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Background One-stage reconstruction with “thin perforator flaps” has been attempted to salvage limbs and restore function. The deep inferior epigastric perforator (DIEP) flap is a commonly utilized flap in breast reconstruction (BR). The purpose of this study is to present the versatility of DIEP flaps for the reconstruction of large defects of the extremities.

A 10 Gb/s PAM-4 transmitter (TX) with a modulo-based equalization technique is presented. The proposed feed-forward Tomlinson-Harashima precoding (FF-THP) scheme takes advantage of both Tomlinson-Harashima precoding (THP) and feed-forward equalization (FFE). The vertical eye margin (VEM) is enhanced by removing the precursor inter-symbol interference (ISI) with pretaps while incorporating the modulo operation. The VEMs of equalization methods are derived based on z-domain response (ZDR). The effectiveness of the FF-THP is examined by quantitative analysis and numerical simulation. Especially for a one-pole channel with a precursor, optimized tap coefficients of an FFE and an FF-THP are derived as closed-form concerning the precursor and the first postcursor. Calculations of decision threshold voltage and estimated bathtub curve based on Gaussian noise are featured by using the histogram of an eye diagram. The advantages of the FF-THP over a conventional FFE are measured by a fabricated chip. The proposed TX compensates for a 21 dB channel loss with a level mismatch ratio of 99.1% and with a figure of merit (energy efficiency per sum of channel ISI) of 4.05 pJ/b/ISI. Moreover, the FF-THP achieves 38% and 87.5% improvement on VEM and horizontal eye margin, respectively, compared with an FFE. It is fabricated in 28 nm CMOS technology, occupying an active area of 0.075 mm2.

Medical imaging is a form of technology that has revolutionized the medical field over the past decades. Digital pathology imaging, which captures histological details at the cellular level, is rapidly becoming a routine clinical procedure for cancer diagnosis support and treatment planning. Recent developments in deep-learning methods have facilitated tumor region segmentation from pathology images. The traditional shape descriptors that characterize tumor boundary roughness at the anatomical level are no longer suitable. New statistical approaches to model tumor shapes are in urgent need. In this article, we consider the problem of modeling a tumor boundary as a closed polygonal chain. A Bayesian landmark-based shape analysis model is proposed. The model partitions the polygonal chain into mutually exclusive segments, accounting for boundary roughness. Our Bayesian inference framework provides uncertainty estimations on both the number and locations of landmarks, while outputting metrics that can be used to quantify boundary roughness. The performance of our model is comparable with that of a recently developed landmark detection model for planar elastic curves. In a case study of 143 consecutive patients with stage I to IV lung cancer, we demonstrated the heterogeneity of tumor boundary roughness derived from our model effectively predicted patient prognosis (p-value < 0.001 ). for this article are available online. [ABSTRACT FROM AUTHOR]

The structural, photophysical and electrochemical properties of three luminescent 2-coordinate coinage metal (i.e., M = Cu, Ag, Au) complexes bearing a sterically bulky benzimidazolyl carbene, 1,3-bis(2,6-diisopropylphenyl)-1-H-benzo[d]imidazol-2-ylidene (BZI), and carbazolide (Cz) as the anionic ligand were investigated. All the complexes emit in the deep blue region (~430 nm) with relatively narrow spectra (full width at half maximum = 44 nm, 2,300 cm−1) characterized by vibronic fine structure in nonpolar media (methylcyclohexane at room temperature), and with high photoluminescence quantum yields (ΦPL > 80%) and radiative rate constants (kr ~ 7.8 × 105 s−1). The luminescence is solvatochromic, undergoing a red-shift in a polar solvent (CH2Cl2) at room temperature that are accompanied by a decrease in quantum yields (ΦPL < 23%) and radiative rate constants (kr < 4.0 × 104 s−1), whereas the non-radiative rate constants remain nearly constant (knr ~ 1.0 × 105 s−1). The radiative rate is controlled via thermally assisted delayed fluorescence (TADF) and temperature-dependent luminescence studies of the gold complex (AuBZI) in methylcyclohexane solution reveal an energy difference between the lowest singlet and triplet excited states of 920 cm−1. An organic light-emitting diode (OLED) fabricated using AuBZI as a luminescent dopant has an external quantum efficiency of 12% and narrow, deep-blue emission (CIE = 0.16, 0.06).

