Lower Absolute Values Research Articles

Low PSA radiographic disease progression on C11-choline PET.

For men with prostate cancer, radiographic progression may occur without a concordant rise in prostate-specific antigen (PSA). Our study aimed to assess the prevalence of radiographic progression using C-11 choline positron emission tomography (PET) imaging in patients achieving ultra-low PSA values and to evaluate clinical outcomes in this patient population. In a single institution study, we reviewed the prospectively maintained Mayo Clinic C-11 Choline PET metastatic prostate cancer registry to identify patients experiencing radiographic disease progression (rDP) on C-11 choline PET scan while the PSA value was less than 0.5ng/mL. Disease progression was confirmed by tissue biopsy or response to subsequent therapy. Clinicopathologic variables were abstracted by trained research personnel. Overall survival was estimated using the Kaplan-Meier method. Intergroup differences were assessed using the log-rank test. A univariate and multivariate Cox regression model was performed to investigate variables associated with poor survival after rDP. A total of 1323 patients within the registry experienced rDP between 2011 and 2021, including 220 (16.6%) men with rDP occurring at low PSA level. A median (interquartile range [IQR]) of 54.7 (19.7-106.9) months elapsed between the time of prostate cancer diagnosis and low PSA rDP, during which 173 patients (78%) developed castration-resistant prostate cancer (CRPC). Sites of low PSA rDP included local recurrence (n = 17, 8%), lymph node (n = 90, 41%), bone (n = 94, 43%) and visceral metastases (n = 19, 9%). Biopsy at the time of rDP demonstrated small-cell or neuroendocrine features in 21% of patients with available tissue. Over a median (IQR) follow-up of 49.4 (21.3-95.1) months from the time of low PSA rDP, 46% (n = 102) of patients died. Factors associated with poorer survival outcomes include advanced age at rDP, CRPC status, bone and visceral metastasis (p value <0.05). Visceral metastases were associated with decreased overall survival (p = 0.009 by log-rank) as compared with other sites of rDP. Men with prostate cancer commonly experience metastatic progression at very low or even undetectable PSA levels. Periodic imaging, even at low absolute PSA values, may result in more timely identification of disease progression.

Respiratory Diaphragm Motion-Based Asynchronization and Limitation Evaluation on Chronic Obstructive Pulmonary Disease.

Background: Chronic obstructive pulmonary disease (COPD) typically causes airflow blockage and breathing difficulties, which may result in the abnormal morphology and motion of the lungs or diaphragm. Purpose: This study aims to quantitatively evaluate respiratory diaphragm motion using a thoracic sagittal magnetic resonance imaging (MRI) series, including motion asynchronization and limitations. Method: First, the diaphragm profile is extracted using a deep-learning-based field segmentation approach. Next, by measuring the motion waveforms of each position in the extracted diaphragm profile, obvious differences in the independent respiration cycles, such as the period and peak amplitude, are verified. Finally, focusing on multiple breathing cycles, the similarity and amplitude of the motion waveforms are evaluated using the normalized correlation coefficient (NCC) and absolute amplitude. Results and Contributions: Compared with normal subjects, patients with severe COPD tend to have lower NCC and absolute amplitude values, suggesting motion asynchronization and limitation of their diaphragms. Our proposed diaphragmatic motion evaluation method may assist in the diagnosis and therapeutic planning of COPD.

EAU Biochemical Recurrence Risk Classification and PSA Kinetics Have No Value for Patient Selection in PSMA-Radioguided Surgery (PSMA-RGS) for Oligorecurrent Prostate Cancer.

