Monitoring Treatment Effects Research Articles

Hydrogel based Flexible wearable sweat sensor for SERS-AI monitoring treatment effect of Lung Cancer

Hydrogel based Flexible wearable sweat sensor for SERS-AI monitoring treatment effect of Lung Cancer

Evaluation of the Effect of Thrombolytic Therapy on Inflammatory Markers in Patients With Acute Pulmonary Embolism.

Acute pulmonary embolism (APE) is a serious cardiovascular condition characterized by high rates of morbidity and mortality, with inflammation playing a significant role in the severity of the disease and patient outcomes. This study aimed to evaluate the effects of thrombolytic therapy on inflammatory markers in patients diagnosed with APE. The study was conducted retrospectively on 138 individuals, 69 with pulmonary embolism and 69 without pulmonary embolism (control), who were admitted to Necmettin Erbakan University between January 2019 and April 2023. Demographic information, C-reactive protein (CRP), white blood cells (WBC), neutrophils, platelets, systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), multi-inflammatory index (MII-1 and MII-2), hemoglobin, and lymphocyte-to-C-reactive protein ratio (LCR) levels of the cases were evaluated. The inflammatory markers were measured before and after thrombolytic therapy. Levels of CRP, WBC, SII, NLR, and MII-1 were significantly increased in the pulmonary embolism group compared to the control group (p<0.05). In contrast, there was a notable decrease in hemoglobin, MII-2, and LCR levels (p<0.05). In the pulmonary embolism group, levels of CRP, WBC, neutrophils, lymphocytes, hemoglobin, SII, NLR, and MII-1 were significantly lower after thrombolytic treatment compared to their levels before the treatment (p<0.05). Conversely, the post-thrombolytic treatment group exhibited significantly higher levels of platelets, PLR, and LCR compared to the pre-thrombolytic treatment group (p<0.05). The findings indicate that novel inflammatory markers, such as SII, NLR, and MII, are elevated in APE and tend to decrease following thrombolytic therapy. This suggests that these markers could be useful for monitoring treatment effectiveness and predicting patient outcomes. However, further research is necessary to confirm their clinical utility.

Innovative Applications and Perspectives of Surface-Enhanced Raman Spectroscopy Technology in Biomedicine.

Surface-enhanced Raman spectroscopy (SERS) has become a revolutionary technique in the biomedical field, providing unparalleled sensitivity for the detection and characterization of biological samples. In this review, recent SERS innovations are comprehensively discussed, including advanced substrate materials, different SERS detection strategies, and multimodal approaches that combine SERS with other biotechnologies. Among them, the role of SERS in the accurate diagnosis of tumors is highlighted, which has promoted accurate molecular analysis and real-time monitoring of treatment effects. In addition, the growing potential of SERS in the treatment of chronic diseases such as cardiovascular disease, diabetes, and neurodegenerative diseases is discussed. Moreover, the integration with microfluidic chip systems for precise single-cell analysis is presented. To give a forward-looking view, the key challenges faced by SERS technology are also proposed, and possible solutions to overcome these obstacles are provided.

CFTrack: Advanced Diagnostic, Monitoring, and Tracking Device for Cystic Fibrosis Care.

Cystic fibrosis (CF) is a genetic disorder that primarily affects the respiratory, digestive, and reproductive systems. In the United States, approximately 32,000 individuals, spanning both children and adults, suffer from CF, and roughly 1,000 new cases are diagnosed annually. The current gold standard for CF diagnosis is the sweat test, yet this method is plagued by issues such as being time-consuming, expensive, challenging to replicate, and lacking treatment monitoring capabilities. In contrast, the emerging field of wearable sweat biosensors has gained significant attention due to their potential for noninvasive health monitoring. Despite this, there remains a conspicuous absence of a wearable sweat biosensor tailored specifically for CF diagnosis and monitoring. Here, this study introduces a flexible wearable sweat biosensor, named CFTrack, designed to address the unique challenges associated with CF. This proposed CFTrack biosensor not only facilitates CF diagnosis but also enables the monitoring of medication treatment effectiveness and tracks therapy activities. In addition, it operates in a self-powered and customized manner, ensuring seamless integration into the daily lives of individuals with CF. Given that sweat tests and fitness routines are the predominant methods for diagnosing and treating cystic fibrosis patients, respectively, the proposed CFTrack biosensor leverages ion concentration in sweat for diagnostic purposes. Additionally, it incorporates a motion-tracking function to monitor physical activity, providing a comprehensive approach to CF management. To evaluate the feasibility of the proposed CFTrack biosensor, a comprehensive evaluation has been performed including numerical simulations, theoretical analyses, and experimental tests. The results demonstrate the efficacy of the proposed CFTrack biosensor in diagnosing and monitoring CF conditions while also showcasing its ability to effectively track the progress of patients undergoing physical therapy. The proposed CFTrack biosensor resolves key issues associated with existing sweat sensors including high energy consumption, intricate fabrication procedures, and the absence of continuous monitoring capabilities. By addressing these challenges, the proposed sweat biosensor aims to revolutionize CF diagnosis and monitoring, offering a more efficient and user-friendly alternative to current methods.

