Nevin Manimala

Tomography. 2022 Apr 14;8(2):1129-1140. doi: 10.3390/tomography8020092.

ABSTRACT

Purpose: The aortic time-enhancement curve obtained from dynamic CT myocardial perfusion imaging can be used to derive the cardiac output (CO) index based on the indicator dilution principle. The objective of this study was to investigate the effect of cardiac phase at which CT myocardial perfusion imaging is triggered on the CO index measurement with this approach. Methods: Electrocardiogram (ECG) gated myocardial perfusion imaging was performed on farm pigs with consecutive cardiac axial scans using a large-coverage CT scanner (Revolution, GE Healthcare) after intravenous contrast administration. Multiple sets of dynamic contrast-enhanced (DCE) cardiac images were reconstructed retrospectively from 30% to 80% R-R intervals with a 5% phase increment. The time-enhancement curve sampled from above the aortic orifice in each DCE image set was fitted with a modified gamma variate function (MGVF). The fitted curve was then normalized to the baseline data point unaffected by the streak artifact emanating from the contrast solution in the right heart chamber. The Stewart-Hamilton equation was used to calculate the CO index based on the integral of the fitted normalized aortic curve, and the results were compared among different cardiac phases. Results: The aortic time-enhancement curves sampled at different cardiac phases were different from each other, especially in the baseline portion of the curve where the effect of streak artifact was prominent. After properly normalizing and denoising with a MGVF, the integrals of the aortic curve were minimally different among cardiac phases (0.228 ± 0.001 Hounsfield Unit × second). The corresponding mean CO index was 4.031 ± 0.028 L/min. There were no statistical differences in either the integral of the aortic curve or CO index among different cardiac phases (p > 0.05 for all phases).

PMID:35448726 | DOI:10.3390/tomography8020092

Tomography. 2022 Apr 11;8(2):1090-1096. doi: 10.3390/tomography8020089.

ABSTRACT

We aimed to retrospectively analyze consecutive prostate cancer patients diagnosed with biochemical or clinical recurrence after local treatment with curative intent, with no evidence of distant metastases, who underwent positron emission tomography/computed tomography (PET/CT) with choline followed by salvage lymph node dissection (SLND) in three academic centers between 2013 and 2020. A total of 27 men were included in the analyses. Sensitivity, specificity, positive and negative predictive values, and accuracy of choline-PET/CT in predicting pathology-proven lymph node involvement were 75%, 43%, 79%, 38% and 67% on per-patient and 70%, 86%, 80%, 78%, and 79% on per-site analyses, respectively, with the differences in specificity and NPV between per-patient and per-site analyses being statistically significant (p = 0.03 and 0.04, respectively). The study provides further insight into the role of preoperative choline-PET/CT in patients undergoing SLND for recurrent PC.

PMID:35448723 | DOI:10.3390/tomography8020089

Tomography. 2022 Apr 3;8(2):1033-1040. doi: 10.3390/tomography8020083.

ABSTRACT

BACKGROUND: The ideal central venous catheter (CVC) tip position placement is controversial, and CVCs do not remain in a fixed position after placement. This study evaluates both patient and procedural factors which may influence CVC tip migration and subsequent catheter dysfunction.

MATERIALS AND METHODS: This study evaluates CVC placements at a single institution. Patient age, gender, body mass index (BMI), catheter laterality, CVC type and indication for central venous access were recorded. Catheter tip location relative to the carina was measured at time of placement and removal utilizing supine fluoroscopic imaging. Patients’ electronic medical records were reviewed for evidence of catheter dysfunction. Statistical analysis was performed utilizing odds ratios and two tailed Student’s t-test.

RESULTS: 177 patients were included (101 female; mean age 55; mean BMI 29.2). Catheter types included 122 ports, 50 tunneled large bore central venous catheters (≥9 French), and 5 tunneled small bore central venous catheters (<9 French). 127 were right sided catheters, and 50 were left sided. Left sided CVCs had a mean cranial tip migration of 3.2 cm (standard deviation ±2.9 cm) compared to 0.8 cm (standard deviation ±1.9 cm) for right sided catheters (p = 0.000008). Catheters that migrated cranially by >2 cm had more than 7× greater risk of dysfunction compared to catheters that migrated ≤2 cm (odds ratio of 7.2; p = 0.0001). Left sided CVCs were significantly more likely to have >2 cm of cranial migration (odds ratio 6.9, 95% CI 3.4-14.2, p < 0.0001) and had a higher rate of dysfunction, likely due to this cranial migration (32% vs. 4.7%; p = 0.00001). Gender and BMI were not found to be associated with catheter dysfunction or an increased odds ratio of >2 cm cranial migration.

CONCLUSIONS: Left-sided CVCs migrate an average of 2.4 cm cranially more than right-sided catheters. Additionally, when migration occurs, left-sided catheters are more likely to be dysfunctional. These suggest that lower initial placement may be beneficial in left-sided catheters.

