Mean HD Research Articles

Identification and analysis of the genetic diversity of Dermacentor everestianus using mitochondrial 16S rRNA and COI sequences in the Xizang Autonomous Region of China

Ticks serve as vectors and reservoirs for a variety of pathogens, including protozoa, bacteria, and viruses, that cause tick-borne diseases in both humans and livestock. Despite their widespread distribution, their genetic diversity and population structure in Xizang have not been thoroughly investigated. In this study, sheep ticks were identified from four counties by microscopy, followed by genetic analysis of Dermacentor everestianus populations in Xizang based on mitochondrial 16S rRNA and cytochrome oxidase subunit 1 (COI) gene sequences. D. everestianus was the predominant species and 16S rRNA gene sequence analysis revealed nine haplotypes with seven nucleotide variations, showing a mean haplotype diversity (Hd) of 0.505 and mean nucleotide diversity (Pi) of 0.00129. Similarly, the COI sequences revealed 28 haplotypes with 26 nucleotide variations, yielding a mean Hd of 0.828 and a mean Pi of 0.00279. Molecular variance analysis (AMOVA) indicated that most genetic variation occurs within populations. In addition, neutral test analyses suggested potential bottleneck events in the D. everestianus populations. The haplotype network had a star-like distribution with the common haplotypes A1, A2, B1, and B5. The phylogenetic tree separated haplotypes of both genes into two branches on the haplotype network indicating no distinct geographical clustering. This study is the first to highlight the prevalence of D. everestianus in Xizang, revealing moderate genetic differentiation among the four populations, possibly due to host mobility. This intensive investigation of genetic variation and population structure contributes valuable insights into the current population genetics of D. everestianus in Xizang, China.

Population genetic diversity of Culex tritaeniorhynchus in Jining City of Shandong Province based on the mitochondrial cytochrome C oxidase I gene

To understand the genetic basis of the adaptation of Culex tritaeniorhynchus to different environmental ecology in Jining City, Shandong Province, so as to provide insights into understanding of the population structure or isolation pattern of Cx. tritaeniorhynchus in the city. Seven sampling sites were selected from urban, suburban and rural areas of Jining City, Shandong Province from June to August 2023, and mosquitoes were collected using mosquito-trapping lamps. All collected adult mosquitoes were identified morphologically. Genomic DNA was extracted from a single female Cx. tritaeniorhynchus mosquito, and the mitochondrial cytochrome C oxidase I (COI) gene was amplified using a PCR assay, sequenced and subjected to molecular identification. The number of haplotypes, haplotype diversity (Hd), nucleotide diversity (Pi), and average number of nucleotide differences (K) of Cx. tritaeniorhynchus DNA sequences were estimated among different sampling sites using the software DnaSP 6, and a neutrality test was performed. The fixation index (FST), and gene flow (number of migrants, Nm) of Cx. tritaeniorhynchus populations were calculated using the software Arlequin 3.5.2, and subjected to analysis of molecular variance (AMOVA). In addition, a haplotype network diagrams and a phylogenetic tree of Cx. tritaeniorhynchus populations were created using the software PopART and MEGA 11, respectively. A total of 420 sequences were successfully amplified from the COI gene of Cx. tritaeniorhynchus samples collected from 7 sampling sites in Jining City, and a gene fragment sequence with a length of 603 bp was obtained, with 55 variable sites and 46 haplotypes and without insertion or deletion mutations. Of the 46 haplotypes, H01 was the dominant shared haplotype, and the haplotype frequency increased gradually from urban areas (34.00%) to rural areas (47.00%). The mean Hd, Pi and K values of Cx. tritaeniorhynchus COI genes were 0.814, 0.024 and 14.129, 0.489, 0.016 and 7.941 and 0.641, 0.016 and 10.393 in suburban, urban, and rural areas, respectively, with the highest population diversity of Cx. tritaeniorhynchus in suburban areas and the lowest in urban areas. Paired FST analysis among different types of sampling sites showed that the mean FST value was 0.029 between urban and suburban areas, indicating more frequent inter-population communication. AMOVA revealed that the percentage of intra-population variation (95.74%) was higher than that of inter-population variation (4.26%). Neutrality tests showed deviation from neutrality in Cx. tritaeniorhynchus populations collected from Nanyang Township (Tajima's D = 2.793, Fu's Fs = 6.429, both P values < 0.05). In addition, the mismatch distribution curves of Cx. tritaeniorhynchus COI gene appeared bimodal or multimodal patterns in Jining City, indicating a relatively stable overall population size. The mitochondrial COI gene may be used as a molecular marker to investigate the population genetic diversity of Cx. tritaeniorhynchus. The population genetic diversity of Cx. tritaeniorhynchus is higher in the suburban areas of Jining City than in rural and urban areas, and there are frequent genetic exchanges between Cx. tritaeniorhynchus populations from urban and suburban areas.

