Relative Volume Change Research Articles

Orbital computed tomography imaging characteristics of thyroid-associated ophthalmopathy

This study aims to investigate the distribution characteristics and correlations of orbital soft tissue volume expansion in patients with thyroid-associated ophthalmopathy (TAO) by analyzing orbital computed tomography (CT) data and to determine the most appropriate parameters and corresponding cut-off values for imaging classification. Patients with TAO who met the inclusion and exclusion criteria, along with those with lacrimal duct obstruction requiring orbital CT examination, were included in the study. Raw CT data were imported into Mimics and RadiAnt software for analysis, and measurements of orbital volume, orbital fat volume, extraocular muscle volume, optic nerve volume, and exophthalmos were obtained. The results demonstrated that the combination of Mimics and other softwares for processing orbital CT scans allows for the quantitative analysis of various soft tissue volumes within the orbit. The MV/FV ratio was found to effectively reflect the relative changes in extraocular muscle volume, serving as a valuable indicator for identifying different subtypes of TAO and providing significant clinical reference value.

Investigation of geochemically induced permeability alteration in geothermal reservoirs and its implications for sustainable geothermal energy production

Geothermal resources constitute a significant portion of the world's low-carbon, renewable energy potential, with about 75% classified as low-temperature. One such potential resource exists in Precambrian basement rocks underlying the Williston Basin in southern Saskatchewan, Canada, with a reservoir temperature of 120 °C. However, geochemically induced permeability alteration in these highly reactive low-temperature granitoid resources poses a significant risk to long-term heat production. To assess and potentially mitigate this risk, we conducted a geochemical and mineralogical study of both altered and unaltered samples. Our findings facilitated the parameterization of geochemical simulations of water-rock interactions to predict mineral volume changes and, by extension, draw inferences on porosity and permeability changes resulting from these interactions. The simulations indicate an increased mineral volume in both samples, yet geothermal alteration of the unaltered, and thus more reactive, rocks induced relative mineral volume changes about 30% greater than those in the altered rocks. The resulting absolute change in porosity is 0.5 vol% for the unaltered rocks and 0.35 vol% for the altered rocks. Utilizing an empirical porosity-permeability relationship, the computed change in permeability indicates that the unaltered basement rock experienced a greater change in total permeability than the altered basement rocks. Additional calculations demonstrate the sensitivity of the porosity-permeability equation to critical porosity and power exponent, forecasting various scenarios with permeability changes ranging from 1.0 × 10−13 to 1 × 10−20 m2. Consequently, we infer that altered, permeable zones of the examined Precambrian basement rocks are likely to offer favourable conditions for sustained, multi-decade heat production, and thus should be targeted over less altered zones to justify initial capital expenditures. Globally, geothermal heat extraction from these rocks remains an underexplored yet promising resource for generating reliable, low-carbon renewable energy, crucial in our efforts to decarbonize the global economy.

Changes in Internet Search Behavior After a Direct-to-Consumer Advertising Campaign for Faricimab-svoa.

Purpose: To analyze changes in Google search volume after US Food and Drug Administration (FDA) approval and initiation of a direct-to-consumer marketing campaign for faricimab-svoa. Methods: Google Trends data between December 26, 2021, and June 17, 2023, were downloaded and searched for terms prominently featured in the marketing campaign, including "wet AMD", "diabetic macular edema", "Vabysmo", and "faricimab-svoa". Data were standardized to the week and the term with the highest search volume, resulting in weekly relative search volumes for each term. The mean relative search volume and percentage change in relative search volume were calculated for the time periods of interest. Results: The direct-to-consumer campaign was associated with an increase in relative search volume in the first month for the terms "Vabysmo" (2.5% to 18.0%) and "wet AMD" (3.0% to 77.3%) and was sustained in the second month (P < .01). No significant changes in relative search volume were seen for the terms "diabetic macular edema" or "faricimab-svoa". After FDA approval, "Vabysmo" had the only significant increase in relative search volume (0.3% to 2.8%; P = .02). Conclusions: A direct-to-consumer advertising campaign for faricimab-svoa was associated with a surge in Google search volume of 620% and 2475% for "Vabysmo" and "wet AMD," respectively (P < .01), without a corresponding increase for "diabetic macular edema". Although FDA approval was associated with an increase in search volume for "Vabysmo" (P = .02), the marketing campaign was more influential at driving internet search behavior.

