Benzoquinone-Lubricated Intercalation in Manganese Oxide for High-Capacity and High-Rate Aqueous Aluminum-Ion Battery.

Aqueous aluminum-ion batteries are attractive post-lithium battery technologies for large-scale energy storage in virtue of abundant and low-cost Al metal anode offering ultrahigh capacity via a three-electron redox reaction. However, state-of-the-art cathode materials are of low practical capacity, poor rate capability, and inadequate cycle life, substantially impeding their practical use. Here layered manganese oxide that is pre-intercalated with benzoquinone-coordinated aluminum ions (BQ-AlxMnO2) as a high-performance cathode material of rechargeable aqueous aluminum-ion batteries is reported. The coordination of benzoquinone with aluminum ions not only extends interlayer spacing of layered MnO2 framework but reduces the effective charge of trivalent aluminum ions to diminish their electrostatic interactions, substantially boosting intercalation/deintercalation kinetics of guest aluminum ions and improving structural reversibility and stability. When coupled with Zn50Al50 alloy anode in 2 m Al(OTf)3 aqueous electrolyte, the BQ-AlxMnO2 exhibits superior rate capability and cycling stability. At 1 A g-1, the specific capacity of BQ-AlxMnO2 reaches ≈300 mAh g-1 and retains ≈90% of the initial value for more than 800 cycles, along with the Coulombic efficiency of as high as ≈99%, outperforming the AlxMnO2 without BQ co-incorporation.

Inhibition of DNA Topoisomerase Ι by Flavonoids and Polyacetylenes Isolated from Bidens pilosa L.

Human DNA topoisomerase I (Topo I) is an essential enzyme in regulating DNA supercoiling during transcription and replication, and it is an important therapeutic target for anti-tumor agents. Bidens pilosa L. is a medicinal herb that is used as a folk medicine for cancers in China. A new flavonoid (1) and a new polyacetylene (20), along with eighteen flavonoids (2-19) and nine polyacetylenes (21-29), were isolated and identified from the methanol extract of the whole plant of B. pilosa, and some of the compounds (4, 5, 6 and 7) exhibited potent cytotoxicity against a panel of five human cancer cell lines. The DNA relaxation assay revealed that some flavonoids and polyacetylenes exerted inhibitory activities on human DNA Topo I, among them compounds 1, 2, 5, 6, 7, 8, 15, 19, 20, 22, and 24 were the most active ones, with IC50 values of 393.5, 328.98, 145.57, 239.27, 224.38, 189.84, 89.91, 47.5, 301.32, 178.03, and 218.27 µM, respectively. The structure-activity analysis of flavonoids was performed according to the results from the Topo I inhibition assay. The DNA content analysis revealed that 5, 6, and 7 potently arrested cell cycle at the G1/S and G2/M phases in human colon cancer cell DLD-1 depending on the concentration of the inhibitors. The levels of protein expression related to the G1/S and G2/M cell cycle checkpoints were in accordance with the results from the DNA content analysis. These findings suggest that flavonoids are one of the key active ingredients accounting for the anti-tumor effect of B. pilosa.

Electroacupuncture relieves postoperative cognitive dysfunction in elderly rats via regulating amp-activated protein kinase autophagy signaling.

Postoperative cognitive dysfunction (POCD) is a common complication after surgery in elderly patients. Electroacupuncture (EA) has been reported to relieve POCD in animal models, but the mechanism remains fully elucidated. The objective of this work was to clarify whether EA could alleviate POCD via regulating autophagy. In this study, aged rats were assigned into 4 groups: control, surgery (rats underwent exploratory laparotomy to induce POCD), EA + S (rats received EA pre-stimulation before surgery), and EA + S + Chloroquine (CQ) (rats were intraperitoneally injected with CQ before EA stimulation and then underwent surgery). The cognitive function of rats was assessed by Morris Water Maze (MWM) test after surgery, and autophagy in hippocampal tissues of rats was evaluated by western blotting and transmission electron microscope. Results indicated that the MWM test revealed that rats showed reduced platform crossing and increased total swimming distance after surgery. However, this impaired spatial memory was improved by EA and EA plus CQ pre-treatment. Besides, the surgery caused an increased expression in LC3II, Beclin-1, AMP-activated protein kinase (AMPK), and p-AMPK in hippocampal tissues of rats, while EA and EA plus CQ pre-treatment also reversed this effect. In addition, the surgery-induced increased amount of autophagic vesicles in hippocampal tissues of rats was reduced by EA and EA plus CQ pre-treatment. In conclusion, EA pre-stimulation could effectively attenuate cognitive impairment in aged rats with POCD via inhibiting AMPK signaling-mediated autophagy.

