Nevin Manimala

Langmuir. 2023 Mar 21. doi: 10.1021/acs.langmuir.3c00061. Online ahead of print.

ABSTRACT

This study aims to understand and compare the evaporation dynamics of drops of healthy and pathological porcine blood (glomerulonephritis disease) evaporated on hydrophilic glass substrates at different surface temperatures (T_s): 23, 37, 60, and 90 °C. Subsequently, the different induced phenomena are characterized and described. Additionally, drops of water were evaporated at these four surface temperatures to better understand the difference between healthy and pathological porcine blood. Statistical studies were performed to analyze the evaporation rate, the maximum and average values of Marangoni numbers (Ma), and the evaporated specific time. The statistical tests showed significant differences in these parameters between healthy and pathological blood for each surface temperature. The mean and the maximum of the Ma increase with the increase in T_s caused by the increase in the temperature differences between the edge and the center of the drop. When comparing healthy and diseased blood, the Ma maximum and mean of healthy blood were higher than those of diseased blood for all T_s. Besides, this study emphasizes the influence of temperature on blood evaporation and the pattern caused by the Marangoni effect. These results demonstrate that differences between the two blood types are related to the disease and pave the way to developing a new methodology for medical decision-making.

PMID:36944107 | DOI:10.1021/acs.langmuir.3c00061

Int J Epidemiol. 2023 Mar 21:dyad034. doi: 10.1093/ije/dyad034. Online ahead of print.

ABSTRACT

BACKGROUND: Epidemiological studies demonstrated that adverse in utero environment was associated with increased risk of offspring high blood pressure, by using birthweight as the proxy of maternal intrauterine exposure; however, the nature of such association remains less understood.

METHODS: With maternal/fetal-specific summary statistics of birthweight (n = 297 356 for own birthweight and n = 210 248 for offspring birthweight) and summary statistics of blood pressure [i.e. systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP)] (n = 757 601), we evaluated the genetic correlation between fetal-specific birthweight and blood pressure using cross-trait linkage disequilibrium score regression, and next detected pleiotropic genes for them with a pleiotropy mapping method called mixture-adjusted intersect-union pleiotropy test. Furthermore, we conducted a genetic risk score (GRS)-based Mendelian randomization analysis in parent-offspring pairs (n = 6031) of the UK Biobank cohort, to assess the causal relation between maternal-specific GRS and blood pressure conditioning on fetal genotypes.

RESULTS: We found fetal-specific birthweight had a negative genetic correlation with DBP (ρ^g = -0.174, P = 1.68 × 10-10), SBP (ρ^g = -0.198, P = 8.09 × 10-12), and PP (ρ^g = -0.152, P = 6.04 × 10-8), and detected 143, 137 and 135 pleiotropic genes shared between fetal-specific birthweight and PP, SBP and DBP, respectively. These genes often exhibited opposite genetic effects, and were more likely to be differentially expressed in pancreas, liver, heart, brain, whole blood and muscle skeletal tissues. A causal negative association of maternal-specific birthweight was identified with SBP (P = 2.20 × 10-2) and PP (P = 7.67 × 10-3) but not DBP (P = 0.396) in mother-offspring pairs, after accounting for the influence of fetal-specific GRS; and the two significant relations were robust against the horizontal pleiotropy of instruments and the confounding influence of gestational duration and preterm birth. However, these causal associations could not be detected in father-offspring pairs.

CONCLUSIONS: This study revealed common genetic components underlying birthweight and blood pressure, and provided important insight into aetiology and early prevention of high blood pressure.

PMID:36944101 | DOI:10.1093/ije/dyad034

J Comput Assist Tomogr. 2023 Mar 22. doi: 10.1097/RCT.0000000000001442. Online ahead of print.

ABSTRACT

OBJECTIVE: Advancements in computed tomography (CT) reconstruction have enabled image quality improvements and dose reductions. Previous advancements have included iterative and model-based reconstruction. The latest image reconstruction advancement uses deep learning, which has been evaluated for polychromatic imaging only. This article characterizes a commercially available deep learning imaging reconstruction applied to dual-energy CT.

METHODS: Monochromatic, iodine basis, and water basis images were reconstructed with filtered back projection (FBP), iterative (ASiR-V), and deep learning (DLIR) methods in a phantom experiment. Slice thickness, contrast-to-noise ratio, modulation transfer function, and noise power spectrum metrics were used to characterize ASiR-V and DLIR relative to FBP over a range of dose levels, phantom sizes, and iodine concentrations.

