Diameter Measurements Research Articles

A single-pixel and non-redundant branching-based algorithm for nailfold capillary skeleton line extraction.

Static nailfold capillary parameters are important parameters that reflect the health of the human body. Disease onset or progression is often accompanied by changes in the physiological parameters of the nailfold. Hence, the physiological parameters of the nailfold are closely related to the study of disease, with their automated and high-precision measurements playing a crucial role in these studies. Currently, manually measured values of the nailfold's parameters are the gold standard; however, they are time consuming and labor intensive, making the development of automated measurement methods essential. Most automated measurement methods use skeleton lines; however, current skeleton-thinning algorithms have non-single pixels and redundant branches that lead to reduced measurement accuracy. This study proposes a single-pixel and non-redundant branching-based skeleton line extraction algorithm for nailfold capillaries, which is then applied to nailfold static parameter calculations to improve accuracy. The algorithm includes deletion and restoration templates combined with the depth-first search method to obtain single-pixel skeleton lines without redundant branches. These lines are applied to the static nailfold capillary parameter measurement method based on digital image processing to calculate the blood vessel diameter. The results show that the proposed method can obtain the single-pixel skeleton line without the redundant branches that are required for the parameter calculations and improve the accuracy of the nailfold capillary diameter measurement. Experiments showed that the root mean square errors (RMSEs) of the labeled apical diameter, arterial limb diameter, and venous limb diameter were 0.794, 0.756, and 0.830 µm, respectively, when the calculated results were compared with those of the manual calculations. According to the accuracy formula, the accuracy of the method in this study is 90%. We calculated the P values of the algorithmic and manual measurements to P<0.001 and found that the difference in the measurements of the proposed algorithm is statistically significant. Therefore, the method in this study has high sensitivity and specificity for the measurement of normal nailfold capillaries. The proposed algorithm could obtain single-pixel skeleton lines without redundant branches, thereby improving the nailfold static parameter measurement accuracy.

Novel multimodal sensing and machine learning strategies to classify cognitive workload in laparoscopic surgery

BackgroundSurgeons can experience elevated cognitive workload (CWL) during surgery due to various factors including operative technicalities and the environmental demands of the operating theatre. This can result in poorer outcomes and have a detrimental effect on surgeon well-being. The objective measurement of CWL provides a potential solution to facilitate classification of workload levels, however results are variable when physiological measures are used in isolation. The aim of this study is to develop and propose a multimodal machine learning (ML) approach to classify CWL levels using a bespoke sensor platform and to develop a ML approach to impute missing pupil diameter measures due to the effect of blinking or noise. Materials and MethodsTen surgical trainees performed a simulated laparoscopic cholecystectomy under cognitive conditions of increasing difficulty, namely a modified auditory N-back task with increasing difficulty and a verbal clinical scenario. Physiological measures were recorded using a novel platform (MAESTRO). Electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) were used as direct measures of CWL. Indirect measures included electromyography (EMG), electrocardiography (ECG) and pupil diameter (PD). A reference point for validation was provided by subjective assessment of perceived CWL using the SURG-TLX. A multimodal machine learning approach that systematically implements a CNN-BiLSTM, a binary version of the metaheuristic Manta Ray Foraging Optimisation (BMRFO) and a version of Fuzzy C-Means (FCM) called Optimal Completion Strategy (OCS) was used to classify the associated perceived CWL state. ResultsCompared to other state-of-art classification techniques, cross-validation results for the classification of CWL levels suggest that the CNN-BLSTM and BMRFO approach provides an average accuracy of 97% based on the confusion matrix. Additionally, OCS demonstrated a superior average performance of 9.15% in terms of Root-Mean-Square-Error (RMSE) when compared to other PD imputation methods. ConclusionPerceived CWL levels were correctly classified using a multimodal ML approach. This approach provides a potential route to accurately classify CWL levels, which may have application in future surgical training and assessment programs as well as the development of cognitive support systems in the operating room.