Biometric Data of Adults’ Aortic Knob Diameter in Posteroanterior Chest Radiograph, Correlation to Age and Normative Heart Diameter: A Cross-Sectional Study

Background: The aortic knob (AK) is an essential feature on a chest x-ray. It could be the first sign of a cardiovascular problem if there is any deformation or enlargement of the knob. This study aimed to measure the normal AK diameter (AKD) on a posteroanterior chest radiograph in healthy adult Sudanese. Methods and Results: The study was conducted in the Department of Radiology and Imaging in Ribat Hospital (Sudan) between Jun 2019 and Jan 2020. A total of 113 participants of both sexes (45.1% males and 54.9% females) with a normal chest x-ray and no history of diabetes, blood hypertension, cardiovascular disease, or skeletal abnormality were selected. Participants' age fluctuated from 18 to 75 years. The measurements (AK, heart diameter [HD], cardiothoracic ratio [CTR]) were carried out with the measuring tools available on the software of the computed radiography system. The mean AKD was 2.8±0.8 cm (2.94±0.8 cm in males and 2.51±0.77 cm in females, P=0.005)). The mean HD was 9.22±2.8 cm (9.8±3.3 cm in males and 8.7±0.2.1 cm in females, P=0.005). The mean CTR was estimated as 46.6±7.7% with a significant difference between males and females and significantly correlated with HD and BMI (P&lt;0.05). The AKD increased by 0.019 cm with an increase of one year of age (AKD = 0.0199(age)+1.9469), and there was a strong positive correlation between age and AKD (P&lt;0.001). Conclusion: The study found a significant positive correlation between age and AKD. Increased heart sizes increase AKD. The AKD value is greater in males than in females.

Genetic Variation and Population Structure of the Old World Bollworm Helicoverpa armigera (Hübner, 1808) (Lepidoptera: Noctuidae) in Ethiopia

Helicoverpa armigera is one of the most destructive insect pests of economically valuable crops in the world. Despite its economic importance, the population genetic structure of this insect remains unexplored in Ethiopia. To investigate the genetic diversity and population structure of H. armigera, we sampled 170 individuals from 15 populations throughout Ethiopia. We sequenced a fragment of the mitochondrial cytochrome b (cyt b) gene and five exon-primed intron-crossing (EPIC) markers. Twenty cyt b haplotypes with low-to-moderate haplotype diversity (mean Hd = 0.537) and high nucleotide diversity (mean Pi = 0.00339) were identified. The most frequently observed and widely distributed cyt b haplotype was designated as Hap_1 (67.058%), which is identical to sequences found across the globe. Tajima's D and Fu's F for the cyt b data were negative, supporting a model of population expansion. Within populations, a mean of 2.493 alleles/locus was recorded across the five EPIC loci, ranging from 1.200 to 3.600 alleles/locus. The highest mean effective number of alleles/population was 2.369 and the lowest was 1.178. The mean observed heterozygosity (HO) of the five loci (0-0.289; mean 0.104 ± 0.020) was lower than the expected heterozygosity (HE) (0.095-0.523; mean 0.258 ± 0.028). AMOVA detected significant genetic structure with 61% of the total molecular genetic variation of EPIC genotypes occurring between populations, suggesting a considerable degree of differentiation among populations. STRUCTURE analyses clustered the H. armigera populations into three distinct population groups but very low isolation by distance (R2 = 0.0132, P < 0.05).

Automatic femoral articular cartilage segmentation using deep learning in three-dimensional ultrasound images of the knee