Background: This study assessed the efficacy of pulmonary metastasectomy for synovial sarcoma in adult patients. Methods: Fifty patients, diagnosed with pulmonary metastasis from June 1990 to August 2010, were reviewed retrospectively. Twenty-eight patients underwent complete pulmonary metastasectomy, and their survival was evaluated. Age, sex, time to metastatic progression, laterality, number of tumors, size of largest nodule, and number of metastasectomies were analyzed as potential prognostic factors. Results: I n all, 2 9 patients underwent at least one pulmonary metastasectomy, and 51 resections were performed. One intraoperative mortality occurred, and the 5-year survival rate was 58.4%. Bilateral metastases and early metastatic progression were associated with poor survival in multivariate analyses. Conclusion: Surgical resection can be a good option for treating pulmonary metastasis in patients with synovial sarcoma. Repeated resection was feasible with low mortality and morbidity.

Background One-stage reconstruction with "thin perforator flaps" has been attempted to salvage limbs and restore function. The deep inferior epigastric perforator (DIEP) flap is a commonly utilized flap in breast reconstruction (BR). The purpose of this study is to present the versatility of DIEP flaps for the reconstruction of large defects of the extremities. Methods Patients with large tissue defects on extremities who were treated with thin DIEP flaps from January 2016 to January 2018 were included. They were minimally followed up for 36 months. We analyzed the etiology and location of the soft tissue defect, flap design, anastomosis type, outcome, and complications. We also considered the technical differences in the DIEP flap between breast and extremity reconstruction. Results Overall, six free DIEP flaps were included in the study. The flap size ranged from 15 × 12 to 30 × 16 cm 2. All flaps were transversely designed similar to a traditional BR design. Three flaps were elevated with two perforators. Primary closure of the donor site was possible in all cases. Five flaps survived with no complications. However, partial necrosis occurred in one flap. Conclusion A DIEP flap is not the first choice for soft tissue defects, but it should be considered for one-stage reconstruction of large defects when the circulation zone of the DIEP flap is considered. In addition, this flap has many advantages over other flaps such as provision of the largest skin paddle, low donor site morbidity with a concealed scar, versatile supercharging technique, and a long pedicle. [ABSTRACT FROM AUTHOR]

We propose a Bayesian elastic net that uses empirical likelihood and develop an efficient tuning of Hamiltonian Monte Carlo for posterior sampling. The proposed model relaxes the assumptions on the identity of the error distribution, performs well when the variables are highly correlated, and enables more straightforward inference by providing posterior distributions of the regression coefficients. The Hamiltonian Monte Carlo method implemented in Bayesian empirical likelihood overcomes the challenges that the posterior distribution lacks a closed analytic form and its domain is nonconvex. We develop the leapfrog parameter tuning algorithm for Bayesian empirical likelihood. We also show that the posterior distributions of the regression coefficients are asymptotically normal. Simulation studies and real data analysis demonstrate the advantages of the proposed method in prediction accuracy. [ABSTRACT FROM AUTHOR]

Topological data analysis involves the statistical characterization of the shape of data. Persistent homology is a primary tool of topological data analysis, which can be used to analyze topological features and perform statistical inference. In this paper, we present a two-stage hypothesis test for vectorized persistence diagrams. The first stage filters vector elements in the vectorized persistence diagrams to enhance the power of the test. The second stage consists of multiple hypothesis tests, with false positives controlled by false discovery rates. We demonstrate the flexibility of our method by applying it to a variety of simulated and real-world data types. Our results show that the proposed hypothesis test enables accurate and informative inferences on the shape of data compared to the existing hypothesis testing methods for persistent homology. [ABSTRACT FROM AUTHOR]