Molecular Characterization of an Isoflavone 2'-Hydroxylase Gene Revealed Positive Insights into Flavonoid Accumulation and Abiotic Stress Tolerance in Safflower.

Flavonoids with significant therapeutic properties play an essential role in plant growth, development, and adaptation to various environments. The biosynthetic pathway of flavonoids has long been studied in plants; however, its regulatory mechanism in safflower largely remains unclear. Here, we carried out comprehensive genome-wide identification and functional characterization of a putative cytochrome P45081E8 gene encoding an isoflavone 2'-hydroxylase from safflower. A total of 15 CtCYP81E genes were identified from the safflower genome. Phylogenetic classification and conserved topology of CtCYP81E gene structures, protein motifs, and cis-elements elucidated crucial insights into plant growth, development, and stress responses. The diverse expression pattern of CtCYP81E genes in four different flowering stages suggested important clues into the regulation of secondary metabolites. Similarly, the variable expression of CtCYP81E8 during multiple flowering stages further highlighted a strong relationship with metabolite accumulation. Furthermore, the orchestrated link between transcriptional regulation of CtCYP81E8 and flavonoid accumulation was further validated in the yellow- and red-type safflower. The spatiotemporal expression of CtCYP81E8 under methyl jasmonate, polyethylene glycol, light, and dark conditions further highlighted its likely significance in abiotic stress adaption. Moreover, the over-expressed transgenic Arabidopsis lines showed enhanced transcript abundance in OE-13 line with approximately eight-fold increased expression. The upregulation of AtCHS, AtF3'H, and AtDFR genes and the detection of several types of flavonoids in the OE-13 transgenic line also provides crucial insights into the potential role of CtCYP81E8 during flavonoid accumulation. Together, our findings shed light on the fundamental role of CtCYP81E8 encoding a putative isoflavone 2'-hydroxylase via constitutive expression during flavonoid biosynthesis.

Alpha lipoic acid inhibits oxidative stress-induced apoptosis by modulating of Nrf2 signalling pathway after traumatic brain injury.

Alpha lipoic acid (ALA) is a powerful antioxidant which has been widely used in the treatment of different system diseases, such as cardiovascular and cerebrovascular diseases. But, there are few studies that refer to protective effects and potential mechanisms on traumatic brain injury (TBI). This study was carried out to investigate the neuroprotective effect following TBI and illuminate the underlying mechanism. Weight drop-injured model in rats was induced by weight-drop. ALA was administrated via intraperitoneal injection after TBI. Neurologic scores were examined following several tests. Neurological score was performed to measure behavioural outcomes. Nissl staining and TUNEL were performed to evaluate the neuronal apoptosis. Western blotting was engaged to analyse the protein content of the Nuclear factor erythroid 2-related factor 2 (Nrf2) and its downstream protein factors, including hemeoxygenase-1 (HO-1) and quinine oxidoreductase-1 (NQO1). ALA treatment alleviated TBI-induced neuron cell apoptosis and improved neurobehavioural function by up-regulation of Nrf2 expression and its downstream protein factors after TBI. This study presents new perspective of the mechanisms responsible for the neuronal apoptosis of ALA, with possible involvement of Nrf2 pathway.

Protective effect of methylallyl sulfone in the development of cigarette smoke extract-induced apoptosis in rats and HFL-1 cells.

Although the organosulfur compounds from garlic have shown diverse pharmacological activities, the prototype drug was almost undetectable in vivo. As known, methylallyl sulfone (AMSO2) is the main metabolite of some active organosulfur compounds derived from garlic. The purpose of this article was to study the protective effect of AMSO2 on cigarette smoke extract (CSE) induced cell apoptosis in lungs in vivo and in vitro. The male rats were injected intraperitoneally with 900 µL of 100% CSE 3 times for three successive weeks. The rats from treatment groups were injected intraperitoneally with AMSO2 (50 mg/kg/day or 100 mg/kg/day) or DEX (1 mg/kg/day) for 21 days. We observed that pretreatment of AMSO2 effectively reversed apoptosis and oxidative stress in rats induced by CSE. Moreover, CSE-induced apoptosis in the HFL-1 cells was significantly suppressed by pretreated AMSO2 (400 µM) and DEX (0.1 mg/mL). Mechanistic studies suggested that this activity may arise from its effects on the regulation of p38 MAPK, Nrf-2 and Bcl-2/Bax signaling pathways. Overall, the metabolite of active organosulfur compounds AMSO2 might be a potential candidate for the treatment of CSE-induced apoptosis in rats.