Effect of The Temperature on The Size of Inhibition Zone of the Clindamycin, Levofloxacin, Tetracycline, and Trimethoprim Activity Against Staphylococcus aureus ATCC 25923

Antibiotic sensitivity should be tested. In the sensitivity test, there are technical factors that influence the formation of the inhibition zone diameter. Based on several research one of the technical factors that affect the diameter of the inhibition in the disc diffusion method is the temperature incubation of the media, this must be examined so that it can be controlled to ensure the validity of the sensitivity test results. This study aims to determine the mean, difference, and analyze the diameter of the inhibition zone of the antibiotics namely Clindamycin, Levofloxacin, Tetracycline, and Trimethoprim against Staphylococcus aureus on Mueller-Hinton agar media with incubation temperatures of 33°C, 34°C, 35°C, 36°C and 37°C for 18 hours. This research is observational, with a cross-sectional design. The data used are primary data with 100 data on the diameter of the antibiotic inhibition zone, obtained by measuring the diameter of the inhibition zone with different incubation temperatures. The selection of antibiotics is based on the mechanism of action of antibiotics inhibiting bacteria namely, the cell wall or membranes that surrounds the bacterial cell; the machineries that make the nucleic acids DNA and RNA and the machinery that produce proteins (the ribosome and associated proteins) with a range of inhibition zones based on Internal Quality Control CLSI. The data will be processed univariately and the Repeated Measure statistical test to determine the significance of the difference in the diameter of the formed inhibition zone using the ANOVA test. The results of the measurement of the inhibition zone diameter on the incubation temperature variation showed a significant difference with p-value 0.000 for Levofloxacin, Tetracycline and Trimethoprim, while for p-value Clindamycin is 0.010. Levofloxacin, Tetracycline, and Trimethoprim antibiotics, the higher the incubation temperature, the average diameter of the inhibition zone is smaller, while for Clindamycin the higher the incubation temperature, the higher the average diameter of the inhibition zone is the same. There is an effect of incubation temperature volume on the diameter of the antibiotic inhibition zone in the disc diffusion method antibiotic sensitivity test. The research indicates that incubation temperature affects the diameter of the antibiotic inhibition zone in disc diffusion tests, underscoring the need for standardized and precise testing conditions to ensure accurate and reliable antibiotic sensitivity results.

Precision forestry: an open-source IoT digital caliper and app to simplify tree diameter measurements

Precision forestry: an open-source IoT digital caliper and app to simplify tree diameter measurements

Can tree hollow diameter be predicted? A study of native commercial trees in the eastern brazilian Amazon

The objective of this research was to test selected and validated generic and species-specific equations to estimate three different hollow diameter measurements in native commercial trees from a managed forest in the state of Pará, Brazil. A sample of 4,912 hollow trees, involving 29 species, was used to model the mean hollow diameter at tree level, and another composed of 3,867 hollow trees, belonging to 28 species, was used to model the mean hollow diameter of the first log of the commercial stem and the hollow diameter at the base of the tree. 30% of the two samples were previously randomly separated to validate the equations. The variables diameter at breast height (DBH), commercial height (hc), diameter of the log at the base of the tree (Db) and stem quality (SQ) were used in the modeling. In general, the models showed low adjusted coefficients of determination and the relevant standard errors of estimation. Despite this, validation indicated that the equations could generate accurate estimates. It has been found that it is more efficient, in terms of accuracy, to estimate the mean hollow diameter of the first log of the commercial stem, although it is more practical to estimate the hollow diameter at the base of the tree. Compared to generic equations, specific equations can generate more accurate estimates. Therefore, the hollow diameter in commercial trees can be estimated as a function of variables obtained from the forest inventory, and the best strategy is the use of species-specific equations to estimate the average hollow diameter in the initial portion of the commercial stem.

Comparison of ultrasound assisted and intraoperative diameter measurement in acute appendicitis.