Development and Evaluation of a Bariatric Mannequin Simulation System.

Physical assessment of obese patients is an essential clinical skill for identifying the numerous health problems of obese patients and monitoring treatment effectiveness. Use of simulation mannequins facilitates teaching and learning of physical assessment. Available bariatric simulation mannequins have poor functional design, unrealistic appearance, and limited assessment functions. We developed a bariatric mannequin simulation system and an associated education curriculum of seven case scenario and debriefing exercises focused on health problems experienced by individuals who are obese. An innovation of our mannequin is inclusion of programmable electronics that can be used with clinical tools that receive the electronic signals; together they provide ability to assess normal and abnormal signs of a wide variety of health problems. Ten nursing faculty and 51 nursing and medical students at a Midwestern university evaluated the features and satisfaction of a prototype bariatric mannequin in separate simulation sessions using Likert-scale questionnaires. Results showed that the majority of faculty (60%) and student participants (70%+) agreed/highly agreed that the bariatric mannequin was innovative, engaging, user-friendly, useful, and likely effective for teaching or learning. Satisfaction ratings of both groups were similar. Feedback from participants was incorporated into a final refined product that improved its realistic appearance.

Abstract B047: Monitoring treatment response and toxicity in BRAF V600-mutant metastatic melanoma with circulating cell-free DNA

Abstract Background: The DREAMseq trial (EA6134, NCT02224781) was a national multi-center randomized phase III trial coordinated by ECOG-ACRIN that found that immune checkpoint inhibitor (IO) treatment achieves improved survival outcomes compared to targeted therapy (TT) in patients with BRAF V600-mutant metastatic melanoma. Still, approximately 40% of patients do not respond to IO, and existing biomarkers fail to distinguish this subset of patients who do not benefit from IO therapy. Additionally, as many as 80% of patients may experience immune- related adverse events (irAEs), which range from mild dermatological symptoms to life- threatening myocarditis. Here, we explore the use of the methylation status of cell-free DNA (cfDNA) in serially collected blood samples to measure response and toxicity in the context of IO- and TT-treated metastatic melanoma. Methods: Serial serum samples were collected from patients with BRAF V600-mutant metastatic melanoma treated with ipilimumab/nivolumab (IO) or dabrafenib/trametinib (TT). Circulating cfDNA was isolated from serially collected serum samples, enriched for regions of interest by hybridization capture and sequenced using enzymatic methyl-seq. Cell-type deconvolution was performed to determine the abundance of cell type- specific methylation patterns of cfDNA molecules in patient serum at different time points of treatment. The BRAF V600 mutation abundance in total cfDNA was also assessed. Results: We identified melanocyte lineage-specific DNA methylation regions and demonstrate that the methylation status of these regions remains conserved in malignant melanoma. We characterized the changes in abundance of the melanocyte-lineage cfDNA over the course of treatment and show that these changes distinguish responders from non-responders to either IO or TT. Furthermore, we track the abundance of cell type-specific DNA from normal tissues to identify markers indicative of adverse effects or disease progression. Conclusions: We established melanocyte-lineage methylation markers and evaluated the use of cell-type specific DNA methylation to monitor treatment effects of immune checkpoint or BRAF/MEK inhibitors in metastatic melanoma using serially collected blood samples. Citation Format: Sidharth S Jain, A. Patrick IV McDeed, Megan E McNamara, Amber R Alley, Dori S Rosenstrauch, Harry Sun, Natalie Thompson, John M Kirkwood, Geoffrey T Gibney, Michael B Atkins, Anton Wellstein. Monitoring treatment response and toxicity in BRAF V600-mutant metastatic melanoma with circulating cell-free DNA [abstract]. In: Proceedings of the AACR Special Conference: Liquid Biopsy: From Discovery to Clinical Implementation; 2024 Nov 13-16; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(21_Suppl):Abstract nr B047.

