Categories
Nevin Manimala Statistics

The adhesion behavior of the retina

Exp Eye Res. 2023 Jun 13:109541. doi: 10.1016/j.exer.2023.109541. Online ahead of print.

ABSTRACT

Ocular diseases and treatment related to rhegmatogenous retinal detachment (RRD) are highly correlated with retinal adhesion behavior. Therefore, this paper proposes to study the adhesion behavior of the intact retina. This can provide theoretical guidance for the treatment and research of retinal detachment (RD) related diseases. To systematically analyze this aspect, two experiments were performed on the porcine retina. The pull-off test combined with the modified JKR theory was used to study the adhesion behavior of the vitreoretinal interface, while the peeling test was used to study the adhesion behavior of the chorioretinal interface. In addition, the adhesion phase involved in the pull-off test was simulated and analyzed by building the corresponding finite element method (FEM). The experimental results of adhesion force on the vitreoretinal interface were obtained by pull-off test with five sizes of rigid punch. The experimental value of the pull-off force FPO tends to increase gradually with increasing punch radius in the range of 0.5-4 mm. A comparison of the experimental results with the simulation results shows that they are in a well agreement. And there is no statistical difference between the experimental and theoretical values of the pull-off force FPO. In addition, the values of retinal adhesion work were also obtained by pull-off test. Interestingly, there is a significant scale effect of the retinal work of adhesion. Finally, the peeling test gave a maximum peeling strength TMax of about 13 mN/mm and a stable peeling strength TD of about 11 mN/mm between the retina and the choroid. The pull-off test well shows the process of retinal traction by the diseased vitreous at the beginning of RRD. A comparison of the experimental results with the finite element results verifies the accuracy of the simulation. The peeling test well investigated the adhesion behavior between the retina and the choroid and obtained key biomechanical data (peeling strength, etc.). The combination of the two experiments allows a more systematic study of the whole retina. This research can provide more complete material parameters for finite element modeling of retina-related diseases, and it also can provide the theoretical guidance for individualized design of retinal repair surgery.

PMID:37321365 | DOI:10.1016/j.exer.2023.109541

Categories
Nevin Manimala Statistics

Effects of Deep Venous Thrombosis Treatments on Early and Long-term Quality of Life: Medical Therapy vs. Systemic Thrombolysis vs. Pharmacomechanical Thrombolysis

Vasc Endovascular Surg. 2023 Jun 15:15385744231184654. doi: 10.1177/15385744231184654. Online ahead of print.

ABSTRACT

OBJECTIVES: The present study aimed to compare the effects of medical therapy (MT), systemic thrombolysis (ST), and pharmacomechanical thrombolysis (PMT) methods used in our clinic for the treatment of deep venous thrombosis (DVT) on symptom reduction, the incidence of post-thrombotic syndrome (PTS) development, and quality of life.

METHODS: Data from160 patients diagnosed with acute DVT between January 2012 and May 2021 and treated and followed up in our clinic were retrospectively analyzed. The patients were divided into three groups according to treatment method. The patients who received MT treatment were defined as Group 1, anticoagulant treatment after ST as Group 2, and anticoagulant treatment after PMT as Group 3. The patients were called to the outpatient clinic, informed consent was obtained, EuroQol-5D-3 L (EQ-5D-3 L) scoring and Villalta scoring were performed, and anamnesis was taken.

RESULTS: A total of 160 patients were included, with 71 (44.4%) patients in Group 1, 45 (28.1%) in Group 2, and 44 (27.5%) in Group 3. The mean age was 48.9 ± 14.9 years for Group 1, 42.2 ± 10.8 for Group 2, and 29.0 ± 7.2 for Group 3. When the time to return to normal life and the EQ-5D-3 L score index were compared, the differences between Groups 1 and 2 and between Groups 1 and 3 were statistically significant (P = .000 and P = .000, respectively). However, the differences between Groups 2 and 3 were statistically insignificant (P = .213 andp = .074, respectively). When Villalta scores and EQ Visual Analogue Scale (EQ-VAS) scores were compared between groups, the difference between all groups was statistically significant (P = .000).

CONCLUSIONS: The medical treatment alone was observed to be insufficient in terms of symptomatic improvement, development of PTS, quality of life, and long-term complications. When the ST and PMT groups were compared, it was determined that PMT treatment was more advantageous in terms of EQ-VAS score and PTS development, although there was no statistical difference regarding complications, such as return to normal life and long-term quality of life, the incidence of recurrent DVT development, and pulmonary thromboembolism incidence.