To assess the influence of biochemical recurrence (BCR) risk groups and PSA kinetics on the outcomes of radioguided surgery against prostate-specific membrane antigen (PSMA-RGS). Currently, neither BCR risk group nor PSA doubling time (PSA-DT), or PSA velocity (PSA-V) are actively assigned or relevant for counseling prior to PSMA-RGS. We retrospectively analyzed PSMA-RGS cases for oligorecurrent prostate cancer between 2014 and 2023. BCR risk groups, PSA-DT, and PSA-V were analyzed as predictors for complete biochemical response (cBR, PSA < 0.2 ng/mL), BCR-free, and therapy-free survival (BCRFS, TFS). Of 374 included patients, only 21/374 (6%) and 201/374 (54%) were classified as low- and high-risk BCR (no group assignment possible in 152/374, 41%). A total of 13/21 (62%) patients with low- and 120/201 (60%) with high-risk BCR achieved cBR (p = 1.0). BCR classification was no predictor for BCRFS (HR:1.61, CI: 0.70-3.71, p = 0.3) or subsequent TFS (HR:1.07, CI: 0.46-2.47, p = 0.9). A total of 47/76 (62%) patients with PSA-DT ≤ 6 mo and 50/84 (60%) with PSA-DT > 6 mo achieved cBR (p = 0.4). PSA-DT was not associated with cBR (OR: 0.99, CI: 0.95-1.03, p = 0.5), BCRFS (HR: 1.00, CI: 0.97-1.03, p = 0.9), or TFS (HR: 1.02, CI: 0.99-1.04, p = 0.2). Consistent negative findings were recorded for PSA-V. The BCR risk groups and PSA kinetics do not predict the oncological success of PSMA-RGS performed at low absolute PSA values. Indolent low-risk BCR is rarely treated by PSMA-RGS.

Low Ocular Perfusion Pressure Values at Rest and during Resistance Exercise in Offspring of Glaucoma Patients.

To compare the ocular perfusion pressure (OPP) response during physical exercise in individuals with and without a family history (FH+, FH-) of glaucoma. Thirty-four subjects, divided into FH+ and FH- groups, realized 3 min at rest, 3 min of isometric handgrip exercise at 30% of maximal voluntary contraction, followed by 3 min of recovery. Blood pressure (Dixtal® automatic device) and intraocular pressure (Goldmann applanation tonometer) were measured during rest, exercise, and recovery. The mean OPP (mOPP) was calculated. In the FH+ group (17 subjects), baseline mOPP values were significantly lower than in the FH- group (17 subjects) (right eye: P < 0.001, left eye: P < 0.001, respectively). During exercise, both the FH+ and FH- groups showed a similar increase in mOPP in both eyes (right eye: FH+: 38 ± 4 mmHg vs. 51 ± 7 mmHg, FH-: 48 ± 5 mmHg vs. 57 ± 9 mmHg, P < 0.001; left eye: FH+: 39 ± 3 mmHg vs. 51 ± 7 mmHg; FH-: 46 ± 5 mmHg vs. 58 ± 8 mmHg, P < 0.001, respectively). However, the FH+ group maintained significantly lower mOPP values compared to the FH- group in the right and left eyes (group effect: P = 0.002, P = 0.002, respectively). The percentage of increase in mOPP in the FH+ group was greater compared to the FH- group during exercise (right eye: 34.1% ± 15.9% vs. 22.1% ± 13.2%, respectively; P = 0.025; left eye: 33.2% ± 17.7% vs. 22.4% ± 13.7%, respectively, P = 0.056). mOPP increased during physical exercise in both groups, but the FH+ group had lower absolute values. In addition, the FH+ group appears to demonstrate a higher percentage increase in mOPP compared to the FH- group.

Accelerated screening of sensitive and selective MoO3-based gas sensing materials by combining first-principles and machine learning approach

A large amount of hybrid metal oxides can be proposed for detecting various gases from rapidly developing of 2D materials and elemental doping technologies, and the key issue is how to search the large parameter space in an efficient way. First-principles approach can calculate molecular-scale electronic properties and provide a guide of material design for experiments, however, it is too time-consuming to explore all the possible metal oxides doped with different elements. Herein, we develop a novel framework via combining first-principles and machine learning, with the aim of enabling more efficient and practical screening of MoO3-based gas sensors than by experiments or first-principles alone. Owing to the high accuracy of first-principles calculations verified by experimental results, we demonstrate the reliability of the proposed methods for evaluating gas sensing performance. By proposing a set of new descriptors including d-band center and average bond length with demanding low-cost calculations, we significantly reduce the amount of required training data. In particular, the gradient boosting regression algorithm exhibits highR-square value of 0.96 and low mean absolute error value of 0.22, indicating superior reliability of the model. This work opens an avenue for quickly screening of novel metal oxides and other nano-materials with superior sensitivity and selectivity for gas detection.

