Blood Leakage Research Articles

Dissolution of clotted blood from slaughtered cattle by alkaline protease produced by Streptomyces violaceoruber isolated from saline soil in Saudi Arabia

Saudi Arabia suffers from the spread of diseases linked to clotted blood leaking from slaughtered livestock. Anticoagulant proteases produced by Streptomyces are used to safely dissolve clotted blood. Halophilic Streptomyces isolates were extracted from saline soil in Saudi Arabia and tested to dissolve clotted blood by protease. The most protease-producing isolate was identified using classical and genetic methods. The protease was precipitated with saturated ammonium sulfate from a batch of blood clots inoculated with the most protease-producing isolates. Streptomyces isolates (410) were recovered from thirty saline soil samples collected from Dammam (170 isolates, 41.4 %), Al-Khobar (126 isolates, 30.8 %) and Al-Ahsa (114 isolates, 27.8 %). Proteolytic activity was observed in 305 isolates including the most protease-producing isolate S295, which showed the highest activity (33.8 mm), and was identified as S. violaceoruber (99 % similarity). Among all isolates, 241 showed partial hemolysis (alpha) and 64 showed complete hemolysis (beta), including isolate S295 that presented the highest hemolytic activity (0.58 %). The alkaline protease was precipitated with saturated ammonium sulfate (60 %), and it was found that its activity was 5.2 U/ml, total activity 24,960 U/ml, specific activity 463 U/mg, purification fold 15.2 and yield 78 %. The purified alkaline protease was electrophoresed as a single band at 45 kDa.

Linkage of Diabetic Retinopathy with Blood Antioxidants and Gut Microbiota in Type Two Diabetes Mellitus Saudi Patients

Background: The retina is a light-sensitive nerve layer located at the back of the eye that creates images of objects. These cells kept alive by getting oxygen and nutrients from tiny blood vessels in the eye. Retinopathy is a disease of the retina that is more prevalent in type 2 diabetes mellitus patients. Diabetic retinopathy is a leading cause of blindness because hyperglycemia weakens retinal capillaries, resulting in leakage of blood into the surrounding space. This bleeding can result in formation of scar tissue, which can cause traction retinal detachment and maculopathy. The development of a panel of blood biomarkers to monitor diabetic retinopathies is essential for both diagnosis and prognosis. Proteomics as a powerful tool for the analysis of complex mixtures of proteins and the identification of biomarkers can be of great importance. Purpose: To detect early nerve fiber layer changes around macula and optic disc in diabetic patients and to correlate diabetic retinopathy with blood antioxidants and gut microbiota in T2DM in Saudi patients. Materials and Methods: In this cross-sectional case-control study, a total of 77 eyes of 39 subjects aged 40-60 years who did not have any history of eye injuries or eye diseases affecting fundus viewing, were recruited from King Saud University Campus and the department of ophthalmology in King Abdul Aziz university hospital in Riyadh. All subjects underwent full ophthalmic examination including Peripapillary retinal nerve fiber layer thickness and macular profile, Proteomic approach of collected overnight fasting plasma and Microbial stool examination. Results: The nerve fiber layer thickness around the optic disc was measured for all groups and there was no statistically significant difference in all quadrants between groups. The total retinal thickness at the macular area was different among all groups and tends to increase in group 3 due to diabetic retinopathy. The macular thickness in the 4 quadrants revealed no statistical difference except in the inferior quadrant. Glutathione S transferase and lipid peroxides showed no significant difference between the three studied groups; vitamin C and Glutathione were surprisingly higher in controlled diabetic patients relative to controls. Moreover, over growth of bacteroids participated to the evolution of retinopathy in diabetic patients. Conclusion: As hyperglycemia and oxidative stress are implicated in the pathogenesis of diabetic retinopathy, the present study certified that the progressive damage can be delayed in controlled type 2 diabetic patients using different treatment modalities that subside oxidative stress.