High precision vehicle simulation environment is required for development of control system of any newly suggested intelligent system. Hence, a high precision full-vehicle simulation environment integrated with an intelligent torque transfer system should be developed for an advanced control logic for enhancement of vehicle stability. In the perspective of making enhanced AWD system, there are many kinds of methods to make the system. And a controller part of the AWD module is regarded as a major part of the system development in consideration of enhancement of the vehicle stability with the suggested AWD system. Therefore, in this study, high precision full-vehicle simulation environment is developed for the development of an intelligent control system of the AWD module. In order to make models for the simulation, vehicle test is performed with a commercial vehicle, and the several performance tests of the developed AWD system are also conducted in a laboratory. Then, the simulation environment comprised of several models of important sub-systems is developed based on the previously conducted test results, and the developed simulation environment is verified by comparing the simulation results to the test results.

Chronic compression of dorsal root ganglion (CCD) results in neuropathic pain. We investigated the role of spinal GABA in CCD-induced pain using rats with unilateral CCD. A stereological analysis revealed that the proportion of GABA-immunoreactive neurons to total neurons at L4/5 laminae I–III on the injured side decreased in the early phase of CCD (post-CCD week 1) and then returned to the sham-control level in the late phase (post-CCD week 18). In the early phase, the rats showed an increase in both mechanical sensitivity of the hind paw and spinal WDR neuronal excitability on the injured side, and such increase was suppressed by spinally applied muscimol (GABA-A agonist, 5 nmol) and baclofen (GABA-B agonist, 25 nmol), indicating the reduced spinal GABAergic inhibition involved. In the late phase, the CCD-induced increase in mechanical sensitivity and neuronal excitability returned to pre-CCD levels, and such recovered responses were enhanced by spinally applied bicuculline (GABA-A antagonist, 15 nmol) and CGP52432 (GABA-B antagonist, 15 nmol), indicating the regained spinal GABAergic inhibition involved. In conclusion, the alteration of spinal GABAergic inhibition following CCD and leading to a gradual reduction over time of CCD-induced mechanical hypersensitivity is most likely due to changes in GABA content in spinal GABA neurons.

The area under a receiver operating characteristic curve (AUC) is a useful tool to assess the performance of continuous‐scale diagnostic tests on binary classification. In this article, we propose an empirical likelihood (EL) method to construct confidence intervals for the AUC from data collected by ranked set sampling (RSS). The proposed EL‐based method enables inferences without assumptions required in existing nonparametric methods and takes advantage of the sampling efficiency of RSS. We show that for both balanced and unbalanced RSS, the EL‐based point estimate is the Mann–Whitney statistic, and confidence intervals can be obtained from a scaled chi‐square distribution. Simulation studies and two case studies on diabetes and chronic kidney disease data suggest that using the proposed method and RSS enables more efficient inference on the AUC. [ABSTRACT FROM AUTHOR]

This brief presents a programmable phase detector (PD) for the Baud-rate clock and data recovery (CDR) in four-level pulse amplitude modulation (PAM-4) quarter-rate receiver, using a transition weighted gain (TWG) technique. By assigning a different gain to the phase detection for each data-level transition, the TWG-based CDR (TWG-CDR) achieves stable operation of the CDR and jitter tracking. An optimal phase detection transfer characteristic is obtained by assigning the highest weight on the 1-level data transition and the lowest on the 3-level transition. The proposed CDR fabricated in 40 nm CMOS technology performs at 64-Gb/s in PAM-4. The measured jitter tolerance (JTOL) shows that the TWG-CDR improves the horizontal eye opening margin compared to the sign-sign Mueller-Müller CDR. The TWG-CDR tested around a 6dB loss channel achieves a BER less than 10−11 and energy efficiency of 2.37 pJ/b. [ABSTRACT FROM AUTHOR]