Detailed anamnesis and systematic physical examination are often relevant in the diagnostic routine of acute appendicitis. However, physicians are increasingly motivated to obtain radiological approval. Inherent limitations due to radiologists' experience and the presenting anatomy may result in contradictory outcomes between the described and intraoperative findings. In this study, a comparison of anthropometric measurements of the appendix vermiformis obtained by radiologists and surgeons in children with acute appendicitis is discussed. The external appendiceal diameter in 53 patients who underwent surgery between April 2022 and January 2024 was measured at three different anatomical locations during preoperative ultrasound and intraoperatively with the help of Vernier calipers. Appendectomy materials were classified into negative, acute, and complicated appendicitis subgroups on the basis of histopathological results. The widest median diameter, expressed in millimeters, was analyzed statistically in terms of diagnostic accuracy. Histopathological analysis revealed negative appendectomy in 15.1%, acute appendicitis in 66%, and complicated appendicitis in 18.8% of the patients. The median age at presentation was 11.4 years (4-17.3 years), and 45.3% of the patients were females. The average median appendiceal diameter was 7.8 ± 2.4 mm according to the caliper and 7.9 ± 2.7 mm according to ultrasound (p > 0.05). The evaluation by the caliper revealed a much smaller diameter in 19 patients than did ultrasound. The appendiceal diameter of eight documented negative appendectomy samples was 7 mm or greater. US failed to identify the presence of an appendicolith in 11 cases (20.8%), all of which were disclosed during histopathological evaluation. It is possible to conclude that ultrasound and intraoperative anthropometric measurements correlate according to our study. Diagnostic accuracy, however, which is individually based on ultrasound appendix diameter values greater than 6 mm, is controversial. It is clear that comparison and further reinterpretation of such anthropometric measurements in light of histopathological consequences may help diminish the frequency of negative and perforated appendectomies.

Cold Pressor Test Induces Significant Changes in Internal Jugular Vein Flow Dynamics in Healthy Young Adults.

BACKGROUND The cold pressor test (CPT), which has long been used to test autonomic functions by causing sympathetic excitation, increases systolic and diastolic blood pressure and heart rate and causes coronary vasodilation within physiological limits in healthy individuals. This study aimed to evaluate internal jugular vein (IJV) flow parameters using the CPT with systolic and diastolic blood pressure and heart rate in 40 healthy volunteers aged 18-40 years. MATERIAL AND METHODS The volunteers' IJV diameter, blood flow peak velocity, and volumetric flow values were recorded. Then, their right hands were immersed in a bucket of cold water maintained at 1°C up to the wrist level. At the end of the first minute (CPT-1), systolic and diastolic blood pressure, heart rhythm, IJV diameter, peak velocity, and volumetric flow measurements were performed again. RESULTS Systolic and diastolic blood pressure values were significantly higher at CPT-1 compared to baseline values (P<0.001, P<0.001). Heart rate and peak velocity values also showed a significant increase at CPT-1 compared to baseline values (P<0.001, P=0.001). While diameter values showed a significant decrease compared to baseline, volumetric flow rate values showed a significant increase at CPT-1 (P=0.003, P<0.001). CONCLUSIONS Sympathetic nervous system activation triggered by CPT increases IJV volumetric flow and flow velocity in healthy young individuals, and sympathetic nervous system activation causes a venoconstrictive effect in the IJV.

Application of the Optical Fiber Diameter Analyzer for Assessing Cotton Fiber Ribbon Width

ABSTRACT Existing methods for measuring fineness are time-consuming, tedious, and impractical to evaluate many samples. For this reason, the Textile Industry has sought a rapid, accurate, and reliable instrument to determine fiber fineness. Recently, the Optical Fiber Diameter Analyzer (OFDA) was introduced for rapid and precise evaluation of the diameter of different types of fibers. In this study, the OFDA was evaluated for measuring the ribbon width of cotton fiber snippets. One hundred and four carded cotton samples covering a wide range of fiber properties were selected and tested with nine replications per sample. The repeatability of the OFDA diameter measurement was confirmed. Comparisons with the data (cross-sections, AFIS, and Cottonscope) obtained from previous studies on the 104 samples were used to assess the effectiveness of the proposed method. The relationship between ribbon widths measured by Cottonscope and OFDA was found to be weak. Yet, there is a strong correlation between OFDA ribbon width and AFIS standard fineness. We hypothesize that the poor relationship between the Cottonscope and the OFDA is related to the medium in which the measurements are performed. The results are stable and provide measurements closely related to AFIS standard fineness, a trusted measurement within the Textile Industry.

