Anatomical study of all carpal and adjoining bones of the wrist using 3D CT reconstruction -Finding the ultimate biomechanical theory.

Background: The complex interplay of single wrist bones acting in combination with their ligamentous connections is still not fully understood. In this regard various theories exist, divisible in columnar and ring/row theories. The object of this study was to examine the mobility of the individual carpal bones as well as the ulna and metacarpals relative to each other in wrists of cadaveric hands using CT scans.

Perioperative Sensor and Algorithm Programming in Patients with Implanted ICDs and Pacemakers for Cardiac Resynchronization Therapy.

Background: ICDs and pacemakers for cardiac resynchronization therapy (CRT) are complex devices with different sensors and automatic algorithms implanted in patients with advanced cardiac diseases. Data on the perioperative management and outcome of CRT carriers undergoing surgery unrelated to the device are scarce.

Methods: Data from 198 CRT device carriers (100 with active rate responsive sensor) were evaluated regarding perioperative adverse (device-related) events (A(D)E) and lead parameter changes.

Proteomic Approaches to Defining Remission and the Risk of Relapse in Rheumatoid Arthritis.

Objectives: Patients with Rheumatoid Arthritis (RA) are increasingly achieving stable disease remission, yet the mechanisms that govern ongoing clinical disease and subsequent risk of future flare are not well understood. We sought to identify serum proteomic alterations that dictate clinically important features of stable RA, and couple broad-based proteomics with machine learning to predict future flare.

Methods: We studied baseline serum samples from a cohort of stable RA patients (RETRO, n = 130) in clinical remission (DAS28<2.

Personalized Reconstruction of Genital Defects in Complicated Wounds with Vertical Rectus Abdominis Myocutaneous Flaps including Urethral Neo-Orifice.

Non-healing extensive wounds in the perineal region can lead to severe soft tissue infections and disastrous complications, which are not manageable with conservative measures. Specifically in recurrent or advanced pelvic malignancies, irradiation often leads to extensive scarring and wound breakdown, resulting in significant soft tissue defects during surgical tumor excision. Among several surgical options to reconstruct the perineum, the transpelvic vertical rectus abdominis myocutaneous (VRAM) flap has proven to be one of the most reliable methods.

A Low-Power RRAM Memory Block for Embedded, Multi-Level Weight and Bias Storage in Artificial Neural Networks.

Pattern recognition as a computing task is very well suited for machine learning algorithms utilizing artificial neural networks (ANNs). Computing systems using ANNs usually require some sort of data storage to store the weights and bias values for the processing elements of the individual neurons. This paper introduces a memory block using resistive memory cells (RRAM) to realize this weight and bias storage in an embedded and distributed way while also offering programming and multi-level ability.

Bilateral free flap breast reconstruction using venous cross-over bypass to contralateral internal mammary artery for salvaging thrombosed arterial anastomosis in unilateral repeated irradiation of the breast: A case report.

Adjuvant radiotherapy in breast cancer patients might enhance complications after autologous breast reconstruction, including thrombosis of the internal mammary artery (IMA) precluding its use as recipient vessel. This case report shows a salvage procedure for thrombosis of the IMA during bilateral autologous breast reconstruction in a 51-year-old patient who had undergone repeated irradiation of the chest wall after Hodgkin's disease and recurrent breast carcinoma of the right side. After mastectomy of the right breast and prophylactic mastectomy of the left breast, the patient desired breast reconstruction with autologous tissue.

Solid-state construction of zigzag periphery intramolecular C-H insertion induced by alumina-mediated C-F activation.

C-F bond activation has become an important and quickly developing method for construction of carbon-based materials. We report that alumina-mediated C-F bond activation (AmCFA) enables construction of PAHs with zigzag periphery. This method includes formal C-H activation and opens an avenue for generation of carbon-based nanomagnets directly on technologically relevant surfaces.