Quantification of the area and shunt volume of multiple, circular, and noncircular ventricular septal defects: A 2D/3D echocardiography comparison and real time 3D color Doppler feasibility determination study.

BACKGROUND: Quantification of defect size and shunt flow is an important aspect of ventricular septal defect (VSD) evaluation. This study compared three-dimensional echocardiography (3DE) with the current clinical standard two-dimensional echocardiography (2DE) for quantifying defect area and tested the feasibility of real time 3D color Doppler echocardiography (RT3D-CDE) for quantifying shunt volume of irregular shaped and multiple VSDs. METHODS: Latex balloons were sutured into the ventricles of 32 freshly harvested porcine hearts and were connected with tubing placed in septal perforations. Tubing was varied in area (0.13-5.22 cm²), number (1-3), and shape (circle, oval, crescent, triangle). A pulsatile pump was used to pump "blood" through the VSD (LV to RV) at stroke volumes of 30-70 mL with a stroke rate of 60 bpm. Two-dimensional echocardiography (2DE), 3DE, and RT3D-CDE images were acquired from the right side of the phantom. RESULTS: For circular VSDs, both 2DE and 3DE area measurements were consistent with the actual areas (R² = 0.98 vs 0.99). For noncircular/multiple VSDs, 3DE correlated with the actual area more closely than 2DE (R² = 0.99 vs 0.44). Shunt volumes obtained using RT3D-CDE positively correlated with pumped stroke volumes (R² = 0.96). CONCLUSIONS: Three-dimensional echocardiography (3DE) is a feasible method for determining VSD area and is more accurate than 2DE for evaluating the area of multiple or noncircular VSDs. Real-time 3D color Doppler echocardiography (RT3D-CDE) is a feasible method for quantifying the shunt volume of multiple or noncircular VSDs.

Image-Derived Assessment of Left Ventricular Mass in Fetal Myocardial Hypertrophy by 4-Dimensional Echocardiography: An In Vitro Study.

OBJECTIVES: This study tested the accuracy of new 4-dimensional fetal echocardiography to evaluate left ventricular (LV) mass in an experimental model of fetal myocardial hypertrophy. METHODS: Ten fresh rabbit hearts were studied. Fetal myocardial hypertrophy was simulated by fixing different amounts of myocardial tissue to the LV epicardium. A small latex balloon was mounted on vinyl tubing and fixed within each LV cavity. The proximal end of the tube was attached to a pulsatile pump apparatus. The pump was calibrated to deliver stroke volumes of 2 and 4 mL at stroke rates of 60 and 120 beats per minute (bpm). Four-dimensional data were acquired and analyzed with quantification software. Reference values for LV mass were determined by the displacement method. RESULTS: Echo-derived measurements of LV mass showed good correlations with reference values at all stroke rates and stroke volumes: at 2 mL and 60 bpm, r = 0.95; at 2 mL and 120 bpm, r = 0.95; at 4 mL and 60 bpm, r = 0.93; and at 4 mL and 120 bpm, r = 0.95 (P< .01 for all values). There was also excellent interobserver (r = 0.98; mean difference of -0.32 g; -4.4% of the mean) and intraobserver (r = 0.98; mean difference of -0.28 g; -3.8% of the mean) agreement. CONCLUSIONS: In this controlled in vitro study, high-resolution 4-dimensional echocardiography was shown to accurately assess LV mass and have the potential to evaluate fetal myocardial hypertrophy.

[Renal artery injury caused by Kawasaki disease].

