Nevin Manimala

Langmuir. 2023 Oct 27. doi: 10.1021/acs.langmuir.3c02272. Online ahead of print.

ABSTRACT

Droplets made of liquid perfluorocarbon undergo a phase transition and transform into microbubbles when triggered by ultrasound of intensity beyond a critical threshold; this mechanism is called acoustic droplet vaporization (ADV). It has been shown that if the intensity of the signal coming from high ultrasonic harmonics are sufficiently high, superharmonic focusing is the mechanism leading to ADV for large droplets (>3 μm) and high frequencies (>1.5 MHz). In such a scenario, ADV is initiated due to a nucleus occurring at a specific location inside the droplet volume. But the question on what induces ADV in the case of nanometer-sized droplets and/or at low ultrasonic frequencies (<1.5 MHz) still remains. We investigated ADV of perfluorohexane (PFH) nano- and microdroplets at a frequency of 1.1 MHz and at conditions where there is no superharmonic focusing. Three types of droplets produced by microfluidics were studied: plain PFH droplets, PFH droplets containing many nanometer-sized water droplets, and droplets made of a PFH corona encapsulating a single micron-sized water droplet. The probability to observe a vaporization event was measured as a function of acoustic pressure. As our experiments were performed on droplet suspensions containing a population of monodisperse droplets, we developed a statistical model to extrapolate, from our experimental curves, the ADV pressure thresholds in the case where only one droplet would be insonified. We observed that the value of ADV pressure threshold decreases as the radius of a plain PFH droplet increases. This value was further reduced when a PFH droplet encapsulates a micron-sized water droplet, while the encapsulation of many nanometer-sized water droplets did not modify the threshold. These results cannot be explained by a model of homogeneous nucleation. However, we developed a heterogeneous nucleation model, where the nucleus appears at the surface in contact with PFH, that successfully predicts our experimental ADV results.

PMID:37889478 | DOI:10.1021/acs.langmuir.3c02272

Cerebellum. 2023 Oct 27. doi: 10.1007/s12311-023-01621-6. Online ahead of print.

ABSTRACT

Although a large array of biomarkers have been investigated in Friedreich’s ataxia (FRDA) trials, the optimal biomarker for assessing disease progression or therapeutic benefit has yet to be identified. We searched PubMed, MEDLINE, and EMBASE databases up to June 2023 for any original study (with ≥ 5 participants and ≥ 2 months’ follow-up) reporting the effect of therapeutic interventions on any clinical, cardiac, biochemical, patient-reported outcome measures, imaging, or neurophysiologic biomarker. We also explored the biomarkers’ ability to detect subtle disease progression in untreated patients. The pooled standardized mean difference (SMD) was calculated using a random-effects model. The study’s protocol was registered in PROSPERO (CRD42022319196). In total, 43 studies with 1409 FRDA patients were included in the qualitative synthesis. A statistically significant improvement was observed in Friedreich Ataxia Rating Scale scores [combining Friedreich Ataxia Rating Scale (FARS) and modified FARS (mFARS): SMD = – 0.32 (- 0.62 to – 0.02)] following drugs that augment mitochondrial function in a sensitivity analysis. Left ventricular mass index (LVMI) was improved significantly [SMD = – 0.34 (- 0.5 to – 0.18)] after 28.5 months of treatment with drugs that augment mitochondrial function. However, LVMI remained stable [SMD = 0.05 (- 0.3 to 0.41)] in untreated patients after 6-month follow-up. None of the remaining biomarkers changed significantly following any treatment intervention nor during the natural disease progression. Nevertheless, clinical implications of these results should be interpreted with caution because of low to very low quality of evidence. Further randomized controlled trials of at least 24 months’ duration using a biomarker toolbox rather than a single biomarker are warranted.

PMID:37889470 | DOI:10.1007/s12311-023-01621-6

Radiol Phys Technol. 2023 Oct 27. doi: 10.1007/s12194-023-00750-1. Online ahead of print.