NIMG-26. GLIOBLASTOMA TISSUE INVASION MAPPING WITH NOVEL HYPOXIA-TARGETED BLOOD OXYGENATION-LEVEL DEPENDENT MRI

Abstract BACKGROUND Glioblastoma is a devastating incurable malignant primary brain tumor exhibiting an erratic growth pattern and brain tissue invasion exceeding the typically depicted contrast-enhancing lesion on MRI. This behaviour is strongly associated with the presence of aberrant vasculature. Advanced clinical neuroimaging techniques, however, have not provided convincing imaging markers to determine glioblastoma tissue infiltration and monitor treatment effects. We investigated a new imaging technique based on blood oxygenation-level dependent (BOLD) MRI contrast with precise hypoxic respiratory targeting in order to better determine tumor tissue invasion not restricted to the typically depicted focal glioblastoma lesion on contrast-enhanced MRI. METHODS A computer-controlled gas blender was used to induce transient and standardized hypoxic stimulus in isocapnic conditions during echo-planar-imaging acquisition in patients with brain tumors.8,9 Data were preprocessed using SPM and in-house written MATLAB scripts. The induced BOLD signal changes were used to calculate %BOLD signal change during hypoxic stimulus with respect to the baseline, contrast to noise (CNR) ratio and goodness-of-fit (Rsquared) for each voxel in the whole-brain and automatically segmented region of interest (contrast-enhancement, necrosis, edema) and overlayed using color-maps onto anatomical high resolution T1. RESULTS Hypoxic targeting during gas modulation could be performed with high reproducibility, caused no discomfort in patients with brain tumors and was able to induce strong signal change during hypoxic stimulus with high contrast-noise ratio and Rsquared. In particular, when compared with other tumors, BOLD hypoxia glioblastoma tissue invasion maps show very distinct hypoxic signal responses in some cases extending beyond the focal -contrast-enhancing- glioblastoma lesion. CONCLUSION The ability to map at voxel level BOLD hypoxia signal patterns may determine a novel therapeutic imaging marker based on structural vascular alterations in the tumour tissue infiltration zone before these become appreciable with standard neuroimaging. This may support a refinement and tailoring of tumor resection and improve follow-up after resection and during treatment i.e. chemoradiotherapy.

Research progress of organic small probes sensitive to tumor microenvironment

The development, metastasis, and spread of malignant tumors are closely associated with the inherent properties of tumor cells. These tumors often exhibit low pH, low polarity, high viscosity, and hypoxia. Understanding these characteristics is essential for early cancer detection and monitoring treatment effectiveness. Small molecule fluorescent probes have emerged as powerful tools for real-time localization, dynamic detection, and visualization of tumors. In this paper, we review recent progress in the use of these probes to study tumor biology, focusing on their design strategies, response mechanisms, and preclinical applications for detecting pH, viscosity, polarity, and hypoxia.

Spinal Cord Blood Perfusion Deficit is Associated with Clinical Impairment after Spinal Cord Injury.

