Volume Curves Research Articles

Myocardial work index in severe aortic stenosis and its relationship with staging classification of the associated cardiac damage: results of a large transcatheter valve replacement candidate cohort

Abstract Background With increasing life expectancy and aging of the population, aortic valve stenosis (AS) is now the most prevalent valvular disease in developed nations. Left ventricular (LV) functional assessment is challenging in this pressure-overloaded disease state, however, myocardial work analysis may overcome this issue by proving load-adjusted measures of LV function. Notably, long-standing severe AS results in progressive damage of the heart, starting from left ventricular (LV) remodeling to significant backward effects eventually leading to manifest right ventricular dysfunction. Myocardial work parameters, being less load-dependent markers of LV function may follow the extent of cardiac damage. However, the relationship of cardiac damage staging and myocardial work measures is scarcely investigated. Purpose Accordingly, we aimed to examine the relationship of myocardial work indices and AS staging in a transcatheter aortic valve replacement (TAVR) candidate AS cohort. Methods 296 patients (79±7 years, 41% female) with severe AS were enrolled. Medical history was obtained and we performed detailed echocardiography prior to TAVR. Aortic valve area (AVA) was calculated using the continuity equation. LVEDVi was measured using the biplane Simpson method. Based on the echocardiographic data, we determined the extent of cardiac damage caused by AS, patients were classified as Stage 0 (no cardiac damage), Stage 1 (LV damage), Stage 2 (mitral valve or left atrial damage), Stage 3 (pulmonary artery vasculature or tricuspid valve damage), or Stage 4 (right ventricular damage). We determined the LV ejection fraction (EF) and via speckle-tracking echocardiography global longitudinal strain (GLS) was also measured. Then, utilizing left ventricular volume curves derived from systolic blood pressure and mean transaortic gradient, we calculated global myocardial work index (GWI). Results 14 (5%) patients were classified as Stage 0, 61 (21%) as Stage 1, 132 (45%) as Stage 2, 16 (5%) as Stage 3, and 73 (25%) as Stage 4. EF (from Stage 0-4: 61±6 vs. 48±12 vs. 48±11 vs. 45±14 vs. 40±15%, p≤0.01) and GLS (-16.9±3.4 vs.-13.2±3.3 vs. -12.6±3.8 vs. -11.8±4.8 vs. -9.8±4.4%, p≤0.01) only differed in Stages 3 and 4, while GWI values formed a more defined spectrum through the Stages (2481±543 vs. 1726±588 vs. 1717±686 vs. 1581±867 vs. 1185±692 mmHg%, p≤0.001). Using multivariate regression analysis, examining relevant clinical and echocardiographic parameters, age (β=0.15, p=0.02), cardiac damage stage (β=-0.19, p≤0.01), AVA (β=0.21, p≤0.01), LVEDVi (β=-0.33, p≤0.001) and having a pacemaker (β=-0.15, p=0.01) were independent predictors of GWI (R²= 0.41, p≤0.0001). Conculsions LV GWI show distinct changes throughout the spectrum of cardiac damage associated with severe AS. Beyond age, AVA, LVEDVi and having a pacemaker, cardiac damage stage is also an independent determinant of GWI in this population.

Effect of Ti Doping on the Structural, Electronic, Optical and Thermoelectric Properties of ZrO2: A Systematic DFT Approach

AbstractIn this work, the density functional theory (DFT) calculations in wien2k code to investigate the effect of (Titanium) Ti doping (25% and 50%) in ZrO2 is utilized. The negative values of the Ef, i.e., −2.14, −3.42 and −2.31 as well as energy versus volume curves show the stability of pure, 25% and 50% doped ZrO2. From band structure and density of states results it is confirmed that upon doping Ti, the band gap of ZrO2 become direct from indirect and reduces from 3.10 eV to 1.26(25% doped)/1.16(50% doped). The optical investigations reveal that incorporation of Ti improved the optical properties significantly, which show the significance of these materials for optoelectronic device applications. The thermoelectric properties are investigated using the Boltzmann transport theory. The Seebeck coefficient, electronic conductivity, thermal conductivity, power factor and figure of merit is calculated. The obtained results show that the under study compounds are best candidates for different thermoelectric applications.

Microglia Morphology in the Developing Primate Amygdala and Effects of Early Life Stress.

