Publications by authors named "D E Morales"

902 Publications

Surgical Repair of Complete Common Atrioventricular Canal in a Conjoined Twin Following Separation.

World J Pediatr Congenit Heart Surg 2022 Aug 17:21501351221117714. Epub 2022 Aug 17.

The Heart Institute, 2518Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Congenital heart disease (CHD) is common in conjoined twins but reports of surgical repair in this population are rare. We present the case of a conjoined twin diagnosed prenatally with a complete common atrioventricular canal defect (CAVC). Due to wound complications from twin separation, definitive repair was deferred and pulmonary arterial banding was performed initially. At 6 months, a complete CAVC repair was performed. The present case adds to the literature on successful cardiac surgical repairs in conjoined twins.
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http://dx.doi.org/10.1177/21501351221117714DOI Listing
August 2022

Phosphorus removal by steel slag from tile drainage water: Lab and field evaluations.

Chemosphere 2022 Aug 11;307(Pt 3):135850. Epub 2022 Aug 11.

School of Sustainable Engineering and the Built Environment (SSEBE), Arizona State University, PO Box 873005, Tempe, AZ, 85287-3005, USA.

Basic oxygen furnace (BOF) and blast furnace (BF) steel slags are well suited for phosphorous (P) removal from nonpoint sources such as agricultural runoff. However, the reported mechanism(s) of removal varies from study to study which complicates implementation for unique environmental conditions that may interfere with the removal mechanism(s). This work compared laboratory column experiments and field filter experiments to provide insights on the influence of relevant field conditions (water alkalinity, slag grain size distribution, BF:BOF slag ratio, and water stagnation) on P removal by BF and BOF steel slag mixtures. Alkalinity was the most influential variable in lab-scale slag columns that received 250 mg/L alkalinity water and achieved complete P removal throughout the 3-h experiment, while identical columns receiving 500 mg/L alkalinity water averaged 52% P removal and only 14% removal after 2.5 h. Batch regeneration and adsorption experiments were conducted on the exhumed BOF/BF slag mixture from the field filter to evaluate strategies for increasing field P removal capacity. The adsorption capacity of steel slags was effectively regenerated by 0.01 M Al(SO), which allowed for an additional 34% P removal in batch adsorption tests. The acid neutralization capacity of slag samples was effectively regenerated by 1 M NaOH, which allowed previously expended slag to reach a pH of 9.7 even in high alkalinity test water. The results presented here show that BF slag and Al(SO) regeneration of BF slag is best suited for high alkalinity influent conditions and removes P through adsorption while BOF slag and NaOH regeneration perform best under low alkalinity conditions and removes P through mineral precipitation.
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http://dx.doi.org/10.1016/j.chemosphere.2022.135850DOI Listing
August 2022

Virtual particle monte carlo (VPMC), a new concept to avoid simulating secondary particles in proton therapy dose calculation.

Med Phys 2022 Aug 12. Epub 2022 Aug 12.

Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, USA.

Background: In proton therapy dose calculation, Monte Carlo (MC) simulations are superior in accuracy but more time consuming, compared to analytical calculations. Graphic Processing Units (GPUs) are effective in accelerating MC simulations but may suffer thread divergence and racing condition in GPU threads that degrades the computing performance, due to the generation of secondary particles during nuclear reactions.

Purpose: A novel concept of virtual particle (VP) MC (VPMC) is proposed to avoid simulating secondary particles in GPU-accelerated proton MC dose calculation and take full advantage of the computing power of GPU.

Methods: Neutrons and gamma rays were ignored as escaping from the human body; doses of electrons, heavy ions, and nuclear fragments were locally deposited; the tracks of deuterons were converted into tracks of protons. These particles, together with primary and secondary protons, are considered to be the realistic particles. Histories of primary and secondary protons were replaced by histories of multiple VPs. Each VP corresponded to one proton (either primary or secondary). A continuous-slowing-down-approximation (CSDA) model, an ionization model, and a large angle scattering event (LAE) model corresponding to nuclear interactions were developed for VPs by generating probability distribution functions (PDFs) based on simulation results of realistic particles using MCsquare. For efficient calculations, these PDFs were stored in the Compute Unified Device Architecture (CUDA) textures. VPMC was benchmarked with TOPAS and MCsquare in phantoms and with MCsquare in thirteen representative patient geometries. Comparisons between the VPMC calculated dose and dose measured in water during patient-specific quality assurance (PSQA) of the selected 13 patients were also carried out. Gamma analysis was used to compare the doses derived from different methods and calculation efficiencies were also compared.

