Tag: nevin manimala

J Magn Reson Imaging. 2021 Oct 15. doi: 10.1002/jmri.27939. Online ahead of print.

ABSTRACT

BACKGROUND: Magnetic resonance imaging (MRI) is increasingly being used in the diagnosis and treatment planning of uveal melanoma (UM), the most common primary intraocular tumor. Initially, 7 T MRI was primarily used, but more recently these techniques have been translated to 3 T, as it is more commonly available.

PURPOSE: Compare the diagnostic performance of 3 T and 7 T MRI of UM.

STUDY TYPE: Prospective.

POPULATION: Twenty-seven UM patients (19% female).

FIELD STRENGTH/SEQUENCE: 3 T: T1- and T2-weighted three-dimensional (3D) spin echo (SE) and multi-slice (MS) SE, 7 T: T1-weighted 3D gradient echo (GE), T2-weighted 3D SE and MS SE, 3 T and 7 T GE dynamic contrast-enhanced. T1 weighted images: acquired before and after Gadolinium (Gd) administration.

ASSESSMENT: For all sequences, scan and diagnostic quality was quantified using a 5-point Likert scale. Signal intensities on T1 and T2 relative to choroid and eye muscle respectively were assessed as well as the tumor prominence. Finally, the perfusion time-intensity curves (TICs) were classified as plateau, progressive, or wash-out.

STATISTICAL TESTS: Image quality scores were compared between both field strengths using Wilcoxon signed-rank and McNemar tests. Paired t-tests and Bland-Altman were used for comparing tumor prominences. P < 0.05 was considered statistically significant.

RESULTS: Image quality was comparable between 3 T and 7 T, for 3DT1, 3DT2, 3DT1Gd (P = 0.86; P = 0.34; P = 0.78, respectively) and measuring tumor dimensions (P = 0.40). 2DT1 and 2DT2 image quality were rated better on 3 T compared to 7 T. Most UM had the same relative signal intensities at 3 T and 7 T on T1 (17/21) and T2 (13/17), and 16/18 diagnostic TICs received the same classification. Tumor prominence measurements were similar between field strengths (95% confidence interval: -0.37 mm to 0.03 mm, P = 0.097).

DATA CONCLUSION: Diagnostic performance of the evaluated 3 T protocol proved to be as capable as 7 T, with the addition of 3 T being superior in assessing tumor growth into nearby anatomical structures compared to 7 T.

LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 3.

PMID:34652049 | DOI:10.1002/jmri.27939

J Magn Reson Imaging. 2021 Oct 15. doi: 10.1002/jmri.27945. Online ahead of print.

ABSTRACT

BACKGROUND: Adolescents and adults with native Ebstein’s anomaly (EA) are at the benign part of the Ebstein spectrum, having survived infancy without surgery. In this population, surgical indication and timing remain objects of controversy and depend, among other factors, on exercise capacity.

PURPOSE: To better understand the pathophysiology of exercise adaptation in native EA.

STUDY TYPE: Retrospective.

POPULATION: Ten patients with unoperated EA (age range 18-61 years) and 13 healthy subjects as controls.

FIELD STRENGTH/SEQUENCE: Balanced steady-state free precession cine and phase contrast flow sequences at 1.5 T.

ASSESSMENT: We measured volumes and flows at rest and during submaximal exercise. Hemodynamic parameters including stroke volume (SV), cardiac index (CI), ejection fraction (EF), and tricuspid regurgitation (TR) were calculated.

STATISTICAL TESTS: We used nonparametric Mann-Whitney U-test and Wilcoxon signed-rank test. A P-value of <0.05 was considered statistically significant.

RESULTS: Rest CI and SV were significantly higher in controls; rest heart rate (HR) was similar in the two groups (median 71 bpm by patients and 65 bpm by controls, P = 0.448). During exercise, CI increased significantly in both groups: from 2.40 to 3.35 L/min/m² in the patient group and from 3.60 to 4.20 L/min/m² in controls; HR increased significantly in both groups. SV increased significantly in the patient group, whereas it remained stable in controls (P = 0.5284). Patients’ median TR decreased significantly: median 42% at rest and 30% during exercise; concomitantly, left ventricular (LV) preload increased significantly (+3% indexed LV end-diastolic volume) as did LVEF (median 59% at rest vs. 65% during exercise).