Changes in Relative Blood Volume during Hemodialysis: An Extensive US Cohort

Changes in Relative Blood Volume during Hemodialysis: An Extensive US Cohort

Cardiovascular Disease, Brain Glucose Metabolism, and Neurocognitive Decline in People With Human Immunodeficiency Virus.

Cardiovascular disease (CVD) and neuroinflammation are thought to exacerbate neurocognitive dysfunction in treated people with human immunodeficiency virus (PWH). Here, we longitudinally measured brain glucose metabolism as a measure of neuronal integrity in treated PWH using [18F]Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in correlation with atherosclerotic cardiovascular disease (ASCVD) scores, cerebrospinal fluid (CSF) neuroinflammatory markers, neurocognitive outcomes, and other clinical and laboratory variables (CLVs). Well-controlled PWH (n = 36) underwent baseline and follow-up FDG PET/CT obtained 3.5 years apart on average. Longitudinal changes in whole brain and regional relative FDG uptake, brain volumes, CLVs, CSF cytokines, and neuropsychological measures were measured. A variable selection model identified baseline variables related to future brain metabolic changes while multivariable models explored neuropsychological implications of brain metabolism and volumetrics. High ASCVD scores predicted future decreased thalamic uptake (slope = -0.0068, P = .027) and decreasing thalamic uptake correlated with worsening cognition (slope = 15.80, P = .020). Despite longitudinal greater than expected gray matter loss, whole brain FDG uptake did not change over the follow-up period. Most CSF cytokines decreased longitudinally but were not predictive of FDG changes. We found that high ASCVD scores in a group of treated PWH were related to thalamic hypometabolism, which in turn correlated with neurocognitive decline. Our findings support the contribution of CVD to neurocognitive dysfunction. More proactive CVD management may have a role in mitigating progression of cognitive impairment. Lack of change in global brain glucose metabolism despite documented accelerated gray matter volume loss over the same period suggests that FDG PET might underestimate neuronal injury in PWH compared to structural magnetic resonance imaging.

Evaluating stereotactic accuracy with patient-specific MRI distortion corrections for frame-based radiosurgery.

This study examines how MRI distortions affect frame-based SRS treatments and assesses the need for clinical distortion corrections. The study included 18 patients with 80 total brain targets treated using frame-based radiosurgery. Distortion within patients' MRIs were corrected using Cranial Distortion Correction (CDC) software, which utilizes the patient's CT to alter planning MRIs to reduce inherent intra-cranial distortion. Distortion was evaluated by comparing the original planning target volumes (PTVORIG) to targets contoured on corrected MRIs (PTVCORR). To provide an internal control, targets were also re-contoured on uncorrected (PTVRECON) MRIs. Additional analysis was done to assess if 1mm expansions to PTVORIG targets would compensate for patient-specific distortions. Changes in target volumes, DICE and JACCARD similarity coefficients, minimum PTV dose (Dmin), dose to 95% of the PTV (D95%), and normal tissue receiving 12Gy (V12Gy), 10Gy (V10Gy), and 5Gy (V5Gy) were calculated and evaluated. Student's t-tests were used to determine if changes in PTVCORR were significantly different than intra-contouring variability quantified by PTVRECON. PTVRECON and PTVCORR relative changes in volume were 6.19%±10.95% and 1.48%±32.92%. PTVRECON and PTVCORR similarity coefficients were 0.90±0.08 and 0.73±0.16 for DICE and 0.82±0.12 and 0.60±0.18 for JACCARD. PTVRECON and PTVCORR changes in Dmin were -0.88%±8.77% and -12.9±17.3%. PTVRECON and PTVCORR changes in D95% were -0.34%±5.89 and -8.68%±13.21%. The 1mm expanded PTVORIG targets did not entirely cover 14 of the 80 PTVCORR targets. Normal tissue changes (V12Gy, V10Gy, V5Gy) calculated with PTVRECON were (-0.09%±7.39%, -0.38%±5.67%, -0.08%±2.04%) and PTVCORR were (-2.14%±7.34%, -1.42%±5.45%, -0.61%±1.93%). Except for V10Gy, all PTVCORR changes were significantly different (p<0.05) than PTVRECON. MRIs used for SRS target delineation exhibit notable geometric distortions that may compromise optimal dosimetric accuracy. A uniform 1mm expansion may result in geometric misses; however, the CDC algorithm provides a feasible solution for rectifying distortions, thereby enhancing treatment precision.

