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Direct reprogramming involves the conversion of differentiated cell types without returning to an earlier developmental state. Here, we explore how heterogeneity in developmental lineage and maturity of the starting cell population contributes to direct reprogramming using the conversion of murine fibroblasts into neurons. Our hypothesis is that a single lineage of cells contributes to most reprogramming and that a rare elite precursor with intrinsic bias is the source of reprogrammed neurons. We find that nearly all reprogrammed neurons are derived from the neural crest (NC) lineage. Moreover, when rare proliferating NC precursors are selectively ablated, there is a large reduction in the number of reprogrammed neurons. Previous interpretations of this paradigm are that it demonstrates a cell fate conversion across embryonic germ layers (mesoderm to ectoderm). Our interpretation is that this is actually directed differentiation of a neural lineage stem cell in the skin that has intrinsic bias to produce neuronal progeny.
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Because of the abundance of sodium resources, sodium-ion batteries (NIBs) offer a promising alternative electrochemical energy storage solution. One of the current roadblocks to the development of NIBs technology is a lack of electrode materials capable of reversibly storing/releasing sodium ions for a sufficiently long time. Thus, this work aims to study, theoretically, the effect of glycerin incorporation on polyvinyl alcohol (PVA)/sodium alginate (Na Alg) blend as electrode materials for NIBs. The electronic, thermal, and quantitative structure-activity relationship (QSAR) descriptors of polymer electrolytes based on a blend of PVA and Na Alg and glycerin are the main topics of this work. These properties are examined here using semi-empirical methods and the density functional theory (DFT). Bandgap energy (Eg) is examined because the structural analysis reveals details regarding the interactions between PVA/Na Alg and glycerin. The findings indicate that the addition of glycerin caused the Eg value to drop to 0.2814 eV. The molecular electrostatic potential surface, or MESP, shows the electron-rich and deficit regions throughout the electrolyte system as well as the distribution of molecular charges. Thermal parameters that are studied include enthalpy (H), entropy (ΔS), heat capacity (Cp), Gibbs' free energy (G), and heat of formation. Additionally, the study examines several QSAR descriptors, such as total dipole moment (TDM), total energy (E), ionization potential (IP), Log P, and Polarizability. The results show that H, ΔS, Cp, G, and TDM increased with increasing temperature and glycerin content. Meanwhile, heat of formation, IP, and E decreased, improving reactivity and polarizability. Additionally, the cell voltage increased to 2.488 V due to glycerin addition. The overall DFT and PM6 calculations of cost-effective PVA/Na Alg based glycerin electrolytes indicate that they can partially replace lithium-ion batteries due to their multifunctionality, but requires further improvement and investigations.
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The emerging world of 3D food printing is reviewed. Its role in food manufacturing, including benefits and impacts, underemphasized gastrophysical aspects, and limitations are discussed. Foods can be digitally designed and physically prepared using the layer-by-layer deposition of food components, unleashing opportunities to deliver nutritionally personalized food and new food-human interactions. Existing bottlenecks, under-researched gastropsychophysical aspects, and the lack of harmonized standards hindering its use for mass production are mentioned.
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Hepatitis C virus (HCV) is a major global health concern, affecting millions of individuals worldwide. While existing literature predominantly focuses on disease classification using clinical data, there exists a critical research gap concerning HCV genotyping based on genomic sequences. Accurate HCV genotyping is essential for patient management and treatment decisions. While the neural models excel at capturing complex patterns, they still face challenges, such as data scarcity, that exist a lot in computational genomics. To overcome this challenges, this paper introduces an advanced deep learning approach for HCV genotyping based on the graphical representation of nucleotide sequences that outperforms classical approaches. Notably, it is effective for both partial and complete HCV genomes and addresses challenges associated with imbalanced datasets. In this work, ten HCV genotypes: 1a, 1b, 2a, 2b, 2c, 3a, 3b, 4, 5, and 6 were used in the analysis. This study utilizes Chaos Game Representation for 2D mapping of genomic sequences, employing self-supervised learning using convolutional autoencoder for deep feature extraction, resulting in an outstanding performance for HCV genotyping compared to various machine learning and deep learning models. This baseline provides a benchmark against which the performance of the proposed approach and other models can be evaluated. The experimental results showcase a remarkable classification accuracy of over 99%, outperforming traditional deep learning models. This performance demonstrates the capability of the proposed model to accurately identify HCV genotypes in both partial and complete sequences and in dealing with data scarcity for certain genotypes. The results of the proposed model are compared to NCBI genotyping tool.