DATA CONCLUSION: During submaximal exercise, patients with mild to moderate EA improved their cardiovascular system’s total efficiency by increasing CI; this was obtained by an increase in HR and by the recruitment of volume, as shown by an increased LV end-diastolic volume and SV, with simultaneous decrease in TR. This was different from healthy subjects in which CI increased only due to HR increase.

LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY STAGE: 3.

PMID:34652053 | DOI:10.1002/jmri.27945

Microsurgery. 2021 Oct 15. doi: 10.1002/micr.30831. Online ahead of print.

ABSTRACT

BACKGROUND: Numerous studies have compared electrical devices used for flap surgery, but the results are inconsistent. This research was performed to evaluate the efficacy of two different types of electric devices: electrocautery and ultrasonic shears.

METHODS: The PubMed, Embase, and Scopus databases were searched systematically. A total of 505 cases were included in this study, including 209 electrocautery and 296 harmonic scalpel cases. The following information was retrieved from the included studies: the first author of the article, publication year, flap type, flap harvest time, drain volume, bleeding volume and postoperative complications. Hematoma, infection, flap necrosis and wound dehiscence were considered postoperative complications. The Q statistic for heterogeneity and the I² index were calculated. If I² < 50%, we used a fixed-effects model; if I² > 50%, we employed a random-effects model in our meta-analysis.

RESULTS: A total of eight studies which met the inclusion criteria were included and reviewed systematically for a meta-analysis. The harmonic scalpel yielded a statistically significantly more favorable flap harvest time and drain volume than did electrocautery. The Harmonic scalpel led to a shorter flap harvest time by 26.29 min (95% CI = -39.38 to -13.2; p < .00001) and smaller drain volume by 58.76 ml (95% CI = -105.27 to -12.25; p = .01) on average. However, there were no significant differences in the bleeding volume or incidence rates of infection, flap necrosis and wound dehiscence.

CONCLUSION: The Harmonic scalpel method yields better outcomes in terms of the flap harvest time and drain volume than does the conventional electrocautery method. Therefore, the Harmonic scalpel is a better option for cauterization and dissection in flap surgery.

PMID:34652038 | DOI:10.1002/micr.30831

Adv Mater. 2021 Oct 13:e2105868. doi: 10.1002/adma.202105868. Online ahead of print.

ABSTRACT

Conventional optical diffusers, such as thick volume scatterers (Rayleigh scattering) or microstructured surface scatterers (geometric scattering), lack the potential for on-chip integration and are thus incompatible with next-generation photonic devices. Dielectric Huygens’ metasurfaces, on the other hand, consist of two-dimensional arrangements of resonant dielectric nanoparticles and therefore constitute a promising material platform for ultra-thin and highly efficient photonic devices. When the nanoparticles are arranged in a random but statistically specific fashion, diffusers with exceptional properties are expected to come within reach. In this contribution, we explore how dielectric Huygens’ metasurfaces can be used to implement wavelength-selective diffusers with negligible absorption losses and nearly-Lambertian scattering profiles that are largely independent of the angle and polarization of incident waves. We show that the combination of tailored positional disorder with a carefully-balanced electric and magnetic response of the nanoparticles is an integral requirement for the operation as a diffuser. We experimentally and numerically characterize the directional scattering performance of the proposed metasurfaces and highlight their usability in wavefront-shaping applications. Since our metasurfaces operate on the principles of Mie scattering and are embedded in a glassy environment, they may easily be incorporated in integrated photonic devices, fiber optics, or mechanically robust augmented reality displays. This article is protected by copyright. All rights reserved.

