Chronic Administration of Exogenous Lactate Increases Energy Expenditure during Exercise through Activation of Skeletal Muscle Energy Utilization Capacity in Mice.

We compared the effects of chronic exogenous lactate and exercise training, which influence energy substrate utilization and body composition improvements at rest and during exercise, and investigated the availability of lactate as a metabolic regulator. The mice were divided into four groups: CON (sedentary + saline), LAC (sedentary + lactate), EXE (exercise + saline), and EXLA (exercise + lactate). The total experimental period was set at 4 weeks, the training intensity was set at 60-70% VO2max, and each exercise group was administered a solution immediately after exercise. Changes in the energy substrate utilization at rest and during exercise, the protein levels related to energy substrate utilization in skeletal muscles, and the body composition were measured. Lactate intake and exercise increased carbohydrate oxidation as a substrate during exercise, leading to an increased energy expenditure and increased protein levels of citrate synthase and malate dehydrogenase 2, key factors in the TCA(tricarboxylic acid) cycle of skeletal muscle. Exercise, but not lactate intake, induced the upregulation of the skeletal muscle glucose transport factor 4 and a reduction in body fat. Hence, chronic lactate administration, as a metabolic regulator, influenced energy substrate utilization by the skeletal muscle and increased energy expenditure during exercise through the activation of carbohydrate metabolism-related factors. Therefore, exogenous lactate holds potential as a metabolic regulator.

Controlled Molecular Arrangement of Cinnamic Acid in Layered Double Hydroxide through pi-pi Interaction for Controlled Release.

Cinnamic acid (CA) was successfully incorporated into Zn-Al layered double hydroxide (LDH) through coprecipitation. The CA moiety was stabilized in the interlayer space through not only electrostatic interaction but also intermolecular π-π interaction. It was noteworthy that the CA arrangement was fairly independent of the charge density of LDH, showing the important role of the layer-CA and CA-CA interactions in molecular stabilization. Computer simulations using the Monte Carlo method as well as analytical approaches including infrared, UV-vis spectroscopy, and differential scanning calorimetry showed the existence of intermolecular interaction. In order to reinforce molecular stabilization, a neutral derivative of CA, cinnamaldehyde (CAD), was additionally incorporated into LDH. It was clearly shown that CAD played a role as a π-π interaction mediator to enhance the stabilization of CA. The time-dependent release of CA from LDH was first governed by the layer charge density of LDH; however, the existence of CAD provided additional stabilization to the CA arrangement to slow down the release kinetics.

Economic feasibility study of organic and conventional fish farming systems of Indian major carps.

Organic aquaculture is a new approach in the modern farming system. As the capital investment is higher for setting up the organic aquaculture, it is essential to conduct an economic feasibility study with compare the conventional farming system. In the current study, economic feasibility of culturing Indian major carps (IMC) using conventional culture system and organic culture system (OCS) were evaluated. IMC was cultured for three consecutive years from 2017 to 2019 in experimental ponds of 0.015 hectare (ha) area each. The crude protein content of the organic and conventional feed was maintained at the same iso-nitrogenous level (32% crude protein) but the highest production to the tune of 19 tons per ha was obtained in OCS. Further, in case of OCS, apart from fish production, vermicomposting to the tune of 45,000 kg ha-1 in the first year, and 90,000 kg ha-1 from second year onward is achievable by installing a vermicomposting unit of 200 tons annual capacity. Economic analysis of the culture systems assuming a project period of 10 years showed that the highest net present value (NPV) of 1.06 million USD, a payback period of one year and nine months and an internal rate of return (IRR) of 51% are achievable per ha of fish culture pond for OCS. Sensitivity analysis of various costs performed for OCS revealed that profitability of the organic fish farming investment is most sensitive to the total fish production and sale price of the organic fishes. In terms of production of fish and economics of organic culture system is proved to be the best available technique.

Assessment of Imaging Factors Associated with Baker's Cyst Rupture on Knee MRI.