Intraplatelet Calcium Signaling Regulates Thrombus Growth under Flow: Insights from a Multiscale Model

In injured arteries, platelets adhere to the subendothelium and initiate the coagulation process. They recruit other platelets and form a plug that stops blood leakage. The formation of the platelet plug depends on platelet activation, a process that is regulated by intracellular calcium signaling. Using an improved version of a previous multiscale model, we study the effects of changes in calcium signaling on thrombus growth. This model utilizes the immersed boundary method to capture the interplay between platelets and the flow. Each platelet can attach to other platelets, become activated, express proteins on its surface, detach, and/or become non-adhesive. Platelet activation is captured through a specific calcium signaling model that is solved at the intracellular level, which considers calcium activation by agonists and contacts. Simulations reveal a contact-dependent activation threshold necessary for the formation of the thrombus core. Next, we evaluate the effect of knocking out the P2Y and PAR receptor families. Further, we show that blocking P2Y receptors reduces platelet numbers in the shell while slightly increasing the core size. An analysis of the contribution of P2Y and PAR activation to intraplatelet calcium signaling reveals that each of the ADP and thrombin agonists promotes the activation of platelets in different regions of the thrombus. Finally, the model predicts that the heterogeneity in platelet size reduces the overall number of platelets recruited by the thrombus. The presented framework can be readily used to study the effect of antiplatelet therapy under different physiological and pathological blood flow, platelet count, and activation conditions.

Evaluation of a Safety-Engineered Peripherally Inserted Intravenous Catheter With Multiple Access Blood Control: Clinician Acceptability and Ease of Use

Highlights Abstract Aim: Acceptability of a new safety-engineered peripherally inserted intravenous catheter (PIVC) with multiple access blood control (MBC) was evaluated in this observational study by experienced volunteer clinicians on healthy volunteers. Methods: Clinicians and healthy volunteers were recruited for this study. Observers documented study procedures, including if there was any blood leakage from the catheter hub at various times during hub connections and disconnections and how many attempts it took a clinician to get a successful stick. Clinicians responded to yes-or-no and Likert-scale questionnaires describing their experiences with PIVC with MBC after each procedure. Questionnaire data were summarized by frequency and percent of responses; analyses were conducted using binomial statistics. Results: Overall, clinicians considered PIVC with MBC to be acceptable (93.6% agreement). Clinicians were able to easily remove the catheter protective cap, insert the catheter, visualize primary and secondary flashbacks, easily remove the needle from the catheter hub and determine if the safety clip was activated after withdrawing the needle. In addition, they were able to connect or disconnect and flush extension sets. Clinicians did not have to change their insertion technique, found the catheter easy to insert, and believed the catheter would protect them from blood exposure during insertion of the catheter and subsequent hub accesses (agreement ranged from 82.3% to 98.9%). Conclusions: No blood leakage was observed from the catheter hub at any time during the procedures. Overall, clinicians found the new PIVC with MBC to be acceptable, easy to use, and functioned properly.

Diagnostic Wearable Sensing Device for Blood Leak Detection during Hemodialysis Using an Array Sensing Patch

One important medical procedure that necessitates puncturing the skin is hemodialysis (HD). But there is a serious chance that blood will spill from a dislodged needle, endangering the lives of the patients. Numerous devices that use optical or electrical methods to identify blood loss during HD have been proposed in the past. Sadly, multi-bed monitoring was not feasible with these techniques, which were limited to single-point detection only. An array-sensing patch has been proposed as a novel wearable device to monitor blood loss during HD in response to these restrictions. Risk levels can be measured and transmitted using the array sensing patch in conjunction with a wireless module and mapping circuit. This has the potential to greatly improve health care worker productivity and eliminate erroneous risk levels. In addition to lowering false alarms, this can greatly improve health care personnel' productivity. Extensive experimentation results show that up to 0.1 mL of blood loss can be detected a teach spot in the sensing array. In addition, the array sensing patch includes an 8-hour risk level monitoring system, which notifies medical staff of relevant patient danger. A more effective and efficient means of monitoring blood leakage and potentially saving lives, the suggested device is a game-changer in the field of hemodialysis.