A unique pool of immature glutamatergic neurons in the primate amygdala, known as the paralaminar nucleus (PL), are maturing between infancy and adolescence. The PL is a potential substrate for the steep growth curve of amygdala volume during this developmental period. A microglial component is also embedded among the PL neurons and likely supports local neuronal maturation and emerging synaptogenesis. Microglia may alter neuronal growth following environmental perturbations such as stress. Using multiple measures in rhesus macaques, we found that microglia in the infant primate PL had relatively large somas and a small arbor size. In contrast, microglia in the adolescent PL had a smaller soma and a larger dendritic arbor. We then examined microglial morphology in the PL after a novel maternal separation protocol, to examine the effects of early life stress. After maternal separation, the microglia had increased soma size, arbor size, and complexity. Surprisingly, strong effects were seen not only in the infant PL, but also in the adolescent PL from subjects who had experienced the separation many years earlier. We conclude that under normal maternal-rearing conditions, PL microglia morphology tracks PL neuronal growth, progressing to a more "mature" phenotype by adolescence. Maternal separation has long-lasting effects on microglia, altering their normal developmental trajectory, and resulting in a "hyper-ramified" phenotype that persists for years. We speculate that these changes have consequences for neuronal development in young primates.

Night-time blood pressure dipping, but not 24-h blood pressure level, is linked to increased 24-h ocular volume slope.

This study investigated the relationship between blood pressure and intraocular pressure in treatmentnaive, non-glaucoma patients with different blood pressure statuses, focusing on the 24-h ocular volume and nocturnal blood pressure decline. Treatment-naive, non-glaucoma patients undergoing hypertension evaluation were enrolled as study participants. Simultaneous 24-h ambulatory blood pressure measurement and 24-h ocular volume recording with a contact lens sensor. We also compared ocular volume curve parameters between normotensive and hypertensive patients, as well as between those with and without nocturnal blood pressure decline. A total of 21 patients, including 7 normotensive and 14 treatment-naive hypertensive individuals, were included in the study. of them, 11 were dippers and 10 were non-dippers. No significant difference in the 24-h ocular volume slope was observed between the hypertensive and normotensive patients (p=0.284). However, dippers had a significantly higher 24-h ocular volume slope (p=0.004) and nocturnal contact lens sensor output (p=0.041) than non-dippers. Nocturnal blood pressure decline, rather than the blood pressure level, is associated with the increased 24-h ocular volume slope and nocturnal ocular volume. Further studies are required to determine whether the acceleration of glaucoma progression in dippers is primarily due to low blood pressure, high intraocular pressure, or a combination of both.

A Case of Respiratory Retraining With Body Movement for Paradoxical Vocal Fold Movement

Paradoxical vocal fold movement (PVFM) is laryngeal motor dysfunction that is associated with many causes. This type involves involuntary vocal fold adduction during inspiration, reduction of the inspiratory flow volume curve and a perception of breathing difficulty. We present a case of 65-year-old male with gradual onset of inspiratory troubles related with PVFM, and observed pre/post transforming respiratory retraining with body movement.

Evaluation of plan quality, safety, and toxicity of brachytherapy for locally advanced cervical cancer in an Australian setting following changes in prescription and applicator design.

Chemoradiotherapy with MRI-guided brachytherapy boosts is the standard of care for locally advanced cervical cancer. Data from the RetroEMBRACE and EMBRACE I trials provide dose-response curves for target volumes and OAR. This study evaluated plan quality, safety and toxicity following escalation of the CTV_HR D90 prescription from 80-90 Gy to 85-95 Gy for two different applicator designs. A retrospective dosimetric plan quality review was undertaken for consecutively treated locally advanced cervical cancer brachytherapy boosts between 2017 and 2022, and the relationships between implant total reference air kerma (TRAK), CTV_HR volume and vaginal dose were investigated. Safety and ≤grade 3 toxicity results were evaluated. Seventy patients were identified. All patients received a CTV_HR D90 dose >85 Gy and rectum D2cm3 of <75 Gy, while 88.6% of patients received a bladder D2cm3 <90 Gy. Needles were used in 48.6% of patients, and the mean percentage needle TRAK was 38.2%. Increasing the percentage of needle TRAK decreased vaginal TRAK. Sixty-three patients had more than 12 months of follow-up (median 27 months). From this cohort, grade 3 or higher toxicity for vaginal, genitourinary, gastrointestinal and fistula events were seen in 3.2%, 1.6%, 0% and 3.2% of patients, respectively. Increased dose prescriptions and a change of applicator design were successfully adopted into an Australian practice. Applicator design and interstitial needle use affect the plan quality and ability to meet OAR dose constraints following target dose escalation. No safety concerns with needle use or dose escalation were identified.