Objectives: To identify the factors associated with Baker's cyst rupture on MRI. Material and methods: From January 2021 to December 2022, a total of 441 knee MRI examinations in 441 patients (mean age: 47.7 ± 13.8 years) with Baker's cyst were included in this study. Patients were classified into two groups: those with ruptured vs. unruptured Baker's cysts. On knee radiograph, osteoarthritis grade was assessed based on Kellgren-Lawrence grade. On MRI, combined structure injuries, alignment type between semimembranosus tendon and medial head of gastrocnemius tendon, amount of joint effusion, presence of septation, maximal diameters of cyst, and cyst volume were evaluated. Receiver operating characteristic (ROC) analysis was performed to assess the predictive performances of imaging factors for cyst rupture. Results: There were 146 patients with Baker's cyst rupture and 295 patients without rupture. Patients with cyst rupture showed significantly longer maximal transverse diameter (25.8 ± 6.8 mm vs. 21.6 ± 5.8 mm, p = 0.035) and larger volume (13.3 ± 6.2 cm3 vs. 9.9 ± 5.1 cm3, p = 0.012) than those without rupture. On ROC analysis, maximal transverse diameter of cyst ≥ 22.2 mm (sensitivity = 64.4%, specificity = 54.9%) and cyst volume ≥ 10.9 cm3 (sensitivity = 71.2%, specificity = 58.3%) were the cutoff values for predicting rupture of cyst, respectively. The cyst volume showed significantly higher area under the curve (AUC) than maximal transverse diameter (0.726 vs. 0.642, p = 0.002). Conclusion: Longer transverse diameter and larger volume of Baker's cyst could be predictive imaging parameters for cyst rupture.

Primary spontaneous pneumomediastinum: 237 cases in a single-center experience over a 10-year period and assessment of factors related with recurrence.

OBJECTIVE: To evaluate the precipitating factors and symptoms of primary spontaneous pneumomediastinum (PSPM) and to assess the factors related with recurrent spontaneous pneumomediastinum (RSPM). METHODS: From 2010 to 2021, 237 PSPM patients were included in this retrospective study. Clinical information including in-hospital periods, morbidity, mortality, presenting symptoms, precipitating events, smoking, and asthma history was obtained. The patients with smoking history were subdivided into "ex-smoker" or "current smoker". The severity of asthma was categorized into "mild intermittent", "mild persistent", "moderate persistent", or "severe persistent". During follow-up, patients with RSPM were classified into "recurrence" group and the others were into "no recurrence" group. Multivariate regression analysis was used to elucidate the associated factors with RSPM. RESULTS: The mean age of study patients (men: women = 222: 15) was 23.4 years and mean period of hospital stay was 7.5 days. There was no mortality and morbidity. Most frequent symptom and precipitating factor were acute chest pain (n = 211, 89.0%) and cough (n = 72, 30.4%), respectively. RSPM occurred in 11 patients (4.6%). The proportion of patients with smoking (72.8% vs. 37.1%, p = 0.010) or asthma (81.8% vs. 39.8%, p<0.001) was significantly higher in "recurrence" group than "no recurrence" group. On multivariate analysis, asthma was the only factor associated with RSPM (mild intermittent/persistent, OR = 7.092, p = 0.047; moderate persistent, OR = 8.000, p = 0.011). CONCLUSION: PSPM is a benign disease with no morbidity and mortality. Asthma may be the associated factor with RSPM; thus, despite the low rate of recurrence, patients with asthma should be informed about the chance of RSPM.

Assessment of a Therapeutic X-ray Radiation Dose Measurement System Based on a Flexible Copper Indium Gallium Selenide Solar Cell.

Several detectors have been developed to measure radiation doses during radiotherapy. However, most detectors are not flexible. Consequently, the airgaps between the patient surface and detector could reduce the measurement accuracy. Thus, this study proposes a dose measurement system based on a flexible copper indium gallium selenide (CIGS) solar cell. Our system comprises a customized CIGS solar cell (with a size 10 × 10 cm2 and thickness 0.33 mm), voltage amplifier, data acquisition module, and laptop with in-house software. In the study, the dosimetric characteristics, such as dose linearity, dose rate independence, energy independence, and field size output, of the dose measurement system in therapeutic X-ray radiation were quantified. For dose linearity, the slope of the linear fitted curve and the R-square value were 1.00 and 0.9999, respectively. The differences in the measured signals according to changes in the dose rates and photon energies were <2% and <3%, respectively. The field size output measured using our system exhibited a substantial increase as the field size increased, contrary to that measured using the ion chamber/film. Our findings demonstrate that our system has good dosimetric characteristics as a flexible in vivo dosimeter. Furthermore, the size and shape of the solar cell can be easily customized, which is an advantage over other flexible dosimeters based on an a-Si solar cell.