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Genoma Viral , Genótipo , Técnicas de Genotipagem , Hepacivirus , Hepatite C , Hepacivirus/genética , Hepacivirus/classificação , Humanos , Técnicas de Genotipagem/métodos , Hepatite C/virologia , Aprendizado de Máquina Supervisionado , Aprendizado Profundo , Biologia Computacional/métodosRESUMO
Abernethy syndrome is a rare congenital anomaly characterized by an intrahepatic or extrahepatic portosystemic shunt. Most patients are asymptomatic; however, due to the alteration in, or lack of, a portovenous flow, patients with Abernethy syndrome are at high risk of developing sequelae of liver failure. Once these complications develop, the only definitive treatment is transplantation. Patients with Abernethy syndrome are also at a higher risk of developing benign and malignant liver lesions, including hepatic adenomas. Here, we describe the first case of deceased donor liver transplantation as a treatment for a patient with type 1 Abernethy syndrome complicated by large, unresectable hepatic adenoma, found to have focal hepatocellular carcinoma on pathologic examination. Our male patient was found to have elevated liver enzymes at age 33, during a routine outpatient medical appointment. Despite being asymptomatic, his history of prior liver resection prompted CT imaging, which revealed two large liver lesions concerning for hepatic adenomas. When surveillance imaging showed a significant growth of the liver lesions, biopsy was pursued, which confirmed a diagnosis of hepatic adenomas. However, given the size of these lesions, resection was not a viable option for the patient. Instead, the patient underwent liver transplantation at age 41, which he tolerated well. Our case demonstrates the utility of deceased donor liver transplantation as a treatment for patients with Abernethy syndrome complicated by unresectable adenomas.
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BACKGROUND: Current cardiovascular magnetic resonance sequences cannot discriminate between different myocardial extracellular space (ECSs), including collagen, noncollagen, and inflammation. We sought to investigate whether cardiovascular magnetic resonance radiomics analysis can distinguish between noncollagen and inflammation from collagen in dilated cardiomyopathy. METHODS: We identified data from 132 patients with dilated cardiomyopathy scheduled for an invasive septal biopsy who underwent cardiovascular magnetic resonance at 3 T. Cardiovascular magnetic resonance imaging protocol included native and postcontrast T1 mapping and late gadolinium enhancement (LGE). Radiomic features were computed from the midseptal myocardium, near the biopsy region, on native T1, extracellular volume (ECV) map, and LGE images. Principal component analysis was used to reduce the number of radiomic features to 5 principal radiomics. Moreover, a correlation analysis was conducted to identify radiomic features exhibiting a strong correlation (r>0.9) with the 5 principal radiomics. Biopsy samples were used to quantify ECS, myocardial fibrosis, and inflammation. RESULTS: Four histopathological phenotypes were identified: low collagen (n=20), noncollagenous ECS expansion (n=49), mild to moderate collagenous ECS expansion (n=42), and severe collagenous ECS expansion (n=21). Noncollagenous expansion was associated with the highest risk of myocardial inflammation (65%). Although native T1 and ECV provided high diagnostic performance in differentiating severe fibrosis (C statistic, 0.90 and 0.90, respectively), their performance in differentiating between noncollagen and mild to moderate collagenous expansion decreased (C statistic: 0.59 and 0.55, respectively). Integration of ECV principal radiomics provided better discrimination and reclassification between noncollagen and mild to moderate collagen (C statistic, 0.79; net reclassification index, 0.83 [95% CI, 0.45-1.22]; P<0.001). There was a similar trend in the addition of native T1 principal radiomics (C statistic, 0.75; net reclassification index, 0.93 [95% CI, 0.56-1.29]; P<0.001) and LGE principal radiomics (C statistic, 0.74; net reclassification index, 0.59 [95% CI, 0.19-0.98]; P=0.004). Five radiomic features per sequence were identified with correlation analysis. They showed a similar improvement in performance for differentiating between noncollagen and mild to moderate collagen (native T1, ECV, LGE C statistic, 0.75, 0.77, and 0.71, respectively). These improvements remained significant when confined to a single radiomic feature (native T1, ECV, LGE C statistic, 0.71, 0.70, and 0.64, respectively). CONCLUSIONS: Radiomic features extracted from native T1, ECV, and LGE provide incremental information that improves our capability to discriminate noncollagenous expansion from mild to moderate collagen and could be useful for detecting subtle chronic inflammation in patients with dilated cardiomyopathy.