PMID:35448717 | DOI:10.3390/tomography8020083

Tomography. 2022 Mar 22;8(2):891-904. doi: 10.3390/tomography8020072.

ABSTRACT

Background parenchymal enhancement (BPE) of breast fibroglandular tissue (FGT) in dynamic contrast-enhanced breast magnetic resonance imaging (MRI) has shown an association with response to neoadjuvant chemotherapy (NAC) in patients with breast cancer. Fully automated segmentation of FGT for BPE calculation is a challenge when image artifacts are present. Low spatial frequency intensity nonuniformity due to coil sensitivity variations is known as bias or inhomogeneity and can affect FGT segmentation and subsequent BPE measurement. In this study, we utilized the N4ITK algorithm for bias correction over a restricted bilateral breast volume and compared the contralateral FGT segmentations based on uncorrected and bias-corrected images in three MRI examinations at pre-treatment, early treatment and inter-regimen timepoints during NAC. A retrospective analysis of 2 cohorts was performed: one with 735 patients enrolled in the multi-center I-SPY 2 TRIAL and the sub-cohort of 340 patients meeting a high-quality benchmark for segmentation. Bias correction substantially increased the FGT segmentation quality for 6.3-8.0% of examinations, while it substantially decreased the quality for no examination. Our results showed improvement in segmentation quality and a small but statistically significant increase in the resulting BPE measurement after bias correction at all timepoints in both cohorts. Continuing studies are examining the effects on pCR prediction.

PMID:35448706 | DOI:10.3390/tomography8020072

Pharmacy (Basel). 2022 Apr 15;10(2):45. doi: 10.3390/pharmacy10020045.

ABSTRACT

Digital storytelling is a type of active learning that allows instructors to simulate real-life situations through a series of connected videos. While this technique has been used in other healthcare education disciplines, its use in pharmacy has not been well documented. A digital storytelling model was incorporated in a required self-care pharmacy course to assess if the technique was helpful to improve the knowledge, confidence, and satisfaction of students. Due to a shift in online learning, the self-care course offered a remote exam review session containing a digital storytelling model, and this approach was compared to an in-person exam review that followed a lecture-based model held earlier in the course. Pre- and post-knowledge assessments were given to determine the impact of the digital storytelling review. There were 50 students involved in both sessions and there was a 70% response rate in the digital storytelling group and a 90% response rate in the lecture-based group. Students’ knowledge numerically improved, but not to a statistically significant level for most questions. Nonetheless, students reported more confidence (p < 0.05) in their ability to pass the upcoming exam following the digital storytelling review. Thematic analysis revealed that the digital storytelling session was engaging and interactive, though time-management and breakout rooms could be further optimized. Based on these results, exam review in a required self-care pharmacy course using a digital storytelling format may be a suitable method for students to apply course content and may particularly be of utility in online or hybrid courses.

PMID:35448704 | DOI:10.3390/pharmacy10020045

Pharmacy (Basel). 2022 Apr 9;10(2):44. doi: 10.3390/pharmacy10020044.

ABSTRACT

Ensuring an adequate preparation for undergraduate students transitioning to pharmacy school is challenging. A significant barrier is changing from a subordinate to a critical thinking mindset while self-identifying as a professional. Here, we aimed to (1) determine whether our prepharmacy program called “Professional Identity and Me” (PRIME) could enhance learners’ self-awareness of their professional identity and (2) compare the effectiveness of the in-person and online versions of PRIME. PRIME introduced prepharmacy students to aspects of pharmacists’ professional identity including community, hospital, and interprofessional work, as well as mental health, wellness, and time and stress management skills, Top-200 drugs, prerequisite foundational sciences, and calculations. Concepts of professionalism, graduate writing, and ownership were also presented. Bridging exercises were introduced to exemplify application. We used a mixed-methods approach to assess the outcomes. The average performance in knowledge-based assessments increased before and after the PRIME program from 53.8 to 74.6% and from 47.7 to 75.9%, while the difference in the test scores was statistically significant, with a 21% increase (p < 0.001, 95% CI 15-26%) and a 28% improvement (p < 0.001, 95% CI 23-34%) for face-to-face versus virtual PRIME. The results of a student perception survey revealed PRIME was equally effective as a virtual program during the COVID-19 pandemic, suggesting transferability to other pharmacy programs.

PMID:35448703 | DOI:10.3390/pharmacy10020044

Vet Sci. 2022 Apr 17;9(4):193. doi: 10.3390/vetsci9040193.

ABSTRACT

The early and accurate diagnosis of brucellosis, a ubiquitous zoonotic infection, is significant in preventing disease transmission. This study aimed to assess the infection rate of Brucella spp. in ruminants and to evaluate the agreement between a serological test and a molecular method for the detection of infected cases. Blood and milk samples of 136 ruminants were analyzed using two laboratory methods: the Rose Bengal plate (RBP) test to detect B. abortus and B. melitensis antibodies and the molecular polymerase chain reaction (PCR) method for the presence of bacterial DNA. The agreement between the methods was assessed using the kappa statistic. Based on the RBP test, there were 12 (8.8%) seropositive animals (10 sheep and 2 cows), while 2 (1.4%) samples were positive on PCR analysis. The positive PCR samples were from seronegative cow samples on RBP testing. There was slight agreement (k = -0.02) between the two methods, which was not statistically significant. Our results indicate that complementary molecular methods are useful to detect the bacteria in infected animals that are seronegative due to an early stage of infection. Therefore, a combination of molecular methods and serological tests can be applied to detect brucellosis in ruminants efficiently.