Ultrasonographic Measurement of Optic Nerve Sheath Diameter in Patients with Traumatic Head Injury: A Prospective Observational Study

Introduction: The early detection of elevated intracranial pressure is crucial for guiding interventions and improving patient outcomes in head injury patients. The intracranial pressure assessment with invasive intracranial devices is the gold standard. These devices however has a risk of infection, bleeding and dislodgement. Optic nerve sheath diameter measurement using ultrasonography has emerged as a promising method for indirect intracranial pressure estimation. Aims: To observe the changes in optic nerve sheath diameter over period of time, and to correlate the optic nerve sheath diameter with computed tomography findings of raised intracranial pressure in traumatic head injury. Methods: A prospective cross-sectional time series study was conducted at Nepalgunj Medical College to assess the utility of ultrasonography measurement of optic nerve sheath diameter in patients with head injuries from August 2023 to January 2024. Forty-nine patients with head injuries were included in the study. The ultrasonographic optic nerve sheath diameter measurements were obtained at admission, 48 hours post-admission, and 1 month post-head injury. The clinical parameters including Glasgow Coma Scale and radiological findings from Computed Tomography head were recorded. Results: Forty nine patients were enrolled in the study. Among them, 44.90% (27) were male and 55.10% (22) were female. Age ranged from 5 to 66 years, with a mean of 33.94 ± 15.27 years. The mean optic nerve sheath diameter was 5.24±0.86 mm at admission which decreased to 4.31±0.62 mm at 48 hours and 4.02±0.47 mm at 1 month. Our study showed significant reduction in optic nerve sheath diameter after conservative or surgical treatment in patients with head injury (F = 27.017; P =0.002) Conclusion: The ultrasonographic measurement of optic nerve sheath diameter proved to be a valuable tool in monitoring intracranial pressure in patients with head injuries.

Heavy ion detection in thermally and non-thermally treated CR-39 detectors: Fission fragment ranges and etchable track lengths

For the first time, etched track diameter and over-etched track diameter (OETD) measurements have been used to determine etchable track lengths in thermally treated poly allyl diglycole carbonate (PADC) in the form of CR-39, as well as heavy ion track ranges in non-thermally treated samples. These heavy ions are produced spontaneously from 252Cf radioactive source as fission fragments. Isochronal heating experiment was conducted on CR-39 detectors prior to their irradiation to 252Cf radioactive source. In a reverse sequence, another set of detector films was first subjected to 252Cf irradiation and then thermally treated as described above. The diameters of etched heavy ion tracks in non-thermally treated and thermally treated CR-39 detectors have been measured as a function of etching time at different heating temperatures and times. The fission fragment ranges in non-thermally treated CR-39 detectors determined using the OETD method were found to be 17.7 ± 0.2 μm for the heavy group and 21.8 ± 0.3 μm for the light group, whereas the etchable track lengths in thermally treated detectors are by far lesser than that those of non-thermally treated ones. The results of heavy ion ranges in non-thermally treated detectors are in excellent agreement with theoretical calculations based on SRIM code. While in the case of the etchable track lengths of these heavy ions in thermally treated detectors, there is no such theoretical data for comparison with experiment till present.

The Predictive Value of Preoperative Measurements of Cochlear Nerve Diameters From MRT and Postoperative Speech Perception in Adult Patients With Cochlear Implant.

The current study aims to investigate whether objective measurements of the cochlear nerve (CN), derived from preoperative MRI images, correlate with postoperative speech perception in CI patients. Retrospective cohort study. University Medical Center, tertiary academic referral center. Patients undergoing a cochlear implant surgery including MED-EL (Synchrony 2, FLEX electrode series; MED-EL, Innsbruck, Austria) Cochlear (slim straight electrodes; Cochlear Ltd., Sydney, Australia), Advanced Bionics (HiRes Ultra 3D CI, HiFocus SlimJ electrodes; Sonova, Zürich, Switzerland), and Oticon (Neuro Zti EVO; Oticon A/S, Smørum, Denmark) between 2020 and 2023. Preoperative MRI images were utilized to measure the volume of the modiolus (VM), the cross-sectional areas of the CN (ACN), and for normalization, the area of the facial nerve (AFN) and the area of the internal ear canal (AIEC). Postoperative speech perceptions were assessed through word recognition scores (WRS) at several stages following the first fitting (FF) of the CI processor: immediately after FF, 1 month, 3 months, and 6 months after FF. Sixty-eight patients were enrolled in this study. A statistically significant positive correlation between the ratio between ACN and AFN (ACN/AFN) and WRSFF was identified (R = 0.36, p < 0.003). However, this correlation disappeared in subsequent follow-up tests. Moreover, upon grouping patients based on their degree of asymmetrical hearing loss, it was observed that the correlation was primarily driven by patients with moderate to severe asymmetrical hearing loss (AHLm) on the contralateral side (R = 0.62, p = 0.0003). The present results suggest that assessing the size of the CN through MRI has limited predictive utility for postoperative speech perceptions during CI consultations. This limitation seems to be particularly relevant for AHLm patients and is confined to the initial activation period.

