Nevin Manimala

J Magn Reson Imaging. 2021 Sep 23. doi: 10.1002/jmri.27928. Online ahead of print.

ABSTRACT

BACKGROUND: Liver iron concentration (LIC) measured by MRI has become the clinical reference standard for managing iron overload in chronically transfused patients. Transverse relaxivity (R₂ or R₂^* ) measurements are converted to LIC units using empirically derived calibration curves.

HYPOTHESIS: That flip angle (FA) error due to B₁⁺ spatial heterogeneity causes significant LIC quantitation error. B₁⁺ scale (b₁ , [FA_actual /FA_specified ]) variation is a major problem at 3 T which could reduce the accuracy of transverse relaxivity measurements.

STUDY TYPE: Prospective.

POPULATION: Forty-seven subjects with chronic transfusional iron overload undergoing clinically indicated LIC assessment.

FIELD STRENGTH/SEQUENCE: 5 T/3 T dual-repetition time B₁⁺ mapping sequence ASSESSMENT: We quantified the average/standard deviation b₁ in the right and left lobes of the liver from B₁⁺ maps acquired at 1.5 T and 3 T. The impact of b₁ variation on spin echo LIC estimates was determined using a Monte Carlo model.

STATISTICAL TESTS: Mean, median, and standard deviation in whole liver and right and left lobes; two-sided t-test between whole-liver b₁ means.

RESULTS: Average b₁ within the liver was 99.3% ± 12.3% at 1.5 T versus 69.6% ± 14.6% at 3 T and was independent of iron burden (P < 0.05). Monte Carlo simulations demonstrated that b₁ systematically increased R₂ estimates at lower LIC (<~25 mg/g at 1.5 T, <~15 mg/g at 3 T) but flattened or even inverted the R₂ -LIC relationship at higher LIC (≥~25 mg/g to 1.5 T, ≥~15 mg/g to 3 T); changes in the R₂ -LIC relationship were symmetric with respect to over and under excitation and were similar at 1.5 T and 3 T (for the same R₂ value). The R₂^* -LIC relationship was independent of b₁ .

CONCLUSION: Spin echo R₂ measurement of LIC at 3 T is error-prone without correction for b₁ errors. The impact of b₁ error on current 1.5 T spin echo-based techniques for LIC quantification is large enough to introduce measurable intersubject variability but the in vivo effect size needs a dedicated validation study.

LEVEL OF EVIDENCE: 1.

TECHNICAL EFFICACY STAGE: 2.

PMID:34555245 | DOI:10.1002/jmri.27928

J Diabetes Investig. 2021 Sep 23. doi: 10.1111/jdi.13680. Online ahead of print.

ABSTRACT

AIM: The aim of the present study was to evaluate the placental expression of glucose transporters GLUT-1, GLUT-3, GLUT-8 and GLUT-12 in term pregnancies complicated by well-controlled gestational (GDM) and type 1 pregestational diabetes mellitus (PGDM).

MATERIALS AND METHODS: A total of 103 placental samples were obtained from patients diagnosed with GDM (n=60), PGDM (n=20) and a non-diabetic control group (n=23). Computer-assisted quantitative morphometry of stained placental sections was performed to determine the expression of selected GLUT proteins.

RESULTS: Immunohistochemical techniques used for the identification of GLUT-1, GLUT-3, GLUT-8 and GLUT-12 revealed the presence of all glucose transporters in the placental tissue. Morphometric evaluation performed for the vascular density-matched placental samples demonstrated a significant increase in the expression of GLUT-1 protein in patients with PGDM as compared to GDM and control groups (p<.05). With regard to the expression of the other GLUT isoforms, no statistically significant differences were observed between patients from the diabetic and control populations. Positive correlations between fetal birth-weight and the expression of GLUT-1 protein in the PGDM group (rho=.463, p<.05) and GLUT-12 in the control group (rho=.481, p<.05) were noted.

CONCLUSIONS: In term pregnancies complicated by well-controlled GDM/PGDM expression of transporters GLUT-3, GLUT-8 and GLUT-12 in the placenta remains unaffected. Increased expression of GLUT-1 among women with type 1 PGDM may contribute to higher rate of macrosomic fetuses in this population.

PMID:34555239 | DOI:10.1111/jdi.13680

J Clin Lab Anal. 2021 Sep 23:e24020. doi: 10.1002/jcla.24020. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this study was to analyze the levels of tumor-associated autoantibodies (TAAbs) in lung diseases and determine their diagnostic efficiency in early-stage non-small cell lung cancer (NSCLC).