PMID:35448691 | DOI:10.3390/vetsci9040193

Vet Sci. 2022 Apr 13;9(4):187. doi: 10.3390/vetsci9040187.

ABSTRACT

Equine adenovirus 1 (EAdV-1) can cause upper respiratory disease in horses and has been reported worldwide. In this study, and for the first time in Korea, the prevalence of EAdV-1 in equine nasal swabs was investigated using a PCR to identify potential risk factors and examine the genetic diversity of its DNA sequences by a comparison with foreign strains. Nasal swabs collected from 359 horses reared at Korea Racing Authority facilities were tested using an EAdV-1 hexon-specific PCR and the associations between EAdV-1 infection and sex, age, region, breed, and activity were analyzed. Five samples (1.4%, 5/359) tested positive for EAdV-1; however, no statistically significant differences were observed with respect to any variable. Among the five EAdV-1-positive horses, a co-infection with equine influenza, equine herpesvirus 1 and 4, or Streptococcus equi was not detected; however, clinical respiratory signs were observed in one. Phylogenetic analyses based on partial EAdV-1 hexon gene sequences revealed that the Korean EAdV-1 isolates shared approximately 98.8-100% similarity among each other and with foreign strains. Three Korean isolates shared high similarity with strains from Australia and India and the remaining two isolates were separate in phylogenetic analyses. These findings highlight the molecular prevalence and genetic diversity of EAdV-1 in horses in Korea.

PMID:35448685 | DOI:10.3390/vetsci9040187

Vet Sci. 2022 Apr 11;9(4):181. doi: 10.3390/vetsci9040181.

ABSTRACT

Diminishing Campylobacter prevalence in poultry flocks has proven to be extremely challenging. To date, efficacious control measures to reduce Campylobacter prevalence are still missing. A potential approach to control Campylobacter in modern poultry productions is to occupy its niche in the mucosal layer by administering live intestinal microbiota from adult chickens to dayold-chicks (competitive exclusion (CE)). Therefore, this in vivo study investigates the efficacy of a complex CE culture to reduce Campylobacter (C.) jejuni colonization in broiler chickens. For this purpose, the complex CE culture was applied twice: once by spray application to day-old chicks immediately after hatching (on the 1st day of life) and subsequently by an additional application via drinking water on the 25th day of life. We observed a consistent and statistically significant reduction of C. jejuni counts in cloacal swabs throughout the entire fattening period. At the end of the trial after necropsy (at 33 days of age), C. jejuni cecal counts also showed a statistically significant decrease of 1 log₁₀ MPN/g compared to the control group. Likewise, colon counts were reduced by 2.0 log₁₀ MPN/g. These results suggest that CE cultures can be considered a practically relevant control strategy to reduce C. jejuni colonization in broiler chickens on poultry farms.

PMID:35448680 | DOI:10.3390/vetsci9040181

Vet Sci. 2022 Apr 1;9(4):172. doi: 10.3390/vetsci9040172.

ABSTRACT

E-cadherin (E-cad) is a cell-adhesion molecule known for its tumor-invasion suppressor function. E-cad expression was examined immunohistochemically in a series of canine tissue samples, including normal gastric mucosa (NGM; n = 3), gastric carcinomas (GC; n = 33), adjacent non-neoplastic mucosa (NNM; n = 32), neoplastic emboli (n = 16) and metastatic lesions (n = 9). The relationship between E-cad expression and clinicopathological features were investigated. In NGM, epithelial cells showed strong latero-lateral membranous expression of E-cad, and this pattern was considered normal. The membranous staining was preserved in all specimens of NNM (100%), whereas abnormal E-cad expression was found in 87.9% of the GCs. A marked difference in E-cad expression was observed between normal and malignant tissues (p < 0.0002). Abnormal E-cad expression was significantly more frequent in poorly/undifferentiated carcinomas (96%) and diffuse (95%) and indeterminate carcinomas (100%) than in well-differentiated/intestinal ones (62.5%; p = 0.0115 and p = 0.0392, respectively). There was significant association between abnormal E-cad expression and the depth of invasion (p = 0.0117), and the presence neoplastic emboli (p = 0.0194). No statistically significant differences in E-cad expression were observed concerning tumor location, histological type according to WHO classification, and presence of metastatic lesions. Therefore, deregulation of E-cad expression may play a role in canine gastric carcinogenesis and in tumor progression; moreover, it might be a prognostic tool for canine gastric cancer.

PMID:35448670 | DOI:10.3390/vetsci9040172