An In-Vitro Comparison of Steady State Leakage Rates through Introducer Sheaths Used for Fenestrated Endovascular Aortic Aneurysm Repair

Objectives– fEVAR involves deploying a covered stent into the aorta followed by multiple visceral stents through fenestrations in the main body of graft. The most commonly used large sheaths for cannulation of visceral vessels are the Gore DrySeal Flex, Cook Performer Check-Flo and Medtronic Sentrant. None of these sheaths were designed for the insertion of multiple sheaths, and so a slow but steady leakage of blood occurs during the procedure. The aim of this paper is to assess in an in vitro setting which large bore sheath has the best valve for use when multiple smaller sheaths are inserted through it. MethodsThree large bore introducer sheaths (LBIS) were used for this study, The Gore DrySeal Flex LBIS, Medtronic Sentrant LBIS and Cook Performer Check-Flo LBIS. A test rig was constructed, made of an 18-litre fluid reservoir mounted vertically and receiving a constant supply of water from a domestic water supply which flowed into the reservoir and out of an overflow. The reservoir was connected to the LBIS by a vertical plastic pipe with an internal diameter of 40mm and an isolation valve. The LBIS was connected to the isolation valve by inserting the LBIS up a flexible silicone tube connected to the isolation valve. The LBIS was subject to a constant column/pressure of water and fluid leakage from the LBIS was collected in a plastic pot/tray placed underneath the LBIS. The leakage rates through each LBIS were determined for the following smaller diameter sheath combinations inserted through the valve, one 6 French Sheath, two 6 French Sheaths, two 6 French Sheaths and one 7 French Sheath. This was done to closely mimic a fEVAR procedure in vitro. The procedure was to insert different sheath combinations through the non-return valves in the LBIS and measure the volume of fluid that leaked through the valves. The leaked fluid was weighed, and the weight was converted to volume using the density of water (1g/ml). ResultsThe average (mean) leakage rates for each LBIS and each sheath combination showed that leakage rates when only one sheath was inserted were very low. For all three LBIS’s tested, the leakage rates increased dramatically when multiple sheaths were inserted. The Medtronic LBIS leaked the most, followed by Cook, followed by Gore. For the Cook LBIS, the leakage rates exhibited with 2 x 6 French sheaths were approx. 106 times greater than those for the Gore LBIS and five times greater for the 2 x 6 French + 1 x 7 French sheath combination. A similar comparison for the Medtronic LBIS vs the Gore LBIS yields factors of 132 and 8. ConclusionsLeakage rates increase significantly when multiple sheaths are inserted and the Gore LBIS demonstrates significantly lower leakage than both the Cook and Medtronic during procedures that require simultaneous, multiple insertions of smaller sheaths. Although the Gore Dryseal has by far the lowest leakage rate when three small diameter sheaths are inserted (just under 1ml/s), depending on the duration of the procedure this could still result in significant blood loss.

FETAL 3D-ECHO CLASSIFICATION AND SEGMENTATION USING COLOR AND TEXTURAL FEATURES FOR TR DETECTION

Tricuspid regurgitation (TR) is a condition in which the valve between the right atrium and right ventricle does not close properly. Therefore, blood leaks backward into the upper right chamber. Most commonly, tricuspid regurgitation is caused by an enlarged right ventricle. In this paper, a novel deep learning technique called Tricuspid regurgitation identification in the fetal heart (TRI-FH) approach has been proposed, for identifying TR in the early stages. The gathered 3D-echo images are pre-processed to improve the quality of the images. The feature extraction techniques namely color-level co-occurrence matrix (CLCM) and grey-level co-occurrence matrix (GLCM) are applied on both RGB and grey images. The extracted features are extracted using the wrapper method and the unsupervised dimension reduction technique namely independent component analysis (ICA) is used to reduce the dimension of extracted features. Afterward, the deep learning-based Ghost network is used for classifying normal, Mild TR, and severe TR cases. The classified TR cases are fed to the segmentation phase for segmenting the affected valve of the fetus. The experimental TRI-FH approach achieves a total accuracy of 98.07 %. As compared to existing techniques, the proposed TRI-FH method shows higher performance in terms of accuracy, precision, recall, specificity, and F1 score. The proposed TRI-FH model enhances the total accuracy by 95.64 %, 97.82 %, 93.21 %, and 95.67 % better than ResNet, DenseNet, LinkNet, and U-Net respectively.