ObjectiveThis study aimed to develop a deep learning-based approach to automatically segment the femoral articular cartilage (FAC) in 3D ultrasound (US) images of the knee to increase time efficiency and decrease rater variability. DesignOur method involved deep learning predictions on 2DUS slices sampled in the transverse plane to view the cartilage of the femoral trochlea, followed by reconstruction into a 3D surface. A 2D U-Net was modified and trained using a dataset of 200 2DUS images resliced from 20 3DUS images. Segmentation accuracy was evaluated using a holdout dataset of 50 2DUS images resliced from 5 3DUS images. Absolute and signed error metrics were computed and FAC segmentation performance was compared between rater 1 and 2 manual segmentations. ResultsOur U-Net-based algorithm performed with mean 3D DSC, recall, precision, VPD, MSD, and HD of 73.1 ​± ​3.9%, 74.8 ​± ​6.1%, 72.0 ​± ​6.3%, 10.4 ​± ​6.0%, 0.3 ​± ​0.1 ​mm, and 1.6 ​± ​0.7 ​mm, respectively. Compared to the individual 2D predictions, our algorithm demonstrated a decrease in performance after 3D reconstruction, but these differences were not found to be statistically significant. The percent difference between the manually segmented volumes of the 2 raters was 3.4%, and rater 2 demonstrated the largest VPD with 14.2 ​± ​11.4 ​mm3 compared to 10.4 ​± ​6.0 ​mm3 for rater 1. ConclusionThis study investigated the use of a modified U-Net algorithm to automatically segment the FAC in 3DUS knee images of healthy volunteers, demonstrating that this segmentation method would increase the efficiency of anterior femoral cartilage volume estimation and expedite the post-acquisition processing for 3D US images of the knee.

234 Using functional status to aid interpretation of cUHDRS scores in patients with Huntington’s disease

The composite Unified Huntington’s Disease Rating Scale (cUHDRS) is a scoring algorithm that combines Total Functional Capacity (TFC), Total Motor Score, Symbol Digit Modalities Test and Stroop Word Reading measures. Our aim was to enhance understanding of cUHDRS scoring by linking to established measures of meaningful daily function and independence in individuals with early-to-moderate-manifest Hunting- ton’s disease (HD).Data from Enroll-HD were evaluated. For patients meeting the reference population for the cUHDRS (manifest HD, TFC 5–13, ≥20 years; N=3,490), cUHDRS score ranges were calculated. Patients were divided into groups around each integer score; for each grouping, the mean HD stage, Independence Scale (IS) score, mean Functional Assessment (FA) score and number of FA items that ≥50% of individuals achieved were calculated.cUHDRS score groupings ranged 3–18 (N=3,484). For patients in the 14–18 cUHDRS score groupings, ≥50% achieved 25 FA items and had a mean IS=95. For patients in the lowest cUHDRS score group, cUHDRS=3, only 12 FA items were achievable by ≥50% and mean IS=65.cUHDRS scores reflect the differing levels of function in individuals with early-to-moderate-manifest HD. The cUHDRS can better differentiate between individuals with Stage 1 HD than commonly used measures of function.rachel.blair@roche.com

MO918: The Time to Negative Conversion Among Adult COVID-19 Patients on Chronic Hemodialysis Admitted at the Philippine General Hospital

BACKGROUND AND AIMSIn the Philippines, the shortage of dialysis centers that cater to ESKD individuals who tested positive for COVID-19 uniquely presents a logistic challenge, as these patients remain admitted in COVID-19 hospitals with hemodialysis units despite the clinical resolution of their disease. The majority of free-standing hemodialysis units require proof of negative conversion despite recommendations from local guidelines.As proof of negative conversion remains important in many practical settings, the negative conversion rate of SARS-CoV-2 infection has been the subject of several investigations. However, negative conversion rates particularly for ESKD patients with COVID-19 infection are lacking.Hence, this study aims to determine the time to negative conversion of COVID-19 RT-PCR testing among adult COVID-19 patients on chronic hemodialysis admitted at the Philippine General Hospital (PGH), a tertiary government hospital assigned as one of the COVID-19 referral centers in the country. This knowledge will allow for a more systematic and evidence-based implementation of the test-based approach, ultimately determining whether such an approach can be shifted to a symptom or time-based procedure in order to shorten the isolation period and conserve resources, especially in resource-limited settings.METHODThis is a retrospective cohort study. All adult patients on chronic hemodialysis who were admitted at PGH after the diagnosis of COVID-19 by RT-PCR between March 2020 and February 2021 were included. Patients who were asymptomatic for COVID-19, whose charts could not be retrieved, whose COVID-19 RT-PCR results were missing and those who died or got discharged without having a negative COVID-19 RT-PCR result were excluded in this study. Descriptive statistics were used in summarizing the data. Time to negative conversion is the primary outcome measure.RESULTSA total of 90 patients who were on chronic hemodialysis and tested positive for COVID-19 via RT-PCR admitted at PGH at the specified time period met the inclusion and exclusion criteria. A total of 60% were males and the median age was 55 years old. The mean HD vintage was 2.95 years. Among the causes of ESKD, 46% was from hypertension, 31% was due to diabetes mellitus, 15% due to chronic hemodialysis, 0.80% was caused by autosomal polycystic kidney disease, 2.50% was due to obstructive uropathy and the remaining 4.0% of patients with ESKD were due to other causes such as NSAID nephropathy, gouty nephropathy, etc. Of these, 17% had mild, 53% had moderate, 18% had severe and 12% had critical COVID-19. The mean number of days from the onset of symptoms to clinical recovery is 22.48 days; the median was 18 days. One patient had clinical recovery only after 84 days. The median time to first negative conversion was 24.5 days, with a mean of 26.65 days. There were 6.67% who achieved negative conversion on the first week; 15.56% on the second week; 24.44% on the third week; 26.67% on the fourth week; 8.89% on the fifth week; 6.67% on the sixth week; 4.44% on the seventh week; 5.56% on the eighth week; and 1.11% on the ninth week. After 28 days, 90% of the patients had clinical recovery, but 15% of them still had positive RT-PCR results.CONCLUSIONAmong adult patients on chronic hemodialysis who were admitted at PGH after the diagnosis of COVID-19 by RT-PCR between March 2020 and February 2021, the median time to negative conversion was 24.5 days.FIGURE 1:Number of patients who clinically recovered over time was plotted against the number of patients who had negative conversion over time.