Patterns of development of export cargo flows of grain crops from the southern regions of Russia

The topic of the study is to identify patterns of development of export cargo flows of grain crops from the southern regions of the Russian Federation. The analysis of the volumes of grain shipments from the ports of the AzovBlack Sea and Caspian basins separately was carried out. The main consumers and importers of Russian grain are highlighted, as well as the main directions in the transportation of grain cargoes from the southern regions of Russia. Various standard sizes of bags involved in the transportation of this category of goods are considered, as well as the reasons for their use in the export of Russian grain from the ports of the Caspian Sea and the Black SeaAzov basin. The main types of grain crops to be exported from the southern regions of the Russian Federation are noted, including their shares of the total volume of all transported grain. The dynamics of changes in the volume of transportation of individual grain crops from the ports of the Black SeaAzov basin and the Caspian Sea, respectively, is presented. The trend towards a stable annual increase in export cargo flows of Russian grain is analyzed. The seasonality in the export of the studied category of goods is considered, annual temporary peaks in the curves of cargo flows corresponding to a sharp increase in the volume of grain shipments are highlighted. The presence of patterns in the behavior of the curves of grain export cargo flows from the southern regions of Russia is noted, manifested in the similarity of the shapes of the curves of transportation volumes over various years, as well as in their desire to approach the average curve of cargo flows calculated for the entire analyzed period. The question was raised about the possibility of taking into account the trends under consideration when forecasting changes in the volume of grain export shipments from the ports of the Black SeaAzov and Caspian basins.

Investigation of the effect of dead volume on the shape of breakthrough curve – New method designed to correct this effect

Investigation of the effect of dead volume on the shape of breakthrough curve – New method designed to correct this effect

Monitoring and Disaster Assessment of Glacier Lake Outburst in High Mountains Asian Using Multi-Satellites and HEC-RAS: A Case of Kyagar in 2018

The glaciers in the High Mountain Asia (HMA) region are highly vulnerable to global warming, posing significant threats to downstream populations and infrastructure through glacier lake outburst floods (GLOFs). The monitoring and early warnings of these events are challenging due to sparse observations in these remote regions. To explore reproducing the evolution of GLOFs with sparse observations in situ, this study focuses on the outburst event and corresponding GLOFs in August 2018 caused by the Kyagar Glacier lake, a typical glacier lake of the HMA in the Karakoram, which is known for its frequent outburst events, using a combination of multi-satellite remote sensing data (Sentinel-1 and Sentinel-2) and the HEC-RAS hydrodynamic model. The water depth of the glacier lake and downstream was extracted from satellite data adapted by the Floodwater Depth Elevation Tool (FwDET) as a baseline to compare them with simulations. The elevation-water volume curve was obtained by extrapolation and was applied to calculate the water surface elevation (WSE). The inundation of the downstream of the lake outburst was obtained through flood modeling by incorporating a load elevation-water volume curve and the Digital Elevation Model (DEM) into the hydrodynamic model HEC-RAS. The results showed that the Kyagar glacial lake outburst was rapid and destructive, accompanied by strong currents at the end of each downstream storage ladder. A series of meteorological evaluation indicators showed that HEC-RAS reproduced the medium and low streamflow rates well. This study demonstrated the value of integrating remote sensing and hydrodynamic modeling into GLOF assessments in data-scarce regions, providing insights for disaster risk management and mitigation.