Linkage of diabetic retinopathy with blood antioxidants and gut microbiota in type two diabetes mellitus Saudi patients

Background: The retina is a light-sensitive nerve layer located at the back of the eye that creates images of objects. These cells kept alive by getting oxygen and nutrients from tiny blood vessels in the eye. Retinopathy is a disease of the retina that is more prevalent in type 2 diabetes mellitus patients. Diabetic retinopathy is a leading cause of blindness because hyperglycemia weakens retinal capillaries, resulting in leakage of blood into the surrounding space. This bleeding can result in formation of scar tissue, which can cause traction retinal detachment and maculopathy. The development of a panel of blood biomarkers to monitor diabetic retinopathies is essential for both diagnosis and prognosis. Proteomics as a powerful tool for the analysis of complex mixtures of proteins and the identification of biomarkers can be of great importance. Purpose: To detect early nerve fiber layer changes around macula and optic disc in diabetic patients, and to correlate diabetic retinopathy with blood antioxidants and gut microbiota in T2DM in Saudi patients. Materials and Methods: In this cross-sectional case-control study, a total of 77 eyes of 39 subjects aged 40-60 years who did not have any history of eye injuries or eye diseases affecting fundus viewing, were recruited from King Saud University Campus and the department of ophthalmology in King Abdul Aziz university hospital in Riyadh. All subjects underwent full ophthalmic examination including Peripapillary retinal nerve fiber layer thickness and macular profile, Proteomic approach of collected overnight fasting plasma and Microbial stool examination. Results: The nerve fiber layer thickness around the optic disc was measured for all groups, and there was no statistically significant difference in all quadrants between groups. The total retinal thickness at the macular area was different among all groups and tends to increase in group 3 due to diabetic retinopathy. The macular thickness in the 4 quadrants revealed no statistical difference except in the inferior quadrant. Glutathione S transferase and lipid peroxides showed no significant difference between the three studied groups; vitamin C and Glutathione were surprisingly higher in controlled diabetic patients relative to controls. Moreover, over growth of bacteroids participated to the evolution of retinopathy in diabetic patients. Conclusion: As hyperglycemia and oxidative stress are implicated in the pathogenesis of diabetic retinopathy, the present study certified that the progressive damage can be delayed in controlled type 2 diabetic patients using different treatment modalities that subside oxidative stress.

A Hybrid Approach That May Facilitate the Repair of Traumatic Popliteal Artery Pseudoaneurysms.

Traumatic popliteal pseudoaneurysms may occur in accidents or as an iatrogenic complication of a total knee arthroplasty. Complications often arise in open repair because of distorted anatomy. Up to 22% of the patients may suffer above-knee amputation. Endovascular treatment has proven to be an effective solution. However, the long-term performance of stents at the hinge point of the popliteal artery is questionable. We present a hybrid technique that was used successfully in 2 cases. Our approach takes advantage of both open and endovascular techniques. At first, we apply a stent graft at the side of the injury to cover the arterial trauma and stop blood leakage to the aneurysm sac. This allows for a safer dissection and open repair. We clamp the artery proximally and distally, open the sac, extract the stent graft, and extend to a longitudinal arteriotomy. We then reconstruct the entire area with a standard in lay end-to-end anastomosis using a vein graft. This hybrid technique may reduce the risk of uncontrollable bleeding and allow for a safer nerve decompression. Repair of such injuries is technically demanding. A hybrid approach may reduce the risk of complications and offer excellent long-term outcomes. The hybrid approach to the treatment of traumatic popliteal pseudoaneurysms combines the advantages of both open and endovascular approaches. It may be possible to make an acute operation just as safe as an elective operation by implementing the proposed strategy. The procedure can be performed by surgeons of all levels, and patients may benefit from a safer surgical dissection with fewer complications and blood loss. This smart combination of standard techniques may prove invaluable in a hostile surgical environment where limb loss is likely.