Deep learning-based tumour segmentation and total metabolic tumour volume prediction in the prognosis of diffuse large B-cell lymphoma patients in 3D FDG-PET images.

To demonstrate the effectiveness of automatic segmentation of diffuse large B-cell lymphoma (DLBCL) in 3D FDG-PET scans using a deep learning approach and validate its value in prognosis in an external validation cohort. Two PET datasets were retrospectively analysed: 297 patients from a local centre for training and 117 patients from an external centre for validation. A 3D U-Net architecture was trained on patches randomly sampled within the PET images. Segmentation performance was evaluated by six metrics, including the Dice similarity coefficient (DSC), Jaccard similarity coefficient (JSC), sensitivity (Se), positive predictive value (PPV), Hausdorff distance 95 (HD 95), and average symmetric surface distance (ASSD). Finally, the prognostic value of predictive total metabolic tumour volume (pTMTV) was validated in real clinical applications. The mean DSC, JSC, Se, PPV, HD 95, and ASSD (with standard deviation) for the validation cohort were 0.78 ± 0.25, 0.69 ± 0.26, 0.81 ± 0.27, 0.82 ± 0.25, 24.58 ± 35.18, and 4.46 ± 8.92, respectively. The mean ground truth TMTV (gtTMTV) and pTMTV were 276.6 ± 393.5 cm3 and 301.9 ± 510.5 cm3 in the validation cohort, respectively. Perfect homogeneity in the Bland-Altman analysis and a strong positive correlation in the linear regression analysis (R2 linear = 0.874, p < 0.001) were demonstrated between gtTMTV and pTMTV. pTMTV (≥ 201.2 cm3) (PFS: HR = 3.097, p = 0.001; OS: HR = 6.601, p < 0.001) was shown to be an independent factor of PFS and OS. The FCN model with a U-Net architecture can accurately segment lymphoma lesions and allow fully automatic assessment of TMTV on PET scans for DLBCL patients. Furthermore, pTMTV is an independent prognostic factor of survival in DLBCL patients. •The segmentation model based on a U-Net architecture shows high performance in the segmentation of DLBCL patients on FDG-PET images. •The proposed method can provide quantitative information as a predictive TMTV for predicting the prognosis of DLBCL patients.

The Solar Radiation Climate of Greece

The solar radiation climate of Greece is investigated by using typical meteorological years (TMYs) at 43 locations in Greece based on a period of 10 years (2007–2016). These TMYs include hourly values of global, Hg, and diffuse, Hd, horizontal irradiances from which the direct, Hb, horizontal irradiance is estimated. Use of the diffuse fraction, kd, and the definition of the direct-beam fraction, kb, is made. Solar maps of annual mean Hg, Hd, kd, and kb are prepared over Greece under clear and all skies, which show interesting but explainable patterns. Additionally, the intra-annual and seasonal variabilities of these parameters are presented and regression equations are provided. It is found that Hb has a negative linear relationship with kd; the same applies to Hg with respect to kd or with respect to the latitude of the site. It is shown that kd (kb) can reflect the scattering (absorption) effects of the atmosphere on solar radiation, and, therefore, this parameter can be used as a scattering (absorption) index. An analysis shows that the influence of solar variability (sunspot cycle) on the Hg levels over Athens in the period 1953–2018 was less dominant than the anthropogenic (air-pollution) footprint that caused the global dimming effect.