The impact of body mass index on cardiac structure and function in a cohort of obese patients without traditional cardiovascular risk factors

BackgroundObesity has been linked with alterations in hemodynamic, autonomic, and hormonal pathways in the body, leading to a spectrum of cardiovascular changes. We sought to evaluate the effects of obesity on structural and functional changes of the heart in the absence of cardiac disease and associated risk factors. MethodsWe identified healthy outpatients without any cardiovascular disease or risk factors from our institution's echocardiography database (2017–2020). Patients were stratified by body mass index (BMI; normal: 18.5–25 kg/m2; overweight: 25–30 kg/m2; class 1 obesity: 30–35 kg/m2; class 2 obesity: 35–40 kg/m2; class 3 obesity: >40 kg/m2). Traditional and advanced echocardiographic parameters of cardiac chamber size and function including left ventricular global longitudinal strain (LV-GLS), left atrial reservoir strain (LASr), and right ventricular free wall strain (RV-FWS) were examined. The optimal cut-off BMI for discriminating LV-GLS (>-17.5%), LASr (<23%), and RV-FWS (>-23%) impairment was calculated using ROC curves. Results307 patients were assessed (41.5 ± 13.3yrs; 36.5%male; LVEF 61.3 ± 4.8%). No significant differences in indexed chamber volumes or LVEF were appreciated across BMI groups (p > 0.05 for all). LV-GLS, LASr, and RV-FWS were all significant on one-way ANOVA for differences from the group mean (all p < 0.01). Jonckheere-Terpstra test confirmed a significant trend of lower absolute LV-GLS, LASr and RV-FWS values across the rising BMI groups. On ROC curve analysis, a BMI value of 29.9 kg/m2, 35.1 kg/m2, and 37.3 kg/m2 were associated with LASr (AUC: 0.75), RV-FWS (AUC: 0.72), and LV-GLS (AUC: 0.75) impairment respectively. ConclusionObesity is linked with subclinical reduction of cardiac function in otherwise healthy subjects without cardiovascular risk factors, with reduction of left atrial function occurring at lower BMI, followed by the right and left ventricular function.

Speckle-Tracking Echocardiography Predicts Adverse Left Ventricular Remodeling After Valve Replacement in Rheumatic Mitral Stenosis.

Rheumatic mitral stenosis(RMS) may leads to left ventricular remodeling (LVR), which can persist even after valve surgery. Identifying markers for early structure and function in patients with rheumatic heart disease who are at risk for adverse LVR after surgery can help determine the optimal timing of intervention. This study aimed to investigate whether preoperative parameters of global left ventricular long-axis strain (LVGLS) and mechanical discretization (MD) could predict postoperative adverse LVR. A total of 109 adult patients withRMS and 50 healthy controls were enrolled in this study. Baseline clinical features, conventional echocardiography results, LVGLS, and MD were compared between the two groups. Pre- and post-surgery echocardiography measurements were collected, and adverse LVR was defined as a>15% increase in left ventricular end-diastolic volume or >10% decrease in left ventricular ejection fraction. Binary regression analysis was used to determine independent predictors of poor left ventricular remodeling. The variables associated with adverse LVR in this study were LVGLS (P<0.001, odds ratio: 1.996, 95% CI: 1.394-2.856) and MD (P=0.011, odds ratio: 1.031, 95% CI: 1.007-1.055). The poorly reconstructed group had lower absolute values of LVGLS and higher MD than the healthy control group and the non-poorly reconstructed group. A LVGLS cutoff of -15.0% was the best predictor for patients with poorly reconstructed LVR (sensitivity: 75.7%; specificity: 100.0%; AUC: 0.93), and a MD cutoff of 63.8ms was the best predictor (sensitivity: 63.8%; specificity: 98.6%; AUC: 0.88). Speckle tracking echocardiography has potential value for predicting the progression of adverse LVR and for identifying non-responders among patients with RMS undergoing surgery.

Right ventricular and right atrial free wall deformation predicitive value in transformation of preclinical diastolic disfunction to heart failure with preserved ejection fraction.