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Cardiomiopatia Dilatada , Matriz Extracelular , Humanos , Cardiomiopatia Dilatada/diagnóstico por imagem , Cardiomiopatia Dilatada/patologia , Matriz Extracelular/patologia , Matriz Extracelular/metabolismo , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Colágeno/metabolismo , Miocárdio/patologia , Idoso , Fibrose , Imageamento por Ressonância Magnética/métodos , Biópsia , Análise de Componente Principal , RadiômicaRESUMO
BACKGROUND: Regional analgesia techniques are crucial for pain management after cervical spine surgeries. Anesthesiologists strive to select the most effective and least hazardous regional analgesia technique for the cervical region. Our hypothesis is that an intermediate cervical plexus (IC) block can provide adequate postoperative analgesia compared to a cervical erector spinae (ES) block in patients undergoing anterior cervical spine surgery. METHODS: In this double-blind prospective trial, 58 patients were randomly assigned into two equal groups prior to the administration of general anesthesia. Patients in the IC group (n = 29) underwent ultrasound-guided bilateral intermediate cervical plexus block with 15 ml of bupivacaine 0.25% administered to each side. The ES group (n = 29) underwent ultrasound-guided bilateral cervical erector spinae plane blocks with 15 ml of 0.25% bupivacaine administered to each side at the C6 level. The primary outcome was to record the time to the first call for rescue analgesia (nalbuphine), and the secondary outcomes were to measure the performance time, the onset of the sensory block, the intraoperative fentanyl consumption, postoperative pain intensity using VAS, the postoperative total nalbuphine consumption, and postoperative complications such as nausea, vomiting, hypotension, and bradycardia. RESULTS: The performance and onset of sensory block times were significantly shorter in the IC group compared to the ES group. The time to first call for nalbuphine was significantly shorter in the IC group (7.31 ± 1.34 h) compared to the ES group (11.10 ± 1.82 h). The mean postoperative VAS scores were comparable between the two groups at the measured time points, except at 8 h, where it was significantly higher in the IC group, and at 12 h, where it was significantly higher in the ES group. The total nalbuphine consumption was significantly higher in the IC group (33.1 ± 10.13 mg) compared to the ES group (22.76 ± 8.62 mg). CONCLUSIONS: For patients undergoing anterior cervical spine surgery, the intermediate cervical plexus block does not provide better postoperative regional analgesia compared to the cervical erector spinae block. Performance time and onset time were shorter in the IC group, whereas nalbuphine consumption was lower in the ES group. TRIAL REGISTRATION: The trial was registered at clinicaltrials.gov. (NCT05577559, and the date of registration: 13-10-2022).