Morphologic Evaluation of the Flexor Carpi Radialis Muscle Using Ultrasonography for Accurate and Safe Needle Electromyography

Objective This study aimed to determine the proper and safe needle insertion point in the flexor carpi radialis (FCR) muscle under ultrasonography guidance. Methods We identified the center point (CP) of the FCR as the optimal needle insertion point using ultrasonography. The location of the CP was analyzed using ratios and distances from other landmarks. The vertical distance (CP-VD) was measured by drawing an imaginary vertical line from the CP to the elbow crease. We measured the horizontal distance from the point where the imaginary vertical line from the CP meets the elbow crease to the biceps tendon at the elbow crease level (CP-HD). We presented the ratio of CP-HD to forearm circumference (HD ratio) and the ratio of CP-VD to forearm length (VD ratio) as percentages. Results The mean values of CP-HD and CP-VD were 2.0 ± 1.0 cm and 8.2 ± 1.1 cm, respectively. The mean HD and VD ratios were 8.4% ± 4.2% and 32.0% ± 3.1%, respectively. Conclusion When performing electromyography (EMG) of the FCR muscle, it is recommended to perform EMG at the point about 2 cm medial from the biceps tendon at the elbow crease level, to nearly the proximal one-third of forearm length. Keywords: Flexor carpi radialis; Ultrasonography; Electromyography

A High Cattle-Grazing Density Alters Circadian Rhythmicity of Temperature, Heart Rate, and Activity as Measured by Implantable Bio-Loggers.

Six cows managed under extensive grazing conditions were used to study the effect of moving the animals to a higher grazing density on the circadian rhythms of temperature (T), heart rate (HR), and activity (ACT), which were recorded by implantable bio-loggers. Cows were maintained at a density of 1.5 livestock units per hectare (LSUs/ha; low density, LD) until they were moved to a grazing area at 128 LSUs/ha (high density, HD). Animals were implanted subcutaneously with a T, HR, and ACT bio-logger, which was programmed to record data at 5-min intervals. For each animal, cosinor rhythmometry (the study of circadian rhythms by fitting a sine wave to a time series) was applied to the data recorded over 5 days in LD and HD. Mean Midline Estimating Statistic of Rhythm (MESOR; the average value around which the variable oscillates), amplitude (difference between the peak and the mean value of a wave), and acrophase (timing of peak activity) were calculated and evaluated statistically. Differences between mean day and nighttime values, and mean LD and HD values were calculated. Cows presented cosinor curves that fit a 24-h rhythm (p < 0.001) in T, HR, and ACT at both densities. MESOR (T: 37.98 vs. 38.02°C; HR: 69.12 vs. 65.91 bpm; ACT: 49.39 vs. 40.41 mg, for LD and HD, respectively) and amplitude (T: 0.28 vs. 0.28°C; HR: 4.12 vs. 3.14 bpm; ACT: 18.14 vs. 11.28 mg, respectively) did not differ significantly between the two densities; however, significant (p < 0.05) differences between densities occurred in the acrophase of the three variables; specifically, the T acrophase was 2 h later at HD (22:45 h) than LD (20:45 h), and HR (LD: 19:51; HD: 16:49 h) and ACT acrophases 3 and 2 h earlier at HD than LD (LD: 14:47; HD: 12:49 h), respectively. T and ACT differed significantly (p < 0.01) between daytime (mean ± SE; 37.92 ± 0.19°C, 40.39 ± 4.74 mg) and nighttime (38.14 ± 0.17°C, 29.93 ± 5.66 mg). In conclusion, our study suggests that a high animal grazing density might exacerbate the social competence for valuable resources for animals, resulting in shifting the circadian rhythmicity of temperature, heart rate, and activity of the cows, advancing or delaying their acrophases.

Natural History of Clinical, Laboratory, and Echocardiographic Parameters of a Primary Hyperoxaluria Cohort on Long Term Hemodialysis.