Hydrogen, Methane, Brine Flow Behavior, and Saturation in Sandstone Cores During H2 and CH4 Injection and Displacement

Large-scale underground hydrogen storage (UHS) is a critical component in the emerging hydrogen economy. Knowledge of multiphase flow behavior involving hydrogen in storage reservoir formations is crucial to characterizing hydrogen transport properties and essential for the deliverability and storage operations of UHS. There are still many gaps in fully understanding hydrogen–methane–brine multiphase phase flow that require further investigation. In this work, H2 and CH4 were injected through brine-saturated sandstone cores using a tri-axial core holder system fitted with flow rate meters and pressure transducers, while the effluent gas concentrations were analyzed using an online micro gas chromatograph. Brine displacement, permeability, and gas breakthrough curves were measured. We studied the flow behavior of hydrogen and methane in sandstone cores through testing brine displacement by gas injection and comparing the hydrogen displacement of methane with the methane displacement of hydrogen. We also tested the differences between horizontal and vertical flow in brine displacement. The results showed that brine displacement was more efficient in a core with higher permeability and porosity, resulting in a higher initial gas saturation. A higher gas injection rate brought about faster gas breakthrough measured by pore volume and sharper concentration curves. Hydrogen did not exhibit abnormal flow in the sandstone when the flow was horizontal and downward vertical. Gas overriding was observed in brine displacements when the flow was horizontal, with hydrogen showing this behavior more profoundly compared to methane. Downward vertical gas injection induced higher efficiency brine displacement compared to horizontal displacement and resulted in a higher initial gas saturation in the sandstone cores. These findings address critical knowledge gaps regarding gas flow patterns and displacement behaviors during hydrogen injection and recovery phases in UHS facilities using methane as the cushion gas. The insights from this research offer valuable guidance for optimizing UHS systems, ensuring operational efficiency, and advancing sustainable energy solutions in alignment with decarbonization goals.

A Computational Study on Effects of PID Temperature Target and RF Frequency for PID-Controlled Nonablative RF Cosmetic Systems.

Commonly adopted in cosmetic dermatology, nonablative radiofrequency (RF) devices convert high-frequency electromagnetic energy into thermal energy to induce a wound-healing response in skin tissue. However, differences in the electrical properties of different skin layers raise questions about the impact of different RF frequencies and target temperatures on treatment effectiveness. This paper presents a finite element analysis (FEA)-based computational study aimed at simulating and optimizing the effects of a proportional integral derivative (PID)-controlled RF cosmetic devices under different combinations of these two parameters during treatment. A 3D physical model for the application of a nonablative RF device was constructed using COMSOL, which included the human tissue and RF electrodes, electromagnetic and thermal boundary conditions, as well as the PID controller. FEA was performed for each of the twelve models with parameter combinations of three RF frequencies (0.1, 0.5, and 1 MHz) and three PID-controlled target temperatures (60°C, 65°C, and 70°C) plus one group without PID control. Treatment effectiveness was quantitatively assessed using the integration of tissue thermal damage fraction, i.e., thermal damage volume. In the earlier stage of heating (0-10 s), higher RF frequency resulted in a larger thermal damage volume. At 10 s, among models with a temperature target of 70°C, there is a 6.04% difference between the thermal damage volume at RF frequencies of 1.0 and 0.1 MHz. In the later stage of heating(11-80 s), the impact of RF frequency decreases. The difference in thermal damage volume caused by higher temperature targets is more significant, at 80 s, among models with an RF frequency of 1.0 MHz, the 70°C model produces 1.15 and 1.36 times more tissue thermal damage than the 65°C and 60°C models. PID controller has ensured treatment safety and uniformity, in exchange for some efficiency. Among 12 parameter combinations, the one with a temperature of 70°C and RF frequency of 1.0 MHz achieved the highest thermal damage volume, which could potentially result in the best esthetic effect. Considering users' different susceptibility to heat, engineers or physicians can select better temperature targets and RF frequencies to bring the desired cosmetic results based on thermal damage volume curves from this study.

The potential of uroflowmetry to predict and detect hemorrhagic cystitis following hematopoietic stem cell transplantation