Predicting 3D and 2D surface area of corals from simple field measurements

The structural architecture of coral reefs is a known predictor of species richness, fish biomass and reef resilience. At a smaller scale, three-dimensional (3D) surface area of corals is a fundamental determinant of physical and biological processes. Quantifying the 3D surface area of corals has applications for a broad range of scientific disciplines, including carbonate production estimates, coral predation studies, and assessments of reef growth. Here, we present morphotaxon-specific conversion metrics to estimate total 3D surface area and projected 2D surface area of individual colonies from simple field measurements of colony maximum diameter. Underwater photogrammetry techniques were used to quantify surface area and estimate conversion metrics. Bayesian models showed strong non-linear (power) relationships between colony maximum diameter and both total 3D surface area and projected 2D surface area for 13 out of 15 morphotaxa. This study presents a highly resolved and efficient method for obtaining critical surface area assessments of corals for various applications, including assessments of biotic surface area, tissue biomass, calcification rates, coral demographic rates, and reef restoration monitoring.

Modelling branch surface area of Fagus sylvatica L.

ABSTRACT Allometric models describe properties of trees that are difficult to measure. Here, we provide a set of allometric models for estimating branch properties for European beech (Fagus sylvatica L.). Branches affect rainfall and snow interception, provide habitat for other organisms and contribute to the economic and aesthetic value of trees. Using randomized branch sampling (RBS) of 27 beech trees in Austria we developed models for branch surface area, branch number, branch base diameter and branch length, depending on stem diameter, tree height and crown ratio. For individual branches, branch diameter was the best predictor of branch surface area while including branch length or position along the stem did not improve the models. For the entire tree, stem diameter was the most important predictor. Branch surface area (and in consequence also branch volume) assessed by RBS was greater than the branch surface area estimated as a cylinder from measurements of branch length and branch base diameter. Since the branch allometry of beech differs considerably from a previous study on branches of Picea abies, we conclude that assumptions and models derived from other tree species can lead to considerable biased results in assessing the functions of tree branches.

Ophthalmic findings and reference values for selected ocular parameters in whooping cranes (Grus americana) and Mississippi sandhill cranes (Grus canadensis pulla).

To establish baseline ophthalmic parameters for an endangered, semi-wild population of healthy whooping cranes (Grus americana) (WHCR) and Mississippi sandhill cranes (Grus canadensis pulla) (SACR). Eighteen WHCR and 16 SACR. Ophthalmic examination was performed by a single observer, followed by conjunctival swab collection for aerobic bacterial culture and measurement of tear production (phenol red thread test, PRTT) and corneal diameter (CD) as tolerated. Measurement of the axial globe (AG) length, anterior chamber (AC) depth, lens thickness, vitreous chamber (VC) depth, and pecten length was performed via ocular ultrasound (OUS) as tolerated. Eyelid cicatrization (n = 1 WHCR), keratitis (n = 2 WHCR), incipient cataracts (n = 1 WHCR, n = 4 SACR), and uveal cysts (n = 1 SACR) were identified. Twenty-one bacterial species were cultured from SACR, while 18 bacterial species were cultured from WHCR. SACR under 6 months old had increased PRTT values compared to older SACR (p = .0432). AG length and VC depth of male WHCR were greater than in female WHCR (p = .0045 and p = .0008, respectively). WHCR less than 6 months old had greater AC depth and lens thickness than WHCR over 6 months (p < .001 and p = .0013, respectively). SACR less than 6 months old had greater AC depth and lens thickness than WHCR over 6 months (p < .0001 and p < .0001, respectively). WHCR and SACR are amenable to complete ophthalmic examination. Age-related differences in PRTT in SACR, sexual dimorphism in WHCR, and age-related differences in AC depth and lens thickness in WHCR and SACR were identified.