METHODS: We retrospectively analyzed the levels of 7-TAAbs in 177 newly diagnosed early-stage NSCLC patients, 202 patients with lung benign diseases and 137 healthy cases. The levels of a panel of 7-TAAbs, including p53, GAGE7, PGP9.5, CAGE, MAGE A1, SOX2, GBU4-5, were measured by ELISA.

RESULTS: The serum levels of p53, GAGE7, PGP9.5, CAGE, MAGE A1, SOX2, and GBU4-5 were not statistically different among NSCLC, benign and healthy groups (p > 0.05). The area under the curve (AUC) of 7-TAAbs was all lower than 0.70. The sensitivity of combined detection was the highest (23.73%), while the specificity was the lowest (88.79%). The positive rates of PGP9.5, SOX2, and combined detection were significantly different among the three groups (p < 0.05). Among them, PGP9.5 and combined detection were significantly different between the NSCLC and benign groups (p < 0.05), PGP9.5, SOX2 and combined detection were significantly different between the NSCLC and healthy groups (p < 0.05).

CONCLUSIONS: The diagnostic efficiency of 7-TAAbs in early-stage NSCLC was not high, so it cannot be used alone as a screening method for NSCLC.

PMID:34555232 | DOI:10.1002/jcla.24020

J Magn Reson Imaging. 2021 Sep 23. doi: 10.1002/jmri.27929. Online ahead of print.

ABSTRACT

BACKGROUND: Scan acceleration such as parallel imaging reduces scan time, but shorter scan time may reduce the signal-to-noise ratio and affect image quality. The reproducibility of longitudinal changes in the brain structure between non-accelerated and accelerated imaging by surface-based analysis is unclear.

PURPOSE: To determine the reproducibility of longitudinal changes in cortical thickness, measured by surface-based morphometry, between non-accelerated and accelerated structural T₁ -weighted imaging in the healthy elderly and those with mild cognitive impairment (MCI) and Alzheimer’s disease (AD).

STUDY TYPE: Retrospective.

SUBJECTS: Fifty healthy elderly subjects (age = 73 ± 5 years, 29 females, 21 males), 54 MCI patients (age = 71 ± 7 years, 23 females, 31 males), and 8 AD patients (age = 78 ± 6 years, 6 females, 2 males).

FIELD STRENGTH/SEQUENCE: 3 T, magnetization-prepared rapid gradient-echo.

ASSESSMENT: Longitudinal changes in cortical thickness estimated by the longitudinal stream in FreeSurfer from 2-year interval data, and visual assessment of image quality by three radiologists.

STATISTICAL TESTS: Intraclass correlation coefficient (ICC) and Kruskal-Wallis test. A P value <0.05 was considered significant.

RESULTS: Healthy elderly subjects, MCI patients, and AD patients showed different patterns in the ICC maps. For the smoothing of 20 mm full width at half maximum, the mean ICC was 0.45 overall (healthy elderly, 0.33; MCI patients, 0.49; AD patients, 0.31). The within-subject SDs of the symmetrized percent changes were similar between healthy elderly subjects (mean, 1.3%/year) and MCI patients (mean, 1.3%/year) but larger in AD patients (mean, 1.7%/year). Image quality did not significantly differ per group (P = 0.18).

DATA CONCLUSION: The results of this study indicate the reproducibility of longitudinal changes in cortical thickness measured by surface-based morphometry between non-accelerated and accelerated imaging, and that the reproducibility varies by disease and region.

LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 1.

PMID:34555231 | DOI:10.1002/jmri.27929

J Clin Lab Anal. 2021 Sep 23:e24016. doi: 10.1002/jcla.24016. Online ahead of print.

ABSTRACT

BACKGROUND: Recently, the rise of syphilitic seroresistance brings great confusion to the clinical diagnosis and treatment of syphilis, and no clear diagnostic marker has been found to distinguish syphilitic seroresistance from other progression of syphilis. This study evaluated the serum chemokines levels of CCL2, CXCL8, CXCL9, and CXCL10 and its correlation with blood routine, coagulation, and biochemical indexes in seroresistant syphilitic patients.

METHOD: Serum levels of chemokines were quantitatively determined by Flow Cytometric Bead Array (CBA). The results expressed in pg/ml. Clinical parameters were detected and analyzed according to the clinical laboratory standards. A correlation analysis was subsequently performed.

RESULTS: The seroresistant syphilitic patients increased significantly serum chemokines levels of CXCL8 (***p < 0.001), CXCL9 (***p < 0.001), and CXCL10 (**p < 0.01) when compared to noninfected individuals, but the CCL2 was not statistically significant, and serum CXCL8 shows a strong association with platelets (r = 0.51, **p = 0.004) and serum CXCL10 was significantly positively related to INR levels (r = 0.49, **p = 0.007).