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Bloqueio do Plexo Cervical , Vértebras Cervicais , Dor Pós-Operatória , Ultrassonografia de Intervenção , Humanos , Feminino , Ultrassonografia de Intervenção/métodos , Método Duplo-Cego , Masculino , Dor Pós-Operatória/prevenção & controle , Dor Pós-Operatória/tratamento farmacológico , Pessoa de Meia-Idade , Estudos Prospectivos , Vértebras Cervicais/cirurgia , Bloqueio do Plexo Cervical/métodos , Adulto , Anestésicos Locais/administração & dosagem , Bupivacaína/administração & dosagem , Bloqueio Nervoso/métodos , Músculos Paraespinais/diagnóstico por imagem , Analgésicos Opioides/administração & dosagem , Nalbufina/administração & dosagem , IdosoRESUMO
Background and Aims: Intraoperative regional analgesia and enhanced recovery are standard care models aimed at reducing perioperative opioid use following spine surgeries. This study aimed to examine the analgesic effect of retrolaminar block in promoting recovery and pain relief after posterior lumbar discectomy. Methods: The patients undergoing elective posterior lumbar discectomy were randomised into the retrolaminar group (n = 36) (received an intra-operative bilateral retrolaminar block with 15 mL of bupivacaine 0.25%, 2 mL (8 mg) of dexamethasone, and 2 mL of magnesium sulphate 10% (200 mg) on each side) and control group (n = 36) (received standard general anaesthesia). Primary outcomes were recovery time (time from isoflurane discontinuation to the first response to verbal command) and time to discharge (time from admission to the post-anaesthesia care unit (PACU) to discharge from the PACU, when Aldrete score was ≥9). P values < 0.05 were considered statistically significant. Results: The extubation, recovery, and discharge times were significantly shorter in the retrolaminar group compared to the control group (P < 0.001). Postoperative pain scores were significantly lower in the retrolaminar group for up to 8 h compared to only 2 h in the control group (P < 0.001). The time to first administration of ketorolac post-operatively was significantly longer in the retrolaminar group compared to the control group (P < 0.001). The total consumption of ketorolac post-operatively was significantly reduced in the retrolaminar group compared to the control group (P < 0.001). Conclusion: Intra-operative retrolaminar block is an easy and effective opioid-free regional anaesthesia technique that improves recovery after posterior lumbar discectomy.
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Compound nerve action potentials (CNAPs) were used as a metric to assess the stimulation performance of a novel high-density, transverse, intrafascicular electrode in rat models. We show characteristic CNAPs recorded from distally implanted cuff electrodes. Evaluation of the CNAPs as a function of stimulus current and calculation of recruitment plots were used to obtain a qualitative approximation of the neural interface's placement and orientation inside the nerve. This method avoids elaborate surgeries required for the implantation of EMG electrodes and thus minimizes surgical complications and may accelerate the healing process of the implanted subject.
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BACKGROUND: Late gadolinium enhancement (LGE) scar burden by cardiac magnetic resonance is a major risk factor for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM). However, there is currently limited data on the incremental prognostic value of integrating myocardial LGE radiomics (ie, shape and texture features) into SCD risk stratification models. OBJECTIVES: The purpose of this study was to investigate the incremental prognostic value of myocardial LGE radiomics beyond current European Society of Cardiology (ESC) and American College of Cardiology (ACC)/American Heart Association (AHA) models for SCD risk prediction in HCM. METHODS: A total of 1,229 HCM patients (62% men; age 52 ± 16 years) from 3 medical centers were included. Left ventricular myocardial radiomic features were calculated from LGE images. Principal component analysis was used to reduce the radiomic features and calculate 3 principal radiomics (PrinRads). Cox and logistic regression analyses were then used to evaluate the significance of the extracted PrinRads of LGE images, alone or in combination with ESC or ACC/AHA models, to predict SCD risk. The ACC/AHA risk markers include LGE burden using a dichotomized 15% threshold of LV scar. RESULTS: SCD events occurred in 30 (2.4%) patients over a follow-up period of 49 ± 28 months. Risk prediction using PrinRads resulted in higher c-statistics than the ESC (0.69 vs 0.57; P = 0.02) and the ACC/AHA (0.69 vs 0.67; P = 0.75) models. Risk predictions were improved by combining the 3 PrinRads with ESC (0.73 vs 0.57; P < 0.01) or ACC/AHA (0.76 vs 0.67; P < 0.01) risk scores. The net reclassification index was improved by combining the PrinRads with ESC (0.25 [95% CI: 0.08-0.43]; P = 0.005) or ACC/AHA (0.05 [95% CI: -0.07 to 0.16]; P = 0.42) models. One PrinRad was a significant predictor of SCD risk (HR: 0.57 [95% CI: 0.39-0.84]; P = 0.01). LGE heterogeneity was a major component of PrinRads and a significant predictor of SCD risk (HR: 0.07 [95% CI: 0.01-0.75]; P = 0.03). CONCLUSIONS: Myocardial LGE radiomics are strongly associated with SCD risk in HCM and provide incremental risk stratification beyond current ESC or AHA/ACC risk models. Our proof-of-concept study warrants further validation.