O39 IMPACT OF UROMODULIN CONCENTRATION ON RENAL AND HAEMODYNAMIC PARAMETERS IN A BLACK AFRICAN COMMUNITY WITH A HIGH PREVALENCE OF HYPERTENSION

Background and Objective: The burden of hypertension (HTN) and related comorbidities disproportionately affects developing countries like South Africa, particularly in urban populations of African ancestry. This demographic exhibits a volume-dependent form of HTN that is resistant to antihypertensive drugs that target the renin-angiotensin-aldosterone system. Renal fluid retention or abnormalities may cause HTN in this group, thus the need to investigate various nephron components for a better understanding. Uromodulin is a potential biomarker for renal function and tubular reserve. However, the relationship with renal function, haemodynamic parameters and HTN in a Black African population is unknown. Therefore, the aim of this study was to explore the relationship between urinary uromodulin concentration and renal as well as haemodynamic parameters in a Black African community with a high prevalence of volume-dependent HTN. Methods: Systemic haemodynamics (central pressures [SphygmoCor] and echocardiographic aortic velocity and diameter measurements in the outflow tract), urinary uromodulin concentrations (ELISA assay) and renal function (creatinine clearance from 24-hour urine collections [n=370]) were determined in a Black African community (n=397). Results: No relationships between urinary uromodulin concentrations and age, body mass index, blood pressure or hypertension were noted. However, urinary uromodulin concentrations were higher in females than males, even after adjusting for several confounders (p=0.0007). Although urinary uromodulin concentrations were unrelated to renal function, an inverse relationship with stroke volume (SV) was observed (p=0.0023). The inverse relationship between SV and urinary uromodulin concentration was independent of confounders and present in hypertensives (p=0.007) but not normotensives (p=0.43). The hypertensives were noted to have a higher SV than the normotensives (p=0.047). Conclusion: In a Black African community sample with a high prevalence of volume-dependent primary hypertension, urinary uromodulin was inversely related to SV, particularly in participants with hypertension. These data suggest the need to investigate the mechanisms linking urinary uromodulin to haemodynamic parameters to identify novel pathways to target for better treatment strategies in hypertension.

Insights into the bZIP gene family in Osmanthus fragrans and the role of OfbZIP98 in the callus and flower

Osmanthus fragrans has important ornamental and economic value. As the callus re-differentiation process is difficult, a genetic transformation system has not been successfully established in O. fragrans. The basic leucine zipper (bZIP) transcription factors play an important role in plant growth and development. A total of 116 OfbZIP genes were identified in O. fragrans using bioinformatics methods. According to the evolutionary relationships, these genes were divided into 12 subfamilies and were found to be unevenly distributed on 23 chromosomes of O. fragrans. The quantitative real-time PCR results showed that the expression trend of OfbZIP98 was consistent with the proliferation of O. fragrans callus. The subcellular localization and yeast self-activation results showed that OfbZIP98 was localized in the nucleus and had self-activation activity. Further, phenotypic observation of over-expressed tobacco showed that compared with the wild type (WT), the transgenic strain formed callus 4 d earlier, and callus re-differentiation began on day 15. Analysis of the callus differentiation rate showed that after 20 d of culture, the differentiation rate of the leaf callus of the transgenic strain was about twice that of the WT plants. In addition, measurements of corolla diameter, corolla circumference, corolla area, and corolla tube diameter indicated that the petals of the transgenic strain were significantly larger than the WT plants. Our results showed that OfbZIP98 has the important function of promoting callus growth, re-differentiation, and flower organ enlargement. These findings provide new insights into the potential role of OfbZIP98 in the growth and development of O. fragrans.