RESULTS: Slice thicknesses for ASiR-V and DLIR demonstrated no statistically significant difference relative to FBP for all measurement conditions. Contrast-to-noise ratio performance for DLIR-high and ASiR-V 40% at 2 mg I/mL on 40-keV images were 162% and 30% higher than FBP, respectively. Task-based modulation transfer function measurements demonstrated no clinically significant change between FBP and ASiR-V and DLIR on monochromatic or iodine basis images.

CONCLUSIONS: Deep learning image reconstruction enabled better image quality at lower monochromatic energies and on iodine basis images where image contrast is maximized relative to polychromatic or high-energy monochromatic images. Deep learning image reconstruction did not demonstrate thicker slices, decreased spatial resolution, or poor noise texture (ie, “plastic”) relative to FBP.

PMID:36944100 | DOI:10.1097/RCT.0000000000001442

J Comput Assist Tomogr. 2023 Mar 22. doi: 10.1097/RCT.0000000000001449. Online ahead of print.

ABSTRACT

PURPOSES: The aims of the study are to identify factors contributing to computed tomography (CT) trauma scan turnaround time variation and to evaluate the effects of an automated intervention on time metrics.

METHODS: Throughput metrics were captured via picture archiving and communication system from January 1, 2018, to December 16, 2019, and included 17,709 CT trauma scans from our institution. Initial data showed that imaging technologist variation played a significant role in trauma imaging turnaround time. In December 2019, we implemented a 2-pronged intervention: (1) educational intervention to techs and (2) modified trauma CT abdomen/pelvis to autogenerate and autosend reformats to picture archiving and communication system. A total of 13,169 trauma CT scans were evaluated from the postintervention period taking place from January 2020 to March 2021. Throughput metrics such as last image to first report interval and emergency department length of stay were captured and compared with performing technologist, time of day, and weekday versus weekend scans.

RESULTS: Substantial variability among trauma CT scans was observed. For CT trauma abdomen/pelvis, the interval from last image to initial report decreased from 26.4 to 24.0 minutes (P = 0.001) while the interval between first and last image time decreased from 11.4 to 4.2 minutes (P < 0.001). Emergency department length of stay also decreased from 3.9 to 3.7 hours (P < 0.0001) in the postintervention period. Variation among imaging technologist was statistically significant and became less significant after intervention (P = 0.09, P = 0.54).

CONCLUSIONS: Factors such as imaging technologist variability, time of day, and day of the week of trauma scans played a significant role in CT trauma turnaround time variability. Automation interventions can help with efficiency in image turnaround time.

PMID:36944097 | DOI:10.1097/RCT.0000000000001449

Ophthalmic Surg Lasers Imaging Retina. 2023 Mar;54(3):147-152. doi: 10.3928/23258160-20230221-03. Epub 2023 Mar 1.

ABSTRACT

BACKGROUND AND OBJECTIVE: To investigate popular eye health supplements available on Amazon Marketplace to increase awareness about their efficacy, safety, and the validity of their purported benefits.

MATERIALS AND METHODS: An observational quantitative and qualitative analysis of the top 100 eye health products was performed in March 2019. To determine the popular online eye health products on Amazon Marketplace, eight keywords were used for the search: “Eye Health,” “Eye Health Supplements,” “Eye Health Vitamins,” “Retina Vitamins,” “Macular Degeneration,” “Macular Degeneration Vitamins,” “Macular Health,” and “Vision Health.” The active ingredients, cost, and customer rating were all recorded.

RESULTS: No statistically significant association was found between product type and price of the product, number of supplements, average rating, number of customer reviews, or number of verified customer reviews. The average daily cost of the eye health supplements was $0.72 ± $0.55 (range, $0.05 to $2.67).

CONCLUSION: This study evaluated popular eye health supplements publicly available on Amazon Marketplace. The findings of this study help both patients and physicians better understand the safety and efficacy of these products so they may make more informed choices when supporting their eye health with commercially available supplements. [Ophthalmic Surg Lasers Imaging Retina 2023; 54(3):147-152.].

PMID:36944073 | DOI:10.3928/23258160-20230221-03

Ophthalmic Surg Lasers Imaging Retina. 2023 Mar;54(3):153-157. doi: 10.3928/23258160-20230217-01. Epub 2023 Mar 1.

ABSTRACT

BACKGROUND AND OBJECTIVE: The aim of this study was to evaluate the interobserver agreement of the myopic traction maculopathy (MTM) staging system (MSS).