ABSTRACT

The objective is to evaluate the performance of computational image classification for indeterminate pulmonary nodules (IPN) chronologically detected by CT scan. Total 483 patients with 670 abnormal pulmonary nodules, who were taken chest thin-section CT (TSCT) images at least twice and resected as suspicious nodules in our hospital, were enrolled in this study. Nodular regions from the initial and the latest TSCT images were cut manually for each case, and approached by Python development environment, using the open-source cv2 library, to measure the nodular change rate (NCR). These NCRs were statistically compared with clinico-pathological factors, and then, this discriminator was evaluated for clinical performance. NCR showed significant differences among the nodular consistencies. In terms of histological subtypes, NCR of invasive adenocarcinoma (ADC) were significantly distinguishable from other lesions, but not from minimally invasive ADC. Only for cancers, NCR was significantly associated with loco-regional invasivity, p53-immunoreactivity, and Ki67-immunoreactivity. Regarding Epidermal Growth Factor Receptor gene mutation of ADC-related nodules, NCR showed a significant negative correlation. On staging of lung cancer cases, NCR was significantly increased with progression from pTis-stage 0 up to pT1b-stage IA2. For clinical shared decision-making (SDM) whether urgent resection or watchful-waiting, receiver operating characteristic (ROC) analysis showed that area under the ROC curve was 0.686. For small-sized IPN detected by CT scan, this approach shows promise as a potential navigator to improve work-up for life-threatening cancer screening and assist SDM before surgery.

PMID:37889460 | DOI:10.1007/s12194-023-00750-1

Sports Med. 2023 Oct 27. doi: 10.1007/s40279-023-01950-w. Online ahead of print.

ABSTRACT

BACKGROUND: Injuries are common in adult recreational athletes. Exercise-based injury prevention programmes offer the potential to reduce the risk of injury and have been a popular research topic. Yet, syntheses and meta-analyses on the effects of exercise-based injury prevention programmes for adult recreational athletes are lacking.

OBJECTIVES: We aimed to synthesise and quantify the pooled intervention effects of exercise-based injury prevention programmes delivered to adults who participate in recreation sports.

METHODS: Studies were eligible for inclusion if they included adult recreational athletes (aged > 16 years), an exercise-based intervention and used a randomised controlled trial design. Exclusion criteria were studies without a control group, studies using a non-randomised design and studies including participants who were undertaking activity mandatory for their occupation. Eleven literature databases were searched from earliest record, up to 9 June, 2022. The Physiotherapy Evidence Database (PEDro) scale was used to assess the risk of bias in all included studies. Reported risk statistics were synthesised in a random-effects meta-analysis to quantify pooled treatment effects and associated 95% confidence intervals and prediction intervals.

RESULTS: Sixteen studies met the criteria. Risk statistics were reported as risk ratios [RRs] (n = 12) or hazard ratios [HRs] (n = 4). Pooled estimates of RRs and HRs were 0.94 (95% confidence interval 0.80-1.09) and 0.65 (95% confidence interval 0.39-1.08), respectively. Prediction intervals were 0.80-1.09 and 0.16-2.70 for RR and HR, respectively. Heterogeneity was very low for RR studies, but high for HR studies (tau = 0.29, I² = 81%). There was evidence of small study effects for RR studies, evidenced by funnel plot asymmetry and Egger’s test for small study bias: – 0.99 (CI – 2.08 to 0.10, p = 0.07).

CONCLUSIONS: Pooled point estimates were suggestive of a reduced risk of injury in intervention groups. Nevertheless, these risk estimates were insufficiently precise, too heterogeneous and potentially compromised by small study effects to arrive at any robust conclusion. More large-scale studies are required to clarify whether exercise-based injury prevention programmes are effective in adult recreational athletes.

CLINICAL TRIAL REGISTRATION: The protocol for this review was prospectively registered in the PROSPERO database (CRD42021232697).

PMID:37889449 | DOI:10.1007/s40279-023-01950-w

J Gastrointest Cancer. 2023 Oct 27. doi: 10.1007/s12029-023-00976-7. Online ahead of print.