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Cardiomiopatia Hipertrófica , Meios de Contraste , Masculino , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Feminino , Prognóstico , Gadolínio , Cicatriz/diagnóstico por imagem , Cicatriz/complicações , Radiômica , Valor Preditivo dos Testes , Cardiomiopatia Hipertrófica/complicações , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Fatores de Risco , Morte Súbita Cardíaca/etiologia , Medição de Risco/métodosRESUMO
BACKGROUND: In cardiac T1 mapping, a series of T1 -weighted (T1 w) images are collected and numerically fitted to a two or three-parameter model of the signal recovery to estimate voxel-wise T1 values. To reduce the scan time, one can collect fewer T1 w images, albeit at the cost of precision or/and accuracy. Recently, the feasibility of using a neural network instead of conventional two- or three-parameter fit modeling has been demonstrated. However, prior studies used data from a single vendor and field strength; therefore, the generalizability of the models has not been established. PURPOSE: To develop and evaluate an accelerated cardiac T1 mapping approach based on MyoMapNet, a convolution neural network T1 estimator that can be used across different vendors and field strengths by incorporating the relevant scanner information as additional inputs to the model. STUDY TYPE: Retrospective, multicenter. POPULATION: A total of 1423 patients with known or suspected cardiac disease (808 male, 57 ± 16 years), from three centers, two vendors (Siemens, Philips), and two field strengths (1.5 T, 3 T). The data were randomly split into 60% training, 20% validation, and 20% testing. FIELD STRENGTH/SEQUENCE: A 1.5 T and 3 T, Modified Look-Locker inversion recovery (MOLLI) for native and postcontrast T1 . ASSESSMENT: Scanner-independent MyoMapNet (SI-MyoMapNet) was developed by altering the deep learning (DL) architecture of MyoMapNet to incorporate scanner vendor and field strength as inputs. Epicardial and endocardial contours and blood pool (by manually drawing a large region of interest in the blood pool) of the left ventricle were manually delineated by three readers, with 2, 8, and 9 years of experience, and SI-MyoMapNet myocardial and blood pool T1 values (calculated from four T1 w images) were compared with conventional MOLLI T1 values (calculated from 8 to 11 T1 w images). STATISTICAL TESTS: Equivalency test with 95% confidence interval (CI), linear regression slope, Pearson correlation coefficient (r), Bland-Altman analysis. RESULTS: The proposed SI-MyoMapNet successfully created T1 maps. Native and postcontrast T1 values measured from SI-MyoMapNet were strongly correlated with MOLLI, despite using only four T1 w images, at both field-strengths and vendors (all r > 0.86). For native T1 , SI-MyoMapNet and MOLLI were in good agreement for myocardial and blood T1 values in institution 1 (myocardium: 5 msec, 95% CI [3, 8]; blood: -10 msec, 95%CI [-16, -4]), in institution 2 (myocardium: 6 msec, 95% CI [0, 11]; blood: 0 msec, [-18, 17]), and in institution 3 (myocardium: 7 msec, 95% CI [-8, 22]; blood: 8 msec, [-14, 30]). Similar results were observed for postcontrast T1 . DATA CONCLUSION: Inclusion of field strength and vendor as additional inputs to the DL architecture allows generalizability of MyoMapNet across different vendors or field strength. EVIDENCE LEVEL: 2. TECHNICAL EFFICACY: Stage 2.