Nile Tilapia (Oreochromis niloticus) Patched1 Mutations Disrupt Cardiovascular Development and Vascular Integrity through Smoothened Signaling.

Hedgehog (Hh) signaling is crucial in cardiovascular development and maintenance. However, the biological role of Patched1 (Ptch1), an inhibitory receptor of the Hh signaling pathway, remains elusive. In this study, a Ptch1 ortholog was characterized in Nile tilapia (Oreochromis niloticus), and its function was investigated through CRISPR/Cas9 gene knockout. When one-cell embryos were injected with CRISPR/Cas9 targeting ptch1, the mutation efficiency exceeded 70%. During 0-3 days post fertilization (dpf), no significant differences were observed between the ptch1 mutant group and the control group; at 4 dpf (0 day after hatching), about 10% of the larvae showed an angiogenesis defect and absence of blood flow; from 5 dpf, most larvae exhibited an elongated heart, large pericardial cavity, and blood leakage and coagulation, ultimately dying during the 6-8 dpf period due to the lack of blood circulation. Consistently, multiple differentially expressed genes related to angiogenesis, blood coagulation, and heart development were enriched in the ptch1 mutants. Furthermore, Smoothened (Smo) antagonist (cyclopamine) treatment of the ptch1 mutants greatly rescued the cardiovascular disorders. Collectively, our study suggests that Ptch1 is required for cardiovascular development and vascular integrity via Smo signaling, and excessive Hh signaling is detrimental to cardiovascular development.

Assessment of valve regurgitation severity via contrastive learning and multi-view video integration

Objective. This paper presents a novel approach for addressing the intricate task of diagnosing aortic valve regurgitation (AR), a valvular disease characterized by blood leakage due to incompetence of the valve closure. Conventional diagnostic techniques require detailed evaluations of multi-modal clinical data, frequently resulting in labor-intensive and time-consuming procedures that are vulnerable to varying subjective assessment of regurgitation severity. Approach. In our research, we introduce the multi-view video contrastive network, designed to leverage multiple color Doppler imaging inputs for multi-view video processing. We leverage supervised contrastive learning as a strategic approach to tackle class imbalance and enhance the effectiveness of our feature representation learning. Specifically, we introduce a contrastive learning framework to enhance representation learning within the embedding space through inter-patient and intra-patient contrastive loss terms. Main results. We conducted extensive experiments using an in-house dataset comprising 250 echocardiography video series. Our results exhibit a substantial improvement in diagnostic accuracy for AR compared to state-of-the-art methods in terms of accuracy by 9.60%, precision by 8.67%, recall by 9.01%, and F 1-score by 8.92%. These results emphasize the capacity of our approach to provide a more precise and efficient method for evaluating the severity of AR. Significance. The proposed model could quickly and accurately make decisions about the severity of AR, potentially serving as a useful prescreening tool.

3M antimicrobial incise drape combined with MEBO in wound recovery of postoperative hypospadias surgery.

