.     

Exendin‐4 shows no effects on the prostatic index in high‐fat‐diet‐fed rat with benign prostatic hyperplasia by improving insulin resistance

Benign prostatic hyperplasia (BPH) is a prevalent disease globally, and accumulating evidence has indicated an association between BPH, insulin resistance (IR) and diabetes. Exendin‐4 is widely used in clinics, which could enhance the proliferation of pancreatic β cells. The ability of exendin‐4 to promote tumorigenesis has been of concern, and whether exendin‐4 would enhance the propagation of BPH is not fully understood. We aimed to determine whether glucagon‐like peptide‐1 receptors (GLP‐1Rs) were expressed in rat prostate and to determine the effect of exendin‐4 on prostate of BPH. Male Wistar rats were used and assigned to six groups: normal diet (ND), high‐fat diet (HFD), HFD + exendin‐4, HFD + BPH, HFD + BPH + exendin‐4 and HFD + BPH + rosiglitazone group. After castration, steroids were injected subcutaneously for 4 weeks to induce BPH. Rats were kept on high‐fat diet to induce IR. Treatment groups were treated with exendin‐4 and rosiglitazone. Prostatic index and HOMA‐IR index were used to evaluate the prostatic hyperplasia status and the degree of IR respectively. The expression of GLP‐1R was indicated not only by immunohistochemistry, but also by Western blot analysis. The expression of GLP‐1R was significantly higher, and HOMA‐IR index and body weight significantly decreased after administration of exendin‐4. However, no significant differences in the prostatic index were observed between exendin‐4 treatment groups and non‐exendin‐4 treatment groups. Prostatic index was not influenced by exendin‐4 maybe by improving IR and weight loss.     

Quantitating the effect of prosthesis design on femoral remodeling using high‐resolution region‐free densitometric analysis (DXA‐RFA)

Dual energy X‐ray absorptiometry (DXA) is the reference standard method used to study bone mineral density (BMD) after total hip arthroplasty (THA). However, the subtle, spatially complex changes in bone mass due to strain‐adaptive bone remodeling relevant to different prosthesis designs are not readily resolved using conventional DXA analysis. DXA region free analysis (DXA RFA) is a novel computational image analysis technique that provides a high‐resolution quantitation of periprosthetic BMD. Here, we applied the technique to quantitate the magnitude and areal size of periprosthetic BMD changes using scans acquired during two previous randomized clinical trials (2004 to 2009); one comparing three cemented prosthesis design geometries, and the other comparing a hip resurfacing versus a conventional cementless prosthesis. DXA RFA resolved subtle differences in magnitude and area of bone remodeling between prosthesis designs not previously identified in conventional DXA analyses. A mean bone loss of 10.3%, 12.1%, and 11.1% occurred for the three cemented prostheses within a bone area fraction of 14.8%, 14.4%, and 6.2%, mostly within the lesser trochanter (p < 0.001). For the cementless prosthesis, a diffuse pattern of bone loss (−14.3%) was observed at the shaft of femur in a small area fraction of 0.6% versus no significant bone loss for the hip resurfacing prosthesis (p < 0.001). BMD increases were observed consistently at the greater trochanter for all prostheses except the hip‐resurfacing prosthesis, where BMD increase was widespread across the metaphysis (p < 0.001). DXA RFA provides high‐resolution insights into the effect of prosthesis design on the local strain environment in bone. © 2017 The Authors Journal of Orthopaedic Research published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 35:2203–2210, 2017.

     

Development of a chemiluminescence immunoassay using recombinant non‐structural epitope‐based proteins to accurately differentiate foot‐and‐mouth disease virus‐infected and vaccinated bovines

The contamination of inactivated vaccine with non‐structural proteins (NSP s) leads to a high false‐positive rate, which is a substantial barrier to accurately differentiate foot‐and‐mouth disease virus (FMDV )‐infected animals from vaccinated animals. To address this problem, a new chemiluminescence immunoassay (CLIA ) method was developed to detect antibodies targeting the two recombinant epitope‐based proteins located in 3A and 3B. The 3Aepitp‐3Bepitp CLIA exhibited a diagnostic sensitivity of 94.0% and a diagnostic specificity of 97.5% for the detection of serum samples (naïve bovines, n  = 52, vaccinated bovines, n  = 422, infected bovines, n  = 116) from animals with known status. The CLIA method also had a concordance rate of 88.1% with the PrioCHECK FMDV NSP ELISA based on the detection of 270 serum samples from the field. Importantly, the 3Aepitp‐3Bepitp CLIA produced no false‐positives when used to detect FMDV in samples from bovines that had been vaccinated up to five times, and it was demonstrated a low false‐positive rate when the bovines had been vaccinated up to ten (2.15%) and fifteen times (5.93%). Therefore, the 3Aepitp‐3Bepitp CLIA detects FMDV in samples from frequently vaccinated bovines with high accuracy and represents an alternative method to differentiate FMDV ‐infected and vaccinated bovines.     

Optimal control of linear multi‐delay systems based on a multi‐interval decomposition scheme

This paper presents a novel approximation scheme to the numerical treatment of linear time‐varying multi‐delay systems with a quadratic performance index. A direct approach based on a hybrid of block‐pulse functions and Chebyshev polynomials is successfully developed. The operational matrix of delay associated to multi‐delay systems is constructed by an efficient manner. The excellent properties of hybrid functions together with the operational matrices of integration, delay, and product are then used to transform the optimal control problem into a mathematical optimization problem whose solution is much more easier than the original one. The procedure described in the current paper can be regarded as a multi‐interval decomposition scheme. The convergence of the proposed method is verified numerically. A wide variety of multi‐delay systems are investigated to demonstrate the effectiveness and computational efficiency of the proposed numerical scheme. The method has a simple structure, is easy to implement, and provides very accurate solutions. Copyright © 2015 John Wiley & Sons, Ltd.     

Radio‐guided and clip‐guided preoperative localization for malignant microcalcifications offer similar performances in breast‐conserving surgery

Obtaining a tailored breast resection is challenging in microcalcifications detected on screening mammography, and an accurate localization is required. The aim of this study was to compare the efficacy of radio‐guided localization (ROLL) versus ultrasound localization of a titanium clip with collagen (TCC) in terms of clear margins, re‐intervention rates, excess of resected breast tissue, and operative times in pure malignant microcalcifications detected on screening mammography. Two hundred and twenty‐one consecutive patients with malignant microcalcifications detected on screening mammography from a tertiary breast unit were reviewed: 177 patients were localized by TCC and 44 patients by stereotactic ROLL. A propensity score‐matched analysis was performed, followed by a logistic regression model, to avoid selection bias. Adequacy of resection was expressed as the calculated resection ratio considering lesion size. No differences were found in clear margins with ROLL versus TCC (77.3% vs 81.8%, adjusted OR 2, P = 0.27). Re‐operation rates were similar, being 11.3% with ROLL and 7.4% with TCC (P = 0.627). Mean resection volume was 46.2 cm³ with ROLL versus 54.2 cm³ with TCC (P = 0.222). Adjusted mean calculated resection ratio was 1.8 with ROLL and 2.1 with TCC (P = 0.38). Surgery time was longer with TCC compared to ROLL (69.6 vs 52.7 minutes, P < 0.0001). ROLL and TCC are equally effective to excise malignant microcalcifications with clear margins, providing similar re‐intervention rates and resection volumes.