ABSTRACT

AIM: Recently, change in the neutrophil to lymphocyte ratio (cNLR) has been shown to be a promising prognostic inflammation marker in some malignancies. The aim of the present study was to evaluate the clinical impact of the cNLR in gastric cancer patients who received curative gastrectomy.

PATIENTS AND METHODS: The present study included 450 patients who underwent curative treatment for gastric cancer between 2013 and 2017 at Kanagawa Cancer Center. The cNLR was defined as follows: cNLR = NLR at 1 month after surgery-NLR at 1 week before surgery. The prognosis and clinicopathological parameters of the increased cNLR and decreased cNLR groups were analyzed.

RESULTS: The OS stratified by each clinical factor was compared using the log-rank test, and a significant difference was observed using a cutoff value of cNLR at 0.762. When comparing the patient background factors between the increased cNLR (≥ 0.762) and decreased cNLR (< 0.762) groups, there were no significant differences in age, sex, T status, or N status. In the increased cNLR group, the OS rates at 3 and 5 years after surgery were 87.5% and 77.3%, respectively, while those in the decreased cNLR group were 92.8% and 87.3%, which amounted to a statistically significant difference (p = 0.041). The univariate and multivariate analyses of factors associated with OS showed that cNLR was a significant prognostic factor. When the postoperative course was compared between the two groups, the incidence rates of postoperative surgical complications and other-cause death were significantly higher in the increased cNLR group (p = 0.001 and p = 0.005, respectively).

CONCLUSION: The cNLR is one of the significant risk factors in gastric cancer patients. Our results suggested that the changes of inflammation status during perioperative periods might be a promising prognostic factor for gastrointestinal cancer patients.

PMID:37889434 | DOI:10.1007/s12029-023-00976-7

Environ Sci Pollut Res Int. 2023 Oct 27. doi: 10.1007/s11356-023-30530-8. Online ahead of print.

ABSTRACT

In Iran, similar to other developing countries, groundwater quality has been seriously threatened. Therefore, this study aimed to apply Machine Learning Algorithms (MLAs) in Groundwater Quality Modeling (GQM) and determine the optimal algorithm using the Best-Worst Method (BWM) in Ardabil province, Iran. Groundwater quality parameters included calcium (Ca²⁺), magnesium (Mg²⁺), sodium (Na⁺), potassium (K⁺), chlorine (Cl^–), sulfate (SO₄^–), total dissolved solids (TDS), bicarbonate (HCO₃^–), electrical conductivity (EC), and acidity (pH). In the following, seven MLAs, including Support Vector Regression (SVR), Random Forest (RF), Decision Tree Regressor (DTR), K-Nearest Neighbor (KNN), Naïve Bayes, Simple Linear Regression (SLR), and Support Vector Machine (SVM), were used in the Python programming language, and groundwater quality was modeled. Finally, BWM was used to validate the results of MLAs. The results of examining the error statistics in determining the optimal algorithm in groundwater quality modeling showed that the RF algorithm with values of MAE = 0.28, MSE = 0.12, RMSE = 0.35, and AUC = 0.93 was selected as the most optimal MLA. The Schoeller diagram also showed that various ion ratios, including Na⁺K, Ca²⁺, Mg²⁺, Cl^–, and HCO₃+CO₃, in most of the sampled points had upward average values. Based on the results of the BWM method, it can be concluded that a great similarity was observed between the results of the RF algorithm and the classification of the BWM method. These results showed that more than 50% of the studied area had low quality based on hydro-chemical parameters of groundwater quality. The findings of this research can assist managers and planners in developing suitable management models and implementing appropriate strategies for the optimal exploitation of groundwater resources.

PMID:37889408 | DOI:10.1007/s11356-023-30530-8

Doc Ophthalmol. 2023 Oct 27. doi: 10.1007/s10633-023-09956-5. Online ahead of print.