OBJECTIVE: To investigate renal artery injury caused by Kawasaki disease (KD). METHODS: Forty-three children with KD were enrolled in the study. According to the blood pressure in the acute stage, these children were classified into normal blood pressure subgroup and increased blood pressure subgroup. Eighteen children with fever caused by acute upper respiratory tract infection were enrolled as the control group. The diameter of the origin of the main renal artery, hemodynamic parameters of the main renal artery and the renal interlobar artery, rennin activity, and levels of angiotensin II and aldosterone were compared between groups. RESULTS: During the acute stage of KD, both subgroups had a significantly smaller diameter of the origin of the main renal artery, a significantly higher resistance index (RI) of the main renal artery, and a significantly lower end-diastolic velocity (EDV) than the control group (P<0.05).The increased blood pressure subgroup had a significantly lower EDV of the interlobar artery than the normal blood pressure subgroup, a significantly higher RI than the normal blood pressure subgroup and the control group, as well as a significantly higher rennin activity and significantly higher levels of angiotensin II and aldosterone than the normal blood pressure subgroup (P<0.05). A significantly increased EDV and a significantly reduced RI of the renal interlobar artery were observed in the increased blood pressure subgroup in the subacute stage compared with the acute stage (P<0.05). CONCLUSIONS: KD may cause renal artery injury and early hemodynamic changes, resulting in a transient increase in blood pressure in some patients.

Comprehensive evaluation of cardiac function and detection of myocardial infarction based on a semi-automated analysis using full-volume real time three-dimensional echocardiography.

OBJECTIVE: Quantitative left ventricular mass (LVM) as well as regional strain values may be obtained from full-volume real time 3D echocardiography data via semi-automated feature tracking and represent indices of heart function, both in health and disease. METHODS: Fresh adult porcine and ovine hearts were passively pumped to simulate normal cardiac motion at stroke volumes (SVs) varying from 30 to 70 mL. A 3V-D Matrix probe, interfaced with a GE Vivid E9 ultrasound system, was used to image each heart at baseline conditions and after simulated myocardial infarction (MI). The 4D LV quantification function of EchoPAC PC was used to quantify the LVM and longitudinal and circumferential strain (LS & CS) of LV segments at each SV prior and subsequent to simulated MI. LVM was validated by volumetric displacement, while LS and CS values were compared to sonomicrometry-based strain. RESULTS: Linear regression analyses show excellent correlations in LVM, LS, and CS between the 4D echo and volumetric/sonomicrometric displacement with R(2) values of 0.99, 0.88, and 0.67, respectively. Bland-Altman analyses for all variables validate the compatibility of both methods. It was also determined that EchoPAC PC was able to detect a decrease in LS and CS in the relevant segments between pre- and post-MI at all SVs (P < 0.05). CONCLUSIONS: EchoPAC PC is a robust utility with the ability to accurately obtain quantitative LVM, LS, and CS values from 4D echo volumes and has the potential to improve the yield of clinical studies in cases of suspected MI.

Regional strain determination and myocardial infarction detection by three-dimensional echocardiography with varied temporal resolution.

BACKGROUND: Three-dimensional echocardiography (3DE) is a promising method for strain determination; however, there are temporal resolution concerns. This study aims to evaluate the feasibility and accuracy of 3DE on longitudinal and circumferential strain (LS, CS) determination and infarction detection under variable frame rates (FR) and "heart rates" (stroke rates [SR]) conditions. METHODS: Latex balloons were sewn into the left ventricle (LV) of 20 freshly harvested pig hearts which were then passively driven by a pulsatile pump apparatus at stroke volumes (SV) 30-70 mL. The hearts were pumped at 2 normal limits of human heart rate. Full-volume data were acquired before and after a simulated myocardial infarction (MI) at the 2 most commonly used FRs. LS and CS values were evaluated against sonomicrometry. RESULTS: Longitudinal strain and CS derived from high FR acquisitions showed statistically superior correlations with sonomicrometry data (LS: R(2) = 0.85, CS: R(2) = 0.84) than strain values from low FR (LS: R(2) = 0.78, CS: R(2) = 0.76) (all P < 0.01). After MI induction, LS and CS at different FRs were significantly decreased while maintaining excellent correlations with sonomicrometry data (all P < 0.001). There is no statistical difference of strain values between different SR acquisitions. CONCLUSION: Three-dimensional wall-motion tracking has the ability to accurately determine regional myocardial deformation and detect MI. Different heart rates within a physiologically relevant range have no effect on 3D strain accuracy. Strain values calculated from higher frame rate acquisitions were found to have a slightly better accuracy.

Real Time Three-Dimensional Echocardiographic Evaluations of Fetal Left Ventricular Stroke Volume, Mass, and Myocardial Strain: In Vitro and In Vivo Experimental Study.