Background: Primary hyperoxaluria type 1 (PH1) is a rare monogenic disorder characterized by excessive hepatic production of oxalate leading to recurrent nephrolithiasis, nephrocalcinosis, and progressive kidney damage, often requiring renal replacement therapy (RRT). Though systemic oxalate deposition is well-known, the natural history of PH1 during RRT has not been systematically described. In this study, we describe the clinical, laboratory, and echocardiographic features of a cohort of PH1 patients on RRT.Methods: Patients with PH1 enrolled in the Rare Kidney Stone Consortium PH Registry who progressed to require RRT, had ≥2 plasma oxalate (pOx) measurements 3–36 months after start of RRT, and at least one pair of pOx measurements between 6 and 18 months apart were retrospectively analyzed. Clinical, echocardiographic, and laboratory results were obtained from the Registry.Results: The 17 PH1 patients in our cohort had a mean total HD hours/week of 17.4 (SD 7.9; range 7.5–36) and a range of age of RRT start of 0.2–75.9 years. The average change in plasma oxalate (pOx) over time on RRT was −0.74 [−2.9, 1.4] μmol/L/month with the mean pOx never declining below 50 μmol/L. Over time on RRT, oxalosis progressively developed in multiple organ systems. Echocardiography performed on 13 subjects showed worsening of left ventricular global longitudinal strain correlated with pOx (p < 0.05).Conclusions: Even when a cohort of PH1 patients were treated with intensified RRT, their predialysis pOx remained above target and they developed increasing evidence of oxalosis. Echocardiographic data suggest that cardiac dysfunction could be related to elevated pOx and may worsen over time.

High low-density lipoprotein cholesterol as an independent risk factor for coronary restenosis in hemodialysis patients undergoing percutaneous coronary interventions.

HD patients have been reported to have a higher risk of restenosis after percutaneous coronary intervention (PCI). The aim of this study was to investigate the risk factors of coronary restenosis in HD patients. We enrolled 54 HD patients (mean age: 66.5 ± 10.1 years; 72.2% men; mean HD duration: 3.7 years), who received PCI and follow-up coronary angiography. Of the patients, 22 (40.7%) had restenosis within 3 to 12 months of PCI. Univariate logistic analysis showed low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio, LDL-C, non-HDL-C, and history of major adverse cardiovascular events were significantly associated with coronary restenosis (OR]: 1.89, 1.27, 1.22, and 5.79, respectively). Multivariate analysis showed that LDL-C was significantly associated with coronary restenosis (OR: 1.43). These data suggest that LDL-C is an independent risk factor for coronary restenosis in HD patients undergoing PCI, and strict lipid management may be required.

BLOOD FLOW VELOCITY (QB) ON HYPERTENSION INTRADIALYTIC OF HEMODIALYSIS PATIENTS

Blood Flow Velocity (Qb) is one of the factors that has a relationship with the incidence of intradialytic hypertension and other hemodynamic changes. Quick of blood is the amount of blood flowed in units of minutes (ml/minute) that can be set and adjusted to the patient's condition. In addition, Qb settings can be determined based on the patient's heartbeat. Provision of higher Qb will have an impact on the occurrence of intra and post HD complications. The purpose of this study was to determine the relationship of blood flow velocity (Qb) to hypertension intradialytic. This type of research was quantitative analytic survey design. The approach used was cross sectional. The population in this study was all hemodialysis patients who underwent routine hemodialysis twice a week at RSI Klaten in July 2018 as many as 380 patients. The sampling technique was purposive sampling. Spearman rho was used as a data analysis technique. Characteristics of respondents include the average age of 47±8.16, male gender was as many as 41 people (51.2%), high school education respondents as many as 33 people (41.3%), respondents mostly work as many as 41 people (51, 2%), the mean HD duration is 2.20 ± 2.35 years and the average IDWG is 2.57 ± 1.05kg. Hemodialysis patient’s blood flow velocity at RSI Klaten with a mean of 230.8050 ± 31.77. Intradialytic hypertension in hemodialysis patients at RSI Klaten with a mean of 3.5000 ± 3.50. There is a relationship of blood flow velocity (Qb) to intradialytic hypertension in hemodialysis patients at RSI Klaten with P value = 0.015 (α: 0.05).

A three-dimensional quantification of calcified and non-calcified plaques in coronary arteries based on computed tomography coronary angiography images: Comparison with expert's annotations and virtual histology intravascular ultrasound

The detection, quantification and characterization of coronary atherosclerotic plaques has a major effect on the diagnosis and treatment of coronary artery disease (CAD). Different studies have reported and evaluated the noninvasive ability of Computed Tomography Coronary Angiography (CTCA) to identify coronary plaque features. The identification of calcified plaques (CP) and non-calcified plaques (NCP) using CTCA has been extensively studied in cardiovascular research. However, NCP detection remains a challenging problem in CTCA imaging, due to the similar intensity values of NCP compared to the perivascular tissue, which surrounds the vasculature. In this work, we present a novel methodology for the identification of the plaque burden of the coronary artery and the volumetric quantification of CP and NCP utilizing CTCA images and we compare the findings with virtual histology intravascular ultrasound (VH-IVUS) and manual expert's annotations. Bland–Altman analyses were employed to assess the agreement between the presented methodology and VH-IVUS. The assessment of the plaque volume, the lesion length and the plaque area in 18 coronary lesions indicated excellent correlation with VH-IVUS. More specifically, for the CP lesions the correlation of plaque volume, lesion length and plaque area was 0.93, 0.84 and 0.85, respectively, whereas the correlation of plaque volume, lesion length and plaque area for the NCP lesions was 0.92, 0.95 and 0.81, respectively. In addition to this, the segmentation of the lumen, CP and NCP in 1350 CTCA slices indicated that the mean value of DICE coefficient is 0.72, 0.7 and 0.62, whereas the mean HD value is 1.95, 1.74 and 1.95, for the lumen, CP and NCP, respectively.