Effect of Levobupivacaine Hydrochloride-Loaded Nanospheres on Delayed Cerebral Vasospasm Following Subarachnoid Hemorrhage in Rabbits

This research was aimed to analyze the mechanism of action of levobupivacaine hydrochloride-loaded nanospheres on delayed cerebral vasospasm following subarachnoid hemorrhage (SAH). Levobupivacaine hydrochloride-loaded nanospheres (LevoBPV Hcl/PLGA) were prepared using the solvent evaporation methodology, with the raw material as a control. The blood drug concentrations were detected by HPLC after subcutaneous and subarachnoid administration in experimental rabbits. Forty New Zealand white rabbits were randomly assigned into Sham group, SAH group, LevoBPV Hcl group (10 mg/kg), and LevoBPV Hcl/PLGA group (10 mg/kg), with 10 rabbits in each group. The SAH model was induced using the double blood injection methodology combined with internal carotid artery ligation. Brain tissue samples were collected on day 7 for pathological characterization, determination of neuronal apoptosis, and measurement of basilar artery diameter and area. The levels of oxidative stress factors (superoxide (SOD), malondiadehyde (MDA), glutathione peroxidase (GSH-Px)) and vasoconstrictor factors (nitric oxide (NO), endothelin-1 (ET-1)) in the cerebrospinal fluid (CSF) were detected using assay kits. The results revealed that the drug loading capacity of LevoBPV Hcl/PLGA was 29.13%, encapsulation efficiency was 87.09%, and the average particle size was 81.43 μm. Under the same dosage, both subcutaneous and subarachnoid administration of LevoBPV Hcl/PLGA exhibited two concentration peaks in the blood drug concentration, with lower concentration values versus LevoBPV Hcl group, and a longer average residence time than LevoBPV Hcl group (P &lt; 0.05). Relative to Sham group, SAH group exhibited decreased diameter and area of the basilar artery, reduced neuronal density, increased neuronal apoptosis rate, decreased levels of SOD, GSH-Px, and NO in the CSF, and increased levels of MDA and ET-1 (P &lt; 0.05). Moreover, LevoBPV Hcl group and LevoBPV Hcl/PLGA group showed increased diameter and area of the basilar artery, higher neuronal density, reduced neuronal apoptosis rate, elevated levels of SOD, GSH-Px, and NO in the CSF, and decreased levels of MDA and ET-1 versus SAH group (P &lt; 0.05). The LevoBPV Hcl/PLGA group exhibited increased diameter and area of the basilar artery, higher neuronal density, reduced neuronal apoptosis rate, elevated levels of SOD, GSH-Px, and NO in the CSF, and decreased levels of MDA and ET-1 versus LevoBPV Hcl group (P &lt; 0.05). In short, LevoBPV HCl-loaded nanospheres can prolong the in vivo residence time of subcutaneous and subarachnoid administration, reduce the maximum blood drug concentration, and enhance drug safety. Furthermore, these nanospheres can inhibit neuronal apoptosis following SAH, regulate oxidative stress and vasoconstrictor factor expression, thereby suppressing the occurrence of delayed cerebral vasospasm and alleviating brain tissue damage.

The effect of per-oral endoscopic myotomy by achalasia subtype as measured by impedance planimetry.

Achalasia is an esophageal motility disorder with three subtypes based on manometry that can treated with per-oral endoscopic myotomy (POEM). With the advent of impedance planimetry (EndoFLIP®), we hypothesized the three achalasia subtypes would have different pre-POEM EndoFLIP® diameter and distensibility index (DI) measurements but would be similar after POEM. A single-institution, retrospective review of consecutive POEM cases by a single surgeon-endoscopist team from 04/07/2017 to 08/28/2023. Patients with a diagnosis of achalasia were stratified into type 1, 2, or 3 based on pre-POEM manometry. Patient characteristics, Eckardt scores, and pre-and-post-POEM diameter and DI were compared by subtype with descriptive, univariate, and multivariable linear regression statistics. Sixty-four patients met inclusion criteria, of whom 9(14.1%) had Type 1, 36(56.3%) had Type 2, and 19(29.7%) had Type 3. There were no differences between Types with respect to median pre-POEM Eckardt scores (9[IQR:7-9) vs. 8[IQR:6-9] vs. 7[IQR:5-8], p = 0.148), median post-POEM Eckardt scores (0[IQR:0-1] vs. 0[IQR:0-0] vs. 0[IQR0-0.5], p = 0.112). EndoFLIP® data revealed variation in median pre-POEM diameter and DI between Subtypes (6.9[IQR:6-8.5] vs. 5.5[IQR:5-6.8] vs. 5[IQR:5-6.1], p = 0.025 and 1.8[IQR:1.3-3.2] vs. 0.9[IQR:0.6-1.6] vs. 0.6[IQR:0.5-0.8], p = 0.003, respectively), but not in the change in diameter or DI post-POEM (5.1[IQR:4.3-5.9] vs. 5.1[IQR:4.1-7.1] vs. 5.9[IQR:5-6.4], p = 0.217 and 3.9[IQR:2.5-4.7] vs. 3.4[IQR:2.4-4.7] vs. 2.7[IQR:2.3-3.7], p = 0.461, respectively). However, after adjusting for potentially confounding factors, pre- or post-POEM diameter and DI did not demonstrate statistically significant differences among subtypes. Achalasia subtypes did not demonstrate different pre-POEM diameters or DI as measured by EndoFLIP® nor are there differences after POEM completion. While achalasia subtypes may have slightly different pathophysiology based on manometry findings, similar pre- and post-POEM impedance planimetry findings, along with similar Eckardt scores, support the use of POEM in the treatment of any achalasia subtype.