Hemorrhagic cystitis (HC) is a serious complication following hematopoietic stem cell transplantation (HSCT) associated with significant morbidity and mortality. Early identification of at-risk patients and prompt diagnosis are crucial for effective management. This prospective cohort study evaluated the potential of uroflowmetry as a predictive tool for detecting HC in pediatric HSCT patients. Thirty-one children who underwent allogeneic HSCT were enrolled. Uroflowmetry was performed on admission (Day 0), post-HSCT Day 1 and Day 15, and at HC onset. Uroflowmetric parameters, including maximum flow rate (Qmax), average flow rate (Qavg), voided volume (VV), and flow curve shape, were compared between HC and non-HC patients. The incidence of HC within 100 days post-HSCT was 58%, with a mean onset time of 35 days. At baseline (Day 0), HC patients had significantly lower Qmax (12.5 vs. 17.8mL/s), Qavg (6.8 vs. 9.5mL/s), and VV (185 vs. 245mL) compared to non-HC patients (all p<0.05). Age-stratified analysis revealed the observation of these differences across all age groups. At HC onset, compared to Day 0, patients experienced a significant decrease in Qmax (8.7 vs. 12.5mL/s) and Qavg (4.2 vs. 6.8mL/s) (both p<0.05). Flow curve analysis demonstrated a shift from bell-shaped to interrupted curves in HC patients over time. Uroflowmetry can potentially predict and detect HC in pediatric HSCT patients. Lower baseline uroflowmetric parameters may identify patients at higher risk for HC, while a significant decrease in these parameters from baseline may indicate HC onset. Uroflowmetry is a simple, non-invasive tool that can be performed at home and monitored remotely, facilitating early detection and intervention for HC in this population.

Анализ возможностей метода оценки кривой «поток–объем» по изменению ее формы при обструкции бронхов

In case of obstructive disorders, the flow–volume curve has a concave shape, but this feature is not given due attention. Тhe analysis of the velocity indicators of the respiratory function (such as the peak expiratory flow (PEF) and forced expiratory flows (FEFs)) will significantly expand the diagnostic capabilities of the spirometry method. This paper aims to perform a comparative analysis of the diagnostic strength of the methods of the flow-volume curve assessment by the changes in its shape in patients with obstructive airway diseases to determine the most reliable one. The respiratory function of 540 patients was tested (234 are men (57 [36; 67] years) and 306 are women (59 [44; 69] years)), with the ratio of areas under the actual curve and the predicted curve calculated for each one, as well as the angle formed by the curve; the ratio of the actual FEF (henceforth referred to as FEF) to the predicted FEF, cut-off points to differentiate between obstructive diseases and health. On the basis of these results, we concluded whether the patient’s bronchi were blocked. The results were then compared to the Knudson reference equations, with the test’s operational characteristics calculated compared to the standard. The methods of assessing the angle β and the total concavity of the flow-volume curve have high diagnostic sensitivity (87.8% and 95.6% respectively). The assessment of the area under the curve (AEX-FV) has high diagnostic specificity (88.6%). The results obtained show sufficient diagnostic efficiency of the methods of flow-volume curve estimation by the changes in its shape. However, the use of these methods in isolation from the reference equations does not currently seem reasonable for clinical practice. It appears reasonable to use the reference equations and one of the methods of curve shape assessment together.

Influences of interface bonding behavior on the arresting performance of CFRP buckle arrestors - Part I: Experiments

Influences of interface bonding behavior on the arresting performance of CFRP buckle arrestors - Part I: Experiments

Adaptive stereotactic radiosurgery for cerebral metastases of non-small cell lung cancer: a retrospective study

INTRODUCTION: Non-small cell lung cancer (NSCLC) is a common cause of brain metastases (BM). Adaptive stereotactic radiosurgery (ASRS) may be a useful option in the treatment of patients with large unresectable brain metastases (BM), but to date there are only a limited number of studies evaluating the effectiveness of this method.OBJECTIVE: To analyze the effectiveness of ASRS in patients with large BM NSCLC not subject to surgical resection.MATERIAL AND METHODS: We retrospectively analyzed data from 37 patients suffering from NSCLC with 45 large (&gt;2 cm in diameter, volume &gt;4 cm3) unresectable BM treated with the Gamma Knife Perfexion model using two- and three-fraction ASRS. Of these, 14 foci (31.1%) were metastases of squamous cell lung cancer, 31 (68.9%) were metastases of adenocarcinoma. The median volume of lesions treated with ASRS was 9.8 (range 4.6–30.6 cm3). The dynamics of volume changes between fractions and the cumulative incidence of local relapses (CILR) were studied, and ROC analysis was performed for the tumor volume parameter. Intracranial progression-free survival (iPFS) and overall survival (OS) were assessed. Statistics: To establish statistical significance of differences for related variables, the Wilcoxon test for pairwise comparisons and the Friedman test for three or more groups were used. The Kaplan-Meier method was used to calculate local control, PFS, and OS rates. The log-rank test was used to compare survival data in two groups.RESULTS: The median follow-up period was 19.4 months. With two-fraction ASRS, the median volume of metastasis decreased by 28.6% by the second session, with three-fraction — by 40.0% by the third session. The 1-year and 2-year CILR rates were 8.6±6.1%, respectively; 26.1±12.3%. In ROC analysis, the area under the curve (AUC) for tumor volume was 0.80 (95% CI 0.6– 1.0) with an optimal cutoff of 18.5 cm3. The differences in CILR between the groups with metastasis volume &lt;18.5 cm3 and ≥18.5 cm3 were statistically significant (p&lt;0.001). Median iPFS was 8.3 (95% CI 5.9–10.7) months, 1-year iPFS was 33.5±8.1%;2-year — 7.8±5.2%. Median OS was 13.2 (95% CI 9.0–17.4) months; 1-year OS — 52.9±8.7%, 2-year — 22.4±8.8%.DISCUSSION: Using two- and three-fraction ASRS, we delivered doses to large BM sufficient for a high level of local control with an acceptable risk of neurotoxicity: 1-year local control was 91.4%; 2-year — 73.9%; the incidence of radionecrosis is 8.5%. A statistically significant effect of lesion volume ≥18.5 cm3 on the risk of local recurrence was found. The iPFS and OS indicators after ASRS can be considered satisfactory for this group of patients.CONCLUSION: ASRS is an effective and perhaps optimal strategy for the treatment of large unresectable BM in patients with NSCLC, but comparison with other modern radiotherapy modalities such as stereotactic hypofractionated radiotherapy and WBRT with simultaneous integrated boost is needed.