Refining hemodynamic correction in in vivo wide-field fluorescent imaging through linear regression analysis

Accurate interpretation of in vivo wide-field fluorescent imaging (WFFI) data requires precise separation of raw fluorescence signals into neural and hemodynamic components. The classical Beer-Lambert law-based approach, which uses concurrent 530-nm illumination to estimate relative changes in cerebral blood volume (CBV), fails to account for the scattering and reflection of 530-nm photons from non-neuronal components leading to biased estimates of CBV changes and subsequent misrepresentation of neural activity. This study introduces a novel linear regression approach designed to overcome this limitation. This correction provides a more reliable representation of CBV changes and neural activity in fluorescence data. Our method is validated across multiple datasets, demonstrating its superiority over the classical approach.

Identifying Risk Factors for Wound Complications Following Fronto-Orbital Advancement in Patients With Craniosynostosis: 3-dimensional Craniometrics Analysis.

This study aims to identify 3-dimensional (3D) craniometric predictors of wound complications following fronto-orbital advancement (FOA) surgery in craniosynostosis patients. The authors conducted a retrospective review of medical records for 43 patients (25 female, 18 male) who underwent open FOA between 2006 and 2023, with an average follow-up duration of 91.8 months. The data collected included age at surgery, sex, whether the craniosynostosis was syndromic, involvement of multiple sutures, history of suturectomy, wound complications (categorized as minor or major), and preoperative and postoperative 3D CT scans. The authors quantified relative changes in intracranial volume (ICV), cranial area above the Frankfurt Horizontal plane, anteroposterior diameter (APD), and cranial height (CH) using Mimics software. A logistic regression analysis was performed to identify predictors of wound complications post-FOA. Among the 43 patients who underwent FOA, 10 experienced postoperative wound complications (4 minor, 6 major), revealing significant associations with multisuture involvement and changes in △cranial area, △APD, and △CH (all P<0.05). In the multivariable analysis with backward elimination, △cranial area, and △CH were identified as significant risk factors for wound complications (OR 1.17, 95% CI: 1.01-1.36, P=0.032; and OR 0.59, 95% CI: 0.38-0.92, P=0.019, respectively). The cutoff values for △cranial area and △APD were 5.95% and 7.93%, respectively. This study identified measurable craniometric changes, especially in the cranial area, as risk factors for wound complications following FOA. It underscores the necessity for personalized surgical planning and meticulous postoperative wound care in FOA to enhance patient outcomes through risk-aware strategies.

A Retrospective Evaluation of the Treatment Effects of Rituximab in Patients with Progressive and Symptomatic Fibrosing Mediastinitis.

Rationale: Fibrosing mediastinitis (FM) is an uncommon fibroinflammatory condition without established or effective medical therapies. Infiltrating B lymphocytes are commonly present, and progressive fibrosis compromises mediastinal structures, including blood vessels and airways, resulting in significant morbidity and mortality. Objective: To evaluate the benefits and side effects of rituximab in patients with progressive and symptomatic FM. Methods: We treated 22 patients (median age, 35 yr; range, 15-68 yr; 45% female) with metabolically active, progressive FM with rituximab on an off-label basis. Additionally, patients were administered pneumocystis and antifungal prophylaxis when immunosuppressed with rituximab. Modeling of longitudinal treatment response based on changes in relative lesion volume from baseline was performed retrospectively using functional data analysis, and time-to-event modeling was performed to estimate treatment response rates based on a >30% reduction in pretreatment volume. The primary endpoints were lack of disease progression and change in mediastinal lesion volume on computed tomography (evaluated retrospectively). Results: No patient experienced disease progression after rituximab therapy. Median clinical follow-up was 42 months (range, 7-94 mo) and imaging follow-up 21 months (range, 7-62 mo). A total of 82% of patients had confirmed histoplasmosis-associated FM. After rituximab treatment, a 49.6% (95% confidence interval, 17.5-64.4%) mean estimated decrease in pretreatment lesion volume was observed at 24 months. The estimated objective treatment response rate was 47.9% (95% confidence interval, 26.7-70.3%). Conclusions: This observational study suggests that rituximab is a well tolerated and potentially effective therapy in a cohort of patients with symptomatic and progressive FM.