Morphometry of adult cricoid cartilage in Nepalese cadavers: a cross-sectional observational study

Background: Cricoid cartilage is crucial during endotracheal intubation, yet its dimensions in the Nepali population remain uncharacterized. This study aimed to measure cricoid cartilage dimensions in adult Nepalese. Methods: A total of 105 cadavers (75 males, 30 females) were dissected at *** Medical Campus, Nepal. Measurements of outer and inner transverse and anteroposterior diameters, as well as heights of the cricoid arch and lamina, were taken using digital vernier calipers. Statistical analyses included gender comparisons and correlations with age. Results: The mean age of the 105 cadavers studied was 34.11 years (SD = 12.08). The measurements of outer anteroposterior diameter, outer transverse diameter, inner anteroposterior diameter, inner transverse diameter, arch height and lamina height were respectively 22mm (SD=4), 21mm (SD=4), 18mm (SD=3), 17mm (SD=3), 9mm (SD=3) and 24mm (SD=4). Inner AP (p = 0.009) and inner TR (p = 0.021) measurements correlated significantly with age. Males had significantly larger cricoid cartilage dimensions than females (p &lt; 0.001). Conclusions: This study provided essential data for selecting appropriately sized endotracheal tubes in Nepalese patients, reducing airway complications. It underscored the need to tailor medical devices to local anatomical variations, supporting advancements in biomechanical modeling and medical research.

Predicting resistance and pseudoprogression: are minimalistic immunoediting mathematical models capable of forecasting checkpoint inhibitor treatment outcomes in lung cancer?

Background:The increased application of immune checkpoint inhibitors (ICIs) targeting PD-1/PD-L1 in lung cancer treatment generates clinical need to reliably predict individual patients’ treatment outcomes. Methods:To bridge the prediction gap, we examine four different mathematical models in the form of ordinary differential equations, including a novel delayed response model. We rigorously evaluate their individual and combined predictive capabilities with regard to the patients’ progressive disease (PD) status through equal weighting of model-derived outcome probabilities. Results:Fitting the complete treatment course, the novel delayed response model (R2=0.938) outperformed the simplest model (R2=0.865). The model combination was able to reliably predict patient PD outcome with an overall accuracy of 77% (sensitivity = 70%, specificity = 81%), solely through calibration with primary tumor longest diameter measurements. It autonomously identified a subset of 51% of patients where predictions with an overall accuracy of 81% (sensitivity = 81%, specificity = 81%) can be achieved. All models significantly outperformed a fully data-driven machine learning-based approach. Implications: These modeling approaches provide a dynamic baseline framework to support clinicians in treatment decisions by identifying different treatment outcome trajectories with already clinically available measurement data. Limitations and future directions:Conjoint application of the presented approach with other predictive tools and biomarkers, as well as further disease information (e.g. metastatic stage), could further enhance treatment outcome prediction. We believe the simple model formulations allow widespread adoption of the developed models to other cancer types. Similar models can easily be formulated for other treatment modalities.