CONCLUSION: Increasing serum abnormalities in CXCL8, CXCL9, and CXCL10 level combining with platelets of peripheral blood and plasmatic INR in syphilis patients may be helpful for the diagnosis of serofast state.

PMID:34555221 | DOI:10.1002/jcla.24016

Skin Res Technol. 2021 Sep 23. doi: 10.1111/srt.13101. Online ahead of print.

ABSTRACT

Skin is our barrier against environmental damage. Moisturizers are widely used to increase hydration and barrier integrity of the skin; however, there are contrasting observations on their in vivo effects in real-life settings. In cosmetic studies, corneometers and tewameters are traditionally used to assess skin hydration. In this study, two novel noninvasive diagnostic techniques, optical coherence tomography (OCT) and confocal Raman spectroscopy, were used to analyze stratum corneum and epidermal thickness (ET), water content, blood flow in function of depth, skin roughness, attenuation coefficient, natural moisturizing factor, ceramides and free fatty acids, cholesterol, urea, and lactates in 20 female subjects aged between 30 and 45 before and after 2 weeks application of a commercially available moisturizing lotion on one forearm. The untreated forearm served as control. A third measurement was conducted 1 week after cessation of moisturizing to verify whether the changes in the analyzed parameters persisted. We noticed a reduction in skin roughness, an increase in ceramides and free fatty acids and a not statistically significant increase in ET. As a conclusion, short time moisturizing appears insufficient to provide significant changes in skin morphology and composition, as assessed by OCT and RS. Novel noninvasive imaging methods are suitable for the evaluation of skin response to topical moisturizers. Further studies on larger sample size and longer treatment schedules are needed to analyze changes under treatment with moisturizers and to standardize the use of novel noninvasive diagnostic techniques.

PMID:34555219 | DOI:10.1111/srt.13101

Echocardiography. 2021 Sep 23. doi: 10.1111/echo.15189. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate early changes in left ventricular systolic function in patients with systemic lupus erythematosus (SLE) using three-dimensional speckle tracking imaging (3D-STI).

METHODS: A total of 30 SLE patients and 30 healthy people (control group) were selected, the patients were further divided into subgroups according to their Safety of Estrogens in Lupus Erythematosus National Assessment version of the SLE Disease Activity Index (SELENA-SLEDAI) score: ≤ 12: mild-to-moderate group; > 12: severe group. All participants were examined using 3D-STI, the 3D-STI parameters were obtained. Receiver operating curves (ROC) were prepared for above parameters and analyzed to identify correlations among 3D-STI parameters and high sensitivity-TropT (hs-TropT).

RESULTS: Compared with the control group, the absolute values of left ventricular end-diastolic volume (LVEDV), left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), global circumferential strain (GCS), left ventricular twist angle (LVtw), torsion (Tor) and myocardial comprehensive index (MCI) decreased, left ventricular end diastolic mass (LV EDmass), left ventricular end systolic mass (LV ESmass) and peak strain dispersion (PSD) increased in the mild-to-moderate and the severe groups (P₂ < 0.05, P₃ < 0.05). There was statistically significant difference in terms of 3D-STI parameters between the mild-to-moderate group and the severe group (P₁ < 0.05). The highest area under the ROC for MCI was 0.909, the highest sensitivity for MCI was 90.00%, and the highest specificity for Tor was 86.67%. Correlation analysis showed that there was a good correlation between the MCI and hs-TropT (r = – 0.677).

CONCLUSION: 3D-STI technology may help detect early changes in left ventricular systolic function in patients with SLE.

PMID:34555198 | DOI:10.1111/echo.15189

Environ Entomol. 2021 Sep 23:nvab104. doi: 10.1093/ee/nvab104. Online ahead of print.

ABSTRACT

The spotted lanternfly, Lycorma delicatula (Hemiptera: Fulgoridae) (White, 1845), is an invasive pest in the Mid-Atlantic region of the United States. Understanding this pest’s dispersion patterns is fundamental for development of management and surveillance programs. To address this knowledge gap, we quantified spotted lanternfly nymph dispersion patterns by instar for rural and urban/suburban habitats, and we compared the number of sample units required for sticky traps and in situ visual counts to estimate population densities at several precisions. In addition, we assessed the ability of two experimental designs (completely random and randomized complete block) to detect management practices’ impacts in the field. All instars typically followed an aggregated dispersion pattern. Sample size and time requirements for checking and replacing sticky traps and for conducting in situ counts were similar, but in situ counts do not require purchasing traps, installation time, or delays before treatment, and do not remove insects. Although the cost for using in situ counts is likely less than for sticky traps, early instar spotted lanternfly nymph populations are harder to visually detect than later instars because of their small size, which may negate any cost advantage when treatments are applied early. In general, using a randomized complete block design resulted in higher statistical power than a completely random design, allowing detection of proportional population reductions of 10-20% less with equal replication. Studies aiming to evaluate treatments that reduce spotted lanternfly numbers by less than 60% will require researchers to evaluate the feasibility of using the required large sample sizes.