Aim To study echocardiographic parameters of heart chamber strain in patients with left ventricular (LV) preclinical diastolic dysfunction (PDD) for determining predictors of the PDD transition to heart failure with preserved LV ejection fraction (HFpEF).Material and methods The study included 113 patients (including 69 women) with metabolic syndrome and LV PDD (mean age, 65±7 years). The control group consisted of 40 healthy individuals (mean age, 63.0±6.0 years, including 59% women). Metabolic syndrome was diagnosed in consistency with criteria of NCEP-ATP III 2001. PDD was diagnosed based on the absence of heart failure symptoms, normal level of brain natriuretic peptide, and the presence of at least three of the following echocardiographic criteria at rest or after diastolic stress-echocardiography (stress-echoCG): left atrial volume index (LAVI) &gt;34 ml / m2; the ratio of peak early transmitral filling velocity (E) to average lateral and medial mitral annular velocity (e'), Е / е' &gt;14, е' &lt;8.5, and peak tricuspid regurgitation velocity &gt;2.8 m /s. EchoCG that determined LV longitudinal strain (LS), right ventricular (RV) LS, right atrial (RA) LS, and left atrial (LA) LS was performed every year during the 3-year follow-up.Results During the follow-up period, 31 patients developed HFpEF. 19 of them reported symptoms while in the other 12 patients, HFpEF was detected by diastolic stress-echoCG. Patients with HFpEF had significantly lower absolute values of RV LS, LA LS, and RA LS (-27.8±2.9 in the PDD group vs. -23.8±3.2 in the HFpEF group; р&lt;0.03; 38.2±9.1 vs. 28.6±10.2; р&lt;0.03; and 46.2±10.4 vs. 31.6±8.3; р&lt;0.03, respectively). RV LS and RA LS were the strongest independent predictors for PDD transformation into HFpEF (odds ratio, OR, 2.7; 95 % confidence interval, CI, 1.48-2.91; р&lt;0.001 and OR 2.6; 95 % CI: 1.40-2.75; р&lt;0.001, respectively).Conclusion PDD is not a separate clinical nosology but rather an initial stage in the pathogenesis of HFpEF. Approximately ⅓ of PDD patients develop HFpEF. RV LS and RA LS are considered predictors of HFpEF. The duration of PDD is apparently an important factor that provides the development of HFpEF.

Bias-voltage photoconductance and photoluminescence for the determination of silicon-dielectric interface properties in SiO2/Al2O3 stacks

This paper presents an advanced measurement method for controlling the surface charge carrier density of passivated silicon wafers during photoconductance and photoluminescence measurements, by employing semitransparent poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) electrodes with an applied bias voltage. This is employed to study and analyze charge carrier dynamics in dielectric layers by measuring their direct influence on effective lifetime. With this method, the carrier population at the surface and the effective carrier lifetimes of n- and p-type samples can be investigated, from which the fixed charge carrier density Qf of the passivation can be extracted. Additionally, the defect density Dit can also be derived from the minimum lifetime values at flatband voltage. In SiO2/Al2O3 stacks with varying SiO2 interlayer thickness, it was shown that by changing the SiO2 thickness, the carrier density Qf can be tuned to a wide range of values, which corresponds to the results obtained in other studies. An increase in interlayer thickness resulted in a decrease in Qf. Varying the SiO2 thickness, the behavior of the respective effective lifetime under bias voltage also changes, exhibiting hysteresis-like effects, which are attributed to additional charges getting trapped at the surface during bias-voltage application. This effect is much more pronounced for samples with a thinner SiO2 layer as well as for the n-type samples. Additionally, the doping type also influences the magnitude of Qf, with p-type samples generally reaching lower absolute values. It was also shown that aging of the samples had a significant effect on the measured Qf, which was increased compared to the initial Qf of the passivation. This effect was more pronounced for the n-type samples. The measurements were realized by a cost-effective and easy-to-use microcontroller-based potentiostat, which can be used as a simple add-on to existing photoconductance or photoluminescence measurement setups.

Evaluation of left atrial and ventricular remodeling in atrial fibrillation subtype by using speckle tracking echocardiography.