Morphometric analysis of facial and cochlear nerves in normal-hearing ears using 3D-CISS

PurposeThe aim of the current study was to establish a normative data set for the morphometric parameters of the facial nevre (FN) and cochlear nevre (CN) according to age and sex in the adult population, using 3-dimensional constructive interference in steady state (3D-CISS) sequence on magnetic resonance imaging. MethodsWe retrospectively analyzed 157 ears of 102 adults with no hearing impairment, facial palsy or Ménière's disease. The vertical (VD) and horizontal (HD) diameters as well as cross-sectional areas (CSAs) of the FNs and CNs were measured on the parasagittal oblique image created using the axial 3D-CISS sections passing through the internal acoustic canal. We related the measurement results with side, sex and age. ResultsThe mean VD, HD and CSA of the FNs were 1.09 ± 0.18 mm, 0.84 ± 0.17 mm, and 0.75 ± 0.27 mm2, respectively, whereas those of the CNs were 1.34 ± 0.17 mm, 1 ± 0.15 mm and 1.06 ± 0.3 mm2, respectively. There was no statistically significant difference between the morphometric parameters of both the nerves according to side or sex (P > 0.05). However, except for the CSA of the FNs among males, we found a statistically significant decrease in all the morphometric parameters of both the nerves with ageing (P < 0.05). ConclusionThe normative morphometric data obtained in this study can be beneficial in clinical applications for sensorineural hearing loss, facial palsy and Ménière's disease.

Creating hemodynamic atlases of cardiac 4D flow MRI.

PurposeHemodynamic atlases can add to the pathophysiological understanding of cardiac diseases. This study proposes a method to create hemodynamic atlases using 4D Flow magnetic resonance imaging (MRI). The method is demonstrated for kinetic energy (KE) and helicity density (Hd).Materials and MethodsThirteen healthy subjects underwent 4D Flow MRI at 3T. Phase‐contrast magnetic resonance cardioangiographies (PC‐MRCAs) and an average heart were created and segmented. The PC‐MRCAs, KE, and Hd were nonrigidly registered to the average heart to create atlases. The method was compared with 1) rigid, 2) affine registration of the PC‐MRCAs, and 3) affine registration of segmentations. The peak and mean KE and Hd before and after registration were calculated to evaluate interpolation error due to nonrigid registration.ResultsThe segmentations deformed using nonrigid registration overlapped (median: 92.3%) more than rigid (23.1%, P < 0.001), and affine registration of PC‐MRCAs (38.5%, P < 0.001) and affine registration of segmentations (61.5%, P < 0.001). The peak KE was 4.9 mJ using the proposed method and affine registration of segmentations (P = 0.91), 3.5 mJ using rigid registration (P < 0.001), and 4.2 mJ using affine registration of the PC‐MRCAs (P < 0.001). The mean KE was 1.1 mJ using the proposed method, 0.8 mJ using rigid registration (P < 0.001), 0.9 mJ using affine registration of the PC‐MRCAs (P < 0.001), and 1.0 mJ using affine registration of segmentations (P = 0.028). The interpolation error was 5.2 ± 2.6% at mid‐systole, 2.8 ± 3.8% at early diastole for peak KE; 9.6 ± 9.3% at mid‐systole, 4.0 ± 4.6% at early diastole, and 4.9 ± 4.6% at late diastole for peak Hd. The mean KE and Hd were not affected by interpolation.ConclusionHemodynamic atlases can be obtained with minimal user interaction using nonrigid registration of 4D Flow MRI. Level of Evidence: 2 Technical Efficacy: Stage 1J. Magn. Reson. Imaging 2017;46:1389–1399.