The photoluminescence-following electron-transfer (PFET) technique, developed in our laboratory, is a sensitive chromatographic detection method for oxidizable analytes. Because the oxidations are homogeneous, the technique avoids the problem of electrode fouling. A liquid-phase oxidant reacts with the electrochemically active analytes after separation, becoming capable of photoluminescence. Laser-induced photoluminescence is measured to quantitate the analytes. Thus, the electrochemical properties of the oxidant determine the detection selectivity, and the spectroscopic properties define the sensitivity. The properties of tris(2,2'-bipyridine)osmium (1) were investigated for use as the liquid-phase oxidant in the PFET system. The redox potential of the complex is less positive than that of tris(2,2'-bipyridine)ruthenium (2); thus, on-line generation of [1.sup.3+] by reaction with Pb[O.sub.2], and selective oxidation of catechols by [1.sup.3+], was possible. The mild oxidizing power of [1.sup.3+] led to a lower background signal (compared to [2.sup.3+]) when mixed with acidic mobile phases. Photoluminescence from [1.sup.2+] was much weaker than that from [2.sup.2+]; nonetheless, the system achieved subnanomolar detection limits for dopamine, 3-methoxytyramine, and serotonin. Dopamine and 3-methoxytyramine in rat brain striatal dialysates were determined before and after the injection of nomifensine. The pH of the mobile phase can govern the detection selectivity, since oxidation of most organics is accompanied by proton transfer. Reaction of 1 with catechols showed pH-dependent sensitivity resulting from pH-dependent reaction rate changes. Since the reaction rate is also temperature dependent, increased temperature at the mixer resulted in higher sensitivity. However, the noise level also increased at elevated temperature; thus, the detection limit did not improve.

Simultaneous determination of biogenic monoamines such as dopamine, serotonin, and 3-methoxytyramine in brain is important in understanding neurotransmitter activity. This study presents a sensitive determination of biogenic monoamines in rat brain striatum microdialysates using capillary high-performance liquid chromatography with the photoluminescence following electrontransfer detection technique. Separation conditions were optimized by changing the concentration of an ion-interaction agent and the percentage of an organic modifier. The high concentration of ion-interaction agent enabled the amines as a class to be separated from interfering acids, but also made the separation very long. To shorten the separation time, 10% (v/v) acetonitrile was used as the organic modifier. Eight chromatographic runs during a 3-h period were analyzed in terms of retention times, peak heights, and peak widths. Chromatograms are very reproducible, with less than 1% changes in peak height over 3 h. Typical concentration detection limits at the optimum separation conditions were less than 100 pM for metabolic acids and ~200 pM for monoamines. The injection volume of the sample was 500 nL. Thus, the mass detection limits were less than 50 amol for metabolic acids and ~100 amol for monoamines. Typical separation time was less than 10 min. To validate the technique, the separation method was applied to the observation of drug-induced changes of monoamine concentrations in rat brain microdialysis samples. Local perfusion of tetrodotoxin, a sodium channel blocker, into the striatum of an anesthetized rat decreased dopamine, 3-methoxytyramine, and serotonin concentrations in dialysates. Successive monitoring of striatal dialysates at a temporal resolution of 7.7 min showed that the injection of nomifensine transiently increased dopamine and 3-methoxytyramine concentrations in rat brain dialysate.