BACKGROUND: Left ventricular stroke volume, mass, and myocardial strain are valuable indicators of fetal heart function. This study investigated the feasibility of nongated real time three-dimensional echocardiography (RT3DE) to determine fetal stroke volume (SV), left ventricular mass (LVM), and myocardial strain under different conditions. METHODS: To evaluate fetal hearts, fetal-sized rabbit hearts were used in this study. The in vitro portion of this study was carried out using a balloon inserted into the LV of eight fresh rabbit hearts and driven by a calibrated pulsatile pump. RT3DE volumes were obtained at various pump-set SVs. The in vivo experiments in this study were performed on open-chest rabbits. RT3DE volumes were acquired at the following conditions: baseline, simulated hypervolemia, inferior vena cava (IVC) ligation, and ascending aorta (AAO) ligation. Displacement values and sonomicrometry data were used as references for RT3DE-derived SV, LVM, longitudinal strain (LS), and circumferential strain (CS). RESULTS: Excellent correlations between RT3DE-derived values and reference values were demonstrated and accompanied by high coefficients of determination (R(2) ) for both in vitro and in vivo studies for SV, LVM, LS, and CS (in vitro: SV: R(2)  = 0.98; LVM: R(2)  = 0.97; LS: R(2)  = 0.87, CS: R(2)  = 0.80; in vivo: SV: R(2)  = 0.92; LVM: R(2)  = 0.98; LS: in vivo: R(2)  = 0.84; CS: in vivo: R(2)  = 0.76; all P < 0.05). CONCLUSIONS: RT3DE is capable of quantifying the SV, LVM, and myocardial strain of fetal-sized hearts under different conditions. This nongated RT3DE may aid the evaluation of fetal cardiac function, providing a superior understanding of the progress of fetal heart disorders.

Quantitative assessment of mitral inflow and aortic outflow stroke volumes by 3-dimensional real-time full-volume color flow doppler transthoracic echocardiography: an in vivo study.

OBJECTIVES: Noninvasive quantification of left ventricular (LV) stroke volumes has an important clinical role in assessing circulation and monitoring therapeutic interventions for cardiac disease. This study validated the accuracy of a real-time 3-dimensional (3D) color flow Doppler method performed during transthoracic echocardiography (TTE) for quantifying volume flows through the mitral and aortic valves using a dedicated offline 3D flow computation program compared to LV sonomicrometry in an open-chest animal model. METHODS: Forty-six different hemodynamic states in 5 open-chest pigs were studied. Three-dimensional color flow Doppler TTE and 2-dimensional (2D) TTE were performed by epicardial scanning. The dedicated software was used to compute flow volumes at the mitral annulus and the left ventricular outflow tract (LVOT) with the 3D color flow Doppler method. Stroke volumes by 2D TTE were computed in the conventional manner. Stroke volumes derived from sonomicrometry were used as reference values. RESULTS: Mitral inflow and LVOT outflow derived from the 3D color flow Doppler method correlated well with stroke volumes by sonomicrometry (R = 0.96 and 0.96, respectively), whereas correlation coefficients for mitral inflow and LVOT outflow computed by 2D TTE and stroke volumes by sonomicrometry were R = 0.84 and 0.86. Compared to 2D TTE, the 3D method showed a smaller bias and narrower limits of agreement in both mitral inflow (mean ± SD: 3D, 2.36 ± 2.86 mL; 2D, 10.22 ± 8.46 mL) and LVOT outflow (3D, 1.99 ± 2.95 mL; 2D, 4.12 ± 6.32 mL). CONCLUSIONS: Real-time 3D color flow Doppler quantification is feasible and accurate for measurement of mitral inflow and LVOT outflow stroke volumes over a range of hemodynamic conditions.

[Clinical significance of determination of serum IgE in infants with milk allergy].