PATIENTS AND METHODS: Each observer was asked to look at the MSS Table and then identify, in each optical coherence tomography scan, one among four stages of MTM in the retina, one among three stages in the fovea, and, as secondary findings, the presence or absence of an outer lamellar macular hole and the presence or absence of epiretinal abnormalities. The interobserver agreement value was calculated using the Gwet’s AC1 unweighted and AC2 weighted statistics. The outcomes were interpreted as poor (<0.00), slight (0.00 to 0.20), fair (0.21 to 0.40), moderate (0.41 to 0.60), substantial (0.61 to 0.80), or almost perfect (0.81 to 1.00) agreement.

RESULTS: The agreement, among 65 participants, was 0.62 (AC1) and 0.77 (AC2) for the retina stage; 0.63 (AC1) and 0.81 (AC2) for the fovea stage; 0.56 (AC1) for the outer lamellar macular hole; and 0.26 (AC1) for epiretinal abnormalities.

CONCLUSION: The MSS is highly reproducible and helps ophthalmologists to share information on MTM in a more accurate and reliable way. [Ophthalmic Surg Lasers Imaging Retina 2023;54(3):153-157.].

PMID:36944066 | DOI:10.3928/23258160-20230217-01

Urogynecology (Phila). 2022 Dec 23. doi: 10.1097/SPV.0000000000001300. Online ahead of print.

ABSTRACT

IMPORTANCE: Bladder hydrodistention (BH) is commonly used to diagnose and treat patients with interstitial cystitis/bladder pain syndrome (IC/BPS), but the overall assessment of bleeding complications for patients taking antithrombotics is lacking.

OBJECTIVES: The study aimed to investigate if perioperative complications were more common in patients with IC/BPS receiving antithrombotic therapy after BH.

STUDY DESIGN: We retrospectively reviewed patients with IC/BPS who underwent hydrodistention during January 2010 and May 2021. Patients with and without antithrombotic drugs were identified and grouped, and their medical records were reviewed. Perioperative data and symptom scores were assessed. The rates of complications in the 2 groups were recorded at 3 months and at the last visit postoperatively.

RESULTS: A total of 387 patients were eventually included. Among them, 29 (7.5%) patients were receiving systemic antithrombotic therapy and 358 (92.5%) were not. Compared with the non-antithrombotic group, patients receiving antithrombotic therapy demonstrated a longer hospital stay (P = 0.033) and a longer catheterization time (P = 0.034). Moreover, the patients with antithrombotic drugs had increased odds of bladder tamponade (odds ratio, 6.76; P = 0.019) and urinary retention (odds ratio, 5.79; P = 0.033) both 3 months postoperatively and last follow-up, but this is not statistically different between patients with and without Hunner lesions. No thromboembolic events were identified during the study period.

CONCLUSIONS: Although a small number of patients with IC/BPS needed anticoagulants, longer hospital stays, longer catheterization time, and increased odds of bladder tamponade and urinary retention were observed in patients receiving antithrombotic therapy. Still, a comprehensive management scheme to balance bleeding complications and antithrombotic agents is needed for individuals.

PMID:36944055 | DOI:10.1097/SPV.0000000000001300

Ann Fam Med. 2022 Apr 1;(20 Suppl 1). doi: 10.1370/afm.20.s1.2920.

ABSTRACT

Context: At the mid-point of the COVID-19 pandemic, polymerase chain reaction (PCR) testing for SARS-CoV-2 was difficult to obtain and took several days to return a result. Our health system wished to explore the use of the Quidel Sofia™ antigen test to diagnose COVID-19 in our primary care clinics, but the test was approved for emergency use authorization by the US Food and Drug Administration with only 250 test subjects. In addition, because it was important to avoid aerosol generating procedures in primary care clinics, it was necessary to test the diagnostic performance of the antigen test using mid-turbinate (MT) swabs rather than the approved nasopharyngeal (NP) swab technique. Objective: To assess the diagnostic test characteristics of a SARS-CoV-2 antigen test performed using mid-turbinate nasal swabs compared with the presumed reference standard PCR test by NP swab. Study Design: Prospective cohort study. Setting or Dataset: Outpatient. Population studied: Adults with symptoms consistent with mild-moderate COVID-19. We attempted to recruit 800 subjects to provide statistical assurance that the test sensitivity was at least 90%. Intervention/Instrument: After informed consent, subjects underwent MT nasal swab for antigen testing followed by NP swabbing for PCR testing. Outcome Measures: Sensitivity, specificity, positive and negative predictive values, and likelihood ratios, all with associated 95% confidence intervals. Results: Due to recruitment difficulty (subject reluctance and staffing issues at the testing centers), we recruited only 117 subjects. Sensitivity was 0.750 (95% CI 0.566, 0.885), and specificity was 0.988 (95% CI 0.936, 1.000). Positive Predictive Value was 0.960 (95% CI 0.796, 0.999) and Negative Predictive Value was 0.913 (95% CI 0.836, 0.962). The likelihood ratio for a positive test was 63.75 (95% CI 8.99, 451.97) and the likelihood ratio for a negative test was 0.25 (95% CI 0.14, 0.46). Conclusions: This antigen test for SARS-CoV-2 was of reasonable clinical utility in a low prevalence environment but concerns about the actual prevalence of COVID-19 and the ramifications of false negatives limited its use. Difficulty recruiting subjects and the resultant delay in the results made it impossible to implement this antigen testing in primary care practices, but it is hoped that these data will contribute to the accumulation of evidence about diagnostic testing for COVID-19.