Drought response strategies of vascular epiphytes in isolated pasture trees in a Costa Rican tropical montane landscape.

Vascular epiphytes of tropical montane cloud forests are vulnerable to climate change, particularly as cloud bases elevate and reduce atmospheric inputs to the system. However, studies have generally focused on epiphytes in contiguous forests, with little research being done on epiphytes on isolated pasture trees. We investigated water relations of pasture-tree epiphytes at three sites located below and above the elevation of the average cloud base in Monteverde, Costa Rica. We measured sap velocity and four microclimate variables in both the dry and wet season of 2018. We also measured functional traits, including pressure volume (PV) curves, predawn/midday water potential, and various lab-based water relations traits. We used linear mixed models to assess the correlation between microclimate and sap velocity in both seasons and ANOVA to assess the variation in PV curve and water potential variables. The turgor loss point generally increased from the wettest to driest site. However, this trend was driven primarily by the increasing prevalence of leaf succulence at drier sites. Microclimatic variables correlated strongly with sap velocity in the wet season, but low soil moisture availability caused this correlation to break down during the dry season. Our results emphasize the vulnerability of cloud forest epiphytes to rising cloud bases. This vulnerability may be more severe in pasture trees that lack the potential buffer of surrounding forest, but additional research that directly compares the canopy microclimate conditions between forest and pasture trees is needed to confirm this possibility.

Estimation of Systolic and Diastolic Left Ventricular Blood Flow From Derivatives of Transesophageal Echocardiographic 3D Volume Curves in Cardiac Surgery Patients: A Proof-of-Concept Study.

To examine whether estimates of peak global systolic (S') and diastolic (E') left ventricular (LV) flow rates based on 3D echocardiographic volumes are feasible and match physiology. In this retrospective feasibility study, we included patients undergoing major cardiac surgery. S' and E' were derived from 190 patients by taking the first derivative of the volume-time relationship of 3D ecg-gated transesophageal echocardiography (TEE) images. To examine the quality of images upon which the estimates of flow were based we correlated intraoperative 3D TEE and preoperative 2D transthoracic echocardiography (TTE) volumes. As a proof-of-concept, we then correlated S' flow with stroke volume and S' and E' were compared by valve pathology. In each of the 190 images, S' and E' were derived. There was good correlation between 1) the ejection fraction (EF) of 3D LV images obtained intraoperatively by TEE and preoperatively by TTE (Pearson's r = 0.65) and also 2) S' and stroke volume (Pearson's r = 0.73). Patients with aortic or mitral regurgitation showed higher S' than patients without valve pathologies (-315mL/s [95% CI -388mL/s to -264mL/s]P = 0.001, -319mL/s [95% CI -397mL/s to -246mL/s]P = 0.001 vs -242mL/s [95% CI -300mL/s to -196mL/s]). These patients also showed higher E' than patients without valve pathologies (302mL/s [95% CI 237mL/s to 384mL/s]P = 0.006, 341mL/s [95%CI 227mL/s to 442mL/s]P = 0.001 vs 240mL/s [95%CI 185mL/s to 315mL/s]). Patients with aortic stenosis showed no difference in S' or E' (-263mL/s [95%CI -300mL/s to -212mL/s]P = 0.793, 255mL/s [95%CI 188mL/s to 344mL/s]P = 0.400). Estimates of global peak systolic and diastolic LV flow based on 3D TEE are feasible, promising, and match valve pathologies.