Assessment of a novel commercial large field of view phantom for comprehensive MR imaging quality assurance of a 0.35T MRgRT system.

Consistent quality assurance (QA) programs are vital to MR-guided radiotherapy (MRgRT), for ensuring treatment is delivered accurately and the onboard MRI system is providing the expected image quality. However, daily imaging QA with a dedicated phantom is not common at many MRgRT centers, especially with large phantoms that cover a field of view (FOV), similar to the human torso. This work presents the first clinical experience with a purpose-built phantom for large FOV daily and periodic comprehensive quality assurance (QUASAR™ MRgRT Insight Phantom (beta)) from Modus Medical Devices Inc. (Modus QA) on an MRgRT system. A monthly American College of Radiology (ACR) QA phantom was also imaged for reference. Both phantoms were imaged on a 0.35T MR-Linac, a 1.5T Philips wide bore MRI, and a 3.0T Siemens MRI, with T1-weighted and T2-weighted acquisitions. The Insight phantom was imaged in axial and sagittal orientations. Image quality tests including geometric accuracy, spatial resolution accuracy, slice thickness accuracy, slice position accuracy, and image intensity uniformity were performed on each phantom, following their respective instruction manuals. The geometric distortion test showed similar distortions of -1.7 mm and -1.9 mm across a 190 mm and a 283 mm lengths for the ACR and MRgRT Insight phantoms, respectively. The MRgRT Insight phantom utilized a modulation transform function (MTF) for spatial resolution evaluation, which showed decreased performance on the lower B0 strength MRIs, as expected, and could provide a good daily indicator of machine performance. Both the Insight and ACR phantoms showed a match with scan parameters for slice thickness analysis. During the imaging and analysis of this novel MRgRT Insight phantom the authors found setup to be straightforward allowing for easy acquisition each day, and useful image analysis parameters for tracking MRI performance.

Incidence and Survival Rates of Cutaneous Melanoma in South Korea Using Nationwide Health Insurance Claims Data.

PURPOSE: Melanoma incidence is rising worldwide along with the associated personal and socioeconomic health expenditures. We investigated the incidence and survival-rate patterns of melanoma in South Korea using nationwide data. MATERIALS AND METHODS: This retrospective cohort study included patients with melanoma between 2004 and 2017, based on National Health Insurance (NHI) claims data in South Korea. The incidence, prevalence, and survival rate were analyzed along with baseline demographic characteristics. We collected solar irradiation dose (SID) and healthcare ranking score (HRS) according to the administrative district from the Korea Meteorological Administration and Korea Health Promotion Institute. The incidence and survival rates were assessed using Pearson's correlation, the Kaplan-Meier estimation, multiple linear regression, and multiple logistic regression methods. RESULTS: Twenty-five thousand, five hundred ninety-one patients with melanoma were diagnosed during the study period. The age-standardized incidence of melanoma steadily increased from 2004 to 2017 from 2.6 to 3.0/100,000/yr. The incidence of melanoma increased with significantly higher income (p < 0.05). The prevalence followed a similar pattern as the incidence. According to multivariate analysis, HRS significantly influenced the incidence of melanoma in high sun-exposed sites (p < 0.001). There was no significant change in annual mortality. Women had a higher 5-year survival rate than men (78.4% vs. 72.8%). Mortality by the administrative district was highly correlated with HRS. CONCLUSION: The incidence of melanoma is increasing in South Korea. A low HRS is associated with both higher incidence and mortality. The findings of this study could be utilized as a guideline for treating melanoma patients.

Feasibility study of patient-specific energy verification using a multilayer acrylic-disk radiation sensor.