PMID:34555164 | DOI:10.1093/ee/nvab104

PLoS One. 2021 Sep 23;16(9):e0257775. doi: 10.1371/journal.pone.0257775. eCollection 2021.

ABSTRACT

BACKGROUND: In this study, we aimed to investigate whether FIB-4 index is useful in predicting mortality in patients with concurrent hematological malignancies and COVID-19. We also aimed to determine the optimal cut-off point for the prediction.

METHODS: This is a single-center retrospective cohort study conducted in Dharmais National Cancer Hospital, Indonesia. Consecutive sampling of adults with hematological malignancies and COVID-19 was performed between May 2020 and January 2021. COVID-19 screening test using the reverse transcriptase polymerase chain reaction (RT-PCR) of nasopharyngeal samples were performed prior to hospitalization for chemotherapy. FIB-4 index is derived from [age (years) × AST (IU/L)]/[platelet count (109/L) × √ALT (U/L)]. The primary outcome of this study is mortality, defined as clinically validated death/non-survivor during a 3-months (90 days) follow-up.

RESULTS: There were a total of 70 patients with hematological malignancies and COVID-19 in this study. Median FIB-4 Index was higher in non-survivors (13.1 vs 1.02, p<0.001). FIB-4 index above 3.85 has a sensitivity of 79%, specificity of 84%, PLR of 5.27, and NLR of 0.32. The AUC was 0.849 95% CI 0.735-0.962, p<0.001. This cut-off point was associated with OR of 16.70 95% CI 4.07-66.67, p<0.001. In this study, a FIB-4 >3.85 confers to 80% posterior probability of mortality and FIB-4 <3.85 to 19% probability. FIB-4 >3.85 was associated with shorter time-to-mortality (HR 9.10 95% CI 2.99-27.65, p<0.001). Multivariate analysis indicated that FIB-4 >3.85 (HR 4.09 95% CI 1.32-12.70, p = 0.015) and CRP> 71.57 mg/L (HR 3.36 95% CI 1.08-10.50, p = 0.037) were independently associated with shorter time-to-mortality.

CONCLUSION: This study indicates that a FIB-4 index >3.85 was independent predictor of mortality in patients with hematological malignancies and COVID-19 infection.

PMID:34555104 | DOI:10.1371/journal.pone.0257775

PLoS One. 2021 Sep 23;16(9):e0257733. doi: 10.1371/journal.pone.0257733. eCollection 2021.

ABSTRACT

Climate change is causing larger wildfires and more extreme precipitation events in many regions. As these ecological disturbances increasingly coincide, they alter lateral fluxes of sediment, organic matter, and nutrients. Here, we report the stream chemistry response of watersheds in a semiarid region of Utah (USA) that were affected by a megafire followed by an extreme precipitation event in October 2018. We analyzed daily to hourly water samples at 10 stream locations from before the storm event until three weeks after its conclusion for suspended sediment, solute and nutrient concentrations, water isotopes, and dissolved organic matter concentration, optical properties, and reactivity. The megafire caused a ~2,000-fold increase in sediment flux and a ~6,000-fold increase in particulate carbon and nitrogen flux over the course of the storm. Unexpectedly, dissolved organic carbon (DOC) concentration was 2.1-fold higher in burned watersheds, despite the decreased organic matter from the fire. DOC from burned watersheds was 1.3-fold more biodegradable and 2.0-fold more photodegradable than in unburned watersheds based on 28-day dark and light incubations. Regardless of burn status, nutrient concentrations were higher in watersheds with greater urban and agricultural land use. Likewise, human land use had a greater effect than megafire on apparent hydrological residence time, with rapid stormwater signals in urban and agricultural areas but a gradual stormwater pulse in areas without direct human influence. These findings highlight how megafires and intense rainfall increase short-term particulate flux and alter organic matter concentration and characteristics. However, in contrast with previous research, which has largely focused on burned-unburned comparisons in pristine watersheds, we found that direct human influence exerted a primary control on nutrient status. Reducing anthropogenic nutrient sources could therefore increase socioecological resilience of surface water networks to changing wildfire regimes.

PMID:34555099 | DOI:10.1371/journal.pone.0257733