The Early Determination Method of Reservoir Drive of Oil Deposits Based on Jamalbayli Indexes

Summary Historically, the concept of “reservoir drive” aimed to simplify the mathematical modeling in reservoir engineering. Within this framework, the energy of the reservoir, particularly its aquifer, was idealized, leading to classifications such as “partial waterdrive,” “full waterdrive,” “gas cap drive,” and so forth. However, in reality, all existing energy sources interact simultaneously within reservoirs. Accordingly, this study aims to develop a new concept for a more realistic description of reservoir drive mechanisms and evaluation of reservoir energy performance. Numerous computer simulations have revealed a strong correlation between the ratio of relative changes in pore volume to relative changes in reservoir pressure and the reservoir’s energy nature and activity level. Moreover, the noted ratio did not depend on production technology, pressure/volume/temperature properties of hydrocarbon systems, rheological properties of reservoir rocks, or other factors. Based on this correlation, specific parameters termed as Jamalbayli Indexes (JI) have been identified to quantitatively describe reservoir energetic performance. JI consist of two parameters. One of them describes the relative change in pore volume per unit of relative change in reservoir pressure, and the second is the relative change in pore volume per unit of relative change in formation porosity. Here, “relative change” means a change in a parameter relative to its original value. These parameters are dimensionless and can have values around or equal to unity. A new conceptual framework for describing reservoir drive mechanisms based on JI has been formulated. According to this framework, reservoir drive mechanism is determined by comparing the computed JI values with unity rather than relying on subjective assessments of the trend of some functional dependencies. For the first time, it has become possible to express the reservoir drive performance quantitatively and determine the level of energy activity of the reservoirs with the help of JI. Additionally, a technique has been developed to evaluate the numerical values of JI for specific oil (including volatile oil) deposits based on the production data at any stage of production. The proposed methodology was tested using data from the eighth horizon of the Russkiy Khutor field in Russia. The test results not only confirmed the reliability of the obtained model but also demonstrated the adequacy of the proposed concept as a whole. Summarizing the results of other works by the authors, the adequacy of the proposed concept for both oil, gas, and gas condensate deposits has been confirmed. The research findings are expected to contribute to updating the traditional principles used for the mathematical problem statements in fluid flow in porous formations. Additional Key Terms and Phrases Reservoir Drive Mechanism; Early Determination Methods; Reservoir Performance Analysis; Production Data Interpretation; Enhanced Oil Recovery; Reservoir Management; Drive Mechanism Identification; Reservoir Fluid Dynamics; Production Rate Analysis; Reservoir Engineering Techniques; Field Development Planning; Reservoir Simulation; Pressure/Volume/Temperature (PVT) Analysis; Production Monitoring and Evaluation drive mechanisms; production data analysis; volatile oil; Jamalbayli indexes; drive performance indexes

Dualistic effect of the deformation of protective structures made of broken rock in mine workings under static load

Purpose is to reveal physical essence of the dualistic (double) nature of deformation effects and their influence on the mechanical properties of protective structures made of broken rock while unloading coal-bearing mass to ensure stability of side rocks and operational conditions of the development mine working within the working areas of coal mines. Methods. The deformation properties of protective structures made of broken rock was modeled on experimental samples during their static load in terms of uniaxial compression with the possibility of lateral expansion of the original material or its compressive stress. Findings. A dualistic effect of deformations for the conditions of uniaxial compression of protective structures was revealed. Under the effect, a complex transformation of volume and shape occurs in the structures caused by the process of relative changes in the backfill material volume. The observed phenomenon occurs within the range of 0.12 ≤δV ≤ 0.32 and the values of the compaction coefficient of broken rock being 1.13≤k con. ≤ 1.47, depending on the granulometric composition of the source material and its bulk density. It was established that under conditions when broken rock is compressed, there is an effect of forming the bearing capacity of protective structures, which is observed when a relative change in the volume of backfill material is 0.14 ≤ δV ≤ 0.38, and its compaction factor reaches 1.16 ≤ kcon. ≤ 1.59. Depending on the homogeneity degree of the backfill material of protective structures, when comparing the values of kcon., a dualistic (double) effect is manifested in the difference of deformation characteristics of broken rock under uniaxial and compressive stress, reaching two or more times. Originality. A regularity was established that determines the relationship between compaction factor kcon. of broken rock and a relative change in the volume (δV) of backfill material, which makes it possible to evaluate bearing capacity of protective structures, being under static load in a stress-strain state. Practical implications. The research results can be used to substantiate the selection of a method to protect development mine working with flexible supports made of broken rock. To clarify the assessment of bearing capacity of such structures, it is advisable to carry out specific field studies in mine conditions.