Spinal cord injury (SCI) results in intramedullary microvasculature disruption and blood perfusion deficit at and remote from the injury site. However, the relationship between remote vascular impairment and functional recovery remains understudied. We characterized perfusion impairment invivo, rostral to the injury, using magnetic resonance imaging (MRI), and investigated its association with lesion extent and impairment following SCI. Twenty-one patients with chronic cervical SCI and 39 healthy controls (HC) underwent a high-resolution MRI protocol, including intravoxel incoherent motion (IVIM) and T2*-weighted MRI covering C1-C3 cervical levels, as well as T2-weighted MRI to determine lesion volumes. IVIM matrices (i.e., blood volume fraction, velocity, flow indices, and diffusion) and cord structural characteristics were calculated to assess perfusion changes and cervical cord atrophy, respectively. Patients with SCI additionally underwent a standard clinical examination protocol to assess functional impairment. Correlation analysis was used to investigate associations between IVIM parameters with lesion volume and sensorimotor dysfunction. Cervical cord white and gray matter were atrophied (27.60% and 21.10%, p < 0.0001, respectively) above the cervical cord injury, accompanied by a lower blood volume fraction (-22.05%, p < 0.001) and a higher blood velocity-related index (+38.72%, p < 0.0001) in patients with SCI compared with HC. Crucially, gray matter remote perfusion deficit correlated with larger lesion volumes and clinical impairment. This study shows clinically eloquent perfusion deficit rostral to a SCI, its magnitude driven by injury severity. These findings indicate trauma-induced widespread microvascular alterations beyond the injury site. Perfusion MRI matrices in the spinal cord hold promise as biomarkers for monitoring treatment effects and dynamic changes in microvasculature integrity following SCI.

Histomorphometric analysis of excisional cutaneous wounds with different diameters in an animal model.

The skin wound model in rats is a fundamental stage in preclinical trials, but there is a lack of standardization in these trials regarding the initial wound area, making analysis and comparison between studies difficult. Therefore, this study evaluates the healing progression of excisional skin lesions of varying diameters in Wistar rats, aiming to identify the optimal wound size for monitoring treatment effects on wound healing. Excisions of 0.8, 1.5, 2.0 and 3.0 cm in diameter were made on the back of the animals. Thirty animals were used per treatment and evaluated on days 3, 7, 10, 14 and 21 after surgery. The lesions were cleaned daily with saline solution until they were completely closed. The 0.8 cm group showed complete repair on D14, while in the other groups, the wounds persisted until day 21, with a reddened surface and no complete epidermal coverage, but with greater keratinization and presence of appendages in the 1.5 cm lesions. Therefore, as a standardization model for creating skin wounds, we suggest using 1.5 or 2.0 cm excisions, considering that 0.8 cm wounds close very early and 3.0 cm wounds, although behaving similarly to 2.0 cm wounds, are more invasive for the animals. The 1.5 cm model proved to be suitable for closure within 21 days. When evaluating a product intended to accelerate wound healing, 2.0 cm lesions are recommended to assess the effectiveness of the treatment.

Validation of a brief image elicitation task as an indicator of subjective wellbeing in the general population.

A novel image-based method (AgileBrain) demonstrates construct validity as a measure of wellbeing in the general working adult population. Analysis of data from four large nationally representative samples of American full-time workers employed by mid-to-large size companies conducted in November 2021 (n = 812), May 2022 (n = 810), June 2023 (n = 986), and January 2024 (n = 1,179). Across all four studies, AgileBrain demonstrates convergent validity across multiple established indicators of subjective wellbeing including the Patient Health Questionnaire (PHQ-9), Center for Epidemiological Studies Depression Scale (CESD-10), Generalized Anxiety Disorder Scale (GAD-7), Neuroticism (BFI-S), UCLA Loneliness Scale, Perceived Stress Scale (PSS-10), Coping Styles (Brief COPE-28), self-reported diagnosed neurodiversity conditions and symptoms, and trauma history. Results across these studies suggest that AgileBrain is useful as a screening tool for detecting compromised wellbeing in terms of construct validity. Given strong preferences for brief, gamified assessments, the validity advantages stemming from less consciously controllable responses, and the statistical advantages of measures associated with high response rates and normal distributions, AgileBrain emerges as strong tool for assessing subjective wellbeing at the population level and offers a promising approach to monitoring treatment effectiveness.

Liraglutide for the Treatment of Severe Hypoglycemia Following Total Pancreatectomy and Islet Autotransplantation

Abstract Total pancreatectomy and islet autotransplantation (TPIAT) is an effective treatment for chronic and recurrent acute pancreatitis, and it provides a significant potential additional benefit of insulin independence. Spontaneous hypoglycemia in the absence of insulin therapy following TPIAT is a recognized complication, which has been attributed to lack of protective glucagon responses to hypoglycemia, following intrahepatic islet autotransplantation. We describe the use of liraglutide to treat spontaneous hypoglycemia following TPIAT. Continuous glucose monitoring was used to identify timing of hypoglycemia in relation to meals and monitor treatment effect. Liraglutide has been used for management of hypoglycemia following bariatric surgery, but, to our knowledge, this is the first application of its effective use to treat spontaneous severe hypoglycemia following TPIAT.