ABSTRACT

PURPOSE: To compare the diagnostic accuracy of the photopic negative response (PhNR) elicited by red-blue (RB) and white-white (WW) stimuli, for detection of retinal ganglion cell (RGC) dysfunction in a heterogeneous clinical cohort.

METHODS: Adults referred for electrophysiological investigations were recruited consecutively for this single-centre, prospective, paired diagnostic accuracy study. PhNRs were recorded to red flashes (1.5 cd·s·m^-2) on a blue background (10 cd·m^-2) and to white flashes on a white background (the latter being the ISCEV standard LA 3 stimulus). PhNR results were compared with a reference test battery assessing RGC/optic nerve structure and function including optical coherence tomography (OCT) retinal nerve fibre layer thickness and mean RGC volume measurements, fundus photography, pattern electroretinography and visual evoked potentials. Primary outcome measures were differences in sensitivity and specificity of the two PhNR methods.

RESULTS: Two hundred and forty-three participants were initially enrolled, with 200 (median age 54; range 18-95; female 65%) meeting inclusion criteria. Sensitivity was 53% (95% confidence intervals [CI] 39% to 68%) and 62% (95% CI 48% to 76%), for WW and RB PhNRs, respectively. Specificity was 80% (95% CI 74% to 86%) and 78% (95% CI 72% to 85%), respectively. There was a statistically significant difference between sensitivities (p = 0.046) but not specificities (p = 0.08) of the two methods. Receiver operator characteristic (ROC) area under the curve (AUC) values were 0.73 for WW and 0.74 for RB PhNRs.

CONCLUSION: PhNRs to red flashes on a blue background may be more sensitive than white-on-white stimuli, but there is no significant difference between specificities. This study highlights the value and potential convenience of using white-on-white stimuli, already used widely for routine ERG assessment.

PMID:37889400 | DOI:10.1007/s10633-023-09956-5

Obes Surg. 2023 Oct 27. doi: 10.1007/s11695-023-06908-5. Online ahead of print.

ABSTRACT

PURPOSE: Patients after metabolic bariatric surgery (MBS) require attention to maintain energy balance and avoid weight regain. Predictive equations for resting energy expenditure (REE) and total energy expenditure (TEE) are needed since gold standard methods like calorimetry and doubly labeled water are rarely available in routine clinical practice. This study aimed to determine which predictive equation for REE and TEE has the lowest bias in subjects after MBS.

METHODS: MEDLINE, Embase, Web of Science, and CENTRAL searches were performed. Meta-analyses were performed with the data calculated by the predictive equations and measured by the gold standard methods for those equations that had at least two studies with these data. The DerSimonian and Laird random-effects model and the I² statistic were used to quantify heterogeneity in the quantitative analyses. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist.

RESULTS: Seven studies were included. The present study found that the Mifflin St. Jeor (1990) equation had the lowest bias (mean difference = – 39.71 kcal [95%CI = – 128.97; 49.55]) for calculating REE in post-BS individuals. The Harris-Benedict (1919) equation also yielded satisfactory results (mean difference = – 54.60 kcal [95%CI = – 87.92; – 21.28]).

CONCLUSION: The predictive equation of Mifflin St. Jeor (1990) was the one that showed the lowest bias for calculating the REE of patients following MBS.

PMID:37889369 | DOI:10.1007/s11695-023-06908-5

J Magn Reson Imaging. 2023 Oct 27. doi: 10.1002/jmri.29106. Online ahead of print.

ABSTRACT

BACKGROUND: Oscillating gradient diffusion-weighted imaging (DWI) enables elucidation of microstructural characteristics in cancers; however, there are limited data to evaluate its utility in patients with endometrial cancer.

PURPOSE: To investigate the utility of oscillating gradient DWI for risk stratification in patients with uterine endometrial cancer compared with conventional pulsed gradient DWI.

STUDY TYPE: Retrospective.

SUBJECTS: Sixty-three women (mean age: 58 [range: 32-85] years) with endometrial cancer.

FIELD STRENGTH/SEQUENCE: 3 T MRI including DWI using oscillating gradient spin-echo (OGSE) and pulsed gradient spin-echo (PGSE) research sequences.