PMID:34652041 | DOI:10.1002/adma.202105868

Vet Rec. 2021 Jan;188(1):e1. doi: 10.1002/vetr.1. Epub 2021 Jan 12.

ABSTRACT

BACKGROUND: Bovine viral diarrhoea virus (BVDV) and border disease virus (BDV) can cause significant health problems in ruminants and economic impacts for farmers. The aim of this study was to evaluate pestivirus exposure in Northern Ireland sheep and goat flocks, and to compare findings with a previous study from the region.

METHODS: Up to 20 animals were sampled from 188 sheep and 9 goat flocks (n = 3,418 animals; 3,372 sheep and 46 goats) for pestivirus antibodies. Differentiation of the causative agent in positive samples was inferred using serum neutralisation. Abortion samples from 177 ovine cases were tested by BVDV reverse-transcription polymerase chain reaction and antigen ELISA.

RESULTS: Apparent animal and flock (one antibody positive animal within a flock) prevalence was 1.7% and 17.3%, respectively, a statistically significant drop in apparent prevalence since a survey in 1999. 52.6% of samples testing positive had higher antibody titres to BVDV than to BDV. Of the ovine abortion samples, only one positive foetal fluid sample was detected by ELISA.

CONCLUSION: The present study found that, since 1999, there has been a decrease in apparent animal and flock prevalence of 3.7 and 12.8 percentage points respectively, suggesting pestivirus prevalence has decreased across Northern Ireland between 1999 and 2018.

PMID:34651766 | DOI:10.1002/vetr.1

J Clin Lab Anal. 2021 Oct 15:e24059. doi: 10.1002/jcla.24059. Online ahead of print.

ABSTRACT

BACKGROUND: The six sigma model has been widely used in clinical laboratory quality management. In this study, we first applied the six sigma model to (a) evaluate the analytical performance of urinary biochemical analytes across five laboratories, (b) design risk-based statistical quality control (SQC) strategies, and (c) formulate improvement measures for each of the analytes when needed.

METHODS: Internal quality control (IQC) and external quality assessment (EQA) data for urinary biochemical analytes were collected from five laboratories, and the sigma value of each analyte was calculated based on coefficients of variation, bias, and total allowable error (TEa). Normalized sigma method decision charts for these urinary biochemical analytes were then generated. Risk-based SQC strategies and improvement measures were formulated for each laboratory according to the flowchart of Westgard sigma rules, including run sizes and the quality goal index (QGI).

RESULTS: Sigma values of urinary biochemical analytes were significantly different at different quality control levels. Although identical detection platforms with matching reagents were used, differences in these analytes were also observed between laboratories. Risk-based SQC strategies for urinary biochemical analytes were formulated based on the flowchart of Westgard sigma rules, including run size and analytical performance. Appropriate improvement measures were implemented for urinary biochemical analytes with analytical performance lower than six sigma according to the QGI calculation.

CONCLUSIONS: In multilocation laboratory systems, a six sigma model is an excellent quality management tool and can quantitatively evaluate analytical performance and guide risk-based SQC strategy development and improvement measure implementation.

PMID:34652033 | DOI:10.1002/jcla.24059

Brief Bioinform. 2021 Oct 14:bbab433. doi: 10.1093/bib/bbab433. Online ahead of print.

NO ABSTRACT

PMID:34651640 | DOI:10.1093/bib/bbab433

Mil Med. 2021 Oct 15:usab401. doi: 10.1093/milmed/usab401. Online ahead of print.

ABSTRACT

BACKGROUND: The battalion aid station (BAS) has historically served as the first stop during which combat casualties would receive care beyond a combat medic. Since the conflicts in Iraq and Afghanistan, many combat casualties have bypassed the BAS for treatment facilities capable of surgery. We describe the care provided at these treatment facilities during 2007-2020.

METHODS: This is a secondary analysis of previously described data from the Department of Defense Trauma Registry. We included encounters with the documentation of an assessment or intervention at a BAS or forward operating base from January 1, 2007 to March 17, 2020. We utilized descriptive statistics to characterize these encounters.