Assessing the stability of protective structures in preparatory mining workings under conditions of static load

The object of this study is the deformation processes in protective structures under the action of static load in the coal massif in order to preserve the integrity of the side rocks and the operational condition of mine workings. Under laboratory conditions, the deformation characteristics of rigid and flexible protective structures, as well as supports made of crushed rock, were studied on experimental samples. The samples were subjected to uniaxial compression. It was established that there is a functional relationship between the coefficient of transverse deformation ν and the relative change in the volume δV of protection structures, which makes it possible to estimate their bearing capacity. For rigid protection structures (coal pillars, cast strip, cement blocks, blocks of reinforced concrete bollards, bundles of wooden racks), the deformed state of the structures determines their behavior. This happens at values of ν=0.3–0.5 and δV£0.09. Their stability is fixed within the safe deformation resource. An increase in the deformation energy density of such structures beyond the safe deformation resource leads to their destruction due to a change in shape. For flexible protection structures (bundles of wooden racks, rolling bundles made of wooden sleepers), which have a transverse deformation coefficient ν=0.02, at a relative change in volume δV£0.3, the compaction of structures is observed. Increasing their stiffness allows limiting the convergence of side rocks. For a support made of crushed rock, at ν=0.25–0.32 and a relative volume change of 0.12£δV£0.32, its compaction and increase in resistance occur. Under such conditions, the convergence of side rocks is limited. In order to preserve the integrity of the lateral and operational condition of preparatory workings in the excavation areas of coal mines, it is advisable to use flexible protective structures made of wood or supports made of crushed rock

Are Age and Trauma Mechanism Associated with Volume Change in the Fractures of the Bony Orbit?

Blowout fractures are common midfacial fractures in which one or several of the bones of orbital vault break. This is usually caused by a direct trauma to the eye with a blunt object such as a fist. Fracturing of the fragile orbital bones can lead to changes in the orbital volume, which may cause enophthalmos, diplopia, and impaired facial aesthetics. Objectives: The aim of this study is to investigate whether there is an association between volume change of the bony orbit and age, gender, or trauma mechanism. Methods: A retrospective study of patients with unilateral blowout or blow-in fractures treated and examined in Päijät-Häme Central Hospital, Lahti, Finland was conducted. Altogether, 127 patients met the inclusion criteria. Their computed tomographs (CT) were measured with an orbit-specific automated segmentation-based volume measurement tool, and the relative orbital volume change between fractured and intact orbital vault was calculated. Thereafter, a statistical analysis was performed. A p-value less than 0.05 was considered significant. Results: We found that relative increase in orbital volume and age have a statistically significant association (p = 0.022). Trauma mechanism and gender showed no significant role. Conclusions: Patient's age is associated with increased volume change in fractures of the bony orbit.