ASSESSMENT: Mean value of the apparent diffusion coefficient (ADC) values for OGSE (ADC_OGSE ) and PGSE (ADC_PGSE ) as well as the ADC ratio (ADC_OGSE /ADC_PGSE ) within endometrial cancer were measured using regions of interest. Prognostic factors (histological grade, deep myometrial invasion, lymphovascular invasion, International Federation of Gynecology and Obstetrics [FIGO] stage, and prognostic risk classification) were tabulated.

STATISTICAL TESTS: Interobserver agreement was analyzed by calculating the intraclass correlation coefficient. The associations of ADC_OGSE , ADC_PGSE , and ADC_OGSE /ADC_PGSE with prognostic factors were examined using the Kendall rank correlation coefficient, Mann-Whitney U test, and receiver operating characteristic (ROC) curve. A P value of <0.05 was statistically significant.

RESULTS: Compared with ADC_OGSE and ADC_PGSE , ADC_OGSE /ADC_PGSE was significantly and strongly correlated with histological grade (observer 1, τ = 0.563; observer 2, τ = 0.456), FIGO stage (observer 1, τ = 0.354; observer 2, τ = 0.324), and prognostic risk classification (observer 1, τ = 0.456; observer 2, τ = 0.385). The area under the ROC curves of ADC_OGSE /ADC_PGSE for histological grade (observer 1, 0.92, 95% confidence intervals [CIs]: 0.83-0.98; observer 2, 0.84, 95% CI: 0.73-0.92) and prognostic risk (observer 1, 0.80, 95% CI: 0.68-0.89; observer 2, 0.76, 95% CI: 0.63-0.86) were significantly higher than that of ADC_OGSE and ADC_PGSE .

DATA CONCLUSION: The ADC ratio obtained via oscillating gradient and pulsed gradient DWIs might be useful imaging biomarkers for risk stratification in patients with endometrial cancer.

LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 2.

PMID:37886909 | DOI:10.1002/jmri.29106

Int J Eat Disord. 2023 Oct 27. doi: 10.1002/eat.24078. Online ahead of print.

ABSTRACT

OBJECTIVE: Digital interventions show promise as an effective prevention or self-management option for eating disorders (EDs). However, it remains unclear how, for whom, and through what mechanisms they work in this population, as a synthesis of outcome predictors, moderators, and mediators is lacking. This systematic review synthesized empirical research investigating predictors, mediators, and moderators of response to digital interventions for EDs.

METHOD: Six databases were searched (PROSPERO CRD42022295565) for studies that assessed predictors, moderators, or mediators of response (i.e., uptake, drop-out, engagement, and symptom level change) to a digital prevention or treatment program for EDs. Variables were grouped into several overarching categories (demographic, symptom severity, psychological, etc.) and were synthesized qualitatively across samples without a formally diagnosed ED (typically prevention-focused) and samples with a formally diagnosed ED (typically treatment-focused).

RESULTS: Eighty-six studies were included. For studies recruiting samples without a formal diagnosis (n = 70 studies), most predictors explored were statistically unrelated to outcome, although participant age, baseline symptom severity, confidence to change, motivation, and program engagement showed preliminary evidence of prognostic potential. No robust moderators or mediators were identified. Few studies recruiting samples with a formal diagnosis emerged (n = 16), of which no reliable predictors, moderators, or mediators were identified.

DISCUSSION: It remains unclear how, for whom, and under what circumstances digital programs targeting EDs work. We offer several recommendations for future research with the aim of advancing understanding of client characteristics and intervention elements that signal success from this intervention modality.

PUBLIC SIGNIFICANCE: Digital interventions have shown potential as an effective, scalable, and accessible intervention option for EDs. However, responsiveness varies, so advancing understanding of predictors, mediators, and moderators of outcome to digital interventions for EDs is needed. Such knowledge is important for enabling safe and efficient treatment matching, and for informing future development of effective digital interventions.

PMID:37886906 | DOI:10.1002/eat.24078