Robotic-assisted versus laparoscopic-assisted extended mesorectal excision: a comprehensive meta-analysis and systematic review of perioperative and long-term outcomes.

Concurrent neoadjuvant chemo-radiation (nCRT) with total mesorectal excision (TME) alone sometimes fails to cure lateral lymph node metastasis (LLNM). Therefore, additional lateral lymph node dissection (LLND) can help in the treatment of these patients. This is what we refer to as extended total mesorectal excision (eTME). Such operations (TME alone or eTME) can be performed using conventional laparoscopic techniques and robotic-assisted techniques as well. Our meta-analysis aims to compare the results of robot-assisted (R-eTME) versus laparoscopic-assisted extended mesorectal excision (L-eTME) in terms of short- and long-term outcomes. Databases searched using title and abstract included Medline (via PubMed), Web of Science, Scopus, and Embase, up to February 20, 2024. All studies that documented robotic versus laparoscopic procedures for extended total mesorectal excision (R-eTME versus L-eTME) and reported more than two relevant outcomes, were included in the study. Our meta-analysis demonstrates four significant outcomes (operative time, urinary complications, overall recurrence, and admission days) between the laparoscopic and robotic groups. The robotic approach shows advantages over the laparoscopic approach in these outcomes except for the operative time (minute), which was longer in the robotic group compared to the laparoscopic group. The laparoscopic group is associated with a higher overall recurrence than the robotic group with an Odds Ratio of 2(95% CI, 1-4, p = 0.05). This meta-analysis study showed that the R-eTME group had a lower recurrence rate compared to the L-eTME group. Additionally, hospital admission days increased significantly in the laparoscopic group. Other long-term outcomes did not differ significantly between the two groups. Short-term outcomes were similar, except for more urinary complications in the laparoscopic group. In conclusion, the study suggests that robotic surgery may offer advantages over laparoscopic surgery for eTME. Further research and analysis could provide further insight into the potential benefits of robotic surgery in this procedure, particularly when surgeon experience, center volume, and learning curve are taken into consideration.

Evaluation of proudP A sound-based approach to uroflowmetry.

We sought to assess the performance of the proudP artificial intelligence (AI) algorithm, integrated into a mobile application, in estimating uroflow curves and parameters using recorded urination sounds. A direct comparison was made between the peak flow rate (Qmax), voided volume (VV), and uroflow curves predicted by the proudP algorithm and those obtained through established validation methods. A hardware uroflow simulator replicated uroflow profiles by precisely controlling water flow rates and extracting corresponding sound data. Ten uroflow profiles, representing typical patterns observed in male subjects, were selected. Simulation experiments with proudP were conducted using a standard toilet setup. The uroflow simulator was calibrated to reproduce uroflow profiles, and validation was performed against a Flowmaster uroflowmetry device. Statistical analysis included descriptive summaries, Bland-Altman analysis, and concordance correlation coefficient (CCC) analysis. The proudP accurately captured various uroflow patterns generated by the simulator, with low standard deviations in Qmax predictions and biases near zero. The standard deviations of voided volume were slightly larger, primarily due to uroflow patterns with extended voiding times. The study validated the accuracy of proudP against in-office uroflowmetry, demonstrating robustness across different smartphone models. ProudP proved to be as accurate as in-office uroflowmetry in estimating uroflow rate across various patterns. Its convenience in home monitoring offers patients a means to observe their urination patterns accurately, while enabling healthcare professionals to gain detailed insights remotely. ProudP emerges as an essential solution for clinical practice and urological research.

First-Principles insights to probe structural and opto-electronic properties of [formula omitted] (Y=Mg, Sr) halide perovskites with variety of DFT methods

First-Principles insights to probe structural and opto-electronic properties of [formula omitted] (Y=Mg, Sr) halide perovskites with variety of DFT methods