To evaluate the efficacy of different dressing methods in wound healing and the postoperative outcome in children who underwent hypospadias repair. Altogether 109 children with distal hypospadias who underwent urethroplasty were recruited from our hospital between January 2021 and March 2023. All patients were randomized in two groups according to the different dressing methods: Group A receiving 3M antimicrobial incise drape + MEBO (moisture-exposed burn ointment) and Group B receiving absorbent dressing + elastic bandage dressing. The age at surgery, operation time, bleeding during the dressing, postoperative changes in glans color, dressing fell off, comfort of children during the dressing, difficulty in dressing removal, and degree of pain during dressing removal were compared between the two groups. Differences in age at surgery (p = 0.337) and operation time (p = 0.055) were not significant between the two groups. The overall effectiveness of the dressing was better in Group A than that in Group B. Only five cases in Group A had blood leakage after dressing (p = 0.006), and there was no dressing dislocation (p < 0.001) or glans color abnormality (p < 0.001). Moreover, the number of complication cases was less. The overall comfort and pain degree during dressing removal in Group A was better than that in Group B (p < 0.001). Postoperative dressing using 3M antimicrobial incise drape + MEBO can achieve lower incidence rates of bleeding during dressing, postoperative glans darkening, and dressing falling off, a lower pain degree during dressing removal, and a better overall comfort level than those of the control group. This method is cost-effective and clinically safe, which contributes to the postoperative recovery of children with hypospadias and is thus worth promoting and applying.

Anti-adhesion multifunctional poly(lactic-co-glycolic acid)/polydimethylsiloxane wound dressing for bacterial infection monitoring and photodynamic antimicrobial therapy

Wound infection and adhesion are important factors affecting wound healing. Early detection of pathogen infection and reduction of wound-to-dressing adhesion are critical for improving wound healing. Herein, Ester-J, which can rapidly respond to lipase secreted by bacteria, was designed and synthesized. Then, Ester-J was co-spun with poly(lactic-co-glycolic acid) (PLGA) and polydimethylsiloxane (PDMS) to prepare a PP-EsJ hydrophobic anti-adhesion dressing with a contact angle of 140.7°. When the PP-EsJ membrane came into contact with the bacteria, the loaded Ester-J was hydrolyzed to Tph-TSF-OH, releasing bright cyan-blue fluorescence, thus providing a fluorescence switch for an early warning of infection. The detection limits of PP-EsJ for Pseudomonas aeruginosa and Staphylococcus aureus were 1.0 × 105 and 1.0 × 106 CFU/mL, respectively. Subsequently, Tph-TSF-OH released 1O2 through light irradiation, which rapidly killed P. aeruginosa and S. aureus, and accelerated wound healing. Compared with the control group, enhanced wound closure (up to 99.80 ± 1.10 %) was observed in mice treated with the PP-EsJ membrane. The PP-EsJ membrane not only effectively reduced the risk of external infection but also reduced adhesions to the skin during dressing changes. These characteristics make PP-EsJ membranes potentially useful for clinical treatment.

Anterior-interrupted and posterior-continuous suture technique improved the success rate of kidney transplantation model in rats.

This study aimed to introduce and evaluate two new microvascular anastomosis techniques compared to the conventional method in a rat renal transplant model. Using a Fisher-to-Lewis rat kidney transplantation model, the renal artery anastomosis was performed using the interrupted (I) suture technique, Y-shaped continuous (Y) suture technique, and anterior-interrupted and posterior-continuous (I-C) suture technique. The rats were then divided into three groups: I group, Y group, and I-C group. Parameters such as arterial anastomosis time, warm ischemia time, seven-day survival rate of the rats, and vessel histopathology were assessed. The mean arterial anastomosis time, blood leakage scores, and warm ischemia time were significantly reduced in groups Y and I-C compared to group I. Moreover, the seven-day survival rate was significantly higher in the I-C group compared to the other two groups. Arterial histopathology demonstrated vessel wall recovery without damage in all three groups, suggesting the safety of both Y and I-C techniques. The anterior-interrupted and posterior-continuous suture method is particularly beneficial for small artery reconstruction in organ transplantation.