Single-cell resolution of plasma cell fate programming in health and disease.

Long considered a homogeneous population dedicated to antibody secretion, plasma cell phenotypic and functional heterogeneity is increasingly recognized. Plasma cells were first segregated based on their maturation level, but the complexity of this subset might well be underestimated by this simple dichotomy. Indeed, in the last decade new functions have been attributed to plasma cells including but not limited to cytokine secretion.

Brain and Breast Cancer Cells with PTEN Loss of Function Reveal Enhanced Durotaxis and RHOB Dependent Amoeboid Migration Utilizing 3D Scaffolds and Aligned Microfiber Tracts.

Background: Glioblastoma multiforme (GBM) and metastatic triple-negative breast cancer (TNBC) with mutations often lead to brain dissemination with poor patient outcome, thus new therapeutic targets are needed. To understand signaling, controlling the dynamics and mechanics of brain tumor cell migration, we implemented GBM and TNBC cell lines and designed 3D aligned microfibers and scaffolds mimicking brain structures.

Methods: 3D microfibers and scaffolds were printed using melt electrowriting.

Facile Synthesis of Thienoacenes via Transition-Metal-Free Ladderization.

Herein, we report a facile transition-metal-free approach to sulfur-containing heteroacenes from fluorinated oligophenylenes. Unlike most existing methods, the presented approach is not restricted to simple dibenzothiophene derivatives and thus appears to be a useful tool for the synthesis of extended sulfur-containing heteroacenes. The incorporation of sulfur is unambiguously preprogrammed via the positions of fluorines in the precursors, allowing the selective synthesis of extended thienoacenes with up to 96% yield.

The Impossible Anastomosis: Intima-to-adventitia Suture Technique for Microanastomosis of Severely Calcified Arteries.

Microsurgery in patients with advanced atherosclerosis is challenging. Calcified vessels can hinder microanastomosis, which precludes free flap reconstruction in those patients. We present a case of a female patient with stage 4 peripheral artery disease who had undergone mastectomy because of invasive breast cancer.

Predictors of institutionalization in users of day care facilities with mild cognitive impairment to moderate dementia.

Background: Most people with dementia wish to remain at home for as long as possible. Therefore, it is important to know the predictors of institutionalization, especially those that can be influenced. The aim of the present study is to identify predictors of the institutionalization of people with mild cognitive impairment (MCI) to moderate dementia who attend day care facilities (DCFs) throughout Germany.

Geriatric Assessments Can Predict Functional Outcome and Mortality after Urological Tumor Surgery.

Introduction: Older patients undergoing major urological tumor surgery are at severe risk of functional deterioration, complications, and mortality. We prospectively evaluated geriatric assessment tools and developed a novel easy-to-use assessment tool for clinical use.

Methods: In 159 patients, geriatric assessment tools were used prior to cystectomy, prostatectomy, and renal tumor surgery, and their peri- and postoperative courses were recorded.

Alumina-Mediated π-Activation of Alkynes.

The ability to induce powerful atom-economic transformation of alkynes is the key feature of carbophilic π-Lewis acids such as gold- and platinum-based catalysts. The unique catalytic activity of these compounds in electrophilic activations of alkynes is explained through relativistic effects, enabling efficient orbital overlapping with π-systems. For this reason, it is believed that noble metals are indispensable components in the catalysis of such reactions.

Minielectrode catheter technology for near zero-fluoroscopy substrate-guided ablation of typical atrial flutter.

Background: MicroFidelity catheter technology may facilitate voltage-guided ablation by high-resolution electroanatomic mapping (HR-EAM) and precisely targeted energy application.

Objective: To evaluate the performance of minielectrode (ME) technology for zero-fluoroscopy substrate-guided cavotricuspid isthmus (CTI) ablation.

Methods: Eighty-two patients underwent near zero-fluoroscopy substrate-guided CTI ablation using a nonirrigated large-tip catheter with 3 MEs.