Atrial fibrillation (AF) is associated with cardiac structural and functional remodeling. We investigated the left atrial (LA) and left ventricular (LV) changes in AF subtypes by using two-dimensional echocardiography strain techniques. The study population consisted of 102 subjects with sinus rhythm (control group) and 463 patients with AF, among which 284 patients had paroxysmal AF (PAF) and 179 patients had persistent AF (PerAF). A speckle tracking automatic functional imaging software was used to perform the strain analysis. Patients with AF had dilated LA maximum and minimum volume, decreased LA reservoir strain, lower LV ejection fraction (LVEF), and impaired global longitudinal strain (GLS) compared to those of the sinus rhythm control group. In patients with PerAF, the LA maximum and minimum volumes were larger, and the LA reservoir strain [PAF vs. PerAF, 28% (21,33) vs. 19% (14, 28), P < 0.05], LVEF, and absolute GLS value (PAF vs. PerAF, -16.9 ± 3.3 vs. -14.1 ± 3.5%) were lower than those in patients with PAF. Patients with AF regardless of LA enlargement had decreased LA reservoir strain and lower LVEF and absolute GLS value than those in the sinus rhythm control group. Compared with those with normal sinus rhythm, patients with AF had dilated LA volume and impaired LA function, which were further worsened in patients with PerAF than those in patients with PAF. LA functional impairment occurred before LA enlargement. Left atrioventricular remodeling happened across different stages of AF development.

The effects of obesity on longitudinal ventricular and atrial strain in a rural population of Spanish children and adolescents, evaluated by a new strain software.

Research on the relationship between body mass index (BMI) and strain values in children and adolescents is limited. Our aim was to analyse the relationship between BMI and strain values of both ventricles and left atrium in children and adolescents. Both ventricles and left atrial strain values were compared among different BMI categories in children and adolescents from a town in the South of Spain. Of the 198 subjects, aged 6-17 years, 53% were of normal weight, 26% were overweight and 21% had obesity. Lower absolute values of left ventricular global longitudinal strain (25.9 ± 2.0% vs. 26.9 ± 2.2%, p = 0.002) and right ventricular free wall longitudinal strain (29.5 ± 4.2% vs. 30.8 ± 4.5%, p = 0.04) were found in subjects with obesity and overweight versus subjects with normal weight. A lower right ventricular four-chamber longitudinal strain was also observed in males with obesity and overweight (24.8 ± 3.3% vs. 26.4 ± 3.6%, p = 0.03). Statistically significant negative correlations of BMI were found for all ventricular, but not atrial, strain values in univariate analysis. This association turned non-significant for right ventricular four-chamber longitudinal strain in multivariate analysis. Utilizing this new strain software, children and adolescents with high BMI were associated with significantly lower values for left and right ventricular free wall longitudinal strain, without impact in left atrial strain.

Developing an integrated mathematical model of fermentation-pervaporation system for bioethanol production

This study presents a novel integrated model to describe the fermentation-pervaporation system for bioethanol recovery. The proposed model incorporates the effects of by-product inhibition on the fermentation process and variation in feed concentration during the pervaporation process. The model is based on a modified Monod model to describe the fermentation process and the solution diffusion model for the pervaporation process, which can predict the concentrations of biomass, glucose, and ethanol in the bioreactor, as well as the partial flux of ethanol and water, total flux, the volume of permeate, and concentration of ethanol permeate. Simulation results showed that the proposed modified Monod model outperforms the conventional Monod model in predicting biomass, glucose, and ethanol concentrations due to its ability to consider the inhibitory effect of by-products with low mean absolute prediction error values of 4.1%, 12.6 and 5.2%. Moreover, the inclusion of the byproduct inhibitory effect in the fermentation model improved the accuracy of the integrated model in predicting the bioethanol permeation flux by 7.9%. The proposed integrated model provides a useful tool for designing and optimizing fermentation-pervaporation systems for bioethanol recovery to promote the adoption of continuous fermentation at the industrial scale.