Diffuse correlation tomography: a technique to characterize tissue blood flow abnormalities in benign and malignant breast lesions.

Accurate assessment and quantification of neoangiogenesis associated with breast cancer could be potentially used to improve the sensitivity and specificity of non-invasive diagnosis, as well as predict outcomes and monitor treatment effects. In this study, we adapted an emerging technology, namely diffuse correlation tomography (DCT), to image microvascular blood flow in breast tissues and evaluate the potential for discriminating between benign and malignant lesions. A custom-made DCT system was designed for breast blood flow imaging, with both the source-detector array and reconstruction algorithm optimized to ensure precise imaging of breast blood flow. The global features and local features of three-dimensional blood flow images were extracted from the relative blood flow index (rBFI), which was obtained from most of the breasts targeted to the lesion. A total of 37 women with 19 benign and 18 malignant lesions were included in the study. Significant differences between malignant and benign groups were found in 12 image features. Moreover, when selecting the lesion mean relative blood flow index (MrBFI) as a single indicator, the malignant and benign tumors were discriminated with an accuracy of 89.2%. The blood flow features were found to successfully identify malignant and benign tumors, suggesting that DCT, as an alternate functional imaging modality, has the potential to be translated into clinical practice for diagnosis and assessment of breast cancers. There is potential to reduce the need for biopsy of benign lesions by improving the specificity of diagnostic imaging, as well as monitoring response to breast cancer treatment.

Global Metabolomics Using LC-MS for Clinical Applications.

Metabolomics can be used for a multitude of purposes, including monitoring of treatment effects and for increasing the knowledge of the pathophysiology of a wide range of diseases. Global (commonly referred to as "untargeted") metabolomics is hypothesis-generating and provides the opportunity to discover new biomarkers. Being versatile and having a high degree of selectivity and sensitivity, liquid chromatography-mass spectrometry (LC-MS) is the most common technique applied for metabolomics. We here present our global metabolomics LC-electrospray ionization-MS/MS method. The sample preparation procedures for plasma, serum, dried blood spots, urine, and cerebrospinal fluid are simple and nonspecific to reduce the risk of analyte loss. The method is based on reversed-phase chromatography using a diphenyl column. The high-resolution Q Exactive Orbitrap MS with data-dependent acquisition provides MS/MS spectra of a wide range of analytes. Our method covers a large part of the metabolome regarding hydrophobicity and compound class.

Liver Fatty Acid-Binding Protein as a Diagnostic Marker for Non-Alcoholic Fatty Liver Disease

Abstract Background NAFLD is the most common cause of chronic liver disease in the developed world and represents a spectrum of diseases with some patients developing cirrhosis and hepatocellular carcinoma. Fatty acid-binding proteins (FABPs) are a family of small and highly conserved lipid chaperone molecules with highly varied functions. Different members of the FABP family exhibit unique patterns of tissue expression and are expressed most abundantly in tissues involved in active lipid metabolism in hepatocytes, adipocytes and cardiac myocytes, where fatty acids are prominent substrates for lipid biosynthesis, storage or breakdown, the respective FABPs make up between 1% and 5% of all soluble cytosolic proteins. In the hepatic lobule, L-FABP is expressed in hepatocytes in a declining gradient from portal to central location. L-FABP is a protein involved in multiple biologic functions, such as intracellular fatty acid transport, cholesterol and phospholopid metabolism, which plays an important facilitative role in hepatic fatty acid oxidation. Some studies reported that L-FABP level is increased in NAFLD. Therefore, it is preferable to use effective noninvasive methods in clinical practice for identifying NAFLD, tracking disease processes, and monitoring treatment effects. Many studies demonstrated that serological markers are beneficial as noninvasive tools for diagnosis of NAFLD. This study was conducted to determine whether serum L-FABP has a diagnostic value as a marker for NAFLD. Patients and Methods We enrolled in this study 80 consecutive patients with NAFLD who were diagnosed with Ultrasonography and Fibroscan with CAP. The control group consisted of 20 healthy control subjects matched for age and gender. Serum levels of L-FABP were determined by enzyme-linked immunosorbent assay. Results L-FABP levels in NAFLD patients were higher than in the control group (p &amp;lt; 0.05). Conclusion Serum L-FABP could be considered as a reliable non-invasive marker for detection of NAFLD.