Automated Detection and Classification of Retinal Lesions Using Image Processing Techniques

Diabetic Retinopathy (DR), a diabetic eye disease, manifests as damage to the retina due to blood leakage leading to the development of Red Lesions (Microaneurysms and Hemorrhages) and Bright Lesions (Hard Exudates and Cotton Wool Spots). Chronic, uncontrolled diabetes is the primary cause, with delayed treatment potentially resulting in complete blindness. DR is clinically categorized into four stages: No DR, Mild DR, Moderate DR, and Severe DR. Manual detection of DR by ophthalmologists is time-consuming, causing prolonged suffering for patients. To address this, our research leverages advanced technological tools like MATLAB to automate lesion extraction and feature analysis. By quantifying parameters such as lesion number, area, perimeter, and solidity, our model aims to categorize categories accurately. Specifically, we focus on utilizing the area covered by lesions to determine the disease stage, providing valuable insights into disease progression. Our approach accelerates detection and enhances accuracy, potentially improving patient outcomes. By automating lesion extraction and analysis, our system reduces the burden on ophthalmologists, allowing for a more efficient allocation of healthcare resources. This research contributes to the field by offering a robust method for DR assessment, facilitating early intervention and treatment.

Preserving sight: Managing and preventing diabetic retinopathy

Abstract Preserving eyesight in the presence of diabetic retinopathy, a subtle complication of diabetes, requires a proactive and comprehensive approach. This condition, characterized by the gradual deterioration of the blood vessels in the retina, can quietly advance and pose a significant threat to vision. Effectively managing this issue involves careful control of blood glucose levels through medications, dietary choices, and physical activity. By preventing prolonged high blood sugar levels, the main culprit behind retinal damage, individuals can slow down the progression of diabetic retinopathy and minimize its impact on vision. Medical interventions, such as laser therapies and anti-vascular endothelial growth factor injections, offer targeted measures to address abnormal blood vessel growth and leakage. Regular eye assessments are crucial, providing early detection opportunities even in the absence of obvious symptoms and allowing for timely intervention before irreversible damage occurs. Prevention is equally important, emphasizing proactive measures to avoid diabetic retinopathy. Monitoring blood pressure and lipid levels, along with adopting a health-conscious lifestyle, strengthens cardiovascular health, indirectly protecting the fragile retinal blood vessels. By following diabetes management protocols, maintaining a balanced diet, engaging in regular physical activity, and avoiding tobacco use, individuals can significantly reduce their vulnerability to diabetic retinopathy. Combined with efforts to increase community awareness and educate about the importance of regular eye check-ups, this comprehensive approach empowers individuals to actively manage their eye health, ultimately preserving the precious gift of sight.

Cerebral Cavernous Malformation (CCM)-like Vessel Lesion in the Aged ANKS1A-deficient Brain.

In this study, we show that ANKS1A is specifically expressed in the brain endothelial cells of adult mice. ANKS1A deficiency in adult mice does not affect the differentiation, growth, or patterning of the cerebrovascular system; however, its absence significantly impacts the cerebrovascular system of the aged brain. In aged ANKS1A knock-out (KO) brains, vessel lesions exhibiting cerebral cavernous malformations (CCMs) are observed. In addition, CCM-like lesions show localized peripheral blood leakage into the brain. The CCM-like lesions reveal immune cells infiltrating the parenchyma. The CCM-like lesions also contain significantly fewer astrocyte endfeets and tight junctions, indicating that the integrity of the BBB has been partially compromised. CCM-like lesions display increased fibronectin expression in blood vessels, which is also confirmed in cultured endothelial cells deficient for ANKS1A. Therefore, we hypothesize that ANKS1A may play a role in maintaining or stabilizing healthy blood vessels in the brain during aging.

Standardized in vitro bleeding tests in a non-coated novel hybrid prosthesis for frozen elephant trunk demonstrates minimal oozing during full heparinization, supported by clinical data.