Interaction of electrolyzed nanomaterials with sandstone and carbonate rock: Experimental study and DLVO theory approach

The utilization of nanoparticles (NPs) in various applications, such as water pollution treatment, CO2 geological storage enhancement, and enhanced oil recovery, holds great promise. However, the instability of NPs in fluidic environments severely limits their potential applications. Moreover, NPs tend to adsorb onto the surfaces of sandstones and carbonate rocks in high-saline environments, leading to formation damage. To enable large-scale implementation of NPs, comprehensive research is crucial to understand their stable behavior in harsh saline environments. This study focuses on investigating the interaction of electrolyzed synthesized nanomaterials, specifically titanium dioxide (TiO2), manganese oxide (Mn2O3), and graphene oxide (GO), with the surfaces of carbonate rock and sandstone. To characterize the nanomaterials, various techniques were employed, including Fourier transform-infrared spectroscopy (FT-IR), transmission electron microscopy (TEM), Brunauer−Emmett−Teller (BET), x-ray diffraction (XRD), and field emission scanning electron microscopy (FE-SEM). TiO2, Mn2O3, and GO were synthesized using sol-gel, co-precipitation, and modified Hummer's methods, respectively. The stability of nanofluids was assessed through zeta potential and particle size measurements. The results revealed that the inner-sphere complexes formed by Ca2+ on GO NPs were more effective in neutralizing negative surface charges compared to Mg2+, resulting in a shift of the zeta potential towards lower absolute values. CaCl2 and MgCl2 were found to reverse the charges of Mn2O3 and TiO2 NPs (towards positive values), thus enhancing their stability at higher salt content. SEM images and ultraviolet–visible (UV–vis) spectroscopy measurements demonstrated that Mn2O3 and GO NPs were more prone to adsorption on rock surfaces when Ca2+ and Mg2+ ions were present in the nanofluids, respectively. To assess the interaction energies between NPs and surfaces and investigate the reversibility of NP adsorption, Derjaguin-Landau-Verwey-Overbeek (DLVO) analysis was conducted. The outcomes of this analysis were found to be consistent with the data obtained through SEM and UV–vis spectroscopy.

Substitution of diesel fuel in conventional compression ignition engine with waste biomass-based fuel and its validation using artificial neural networks

This study aims to derive bioenergy from waste lather fat and citronella grass. Lather fat oil (LFO), citronella grass oil (CGO), a mixture of leather fat oil and citronella grass oil (LFCGO), and a nano-additive-incorporated mixture of lather fat oil and citronella grass oil (NFCO) were synthesized and used in diesel engines as the novelty of this study. ASTM standards were used to investigate and guarantee the fuel's properties. According to the experimental report, the nanoadditive's brake thermal efficiency and brake-specific fuel consumption were more comparable to diesel fuel. Compared to diesel, the NFCO blend reduced hydrocarbon, carbon monoxide, and particulate emissions by 6.48%, 12.33%, and 16.66%, respectively, while carbon dioxide and oxides of nitrogen emissions increased. The experiment's outcomes were verified using an artificial neural network (ANN). The trained model exhibits a remarkable coefficient of determination of 98%, with high R values varying from 0.9075 to 0.9998 and low mean absolute percentage error values ranging from 0.97% to 4.24%. Based on the experimental findings and validation report, it can be concluded that NFCO is an efficient diesel fuel substitute.

Modulating digestion by composite interfacial layer in structured oil-in-water emulsions

Oleogels were applied as the lipid phase in oil-in-water (O/W) emulsions as a strategy to modulate in vitro lipid digestion. Lipid phase was structured with fruit wax (FW) or FW combined with lecithin (phosphatidylcholine-rich fraction) (FWLEC), while emulsifiers with low (Tween 80- T80) or high (whey protein isolate- WPI) molecular weight emulsifiers were added in the aqueous phase. All emulsions showed comparable mean droplet size (1.2–1.5 µm). The combined effect of emulsifiers (T80 and WPI) and oleogelators (FW and LEC) influenced interfacial behavior, modifying the profile of surface pressure over time and interfacial elasticity (0.9–22.7 mN/m). After the simulation of gastric conditions, WPI emulsions yielded larger droplet sizes, lower absolute values of ζ-potential and extensive aggregation of droplets compared to T80-stabilized emulsions. On the other hand, intestinal lipolysis was highly influenced by the presence of oleogelators and emulsifiers forming the interface of the droplets (32.9–65.1% of free fatty acids released). Interestingly, emulsified FWLEC oleogels stabilized by WPI led to reduced lipolysis, showing the lowest rate and extent of free fatty acids released. This outcome shed light on designing mixed interfaces for lipid digestion control purposes.