PMID:37321364 | DOI:10.1177/15385744231184654

Categories
Nevin Manimala Statistics

Complementary roles of near-infrared spectroscopy and intravascular ultrasound in the prediction of periprocedural myocardial injury

Can J Cardiol. 2023 Jun 13:S0828-282X(23)00455-5. doi: 10.1016/j.cjca.2023.06.005. Online ahead of print.

ABSTRACT

BACKGROUND: Lipid-rich plaque detected by near-infrared spectroscopy (NIRS) and attenuated plaque detected by intravascular ultrasound (IVUS) predict periprocedural myocardial injury (MI) following percutaneous coronary intervention (PCI). Although echolucent plaque by IVUS was reported to be associated with a no-reflow phenomenon in acute myocardial infarction, it remains unclear whether echolucent plaque is predictive of periprocedural MI following elective PCI. We aimed to elucidate whether echolucent plaque is independently associated with periprocedural MI following elective PCI and whether the predictive ability for periprocedural MI is improved by the combination of NIRS and IVUS.

METHODS: This retrospective study included 121 lesions of 121 patients who underwent elective NIRS-IVUS-guided stent implantation. Periprocedural MI was defined as post-PCI cardiac troponin-T >70 ng/L. Maximum 4-mm lipid core burden index >457 was regarded as lipid-rich plaque. Echolucent plaque and attenuated plaque were defined as the presence of an echolucent zone and an attenuation arc >90° on IVUS, respectively.

RESULTS: Periprocedural MI occurred in 39 lesions. In multivariable analysis, echolucent plaque, attenuated plaque, and lipid-rich plaque were independent predictors of periprocedural MI. Adding echolucent plaque and attenuated plaque to lipid-rich plaque improved the predictive performance (C-statistics: 0.825 vs. 0.688; p=0.001). Periprocedural MI increased with the number of predictors (3% [1/39], 29% [10/34], 47% [14/30], and 78% [14/18] for 0, 1, 2, and 3 predictors, respectively; p<0.001).

CONCLUSIONS: Echolucent plaque is a major predictor of periprocedural MI, independent of lipid-rich plaque and attenuated plaque. Compared with NIRS alone, the combination of NIRS with IVUS signatures improves the predictive ability.

PMID:37321347 | DOI:10.1016/j.cjca.2023.06.005

Categories
Nevin Manimala Statistics

A deep learning-based automatic segmentation of zygomatic bones from cone-beam computed tomography images: A proof of concept

J Dent. 2023 Jun 13:104582. doi: 10.1016/j.jdent.2023.104582. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the efficiency and accuracy of a deep learning-based automatic segmentation method for zygomatic bones from cone-beam computed tomography (CBCT) images.

METHODS: One hundred thirty CBCT scans were included and randomly divided into three subsets (training, validation, and test) in a 6:2:2 ratio. A deep learning-based model was developed, and it included a classification network and a segmentation network, where an edge supervision module was added to increase the attention of the edges of zygomatic bones. Attention maps were generated by the Grad-CAM and Guided Grad-CAM algorithms to improve the interpretability of the model. The performance of the model was then compared with that of four dentists on 10 CBCT scans from the test dataset. A p value <.05 was considered statistically significant.

RESULTS: The accuracy of the classification network was 99.64%. The Dice coefficient (Dice) of the deep learning-based model for the test dataset was 92.34 ± 2.04%, the average surface distance (ASD) was 0.1 ± 0.15 mm, and the 95% Hausdorff distance (HD) was 0.98 ± 0.42 mm. The model required 17.03 seconds on average to segment zygomatic bones, whereas this task took 49.3 minutes for dentists to complete. The Dice score of the model for the 10 CBCT scans was 93.2 ± 1.3%, while that of the dentists was 90.37 ± 3.32%.

CONCLUSIONS: The proposed deep learning-based model could segment zygomatic bones with high accuracy and efficiency compared with those of dentists.

CLINICAL SIGNIFICANCE: The proposed automatic segmentation model for zygomatic bone could generate an accurate 3D model for the preoperative digital planning of zygoma reconstruction, orbital surgery, zygomatic implant surgery, and orthodontics.

PMID:37321334 | DOI:10.1016/j.jdent.2023.104582

Categories
Nevin Manimala Statistics

Association of intravascular enhancement sign detected on high-resolution vessel wall imaging with ischaemic events in middle cerebral artery occlusion

Eur J Radiol. 2023 Jun 8;165:110922. doi: 10.1016/j.ejrad.2023.110922. Online ahead of print.