The Aryl Hydrocarbon Receptor-Dependent TGF-α/VEGF-B Ratio Correlates With Disease Subtype and Prognosis in Multiple Sclerosis.

Objective: To evaluate the aryl hydrocarbon receptor (AHR)-dependent transforming growth factor alpha (TGF-α)/vascular endothelial growth factor B (VEGF-B) ratio, which regulates the effects of metabolic, dietary, and microbial factors on acute and chronic CNS inflammation, as a potential marker in multiple sclerosis (MS).

Methods: TGF-α, VEGF-B, and AHR agonistic activity were determined in serum of 252 patients with relapsing-remitting (RR) MS, primary and secondary progressive MS, as well as during active disease (clinically isolated syndrome [CIS] and RRMS relapse).

Results: The TGF-α/VEGF-B ratio and AHR agonistic activity were decreased in all MS subgroups with a stable disease course as compared to controls.

The amount of liver tissue is essential for accurate histological staging in patients with autoimmune hepatitis.

The gold standard for the evaluation of liver fibrosis is histology. However, the heterogenous distribution of fibrosis limits the sensitivity of histology. The collection of two samples with a 16G needle is therefore recommended to reduce the risk of sampling error.

Cross-sectional imaging of intestinal barrier dysfunction by confocal laser endomicroscopy can identify patients with food allergy in vivo with high sensitivity.

Food allergy (FA) affects approximately 3 to 4% of the adult population in westernized countries. Suspected FA is even more prevalent and requires extensive diagnostic work-up. Within this study, we evaluated whether assessment of the integrity of the epithelial barrier by confocal laser endomicroscopy (CLE) during colonoscopy can be used as a screening tool to identify patients with FA.

Novel imaging methods reveal positive impact of topical negative pressure application on tissue perfusion in an in vivo skin model.

The influence of topical negative pressure application (TNPA) on tissue perfusion still remains controversial. TNPA was applied for 30 minutes on intact skin of 21 healthy participants. Measurements of tissue oxygen saturation and tissue temperature as signs of tissue perfusion were performed before application of the TNPA, directly after removal of the TNPA and 5, 10, 15, 20, and 30 minutes after removal of the dressing using the near infrared imaging (NIRI) and a thermal imaging camera.

Improving mandibular reconstruction by using topology optimization, patient specific design and additive manufacturing?-A biomechanical comparison against miniplates on human specimen.

In this study, topology optimized, patient specific osteosynthesis plates (TOPOS-implants) are evaluated for the mandibular reconstruction using fibula segments. These shape optimized implants are compared to a standard treatment with miniplates (thickness: 1.0 mm, titanium grade 4) in biomechanical testing using human cadaveric specimen.

A Singular Molecule-to-Molecule Transformation on Video: The Bottom-Up Synthesis of Fullerene C from Truxene Derivative CH.

Singular reaction events of small molecules and their dynamics remain a hardly understood territory in chemical sciences since spectroscopy relies on ensemble-averaged data, and microscopic scanning probe techniques show snapshots of frozen scenes. Herein, we report on continuous high-resolution transmission electron microscopic video imaging of the electron-beam-induced bottom-up synthesis of fullerene C through cyclodehydrogenation of tailor-made truxene derivative (CH), which was deposited on graphene as substrate. During the reaction, CH transformed in a multistep process to fullerene C.

Endogenous Retroviral-K Envelope Is a Novel Tumor Antigen and Prognostic Indicator of Renal Cell Carcinoma.

Renal cell carcinoma (RCC) is one of the ten most common cancers for men and women with an approximate 75% overall 5-year survival. Sixteen histological tumor subtypes exist and the most common are papillary, chromophobe and clear cell renal cell carcinoma (ccRCC) representing 85% of all RCC. Although epigenetically silenced, endogenous retroviral (ERV) genes become activated in tumors and function to ignite immune responses.