OBJECTIVE: To determine the clinical significance of milk protein-specific IgE (sIgE) for infants with cow's milk protein allergy (CMPA). METHODS: Ninety-six infants with CMPA were divided into IgE+ group (n=26) and IgE- group (n=70) and clinical characteristics were compared between the two groups. Infants were denied allergy-inducing food and fed instead extensively hydrolyzed formulas or amino-acid formulas for 16 weeks before the two groups were compared. RESULTS: Twenty-seven percent of the infants were sIgE-seropositive. The first onset age of CMPA was significantly younger in the IgE+ group than in the IgE- group (P<0.05), and the family history of allergy and respiratory symptoms were significantly less common in the IgE- group than in the IgE+ group (P<0.05). Severe CMPA, gastrointestinal symptoms, underweight, growth retardation, anemia, and hypoproteinemia were significantly more common in the IgE- group than in the IgE+ group (P<0.05). Erythema, urticaria, vomiting, nasal discharge, cough, wheezing, and paroxysms of crying were major clinical symptoms of the IgE+ group, and their incidences were significantly higher in the IgE+ group than in the IgE- group (P<0.05); eczema, constipation, and diarrhea were major symptoms of the IgE- group, and their incidences were significantly higher in the IgE- group than in the IgE+ group (P<0.05). The remission rate of each symptom was as high as over 80% in the two groups after 16 weeks of intervention and there was no significant difference in the remission rates between the two groups (P>0.05). CONCLUSIONS: IgE seropositive rate is not high in infants with CMPA. Atypical signs instead of allergic symptoms are more common in the IgE seronegative infants with CMPA. Avoiding allergy-inducing food and eating extensively hydrolyzed formulas or amino-acid formulas in early age benefit infants with IgE-mediated or non-IgE-mediated CMPA.

[Expression of CysLTR-1 and CysLTR-2 in adenoid tissues from children with adenoid hypertrophy].

OBJECTIVE: To examine the expression of cysteinyl leukotriene receptor-1 (CysLTR-1) and cysteinyl leukotriene receptor-2 (CysLTR-2) in the adenoid tissues from children with adenoid hypertrophy (AH) and to explore the role of leukotrienes in the pathogenesis of AH. METHODS: Sixty children with AH who were treated by adenoidectomy and/or tonsillectomy were classified into two groups: simple AH and AH plus allergic rhinitis (n=30 each). Twenty children who underwent tonsillectomy due to recurrent purulent tonsillitis were selected as the control group. The expression of CysLTR-1 and CysLTR-2 in the excised tonsil and/or adenoid tissues was determined by immunofluorescence histochemical labeling and integrated optical density measurement. RESULTS: The expression of CysLTR-1 and CysLTR-2 in the adenoid and tonsil tissues increased significantly in both the simple AH group and AH plus allergic rhinitis group compared with the control group (P<0.01). The expression of CysLTR-1 and CysLTR-2 in the AH plus allergic rhinitis group increased more significantly compared with the simple AH group (P<0.01). CONCLUSIONS: CysLTR-1 and CysLTR-2 are highly expressed in the adenoid tissues from children with AH, suggesting that leukotrienes are involved in the pathogenesis of AH.

Evaluation of stroke volume and ventricular mass in a fetal heart model: a novel four-dimensional echocardiographic analysis.

AIMS: This study aimed to assess the feasibility and accuracy of nongated four-dimensional echocardiography (4DE) for determining left ventricular (LV) stroke volume (SV) and mass in a fetal heart-sized LV model. METHODS: A balloon was inserted into the LV of 20 fresh rabbit hearts and attached to a calibrated pulsatile pump. Ten hearts retaining the right ventricle were imaged in Group A. Ten hearts without the right ventricles (RVs) attached were imaged in Group B. Nongated 4D volumes were obtained using a Philips iU-22 system with an X6-1 matrix probe at SVs ranging from 1 to 5 mL at increments of 1 mL. At each SV, the volume displacement of the heart was measured at end-systole and end-diastole. Mass was determined by displacement at the conclusion of the experiment. RESULTS: The images were analyzed offline by manually tracing endocardial and epicardial boundaries of stacked contours. An excellent correlation in SV and mass between echo-derived values and displacement values was demonstrated and accompanied by high coefficients of determination (R2 ) in both groups (SV: Group A: R2 = 0.9461, Group B: R2 = 0.9811; Mass: Group A: R2 = 0.9223, Group B: R2 = 0.9602; all P < 0.001). Bland-Altman analyses showed a slight overestimation in both groups for both SV and LV mass. CONCLUSIONS: Nongated 4DE was demonstrated to be feasible and that it could accurately define SV and ventricular mass for a fetal heart-sized LV model.

Evaluation of a new 3-dimensional color Doppler flow method to quantify flow across the mitral valve and in the left ventricular outflow tract: an in vitro study.