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Coração , Miocárdio , Humanos , Masculino , Estudos Retrospectivos , Coração/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Ventrículos do Coração , Reprodutibilidade dos TestesRESUMO
In this case report, we describe the clinical course of a complicated transplant renal artery (TRA) pseudoaneurysm, clinically featured by gross and massive hematuria one month after a kidney transplant was performed on a 50 year-old male patient. TRA pseudoaneurysm is a rare but potentially life-threatening complication that may result in bleeding, infection, graft dysfunction/loss, lower limb ischemia/loss, hemorrhagic shock, and death. TRA pseudoaneurysm treatment remains challenging as it needs to be tailored to the patient characteristics including hemodynamic stability, graft function, anatomy, presentation, and pseudoaneurysm features. This publication discusses the clinical scenario of massive gross hematuria that derived from a retroperitoneal hematoma which originated from an actively bleeding TRA pseudoaneurysm. This case highlights the combined approach of endovascular stent placement and subsequent transplant nephrectomy as a last resort in the management of intractable bleeding from a complicated TRA pseudoaneurysm. To the best of our knowledge, this is the first published case report of an actively bleeding TRA anastomotic pseudoaneurysm that caused a massive retroperitoneal bleed that in turn evacuated via the bladder after disrupting the ureter-to-bladder anastomosis. A temporizing hemostatic arterial stent placed percutaneously allowed for a safer and controlled emergency transplant nephrectomy.
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BACKGROUND: Exercise cardiovascular magnetic resonance (Ex-CMR) myocardial tagging would enable quantification of myocardial deformation after exercise. However, current electrocardiogram (ECG)-segmented sequences are limited for Ex-CMR. METHODS: We developed a highly accelerated balanced steady-state free-precession real-time tagging technique for 3 T. A 12-fold acceleration was achieved using incoherent sixfold random Cartesian sampling, twofold truncated outer phase encoding, and a deep learning resolution enhancement model. The technique was tested in two prospective studies. In a rest study of 27 patients referred for clinical CMR and 19 healthy subjects, a set of ECG-segmented for comparison and two sets of real-time tagging images for repeatability assessment were collected in 2-chamber and short-axis views with spatiotemporal resolution 2.0 × 2.0 mm2 and 29 ms. In an Ex-CMR study of 26 patients with known or suspected cardiac disease and 23 healthy subjects, real-time images were collected before and after exercise. Deformation was quantified using measures of short-axis global circumferential strain (GCS). Two experienced CMR readers evaluated the image quality of all real-time data pooled from both studies using a 4-point Likert scale for tagline quality (1-excellent; 2-good; 3-moderate; 4-poor) and artifact level (1-none; 2-minimal; 3-moderate; 4-significant). Statistical evaluation included Pearson correlation coefficient (r), intraclass correlation coefficient (ICC), and coefficient of variation (CoV). RESULTS: In the rest study, deformation was successfully quantified in 90% of cases. There was a good correlation (r = 0.71) between ECG-segmented and real-time measures of GCS, and repeatability was good to excellent (ICC = 0.86 [0.71, 0.94]) with a CoV of 4.7%. In the Ex-CMR study, deformation was successfully quantified in 96% of subjects pre-exercise and 84% of subjects post-exercise. Short-axis and 2-chamber tagline quality were 1.6 ± 0.7 and 1.9 ± 0.8 at rest and 1.9 ± 0.7 and 2.5 ± 0.8 after exercise, respectively. Short-axis and 2-chamber artifact level was 1.2 ± 0.5 and 1.4 ± 0.7 at rest and 1.3 ± 0.6 and 1.5 ± 0.8 post-exercise, respectively. CONCLUSION: We developed a highly accelerated real-time tagging technique and demonstrated its potential for Ex-CMR quantification of myocardial deformation. Further studies are needed to assess the clinical utility of our technique.