IMG-29. IMPLICATIONS OF IMAGE HARMONIZATION FOR BRAIN TUMOR CLINICAL TRIALS

Abstract BACKGROUND Clinical trials for rare pediatric conditions like optic pathway gliomas associated with NF1 (NF1-OPGs) require numerous sites that utilize different MRI scanners and protocols. These MRIs must be harmonized for reliable comparison using machine learning tools. We propose a deep-learning based MRI harmonization that enables reproducible data analysis across multiple sites and MRI platforms. METHODS One-hundred eighty clinical T1-weighted-MRIs of pediatric NF1-OPG subjects were acquired from three sites [Children’s National Hospital (site A, N=60), Children’s Hospital Colorado (site B, N=60), and Children’s Hospital of Philadelphia (site C, N=60)] using different MR scanners (GE, Phillips, and Siemens, respectively). MRIs from A and B were used to train a branched neural network and C were used for testing. Using unsupervised learning, the neural network identified differences in imaging protocols and harmonized data to a chosen protocol, e.g., that of site A, while preserving the patient anatomy. The harmonization was evaluated using Wasserstein distance (nWD), which measured similarity between two gray scale appearances of MRI intensity histograms. Anatomy preservation metric (AP) measured relative volume changes in gray matter (GM) segmented using Freesurfer, before and after harmonization. For both metrics, 100% means the best possible harmonization was achieved. RESULTS Before harmonization, nWD between grayscale appearance of MRIs from sites A and B was 27.3±3.1%. After harmonization, the similarity became 94.2±2.0% with a GM volume error of 3.11±0.56ml which corresponded to AP of 93.1±4.7%. For the test data, nWD similarity post harmonization improved from 38.2±3.9% to 93.4±2.2% with GM volume error of 4.12±0.47ml which corresponded to AP of 90.3±3.5%. CONCLUSIONS Our approach enables MRI harmonization while preserving anatomy for precise analysis using machine learning tools. It scales to new sites to support multisite clinical trials that utilize imaging outcomes for brain tumors and other rare diseases.

Insight into the diffusion behaviors of SBS‐compatibilizer‐coupled modified asphalt: Molecular dynamics simulation and experimental validation

AbstractCompatibilizers play a crucial role in enhancing the compatibility between styrene–butadiene–styrene (SBS) polymer and asphalt, and the coupling of compatibilizers with SBS affects the motion behavior of asphalt molecules, which influences the performance of SBS modified asphalt. In this investigation, molecular dynamics simulation is employed to evaluate the impact of SBS coupling with compatibilizers on alterations in the self‐motion behavior of asphalt molecules, changes in relative free volume, and modifications in system energy. The findings reveal that with the introduction of a compatibilizer, the combined effect of the compatibilizer and SBS coupling amplifies the mobility of the constituents within the modified asphalt. This amplification manifests as increased relative free volume within the system, heightened activation of modified asphalt molecules, and a simultaneous reduction in the interaction energy among these molecules. Following that, the high‐temperature rheological properties of SBS modified asphalt were verified with the simulation results, coupled with temperature scanning experiments. This study describes the intrinsic mechanism of interaction of compatibilizers in SBS modified asphalt at the molecular scale.Highlights Molecular dynamics simulations and experimental validation were implemented for styrene–butadiene–styrene (SBS)‐modified asphalt. Compatibilizers can activate the activity of SBS modified asphalt. Compatibilizers allow a better release of the properties of the bitumen and SBS. Compatibilizers can replace bitumen and act with SBS to improve its modification efficiency. The optimum dosage of compatibilizer is 3%.

Leadless ultrasound-based cardiac resynchronization system in heart failure results from the SOLVE-CRT randomised sub-study and the primary population patient cohort

Abstract Background Despite the well-established role of CRT in heart failure, major limitations of CRT include an occasional incidence of unsuccessful coronary sinus (CS) lead placement, one third non-responders in conventional CRT patients and higher complications risk in CRT upgrade procedures. The WiSE® CRT System (EBR Systems, Inc) is designed to overcome these limitations. Prior non-randomized studies with the WiSE System have shown high implant success rates and improvement in LV remodeling and heart failure symptoms. Objectives The pivotal SOLVE-CRT study is comprised of two parts: a randomized part and the subsequent single-arm part enrolled during the pandemic. The primary safety endpoint is freedom from Type I (device &amp; procedure-related) complications through 6 months and primary efficacy endpoint is the mean relative (%) change in left ventricular end systolic volume (LVESV) from baseline to 6 months. Method Between Jan. 2018 and Mar. 2020 the randomized part enrolled 108 participants for three indications: non-responders (NR), previously untreated, including acute and chronic lead failures (PU), and high-risk upgrades (HRU). All underwent device implantation and were then randomized in 1:1 ratio to Treatment (system turned ON) or Control (system turned OFF) groups. In the single arm, 75 participants had been enrolled within two indications: PU and HRU. The efficacy analysis of the entire randomised cohort included 99 participants (PU, HRU, NR). For the primary indication sub-population, 57 participants (PU, HRU) were analysed. Results Randomized Group: Results were available for 91 of the 99 patients. Significant improvements were seen between the Treatment and Control groups with a mean reduction in LVESV (-14.6% vs -5.2%, p=0.005), mean reduction in LVEDV (-8.1% vs -3.0%, p=0.027), mean increase in LVEF (5.4% vs 2.4%, p=0.048) and mean reduction in QRS (-41.9ms vs -1.7ms, p=0.001). Primary Indication Sub-Population Group: The primary indication sub-population also saw significant improvements between Treatment and Control group with a mean reduction in LVESV (-18.2% vs -3.1%, p=0.002), mean reduction in LVEDV (-11.6% vs -2.1%, p=0.004), mean increase in LVEF (5.7% vs 1.1%, p=0.025) and mean reduction in QRS (-38.0ms vs -3.1ms, p&amp;lt;0.001). Conclusion This pivotal SOLVE-CRT trial demonstrates that leadless, ultrasound-based endocardial pacing for heart failure is feasible and efficacious showing evidence of left ventricular remodelling and electrical response after 6 month in the primary population as well as in the sub-study group. Picture 1: Efficacy entire randomised population Picture 2: Efficacy primary indications population