ABSTRACT

PURPOSE: Patients with intracranial artery occlusion have high rates of ischaemic events and recurrence. Early identification of patients with high-risk factors is therefore beneficial for prevention. Here we assessed the association between the intravascular enhancement sign (IVES) on high-resolution vessel wall imaging (HR-VWI) and acute ischaemic stroke (AIS) in a population with middle cerebral artery (MCA) occlusion.

METHOD: We retrospectively analysed the records of 106 patients with 111 MCA occlusions, including 60 with and 51 without AIS, who had undergone HR-VWI and computed tomography angiography (CTA) examinations from November 2016 to February 2023. Numbers of IVES vessels were counted and compared to the CTA findings. Statistical analyses of demographic and medical data were also performed.

RESULTS: Occurrence rates and numbers of IVES vessels were significantly higher in the AIS than the non-AIS group (P < 0.05), and most vessels were detected on CTA. Numbers of vessels positively correlated with AIS occurrence (rho = 0.664; P < 0.0001). A multivariable ordinal logistic regression model adjusted for age, degree of wall enhancement, hypertension, and heart status identified the number of IVES vessels as an independent predictor for AIS (odds ratio = 1.6; 95% CI, 1.3-1.9; P < 0.0001).

CONCLUSION: Number of IVES vessels is an independent risk factor for AIS events, and may represent poor cerebral blood flow status and collateral compensation level. It thus provides cerebral haemodynamic information for patients with MCA occlusion for clinical use.

PMID:37320882 | DOI:10.1016/j.ejrad.2023.110922

Categories
Nevin Manimala Statistics

The added value of apparent diffusion coefficient and microcalcifications to the Kaiser score in the evaluation of BI-RADS 4 lesions

Eur J Radiol. 2023 Jun 5;165:110920. doi: 10.1016/j.ejrad.2023.110920. Online ahead of print.

ABSTRACT

PURPOSE: To explore the added value of combining microcalcifications or apparent diffusion coefficient (ADC) with the Kaiser score (KS) for diagnosing BI-RADS 4 lesions.

METHODS: This retrospective study included 194 consecutive patients with 201 histologically verified BI-RADS 4 lesions. Two radiologists assigned the KS value to each lesion. Adding microcalcifications, ADC, or both these criteria to the KS yielded KS1, KS2, and KS3, respectively. The potential of all four scores to avoid unnecessary biopsies was assessed using the sensitivity and specificity. Diagnostic performance was evaluated by the area under the curve (AUC) and compared between KS and KS1.

RESULTS: The sensitivity of KS, KS1, KS2, and KS3 ranged from 77.1% to 100.0%.KS1 yielded significantly higher sensitivity than other methods (P < 0.05), except for KS3 (P > 0.05), most of all, when assessing NME lesions. For mass lesions, the sensitivity of these four scores was comparable (p > 0.05). The specificity of KS, KS1, KS2, and KS3 ranged from 56.0% to 69.4%, with no statistically significant differences(P > 0.05), except between KS1 and KS2 (p < 0.05).The AUC of KS1 (0.877) was significantly higher than that of KS (0.837; P = 0.0005), particularly for assessing NME (0.847 vs 0.713; P < 0.0001).

CONCLUSION: KS can stratify BI-RADS 4 lesions to avoid unnecessary biopsies. Adding microcalcifications, but not adding ADC, as an adjunct to KS improves diagnostic performance, particularly for NME lesions. ADC provides no additional diagnostic benefit to KS. Thus, only combining microcalcifications with KS is most conducive to clinical practice.

PMID:37320881 | DOI:10.1016/j.ejrad.2023.110920

Categories
Nevin Manimala Statistics

Statistics of Mortality in Different Countries

Northwest Med Surg J. 1856 Jan;5(1):47-53.

NO ABSTRACT

PMID:37320580 | PMC:PMC9970425

Categories
Nevin Manimala Statistics

Statistics of Mortality

Northwest Med Surg J. 1855 Mar;4(3):139-141.

NO ABSTRACT

PMID:37320302 | PMC:PMC9956402

Categories
Nevin Manimala Statistics

Statistical Report of the Mercy Hospital for the Year 1853

Northwest Med Surg J. 1854 Mar;3(3):140-141.

NO ABSTRACT

PMID:37320266 | PMC:PMC9946641

Categories
Nevin Manimala Statistics

Statistics of Medical Schools

Northwest Med Surg J. 1851 May;4(1):84-85.

NO ABSTRACT

PMID:37320133 | PMC:PMC9943205