Modeling Mediterranean forest structure using airborne laser scanning data

The conservation of biological diversity is recognized as a fundamental component of sustainable development, and forests contribute greatly to its preservation. Structural complexity increases the potential biological diversity of a forest by creating multiple niches that can host a wide variety of species. To facilitate greater understanding of the contributions of forest structure to forest biological diversity, we modeled relationships between 14 forest structure variables and airborne laser scanning (ALS) data for two Italian study areas representing two common Mediterranean forests, conifer plantations and coppice oaks subjected to irregular intervals of unplanned and non-standard silvicultural interventions. The objectives were twofold: (i) to compare model prediction accuracies when using two types of ALS metrics, echo-based metrics and canopy height model (CHM)-based metrics, and (ii) to construct inferences in the form of confidence intervals for large area structural complexity parameters.Our results showed that the effects of the two study areas on accuracies were greater than the effects of the two types of ALS metrics. In particular, accuracies were less for the more complex study area in terms of species composition and forest structure. However, accuracies achieved using the echo-based metrics were only slightly greater than when using the CHM-based metrics, thus demonstrating that both options yield reliable and comparable results. Accuracies were greatest for dominant height (Hd) (R2=0.91; RMSE%=8.2%) and mean height weighted by basal area (R2=0.83; RMSE%=10.5%) when using the echo-based metrics, 99th percentile of the echo height distribution and interquantile distance. For the forested area, the generalized regression (GREG) estimate of mean Hd was similar to the simple random sampling (SRS) estimate, 15.5m for GREG and 16.2m SRS. Further, the GREG estimator with standard error of 0.10m was considerable more precise than the SRS estimator with standard error of 0.69m.

Segmentation precision of abdominal anatomy for MRI-based radiotherapy

The limited soft tissue visualization provided by computed tomography, the standard imaging modality for radiotherapy treatment planning and daily localization, has motivated studies on the use of magnetic resonance imaging (MRI) for better characterization of treatment sites, such as the prostate and head and neck. However, no studies have been conducted on MRI-based segmentation for the abdomen, a site that could greatly benefit from enhanced soft tissue targeting. We investigated the interobserver and intraobserver precision in segmentation of abdominal organs on MR images for treatment planning and localization. Manual segmentation of 8 abdominal organs was performed by 3 independent observers on MR images acquired from 14 healthy subjects. Observers repeated segmentation 4 separate times for each image set. Interobserver and intraobserver contouring precision was assessed by computing 3-dimensional overlap (Dice coefficient [DC]) and distance to agreement (Hausdorff distance [HD]) of segmented organs. The mean and standard deviation of intraobserver and interobserver DC and HD values were DCintraobserver = 0.89 ± 0.12, HDintraobserver = 3.6mm ± 1.5, DCinterobserver = 0.89 ± 0.15, and HDinterobserver = 3.2mm ± 1.4. Overall, metrics indicated good interobserver/intraobserver precision (mean DC > 0.7, mean HD < 4mm). Results suggest that MRI offers good segmentation precision for abdominal sites. These findings support the utility of MRI for abdominal planning and localization, as emerging MRI technologies, techniques, and onboard imaging devices are beginning to enable MRI-based radiotherapy.

The value of serum FGF-23 as a cardiovascular marker in HD patients

Fibroblast growth factor 23 (FGF-23) is a recently discovered regulator of phosphate and mineral metabolism and has been associated with both progression of CKD and mortality in dialysis patients. To evaluate the association between serum FGF-23 levels and echocardiographic measurements in long-term HD (HD) patients without cardiac symptoms, we studied 90 consecutive patients treated in a single HD center (51 males, 39 females; mean age 41.5 ± 14.2 years, mean HD duration 71.2 ± 14.2 months). Comprehensive echocardiography was performed after HD and blood samples were obtained before HD. The serum FGF-23 level in dialysis patients was 95.7 ± 88.4 pg/mL. In univariate analysis, serum calcium levels (r = 0.33, P <0.05), serum creatinine (r = 0.34, P <0.05), serum albumin (r = 0.35, P <0.05) and left ventricular mass index (LVMI) (r = 0.33, P <0.001) were correlated weakly with the FGF-23 levels. Neither s. phosphorus nor calcium x phosphorus product correlated with FGF-23. In univariate regression analysis, only LVMI [β = 0.42, P <0.05, confidence interval (CI) 0.3-4.3], serum calcium (β= 0.87, P <0.001, CI 0.8-7.3), serum albumin (β= 0.87, P < 0.001, CI 0.8-7.3) and serum creatinine (β= 0.67, P <0.05, CI 0.5-6.5) significantly correlated with FGF-23. FGF-23 was identified as a factor that is weakly associated with LVMI. Thus, FGF-23 alone may not be a parameter that can be used for evaluation of the cardiac status in HD patients.