Two Decades of High-Resolution Peripheral Quantitative Computed Tomography: Present and Future Clinical Perspectives.

Twenty years have passed since the introduction of high-resolution peripheral quantitative computed tomography (HR-pQCT) to assess human bone microarchitecture. During that time, the technique has emerged as an important research tool used by clinicians and scientists to learn about the pathophysiology of bone adaptation in the context of osteoporosis and many other bone-affected conditions. Its rich three-dimensional data is well suited for precise longitudinal monitoring of bone microarchitecture and associated patient-specific estimated bone strength.However, uptake of HR-pQCT as a clinical diagnostic tool has been limited, in part due to challenges such as availability, regulatory approvals, and demonstrated cost effectiveness. New research suggests fracture risk assessment using HR-pQCT is comparable with current standards based on traditional bone densitometry, but its contribution to clinical care is best suited to two areas: (1) leveraging microarchitectural information to assist in treatment decisions for the large subset of patients who lie in the so-called gray zone by current fracture risk assessment, and (2) longitudinal monitoring that establishes highly refined trajectories of bone adaptation and can inform decisions to initiate treatment, monitor treatment effects, and inform cessation.

Visualization and characterization of complement activation in acetylcholine receptor antibody seropositive myasthenia gravis.

There are no blood biomarkers to monitor treatment effects in myasthenia gravis (MG) or studies visualizing the acetylcholine receptor (AChR) antibody-induced membrane attack complex (MAC) at the human muscle membrane. This study aimed to compare levels of complement activation products and native complement components in MG patients and healthy controls (HCs) and to model the AChR antibody-mediated attacks in human muscle cells. We assessed the complement components and activation product levels with enzyme-linked immunosorbent assay and magnetic bead-based sandwich assays in plasma and sera of 23 MG patients and matched HCs. Receiver operator characteristic (ROC) curve analysis evaluated the diagnostic accuracy. Complement levels were correlated with the myasthenia gravis composite (MGC) scores. AChR+ MG modeling in human muscle cells used sera from nine MG patients and three HCs. MG patients had significantly higher plasma levels of C3a (p < .0001), C5 (p = .0003), and soluble C5b-9 (sC5b-9; p < .0001) than HCs. The ROC curve analysis showed a clear separation between MG patients and HCs for plasma C3a (AUC = 0.9720; p < .0001) and sC5b-9 (AUC = 0.8917, p < .0001). MG patients had higher levels of plasma complement Factor I (FI; p = .0002) and lower properdin levels (p < .0001). The MGC had moderate correlations with plasma Factor B (FB), FI, and Factor H. AChR+ MG patient sera triggered the deposition of MAC and reduced AChRs. We suggest validating plasma C3a and sC5b-9 as blood biomarkers for complement activation in MG. Further, the in vitro study allowed visualization of MAC deposition after applying AChR+ MG sera on human muscle cells.

Treatment outcomes in retinoblastoma and the effect of tumor topography.

Retinoblastoma, the most common intraocular malignancy in children, has high fatality rates if untreated. It is crucial to monitor treatment effectiveness and explore factors influencing favorable outcomes. Our study aims to examine how tumor location impacts the response to standard treatments and the achievement of favorable outcomes among retinoblastoma patients, while controlling for other tumor-related factors. This retrospective study analyzed medical records of retinoblastoma patients from November 2012 to December 2022 enrolled in the retinoblastoma program at the Children's Cancer Center of Lebanon (established in collaboration with St.yJude Children's Research Hospital, Memphis, TN). Data were extracted from the electronic chart reviews and operative reports of examinations under anesthesia (EUAs), and included patient's demographics, tumor characteristics (size, location), and treatment parameters (treatment type, resolution, recurrence). The study included 42 patients with retinoblastoma, with a total of 57 eyes and 115 tumors/lesions. The median age at diagnosis was 12months (range: 2-36months). Among the patients, 26 (61.9%) were males and 16 (38.1%) were females. A minority of patients (21.4%) presented with unilateral involvement, whereas the majority (78.6%) had bilateral involvement. The locations of retinoblastoma lesions were distributed as follows: optic nerve (4.4%), macula (19.1%), superior (16.5%), inferior (17.4%), nasal (27.8%), and temporal (14.8%). Resolution rate tended to be highest for tumors close to optic nerve and temporal lesions, but no statistical significance was attained (p=.45). Macular lesions tended to have the fastest resolution, but again not significantly (p=.5). Multiple logistic regression revealed that the odds for resolution of tumor was not significantly associated with tumor size (p=.57) or location (p=.52). Location of retinoblastoma lesions was not directly associated with recurrence-free resolution in our cohort. Further research in large retinoblastoma databases is needed to explore the association of tumor characteristics with recurrence and the need for secondary therapeutic interventions.