PURPOSE: Obtaining an integral depth-dose (IDD) curve using a recently developed acrylic-disk radiation sensor (ADRS) is time-consuming because its single structure requires point-by-point measurements in a water phantom. The goal of this study was to verify the ability of a newly designed multilayer ADRS, composed of 20 layers, to measure the energy of proton pencil beam scanning (PBS) in patient-specific quality assurance (QA). MATERIALS AND METHODS: The multilayer ADRS consisted of a disk-type transmitter, with a diameter of 15 cm and with a thickness of 1 mm, surrounded by a thin optical fiber; this ADRS provided a higher spatial resolution than the single ADRS, which was 2 mm. The dosimetric characteristics of the multilayer ADRS were determined to accurately measure the energy delivered layer-by-layer. We selected five patients to verify the energy measured using the multilayer ADRS from the actual clinical proton therapy plans. The accuracy of the results measured using the multilayer ADRS was compared with that of measurements by a Bragg peak ionization chamber (IC) and that calculated by a Monte Carlo TOPAS simulation. RESULTS: The difference between the multilayer ADRS measurements and those of the TOPAS simulation was within 1% for all patients. The ranges, corresponding to the beam energies for each patient, measured using the multilayer ADRS were closer to those calculated using the TOPAS simulation than those measured using the Bragg peak IC. CONCLUSIONS: The multilayer ADRS is well suited to verifying the energy of a pencil beam. The acrylic materials used in its configuration make this device easier to use and more cost-effective than conventional detectors. This device, with its high extensibility and stability, may be applicable as a new dosimetry tool for PBS.

Technical Note: Real-time 3D MRI in the presence of motion for MRI-guided radiotherapy: 3D Dynamic keyhole imaging with super-resolution.

PURPOSE: The purpose of this study was to present real-time three-dimensional (3D) magnetic resonance imaging (MRI) in the presence of motion for MRI-guided radiotherapy (MRgRT) using dynamic keyhole imaging for high-temporal acquisition and super-resolution generative (SRG) model for high-spatial reconstruction. METHOD: We propose a unique real-time 3D MRI technique by combining a data sharing technique (3D dynamic keyhole imaging) with a SRG model using cascaded deep learning technique. 3D dynamic keyhole imaging utilizes the data sharing mechanism by combining keyhole central k-space data acquired in real-time with high-spatial, high-temporal resolution prior peripheral k-space data at various motion positions prepared by the SRG model. The efficacy of the 3D dynamic keyhole imaging with super-resolution (SR_dKeyhole) was compared to the ground-truth super-resolution images with the original full k-space data. It was also compared with the zero-filling reconstruction (zero-filling), conventional keyhole reconstruction with low-spatial high-temporal prior data (LR_cKeyhole), and conventional keyhole reconstruction with super-resolution prior data (SR_cKeyhole). RESULTS: High-spatial, high-temporal resolution 3D MRI datasets (1.5 × 1.5 × 6 mm3 ) were generated from low-spatial, high-temporal resolution 3D MRI datasets (6 × 6 × 6 mm3 ) using the cascaded deep learning SRG framework (<100 ms/volume). 3D dynamic keyhole imaging with the SRG model provided high-spatial, high-temporal resolution images (1.5 × 1.5 × 6 mm3 , 455 ms) with the highest similarity to the ground-truth SR images without any noticeable artifacts. Structural similarity indices (SSIM) of the reconstructed 3D MRI to the original SR 3D MRI were 0.65, 0.66, 0.86, and 0.89 for zero-filling, LR_cKeyhole, SR_cKeyhole, and SR_dKeyhole, respectively (1 for identical image). In addition, average value of image relative error (IRE) of the reconstructed 3D MRI to the original SR 3D MRI were 0.169, 0.191, 0.079, and 0.067 for zero-filling, LR_cKeyhole, SR_cKeyhole, and SR_dKeyhole, respectively (0 for identical image). CONCLUSIONS: We demonstrated that high-spatial, high-temporal resolution 3D MRI was feasible by combing 3D dynamic keyhole imaging with a SRG model in terms of image quality and imaging time. The proposed technique can be utilized for real-time 3D MRgRT.