Non-invasive Method For Assessment Research Articles

Non-invasive Scores and Serum Biomarkers for Fatty Liver in the Era of Metabolic Dysfunction-associated Steatotic Liver Disease (MASLD): A Comprehensive Review From NAFLD to MAFLD and MASLD.

The prevalence of non-alcoholic fatty liver disease (NAFLD) is rapidly increasing worldwide, making it the leading cause of liver related morbidity and mortality. Currently, liver biopsy is the gold standard for assessing individuals with steatohepatitis and fibrosis. However, its invasiveness, sampling variability, and impracticality for large-scale screening has driven the search for non-invasive methods for early diagnosis and staging. In this review, we comprehensively summarise the evidence on the diagnostic performance and limitations of existing non-invasive serum biomarkers and scores in the diagnosis and evaluation of steatosis, steatohepatitis, and fibrosis. Several non-invasive serum biomarkers and scores have been developed over the last decade, although none has successfully been able to replace liver biopsy. The introduction of new NAFLD terminology, namely metabolic dysfunction-associated fatty liver disease (MAFLD) and more recently metabolic dysfunction-associated steatotic liver disease (MASLD), has initiated a debate on the interchangeability of these terminologies. Indeed, there is a need for more research on the variability of the performance of non-invasive serum biomarkers and scores across the diagnostic entities of NAFLD, MAFLD and MASLD. There remains a significant need for finding valid and reliable non-invasive methods for early diagnosis and assessment of steatohepatitis and fibrosis to facilitate prompt risk stratification and management to prevent disease progression and complications. Further exploration of the landscape of MASLD under the newly defined disease subtypes is warranted, with the need for more robust evidence to support the use of commonly used serum scores against the new MASLD criteria and validation of previously developed scores.

Diagnostics of acute compartment syndrome : Current gold standard and the state of science of noninvasive assessment methods

Acute compartment syndrome (ACS) is defined by a disorder of the microcirculation due to a persistent pathological pressure increase within amuscle compartment. The ischemia of the tissue leads to an initially reversible functional impairment and finally irreversible damage of the musculature, nerves and other structures. Based on the understanding of the pathophysiology, the current diagnostic concepts and treatment using the so-called dermatofasciotomy of the affected muscle compartments can be derived. In addition to the suspicion of a possible ACS based on the medical history of the patient, the findings of the clinical examination are decisive. This review article gives a summary of all the essential aspects of the diagnostics. In clinically uncertain cases and for monitoring, an objectification of the findings using instrument-based techniques is increasingly required. Nowadays, invasive needle pressure measurement is available; however, due to limited reliability, specificity and sensitivity, these measurements only represent an aid to decision guidance supporting or advising against the indications for dermatofasciotomy. The increasing demands on making a certain diagnosis and justification of a surgical intervention from a legal point of view, substantiate the numerous scientific efforts to develop noninvasive instrument-based diagnostics. These methods are based either on detection of increasing intracompartmental pressure or decreasing perfusion pressure and microcirculation. The various measurement principles are summarized in a lucid form.

The role and place of arthroscopy in the early diagnosis of monoarthrosis (literature review)