A deep learning approach for white blood cells image generation and classification using SRGAN and VGG19

The classification of White Blood Cells (WBCs) is crucial for diagnosing diseases, monitoring treatment effectiveness, and understanding how the immune system functions. In this paper, we propose a deep learning approach to classify WBCs using Super Resolution Generative Adversarial Network (SRGAN) and Visual Geometry Group 19 (VGG19). Firstly, microscopic images of WBCs are generated using the SRGAN to obtain more precise and high-resolution images, which are then classified with a pretrained VGG19 classifier. Low-resolution (LR) images are inputted into the generator of SRGAN, and its discriminator compares the High-resolution (HR) image with LR, generating super-resolution images to minimize misclassification risks. A large dataset of 12,447 images containing four classes of WBCs (Eosinophil, Lymphocyte, Monocyte, and Neutrophil) is utilized to train and validate our proposed model. Following extensive experimental analysis, our proposed model achieves a test accuracy of 94.87 %, surpassing traditional Convolutional Neural Network (CNN), Recurrent Neural Network (RNN), Hybrid CNN-RNN models, and other conventional approaches. The generated images of SRGAN overcome challenges associated with misclassification due to the poor resolution of microscopic images, while the use of a pretrained model as a classifier reduces classification complexity. The source code of the entire work is available at https://github.com/Jannatul-Ferdousi/SRGAN_VGG19_WBC.git.

Novel biophysical skin biomarkers discriminate topical anti‐inflammatory treatments based on their potential for local adverse effects

AbstractBackgroundTopical corticosteroids (TCS) are efficacious treatments for inflammatory skin conditions, however, there is a risk of adverse effects; understanding how best to use these treatments is an unmet research priority shared by patients and healthcare professionals.ObjectivesTo develop non‐invasive biomarkers of local adverse effects to facilitate the optimisation of topical therapy.MethodsAn observer‐blind randomised within‐subject controlled trial in atopic dermatitis patients was undertaken (NCT04194814) comparing betamethasone valerate 0.1% cream (BMV) to a non‐steroidal anti‐inflammatory treatment, crisaborole 2% ointment (CRB). Participants underwent 4 weeks twice‐daily treatment with CRB on one forearm and BMV on the other (left/right randomised). Skin properties were assessed on days 1, 15, 29 of treatment and again on day 57, including imaging of skin microstructure using Optical Coherence Tomography (OCT) and Attenuated Total Reflectance (ATR)‐Fourier Transform Infrared (FTIR) spectroscopic assessment of stratum corneum molecular structure. The primary outcome was the difference in the change in epidermal thickness from days 1 to 29.ResultsThirty‐seven participants received the first dose, of which 32 completed the study (all 37 were included in the analysis). Pathologic epidermal thinning at day 29 was significantly greater (p &lt; 0.0001) at sites treated with BMV (−31.66; 95% confidence interval: −35.31, −28.01 µm) compared to CRB (−13.76; −17.42, −10.10 µm). From a panel of exploratory biomarkers, superficial plexus depth and stratum corneum carboxyl group levels had the greatest ability to discriminate the effects of the TCS treatment (p &lt; 0.0001).ConclusionsBMV induced 2.3x more pathologic epidermal thinning than CRB after 4 weeks of treatment, suggesting that CRB may be more appropriate for longer‐term, proactive‐based, treatment strategies where the risks of adverse effects are greatest. By monitoring treatment effects using OCT and ATR‐FTIR spectroscopy, two new non‐invasive biomarkers of skin health have been identified with the potential to help optimise future safe treatment strategies.