Results: Integrated-depth dose and lateral-dose profiles in both homogeneous and inhomogeneous phantoms all matched well among VPMC, TOPAS, and MCsquare calculations. The 3D-3D Gamma passing rates with a criterion of 2%/2mm and a threshold of 10% was 98.49% between MCsquare and TOPAS, and 98.31% between VPMC and TOPAS in homogeneous phantoms, and 99.18% between MCsquare and TOPAS and 98.49% between VPMC and TOPAS in inhomogeneous phantoms, respectively. In patient geometries, the 3D-3D Gamma passing rates with 2%/2mm/10% between dose distributions from VPMC and MCsquare were 98.56±1.09% in patient geometries. The 2D-3D Gamma analysis with 3%/2mm/10% between the VPMC calculated dose distributions and the 2D measured planar dose distributions during PSQA was 98.91±0.88%. VPMC calculation was highly efficient and took 2.84±2.44 seconds to finish for the selected 13 patients running on four NVIDIA Ampere GPUs in patient geometries.

Conclusion: VPMC was found to achieve high accuracy and efficiency in proton therapy dose calculation. This article is protected by copyright. All rights reserved.
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http://dx.doi.org/10.1002/mp.15913DOI Listing
August 2022

Light/Dark and Temperature Cycling Modulate Metabolic Electron Flow in Pseudomonas aeruginosa Biofilms.

mBio 2022 Aug 8:e0140722. Epub 2022 Aug 8.

Department of Biological Sciences, Columbia Universitygrid.21729.3f, New York, New York, USA.

Sunlight drives phototrophic metabolism, which affects redox conditions and produces substrates for nonphototrophs. These environmental parameters fluctuate daily due to Earth's rotation, and nonphototrophic organisms can therefore benefit from the ability to respond to, or even anticipate, such changes. Circadian rhythms, such as daily changes in body temperature, in host organisms can also affect local conditions for colonizing bacteria. Here, we investigated the effects of light/dark and temperature cycling on biofilms of the opportunistic pathogen Pseudomonas aeruginosa PA14. We grew biofilms in the presence of a respiratory indicator dye and found that enhanced dye reduction occurred in biofilm zones that formed during dark intervals and at lower temperatures. This pattern formation occurred with cycling of blue, red, or far-red light, and a screen of mutants representing potential sensory proteins identified two with defects in pattern formation, specifically under red light cycling. We also found that the physiological states of biofilm subzones formed under specific light and temperature conditions were retained during subsequent condition cycling. Light/dark and temperature cycling affected expression of genes involved in primary metabolic pathways and redox homeostasis, including those encoding electron transport chain components. Consistent with this, we found that -type oxidases contribute to dye reduction under light/dark cycling conditions. Together, our results indicate that cyclic changes in light exposure and temperature have lasting effects on redox metabolism in biofilms formed by a nonphototrophic, pathogenic bacterium. Organisms that do not obtain energy from light can nevertheless be affected by daily changes in light exposure. Many aspects of animal and fungal physiology fluctuate in response to these changes, including body temperature and the activities of antioxidant and other redox enzymes that play roles in metabolism. Whether redox metabolism is affected by light/dark and temperature cycling in bacteria that colonize such circadian organisms has not been studied in detail. Here, we show that growth under light/dark and temperature cycling lead to rhythmic changes in redox metabolism in Pseudomonas aeruginosa and identify proteins involved in this response. P. aeruginosa is a major cause of health care-associated infections and is designated a serious threat by the CDC due to its recalcitrance during treatments. Our findings have the potential to inform therapeutic strategies that incorporate controlled light exposure or consider P. aeruginosa's responses to conditions in the host.
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http://dx.doi.org/10.1128/mbio.01407-22DOI Listing
August 2022

Heart-lung transplantation for primary lung transplant complications.

Pediatr Transplant 2022 Aug 3:e14365. Epub 2022 Aug 3.

End-stage Lung Failure Program, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

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http://dx.doi.org/10.1111/petr.14365DOI Listing
August 2022
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