Impact of bronchodilator responsiveness classification changes on a large Australian community cohort

RATIONALE Bronchodilator responsiveness (BDR) was redefined in the 2021 European Respiratory Society/American Thoracic Society (ERS-ATS) technical statement, from at least 200 mL absolute and 12% relative change in forced expiratory volume in 1 sec (FEV1) or forced vital capacity (FVC) in 2005 to more than 10% change from predicted values. OBJECTIVES The objectives of this research are to measure the impact of BDR reclassification and identify the characteristics of reclassified patients. METHODS A retrospective cohort analysis of a convenience sample of 2,065 tests. Repeat tests were excluded. MEASUREMENTS AND MAIN RESULTS A total of 1,429 tests were evaluated; 206 (14%) were BDR by one or both definitions; and 55/206 (27%) of these records were reclassified, with a close number of results newly classified as BDR (n = 27) and losing this classification (n = 28). Analyzing FEV1 only, 159 tests were BDR by one or both definitions; and 48/159 (30%) were reclassified, with 18 newly classified as BDR and 30 losing this classification. Analyzing FVC only, 101 tests were BDR by one or both definitions; and 27/101 (27%) were reclassified, with 19 newly classified as BDR and 8 losing this classification. Individuals with BDR that were reclassified were significantly heavier (81.8 vs 75.8 kg), and taller (170.6 vs 166.1 cm), although there was no significant difference in body mass index (BMI) (27.9 vs 27.3 kg/m2). They had smaller relative changes in FEV1 (12% vs 16%) and FVC (6% vs 12%), and greater baseline FEV1 (1.99 vs 1.74 L) and FVC (3.39 vs 2.97 L) and were more likely to be female (59% vs 42%). CONCLUSIONS More people were reclassified than expected. When evaluated by expiratory maneuver, there were less people classified as BDR using FEV1 in 2021 than 2005, and more using FVC. This analysis illustrates the potential clinical impact of the change in BDR definition.

Disparities in Access to Outpatient Surgery Related to Removal of Procedures from Medicare's Inpatient Only List.

We assessed the shift from inpatient to outpatient surgical care related to changes to the Inpatient Only List in 2020 and 2021 compared to 2019. The extent to which procedures shift from the inpatient to outpatient setting following removal from Medicare's Inpatient Only List is unknown. Many health systems also encouraged a shift from inpatient to outpatient surgery during the COVID-19 pandemic. Assessing the relative change in outpatient surgical utilization for procedures removed from the Inpatient Only List during COVID-19 would provide empirical data on whether reimbursement policy changes or inpatient capacity needs during the pandemic were more likely to shift care from the inpatient to outpatient setting. We used administrative data from the PINC AI Healthcare Database across 723 hospitals to determine the within-facility relative change in outpatient vs inpatient procedural volume in 2020 and 2021 compared to 2019 using a multivariable conditional fixed-effects Poisson regression model. We also assessed whether outpatient surgical utilization varied by race and ethnicity. Using a multivariable linear probability model, we assessed the absolute change in risk-adjusted 30-day complication, readmission, and mortality rates for inpatient and outpatient surgical procedures. In 2020 and 2021 compared to 2019 respectively, there was a 5.3% (95% CI, 1.4% to 9.5%) and 41.3% (95% CI 33.1% to 50.0%) relative increase in outpatient elective procedural volume. Outpatient procedural volume increased most significantly for hip replacement which was removed from the Inpatient Only List in 2020 (increase in outpatient surgical utilization of 589.3% (95% CI, 524.9% to 660.3%)). The shift to outpatient hip replacement procedures was concentrated among White patients; in 2021, hip replacement procedural volume increased by 271.1% (95% CI, 241.2% and 303.7%) for White patients and 29.5% (95% CI, 24.4% and 34.9%) for Black patients compared to 2019 levels. There were no consistent or large changes in 30-day complication, readmission, or mortality risk in 2020 and 2021 compared to 2019. There was a modest increase in elective outpatient surgeries and a pronounced increase in outpatient orthopedic surgeries which were removed from the Inpatient Only List during the COVID-19 pandemic. Utilization of outpatient surgical procedures was concentrated among White patients.