Recent reports have questioned the blood impermeability of the novel frozen elephant trunk (FET) device E-vita Open NEO© (EO-NEO). Therefore, standardized in vitro bleeding tests using porcine heparinized blood were performed, as well as stress testing on the blood tightness of the collar suture line, to investigate this observation. EO-NEO prostheses were examined in vitro for blood permeability in three test series. Initially, antegrade perfusion with heparinized porcine blood [activated clotting time (ACT) of 500 s, with a 60 min duration] was performed, followed by ante/retrograde testing via the EO-NEO side port. Testing of the collar suture line under a tension of 10 Newton (N) within a suspension device (blood pressure 120 mmHg, ACT of 560 s, 1 min duration) was carried out with the suture material force fiber white (FFWs) yarn, using standard fixation (5 stitches/cm), FFWh yarn in hemostatic fixation (15 stitches/cm), and flow weave yarn (FWYh). Blood permeability testing of EO-NEO through the prosthetic lumen or via the side port demonstrated minor leakage without statistical difference between the standard and hemostatic suture lines or suture materials used, or positioning on the crimped or tapered portion (p > 0.05). The specific collar anastomosis testing demonstrated leakage volumes of 140 ml/min for FFWs vs. 16 ml/min for FFWh (p = 0.02), vs. 9 ml/min with the FWYh (p = 0.01). Different blood leakage tests showed minimal oozing and no difference in blood loss through the fabric and different collar suture lines, but unphysiological pressurized retrograde perfusion of the collar region showed significantly less leakage using FWYh and FFWh, prompting production modification of EO-NEO. Clinical results confirmed low blood loss using this novel FET device.

Development of Dialysis and Leakage Detection on Different Technology

Dialysis is the treatment for chronic kidney disease (CKD) patients, including acute or end-stage renal disease (ESRD), by performing the filtration of toxic or waste substances from the patient’s body. Haemodialysis (HD) and peritoneal dialysis (PD) are common treatments for dialysis patients with the use of extracorporeal dialysis machines such as haemodialysis machines or automated peritoneal dialysis (APD) for HD and PD, respectively. For HD, is required a dialyser act as a single-use consumable during the treatment of the patient. However, the major concern on the haemodialysis machine might be the issue on false sense during the treatment. The leakage detector of the dialysis machine is important to detect and sense the parameters when that is a leakage event, such as blood leakage at the dialyser or arteriovenous fistula (AVF) dysfunction. Thus, this study provides a review of leakage detection that has been developed with different methodologies of the sensing unit on a haemodialysis machine.

An end-to-end approach to combine attention feature extraction and Gaussian Process models for deep multiple instance learning in CT hemorrhage detection

Intracranial hemorrhage (ICH) is a serious life-threatening emergency caused by blood leakage inside the brain. Radiologists usually confirm the presence of ICH by analyzing computed tomography (CT) scans, so, developing an automated diagnosis system that can process this type of images has become an important research problem. One of the main challenges to apply AI algorithms in this setting is the lack of labeled data. To mitigate the labeling burden, Multiple Instance Learning (MIL) algorithms group instances into bags, relying solely on bag-level labels for model training. Due to their capacity to handle uncertainty and deliver accurate predictions, Gaussian Processes (GPs) stand out as promising classifiers for MIL problems. Recent research has also demonstrated the effectiveness of combining attention mechanisms with GPs for ICH detection. Nonetheless, existing methods have a notable limitation: they train the attention mechanism and the GP separately, resulting in suboptimal feature extraction for GP-based classification. In this study, we introduce an innovative end-to-end MIL model that concurrently trains the CNN backbone and attention mechanism along with the GP classifier. Our approach enhances the robustness and accuracy of bag predictions by optimizing feature extraction for GP-based classification. We validate our method experimentally by focusing on two ICH detection datasets. Our results reveal a significant performance advantage in terms of accuracy, F1-score, precision, and ROC-AUC score over existing MIL approaches, especially two-stage GP approaches. Additionally, we offer empirical insights into the functionality and effectiveness of our novel model.