RESULTS: There were 28,950 encounters in our original dataset, of which 3.1% (884) had the documentation of a prehospital visit to a BAS. The BAS cohort was older (25 vs. 24, P < .001) The non-BAS cohort saw a larger portion of pediatric (<18 years) patients (10.7% vs. 5.7%, P < .001). A higher proportion of BAS patients had nonbattle injuries (40% vs. 20.7%, P < .001). The mean injury severity score was higher in the non-BAS cohort (9 vs. 5, P < .001). A higher proportion of the non-BAS cohort had more serious extremity injuries (25.1% vs. 18.4%, P < .001), although the non-BAS cohort had a trend toward serious injuries to the abdomen (P = .051) and thorax (P = .069). There was no difference in survival.

CONCLUSIONS: The BAS was once a critical point in casualty evacuation and treatment. Within our dataset, the overall number of encounters that involved a stop at a BAS facility was low. For both the asymmetric battlefield and multidomain operations/large-scale combat operations, the current model would benefit from a more robust capability to include storage of blood, ventilators, and monitoring and hold patients for an undetermined amount of time.

PMID:34651651 | DOI:10.1093/milmed/usab401

Rev Esp Salud Publica. 2021 Apr 19;95:perspectivas17_cirera_zurriaga.

ABSTRACT

The National Spanish Institute of Statistics (INE) website is the main means of communication for official statistics in Spain. The INE publishes the annual statistics of deaths according to the cause of death. This vital statistic has improved a lot in recent years; also, thanks to the collaboration from the Autonomous Communities. There are certain areas that could optimize its usefulness. Indicator improvements could include provisional case-counts by causes of death, besides the age-standardization of specified causes of death and the Potential Years of Life Lost by cause of death, for territorial comparison. Meanwhile, the usefulness of social indicators applied to the statistics of death causes could be enhanced, as is the case of education. By updating the databases, it would be possible to maintain the registries of deceased and their causes of death without an annual closure before the statistical publication. Moreover, we could link the databases of demographic records of the population to their health files, to obtain individually the people at risk of sickness or death, and to enable their respective vital, social, health trajectories for statistics. In this way, the INE would increase its leadership and reference on mortality statistics in Spain and EuroStat, as well. Furthermore, the State, Autonomous and municipal administrations could redefine their publication offer into a more specified or innovative statistics of death causes.

PMID:34651616

Eur J Contracept Reprod Health Care. 2021 Oct 15:1-7. doi: 10.1080/13625187.2021.1988923. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess and compare the risk of unintended pregnancy in NOMAC-E2 users with levonorgestrel-containing COC (COC_LNG) users in clinical practice.

STUDY DESIGN: In this observational study, new users¹ of NOMAC-E2 and COC_LNG were recruited in Europe, Australia, and Latin America and followed for up to 2 years. Unintended pregnancy was expressed by the Pearl Index (contraceptive failures per 100 women-years [WY]), crude hazard ratios (HR_crude) and adjusted hazard ratios (HR_adj).

RESULTS: Overall, 44,559 and 46,754 users were recruited to the NOMAC-E2 and COC_LNG user cohorts, respectively. There were 64 unintended pregnancies in NOMAC-E2 users (0.15 per 100 WY; 95% CI, 0.11-0.19) and 200 in COC_LNG users (0.41 per 100 WY; 95% CI, 0.35-0.47). The unintended pregnancy risk was statistically significantly lower in the NOMAC-E2 cohort (p<.0001) compared to the COC_LNG user cohort. The HR_adj of NOMAC-E2 vs COC_LNG was 0.45 (95% CI, 0.34-0.60; adjusted for age, body mass index, gravidity, COC user status, education level).

CONCLUSIONS: NOMAC-E2 demonstrated superior contraceptive effectiveness compared to COC_LNG, likely due to the comparatively short hormone-free interval and possibly reinforced by the long half-life of NOMAC.

PMID:34651535 | DOI:10.1080/13625187.2021.1988923