Late Changes in Renal Volume and Function after Proton Beam Therapy in Pediatric and Adult Patients: Children Show Significant Renal Atrophy but Deterioration of Renal Function Is Minimal in the Long-Term in Both Groups.

To compare late renal effects in pediatric and adult patients with malignancies after PBT involving part of the kidney. A retrospective study was conducted to assess changes in renal volume and function in 24 patients, including 12 children (1-14 years old) and 12 adults (51-80 years old). Kidney volumes were measured from CT or MRI images during follow-up. Dose-volume histograms were calculated using a treatment planning system. In children, the median volume changes for the irradiated and control kidneys were -5.58 (-94.95 to +4.79) and +14.92 (-19.45 to +53.89) mL, respectively, with a relative volume change of -28.38 (-119.45 to -3.87) mL for the irradiated kidneys. For adults, these volume changes were -22.43 (-68.7 to -3.48) and -21.56 (-57.26 to -0.16) mL, respectively, with a relative volume change of -5.83 (-28.85 to +30.92) mL. Control kidneys in children exhibited a marked increase in size, while those in adults showed slight volumetric loss. The percentage of irradiated volume receiving 10 Gy (RBE) (V10) and 20 Gy (RBE) (V20) were significantly negatively associated with the relative volume change per year, especially in children. The CKD stage based on eGFR for all patients ranged from 1 to 3 and no cases with severe renal dysfunction were found before or after PBT. Late effects on the kidneys after PBT vary among age groups. Children are more susceptible than adults to significant renal atrophy after PBT. V10 and V20 might serve as predictors of the degree of renal atrophy after PBT, especially in children. PBT has a minimal impact on deterioration of renal function in both children and adults.

Pressure dependence of phase transformation, thermal expansion and barocaloric property in a polycrystalline Ni54Mn23Ga23 alloy

An experimental investigation was conducted to understand the influence of hydrostatic pressure on phase transition, thermal expansion and barocaloric property of a polycrystalline Ni54Mn23Ga23 alloy. Two pressure ranges of 0–1.28 GPa and 0–0.74 GPa were selected for thermal expansion and barocaloric property measurements due to the different test limits of instrumentals. The pressure dependence of fourteen parameters was studied systematically. It was found that the sample experiences a martensitic transformation (MT) near room temperature and the response of MT peak temperature (TM) to pressure is about 15.89 K/GPa. The phase transition strain (λtr), transformation width (ΔTtr) relative volume change (|ΔV/V|) and maximum adiabatic temperature change (ΔTad)max increase linearly with pressure and their shifting rates are about 0.071 %/GPa, 7.5 K/GPa, 0.211 %/GPa and 12.2 K/GPa, respectively. Simultaneously, applying hydrostatic pressure can also enhance the barocaloric property of the sample, leading to a large increase in the absolute value of the maximum entropy change (|ΔS|max), the refrigerating capacity (RC) and their reversible values. On cooling, the sensitivities of the reversible RC and its proportion to pressure are around 185.52 J/kg GPa and 16.7 %/GPa, respectively. Finally, the average linear expansion coefficient (αave) of both martensite and austenite phases keeps unchanged while in the MT region it decreases from -99.84×10–6/K to -86.04×10–6/K with increasing pressure from 0 to 1.28 GPa. These findings indicate that applying hydrostatic pressure can effectively adjust the phase transformation, thermal expansion and barocaloric property of Ni-Mn-Ga alloys, which are meaningful for their application in solid-state refrigeration.