Psoriasis Severity, Health-Related Quality of Life, Work Productivity, and Activity Impairments Among Patients With Moderate to Severe Psoriasis Receiving Systemic Treatment: Real-World Data From Clinical Practice in Spain

Background and objectiveThe treatment of psoriasis should not only focus on skin affectations but also weigh the parameters for health-related quality of life (HRQoL), thereby tackling the concept of cumulative life course impairment (CLCI) and treating the patient from a holistic perspective. The CRYSTAL study aimed to characterize psoriasis with real-word data from Spanish clinical practice in patients with moderate to severe disease who received continuous systemic treatment for at least 24 weeks by using the absolute Psoriasis Area and Severity Index (PASI) score and its correlation to HRQoL. Material and methodsThis was a non-interventional, cross-sectional study conducted in 30 centers in Spain, with 301 patients between the ages of 18 and 75 years. The study collected data regarding current treatment and absolute PASI and their relationship to HRQoL using the Dermatology Life Quality Index (DLQI), to activity impairment using the Work Productivity and Activity Impairment (WPAI) questionnaire, and to treatment satisfaction. ResultsThe mean (SD) age was 50.5 (12.5) years, with a duration of disease of 14 (14.1) years. The mean (SD) absolute PASI reported was 2.3 (3.5), with 28.7% of patients presenting with PASI from >1 to ≤3 and 22.6% with PASI>3. Higher PASI scores were associated with higher DLQI (p<0.001) and WPAI scores and lower levels of treatment satisfaction (p<0.001). ConclusionsThese data indicate that achieving lower absolute PASI values may correlate not only with better HRQoL but also with better work productivity and treatment satisfaction.

Dragonfly algorithm–support vector machine approach for prediction the optical properties of blood

Knowledge of the optical properties of blood plays important role in medical diagnostics and therapeutic applications in laser medicine. In this paper, we present a very rapid and accurate artificial intelligent approach using Dragonfly Algorithm/Support Vector Machine models to estimate the optical properties of blood, specifically the absorption coefficient, and the scattering coefficient using key parameters such as wavelength (nm), hematocrit percentage (%), and saturation of oxygen (%), in building very highly accurate Dragonfly Algorithm-Support Vector Regression models (DA-SVR). 1000 training and testing sets were selected in the wavelength range of 250-1200 nm and the hematocrit of 0-100%. The performance of the proposed method is characterized by high accuracy indicated in the correlation coefficients (R) of 0.9994 and 0.9957 for absorption and scattering coefficients, respectively. In addition, the root mean squared error values (RMSE) of 0.972 and 2.9193, as well as low mean absolute error values (MAE) of 0.2173 and 0.2423, this result showed a strong match with the experimental data. The models can be used to accurately predict the absorption and scattering coefficients of blood, and provide a reliable reference for future studies on the optical properties of human blood.

Comparison of free-running whole-heart 5D and 4D flow imaging to standard 2D phase contrast in patients with right-sided congenital heart disease

Abstract Funding Acknowledgements Type of funding sources: None. Background Flow measurements by cardiac magnetic resonance (CMR) are part of a routine assessment in patients with congenital heart disease (CHD). Standard 2D phase contrast (2DPC) sequences, however, require precise prescription of image planes leading to long scan times which could be overcome by 3D-acquisitons covering the entire cardiac anatomy in a single acquisition. Thus, recently introduced accelerated free-breathing 3D whole heart flow sequences promise to simplify CMR exams allowing an easier acquisition and retrospective flow measurements in virtually all vessels. Purpose Comparison of standard 2DPC to an accelerated 4D flow sequence with prospective respiratory navigation (1), and a free-running radial fully self-gated respiratory and cardiac motion-resolved 5D flow sequence (5D flow) (2,3). Methods Patients with right-sided CHD and no intra- or extracardiac shunt underwent a CMR on a 1.5T scanner. 2DPC flow sequences and a 4D flow data set were obtained (1). In addition, a whole-heart free-running 3D radial PC CMR sequence was acquired (2). Using a compressed-sensing-based image reconstruction framework (2,3), 5D flow images were obtained, and the end-expiratory phase was used for analysis. 3D vessel segmentation was based on retrospectively computed phase-contrast angiography images for each 4D and 5D flow datasets. Flow measured in the ascending, descending aorta (AA, DA), main, right and left pulmonary artery (MPA, RPA, LPA) and superior vena cava (SVC) as well as the internal consistency for determination of systemic and pulmonary output were compared between all three sequences by Bland-Altman analyses. Results Twenty CHD patients (age 31±11y, 7 women, tetralogy of Fallot N=7, Ross operation N=10; pulmonary regurgitation, atrial switch and Ebstein’s disease each N=1) were included. Mean peak velocity of MPA/ right ventricle to pulmonary artery conduit was 1.9 (range 0.9; 3.5) m/s. Compared to 2DPC, both 4D and 5D flow moderately underestimated absolute flow with significant lower values for the RPA for 4D flow (Table 1). The bias (i.e. the mean absolute difference) of MPA flow between 2DPC and 4D flow was related to the MPA peak velocity (r2=0.3, p = 0.03) with a similar trend for the comparison of 2DPC vs. 5D flow (r2=0.142, p = 0.141). The comparison of the internal consistency for determination of systemic and pulmonary output showed similar results for 2DPC and 5D flow and a slightly lower agreement for the 4D flow sequence (Table 2). Conclusions In this preliminary study, 4D and 5D flow provide results comparable to 2DPC, however, both sequences showed a trend towards lower absolute flow values. Complex flow patterns due to the right-sided pathologies appear to have an impact on the difference observed between sequences as shown for the MPA. The internal consistency of flow quantification was similar for the 2DPC and 5D flow sequences. The presented observations are currently being evaluated in a larger study.