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Coração , Imagem Cinética por Ressonância Magnética , Humanos , Estudos Prospectivos , Imagem Cinética por Ressonância Magnética/métodos , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Espectroscopia de Ressonância Magnética , Função Ventricular EsquerdaRESUMO
Since its conception, the application of 3D printing in the structuring of food materials has been focused on the processing of novel material formulations and customized textures for innovative food applications, such as personalized nutrition and full sensory design. The continuous evolution of the used methods, approaches, and materials has created a solid foundation for technology to process dynamic food structures. Four-dimensional food printing is an extension of 3D printing where food structures are designed and printed to perform time-dependent changes activated by internal or external stimuli. In 4D food printing, structures are engineered through material tailoring and custom designs to achieve a transformation from one configuration to another. Different engineered 4D behaviors include stimulated color change, shape morphing, and biological growth. As 4D food printing is considered an emerging application, imperatively, this article proposes new considerations and definitions in 4D food printing. Moreover, this article presents an overview of 4D food printing within the current scientific progress, status, and approaches.
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Renal cell carcinoma (RCC) frequently spreads to distant organs like the lung, lymph nodes, bone, and liver. However, there have been some reports of RCC bladder metastasis. We present a case of a 61-year-old man presented with total painless gross hematuria. The patient had a history of right radical nephrectomy for papillary (type 2) RCC, high-grade, pT3a with negative surgical margins. There was no evidence of metastases on 6-month surveillance CT. After one-year post-operation, at this current admission, the cystoscopy discovered a solid bladder mass away from the trigone in the right lateral bladder wall. The resected bladder mass was metastatic papillary RCC with PAX-8 positive but GATA-3 negative on immunostaining. A positron emission tomography scan confirmed multiple lung, liver, and osseous metastases. This case report can highlight the importance of having bladder metastasis in RCC mind, although rare, and may necessitate the surveillance measures like urine analysis at more frequent interval and CT Urography instead of regular CT to detect the RCC metastatic bladder cancer at early stage.
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Objective. Chronic kidney disease (CKD), metabolic syndrome (MetS) and insulin resistance (IR) are the major health problems associated with the increasing risk of cardiovascular and cerebrovascular complications. Methods. This cross-sectional study included 209 CKD patients of stage (3-5) on conservative treatment to assess the usage of lipid accumulation product (LAP) and visceral adiposity index (VAI) to predict both MetS and IR in CKD patients. Results. In males, from the anthropometric measurements, LAP was the best predictor of MetS with 94.4% sensitivity and 77.8% specificity. VAI was the next one with 83.3% sensitivity and 69.4% specificity. The same results were obtained in females. The receiver operating characteristic (ROC) curve showed LAP as the best predictor of MetS with the highest 92.6% sensitivity and 60.6% specificity followed by VAI with 83.6% sensitivity and 83.6% specificity. In addition, LAP was a good predictor of IR with more than 70% sensitivity in both males and females. VAI as a predictor of IR showed 62.2% sensitivity in males and 69.9% in females. Conclusion. The present data indicate that both LAP and VAI can serve as predictors of MetS and IR in CKD patients, whereas LAP is the best anthropometric measure to predict MetS and LAP is more sensitive and specific than VAI in IR predicting in both males and females.