PMID:36944042 | DOI:10.1370/afm.20.s1.2920

Med Glas (Zenica). 2023 Aug 1;20(2). doi: 10.17392/1566-23. Online ahead of print.

ABSTRACT

Aim To determine the value of angles between the left coronary artery main trunk (LMT) and its branches, the anterior interventricular branch (LAD) and the circumflex branch (CX), and their possible relationship with the LMT length. Methods A total of 29 cadaveric hearts were used. The left coronary artery and its branches were dissected. The hearts were then classified according to the number of branches. The LMT length was measured with a digital gauge, and the LAD-CX angle, LMTLAD angle and LMT-CX angle with a manual goniometer. Results The average value of the LMT length was 9.0 mm (6.0-13.5). In 20 (68.97%) samples, the LMT was divided into two terminal branches. There was no statistically significant difference (p=0.321) in LMT length between the hearts with a bifurcation and without it. The average value of the LAD-CX angle was 89.0⁰ (74.5-93.0), with a statistically significant difference (p=0.020) comparing to hearts with trifurcation. The mean value of the LMT-LAD angle was 30.83±9.23⁰ and it was significantly lower (p=0.006) in the group of hearts with bifurcation compared to the group with trifurcation of the main trunk. Conclusion The LMT length shows great variability and is not related to the LAD-CX, LMT-LAD or the LMT-CX angle. Knowledge of the left coronary variation is essential in order to avoid misinterpretation of arteriogram.

PMID:36944018 | DOI:10.17392/1566-23

Circ Cardiovasc Interv. 2023 Mar;16(3):e012623. doi: 10.1161/CIRCINTERVENTIONS.122.012623. Epub 2023 Mar 21.

ABSTRACT

BACKGROUND: Transcatheter aortic valve replacement is approved for treatment of patients with severe aortic stenosis across the spectrum of risk. While considering broader indications for use, transcatheter aortic valve replacement in large native annuli has become increasingly important.

METHODS: Patients with tricuspid aortic stenosis undergoing transcatheter aortic valve replacement using the Evolut R or Evolut PRO+ 34 mm valves (Medtronic, Minneapolis, MN) in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry between October 2016 and September 2020 were stratified according to in range (>12%) device oversizing and below range (0%-12%) device oversizing. Patients undergoing valve-in-valve procedures, having a baseline annulus size <26 or ≥34 mm, or without computed tomography angiography measured annulus size were excluded. Percentage of oversizing was calculated as [(valve diameter-annulus diameter)×100/annulus diameter].

RESULTS: Transcatheter aortic valve replacement in patients with large annuli was performed in 8017 patients with a mean (±SD) age 79.3±7.9 years and 94% were male. Below range (n=1096) was less common than in range oversizing (n=6921). At 1-year follow-up, mortality (19.6% versus 14.9%; P=0.001), aortic valve reintervention (2.1% versus 0.6%; P<0.001) and valve-related readmission rates (3.2% versus 2.0%; P=0.014) were higher in the below range device oversizing group versus in range group respectively. In a multivariable Cox proportional hazards regression model, when controlling for clinically relevant covariates, below range device oversizing was associated with higher 1-year all-cause mortality (HR, 1.28 [CI, 1.07-1.51]; P=0.005).

CONCLUSIONS: Results from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry in patients with large annuli valves using 34mm Evolut R/PRO+ valves suggest that in range (>12%) device oversizing delivered better clinical outcomes than implantation with below range (0%-12%) device oversizing.

PMID:36943929 | DOI:10.1161/CIRCINTERVENTIONS.122.012623