Silanized fiberglass modified by carbon dots as novel and impressive adsorbent for aqueous heavy metal ion removal.

This work discusses the application of a silanized fiberglass (SFG) modified by carbon dots (CDs) as an effective adsorbent for up-taking some heavy metal ions including lead (Pb2+), chromium (Cr3+), cadmium (Cd2+), cobalt (Co2+), and nickel (Ni2+) as pollutant in the aqueous solution by batch method. Removal tests were carried out after optimization of pH, contact time, initial concentration of metal ions, and CDs amount. The SFG modified with CDs (CDs-SFG) was applied for the removal of 10 ppm of each metal ion solution after 100 min and the corresponding results showed the removal efficiencies of 100, 93.2, 91.8, 90, and 88.3% for Pb2+, Cd2+, Cr3+, Co2+, and Ni2+, respectively. The adsorption capacity of CDs-SFG in the metal ion mixed solution was also evaluated, and the results indicated the same trend in the adsorption capacity for metal ions in the mixed solution, though with lower absolute values compared to the single metal solutions. Moreover, the selectivity of this adsorbent for the adsorption of Pb2+ was almost twice of other tested metal ions. The regeneration of the CDs-SFG showed that its adsorption capacity after five cycles was reduced about 3.9, 6.0, 6.8, 6.7, and 8.0% for Pb2+, Cd2+, Cr3+, Co2+, and Ni2+, respectively. Finally, the applicability of the CDs-SFG adsorbent was examined with the analysis of the metal ions in water and wastewater samples.

Surgical Mortality Risk Scores in Transcatheter Aortic Valve Implantation: Is Their Early Predictive Value Still Strong?

Surgical mortality risk scores, even if not properly designed and rarely tested in the transcatheter aortic valve implantation (TAVI) setting, still guide the heart team in managing significant aortic stenosis. After splitting 1763 consecutive patients retrospectively based on their mortality risk thresholds, the composite endpoint early safety (ES) was adjudicated according to Valve Academic Research Consortium (VARC)-2 and -3 consensus documents. ES incidence was higher if VARC-2 rather than VARC-3 defined. Despite only patients showing VARC-2 ES had significantly lower absolute values of all three main risk scores, these last still failed to foresee both VARC-2 and -3 ES in intermediate-risk patients. The receiver operating characteristic analysis also showed a significant correlation, but with poor diagnostic accuracy, among the three scores and only VARC-2 ES; moreover, the absence of VARC-2 ES and low-osmolar contrast media administration were identified as independent predictors of 1-year mortality and absence of VARC-3 ES, respectively. Finally, even a single complication included in the ES definition could significantly affect 1-year mortality. Currently, the most used mortality risk scores do not have adequate diagnostic accuracy in predicting ES after TAVI. The absence of VARC-2, instead of VARC-3, ES is an independent predictor of 1-year mortality.