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Adiposidade , Resistência à Insulina , Produto da Acumulação Lipídica , Síndrome Metabólica , Insuficiência Renal Crônica , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Antropometria , Doenças Cardiovasculares/complicações , Transtornos Cerebrovasculares/complicações , Estudos Transversais , Síndrome Metabólica/complicações , Síndrome Metabólica/diagnóstico , Insuficiência Renal Crônica/complicações , Curva ROC , Sensibilidade e Especificidade , PrognósticoRESUMO
Over the past two decades, there has been a growing demand for generating digital surface models (DSMs) in real-time, particularly for aircraft landing in degraded visual environments. Challenging landing environments can hinder a pilot's ability to accurately navigate, see the ground, and avoid obstacles that may lead to equipment damage or loss of life. While many accurate and robust filtering algorithms for airborne laser scanning (ALS) data have been developed, they are typically computationally expensive. Moreover, these filtering algorithms require high execution times, making them unsuitable for real-time applications. This research aims to design and implement an efficient algorithm that can be used in real-time on limited-resource embedded processors without the need for a supercomputer. The proposed algorithm effectively identifies the best safe landing zone (SLZ) for an aircraft/helicopter based on processing 3D LiDAR point cloud data collected from a LiDAR mounted on the aircraft/helicopter. The algorithm was successfully implemented in C++ in real-time and validated using professional software for flight simulation. By comparing the results with maps, this research demonstrates the ability of the developed method to assist pilots in identifying the safest landing zone for helicopters.
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Undesired dough adhesion is still a challenge during the production of baked goods. There are various methods for determining the adhesive texture properties of dough. In the majority of scientific papers, dough stickiness is measured analytically by the force-distance recording of dough detachment. In this study, we describe a new multi-scale approach to compare dough adhesion phenomena in a laboratory, pilot sale and human sensory assessment. In it, the adhesive material properties of dough were investigated using a pilot scale toppling device representing dough adhesion behavior in the production process, in the laboratory by texture analysis with the Chen-Hoseney method and furthermore with a new, implemented non-oral human sensory analysis. To simulate different dough adhesion behavior, the dough mechanical and adhesion properties were varied by applying dough-modifying enzymes and different dough storage times. The structural changes in the different wheat dough system were compared by rheological characterization. By characterizing the different adhesion phenomena of the doughs, the sample with bacterial xylanase showed the highest values after 80 min of storage time in all three methods. Correlation analysis revealed a strong relationship between the detachment time (pilot scale) and human sensory assessment attributes (Force R = 0.81, Time R = 0.87, Distance R = 0.92, Stickiness R = 0.80) after 80 min of storage time. Even though human sensory assessment showed limits in the detectability of differences in dough adhesion behavior compared to the Chen-Hoseney method, it was better suited to predict machinability.
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Alimentos , Fenômenos MecânicosRESUMO
3-dimensional printing is a novel processing method used for the design and manipulation of food textures. The systematic characterization and modulation of 3D printed food textures is imperative for the future design of sensory profiles using additive manufacturing. For 3D printed closed-cell food foams, the clarification of the deformation behavior in relation to design parameters is of interest for the processing of customized food textures. For this reason, we studied the deformation behavior of 3D printed and thermally stabilized closed-cell starch-based foams beyond the elastic regime. Periodic spherical bubble configurations at different porosity levels were used to modulate the deformation behavior of the printed foams. From a processing perspective, the integration of in-line thermal stabilization was used to eliminate post-processing and to control the moisture content of the starch-based system. Compression analysis combined with FEM simulations were performed to characterize the strain rate dependency of textural properties, the stress relaxation, and the foam's stress-strain behavior with respect to the design porosity and bubble distribution. Results showed that the stress relaxation is solely dependent on cell wall properties while different stress-strain regimes showed distinct dependencies on design parameters such as bubble size and distribution. Consequently, the precise control of the large deformation behavior of foods using 3D printing is challenging due to the superposition of structural and geometrical dependencies. Finally, through the presented approach, the structure-deformation relations of 3D printed closed-cell food structures are adequately described.