Postcolumn derivatization reactions can enhance detector sensitivity and selectivity, but their successful combination with capillary liquid chromatography has been limited because of the small peak volumes in capillary chromatography. A capillary Taylor reactor (CTR), developed in our laboratory, provides simple and effective mixing and reaction in a 25-[micro]m-radius postcolumn capillary. Homogenization of reactant streams occurs by radial diffusion, and a chemical reaction follows. Three characteristic times for a given reaction process can be predicted using simple physical and chemical parameters. Two of these times are the homogenization time, which governs how long it takes the molecules in the analyte and reagent streams to mix, and the reaction time, which governs how long the molecules in a homogeneous solution take to react. The third characteristic time is an adjustment to the reaction time called the start time, which represents an estimate of the average time the analyte stream spends without exposure to reagent. In this study, laser-induced fluorescence monitored the extent of the postcolumn reaction (reduction of [Os(bpy).sub.3.sup.3+] by analyte to the photoluminescent [Os(bpy).sub.3.sup.2+]) in a CTR. The reaction time depends on the reaction rates. Analysis of product versus time data yielded second-order reaction rate constants between the PFET reagent, tris(2,2'-bipyridine)osmium, and standards ((ferrocenylmethyl)trimethylammonium cation and p-hydroquinone) or catechols (dopamine, epinephrine, norepinephrine, 3, 4-dihydroxyphenylacetic acid. The extent of the reactions in a CTR were then predicted from initial reaction conditions and compared to experimental results. Both the theory and experimental results suggested the reactions of catechols were generally kinetically controlled, while those of the standards were controlled by mixing time (1-2 s). Thus, the extent of homogenization can be monitored in a CTR using the relatively fast reaction of the reagent and p-hydroquinone. Kinetically controlled reactions of catechols, however, could be also completed in a reasonable time at increased reagent concentration. A satisfactory reactor, operating at 1.7 cm/s (2 [micro]L/min) velocity with solutes having diffusion coefficients in the 5 x [10.sup.-6] [cm.sup.2]/s range, can be constructed from 8.0 cm of 25-[micro]m-radius capillary. Slower reactions require longer reaction times, but theoretical calculations expect that a CTR does not broaden a chromatographic peak (N = 14 000) from a 100-[micro]m-capillary chromatography column by 10% if the pseudo-first-order rate constant is larger than 0.1 [s.sup.-1].

Aquaporins (AQPs) are a family of transmembrane water channel proteins, which were initially characterized as a novel protein family that plays a vital role in transcellular and transepithelial water movement. AQP1, AQP2, AQP4, AQP5, and AQP8 are primarily water selective, whereas AQP3, AQP7, AQP9, and AQP10 (called "aqua-glyceroporins") also transport glycerol and other small solutes. Recently, multiple reports have suggested that AQPs have important roles in cancer cell growth, migration, invasion, and angiogenesis, each of which is important in human carcinogenesis. Here, we review recent data concerning the involvement of AQPs in tumor growth, angiogenesis, and metastasis and explore the expression profiles from various resected cancer samples to further dissect the underlying molecular mechanisms. Moreover, we discuss the potential role of AQPs during the development of genomic instability and performed modeling to describe the integration of binding between AQPs with various SH3 domain binning adaptor molecules. Throughout review and discussion of numerous reports, we have tried to provide key evidence that AQPs play key roles in tumor biology, which may provide a unique opportunity in designing a novel class of anti-tumor agents. [ABSTRACT FROM AUTHOR]

This brief presents a 2.5 – 32 Gb/s Gen 5-PCIe receiver with a multi-rate clock and data recovery (CDR) engine and a hybrid decision feedback equalizer (DFE). The receiver for the PCIe requires wide-range operation and compensation for high insertion loss. The proposed multi-rate CDR engine enables the receiver to operate with multi-rate clocking schemes according to the data rates, which does not need any additional high-speed analog circuits normally used for wide-range operation. In addition, the hybrid DFE architecture not only meets the DFE feedback timing constraint and but also reduces the equalization power. By using clock gating, the receiver can save power when operating at lower generations such as Gen 1, 2, 3, and 4. The prototype chip is fabricated in a 40-nm CMOS technology and occupies an active area of 0.14 mm2. The receiver achieves BER less than 10−12 with various PCIe channels, satisfying PCIe jitter tolerance masks. It consumes 62.7 mW at 32 Gb/s, compensating for 27.5-dB inserting loss, and the figure of merit (energy efficiency per channel loss at Nyquist frequency) of 0.07 pJ/b/dB is achieved. [ABSTRACT FROM AUTHOR]