OBJECTIVES: The aim of this study was to assess the accuracy, feasibility, and reproducibility of determining stroke volume from a novel 3-dimensional (3D) color Doppler flow quantification method for mitral valve (MV) inflow and left ventricular outflow tract (LVOT) outflow at different stroke volumes when compared with the actual flow rate in a pumped porcine cardiac model. METHODS: Thirteen freshly harvested pig hearts were studied in a water tank. We inserted a latex balloon into each left ventricle from the MV annulus to the LVOT, which were passively pumped at different stroke volumes (30-80 mL) using a calibrated piston pump at increments of 10 mL. Four-dimensional flow volumes were obtained without electrocardiographic gating. The digital imaging data were analyzed offline using prototype software. Two hemispheric flow-sampling planes for color Doppler velocity measurements were placed at the MV annulus and LVOT. The software computed the flow volumes at the MV annulus and LVOT within the user-defined volume and cardiac cycle. RESULTS: This novel 3D Doppler flow quantification method detected incremental increases in MV inflow and LVOT outflow in close agreement with pumped stroke volumes (MV inflow, r = 0.96; LVOT outflow, r = 0.96; P < .01). Bland-Altman analysis demonstrated overestimation of both (MV inflow, 5.42 mL; LVOT outflow, 4.46 mL) with 95% of points within 95% limits of agreement. Interobserver variability values showed good agreement for all stroke volumes at both the MV annulus and LVOT. CONCLUSIONS: This study has shown that the 3D color Doppler flow quantification method we used is able to compute stroke volumes accurately at the MV annulus and LVOT in the same cardiac cycle without electrocardiographic gating. This method may be valuable for assessment of cardiac output in clinical studies.

Development and testing of a deep learning algorithm to detect lung consolidation among children with pneumonia using hand-held ultrasound.

BACKGROUND AND OBJECTIVES: Severe pneumonia is the leading cause of death among young children worldwide, disproportionately impacting children who lack access to advanced diagnostic imaging. Here our objectives were to develop and test the accuracy of an artificial intelligence algorithm for detecting features of pulmonary consolidation on point-of-care lung ultrasounds among hospitalized children. METHODS: This was a prospective, multicenter center study conducted at academic Emergency Department and Pediatric inpatient or intensive care units between 2018-2020. Pediatric participants from 18 months to 17 years old with suspicion of lower respiratory tract infection were enrolled. Bedside lung ultrasounds were performed using a Philips handheld Lumify C5-2 transducer and standardized protocol to collect video loops from twelve lung zones, and lung features at both the video and frame levels annotated. Data from both affected and unaffected lung fields were split at the participant level into training, tuning, and holdout sets used to train, tune hyperparameters, and test an algorithm for detection of consolidation features. Data collected from adults with lower respiratory tract disease were added to enrich the training set. Algorithm performance at the video level to detect consolidation on lung ultrasound was determined using reference standard diagnosis of positive or negative pneumonia derived from clinical data. RESULTS: Data from 107 pediatric participants yielded 117 unique exams and contributed 604 positive and 589 negative videos for consolidation that were utilized for the algorithm development process. Overall accuracy for the model for identification and localization of consolidation was 88.5%, with sensitivity 88%, specificity 89%, positive predictive value 89%, and negative predictive value 87%. CONCLUSIONS: Our algorithm demonstrated high accuracy for identification of consolidation features on pediatric chest ultrasound in children with pneumonia. Automated diagnostic support on an ultraportable point-of-care device has important implications for global health, particularly in austere settings.

An integrated Mg battery-powered iontophoresis patch for efficient and controllable transdermal drug delivery.

Wearable transdermal iontophoresis eliminating the need for external power sources offers advantages for patient-comfort when deploying epidermal diseases treatments. However, current self-powered iontophoresis based on energy harvesters is limited to support efficient therapeutic administration over the long-term operation, owing to the low and inconsistent energy supply. Here we propose a simplified wearable iontophoresis patch with a built-in Mg battery for efficient and controllable transdermal delivery. This system decreases the system complexity and form factors by using viologen-based hydrogels as an integrated drug reservoir and cathode material, eliminating the conventional interface impedance between the electrode and drug reservoir. The redox-active polyelectrolyte hydrogel offers a high energy density of 3.57 mWh cm-2, and an optimal bioelectronic interface with ultra-soft nature and low tissue-interface impedance. The delivery dosage can be readily manipulated by tuning the viologen hydrogel and the iontophoresis stimulation mode. This iontophoresis patch demonstrates an effective treatment of an imiquimod-induced psoriasis mouse. Considering the advantages of being a reliable and efficient energy supply, simplified configuration, and optimal electrical skin-device interface, this battery-powered iontophoresis may provide a new non-invasive treatment for chronic epidermal diseases.