Background. Knee osteoarthritis is a progressive incurable disease that in severe cases leads to total joint replacement, which requires significant economic costs and medical and social adaptation, has a number of postoperative complications and adverse outcomes. Therefore, special attention has recently been paid to the prevention and treatment of the early stages of the disease. The purpose of the study was to conduct a systematic analysis of scientific literature on the prospects and possibilities of using arthroscopy in the early diagnosis of monoarthrosis. Material and methods. A literature search was conducted in the PubMed and MEDLINE databases for 2010–2024 using the following medical subject headings and keywords: “deforming osteoarthritis of the knee joint”, “osteoarthritis of the knee joint”, “unilateral deforming osteoarthritis of the knee joint”, “unilateral osteoarthritis of the knee joint”, “gonarthrosis”, “monoarthrosis”, “arthroscopy”, “diagnosis”, “treatment”. If necessary, literature sources beyond the search period were used in some cases. A general search revealed 48 references on the use of arthroscopy as a diagnostic and therapeutic method in the early stages of monoarthrosis. The primary exclusion concerned the literature in which arthroscopy was used for the diagnosis and treatment of late-stage knee osteoarthritis (n = 38). The secondary exclusion included literature sources that contained only background information (summary, figures, references) (n = 12). As a result, only relevant full-text articles in professional journals remained (n = 15). Results. The lack of correlation between clinical symptoms and radiological signs of knee osteoarthritis causes low availability of orthopaedic care: more than 30 % of newly diagnosed patients have a severe stage of the disease, and in some cases the pathology is detected only in connection with the manifestation of complications; the diagnosis of osteoarthritis due to a large percentage of painless development of the disease (40 %) is often established at terminal stages. All of this suggests the need for further research into the various factors that influence the frequency, prevalence, economic and social burden of knee osteoarthritis. Arthroscopy is potentially the gold standard for validating non-invasive assessment methods such as magnetic resonance imaging, as it provides high magnification and direct view of articular cartilage with non-destructive interactive assessment of its structure and functional properties. Arthroscopy allows for a more detailed description of the depth and extent of lesions, as well as the detection of subtle changes such as cartilage softening, fibrillations, and tangential peeling. Clinical symptoms and structural changes in the knee joint elements visualised during arthroscopy in patients with monoarthrosis are covered in a few studies, some of which were published 10 years ago. The results of modern arthroscopic studies can be an important contribution to the development of diagnostic and differential diagnostic criteria for the early stages of monoarthrosis. Conclusions. Based on information and analytical studies of modern scientific literature, it has been found that knee osteoarthritis is accompanied by persistent pain, significant limitation of the lower limb function, and reduced ability to work, which often leads to joint replacement. Diagnosis of osteoarthritis in the early stages is difficult due to the absence of pathognomonic clinical, radiological and laboratory parameters, and in case of monoarthrosis with synovitis, it is complicated by differentiation with specific arthritis of the knee joint. Arthroscopy allows performing the necessary scope of diagnostic and therapeutic measures with verification of the pathological process and determination of gonarthrosis stage.

Body composition analysis using dual-energy x-ray absorptiometry in an Egyptian pediatric sickle cell disease cohort.

Growth failure is commonly encountered in sickle cell disease (SCD). Tissue compartment growth and development are subsequently likely to be altered in such patients. We aimed to analyze body composition in an Egyptian pediatric SCD cohort using dual-energy x-ray absorptiometry (DEXA), one of the most comprehensive and noninvasive assessment methods available. Forty children with SCD ≤18years and 40 healthy youngsters age- and gender-matched were enrolled. Patients' demographic, clinical, and laboratory parameters were obtained from their archived files. All patients and controls were subjected to body composition assessment using a MedixDR-Whole Body DEXA System. In SCD patients; weight and height relative to age Z scores were significantly lower (p<.001), total body lean was significantly higher (p=.006), and total body fat percentage was lower, yet the difference was not statistically significant (p=.09). There were no statistically significant variations in bone mineral density or content, basal metabolic rate, subcutaneous adipose tissue, android/gynoid fat ratio, and visceral adipose tissue. There were no significant gender disparities between SCD patients and controls. Faltering growth in children with SCD should be addressed with a multidisciplinary approach including nutritional support, correction of anemia, and proper medical care. Body composition parameters assessed using DEXA were comparable between cases and controls apart from total body lean. Further clinical studies are needed with multicenter cooperation and a larger sample size to assess the usefulness of DEXA as an assessment tool for body composition in children with SCD.

Impact of obstruction size on ureter dynamics: A computational investigation

Kidney stones, known medically as nephrolithiasis, present a significant health concern globally, particularly in regions such as India and the Middle East. Despite extensive research, the complexity of ureteral obstruction due to kidney stones remains a challenge in urology. This study addresses this gap by analysing the effects of obstruction in a three-dimensional model of the ureter with a constant diameter, simulating various percentages of blockage. Through computational analysis, the pressure and velocity effects on the ureter wall are explored, providing insights into the dynamics of obstructed ureters. Building upon previous research, this study contributes to a deeper understanding of the factors influencing flow patterns and pressure variations within the urinary tract. Additionally, findings from this study may lead to advancements in non-invasive assessment methods for diagnosing and treating ureteral obstruction caused by kidney stones. Furthermore, insights gained from this research could potentially inform clinical decision-making, leading to improved management strategies and better outcomes for patients affected by this debilitating condition. The novelty of this work lies in its comprehensive analysis of the effects of obstruction on the ureteral wall, offering valuable implications for urological practice and patient care.

Interpretable machine learning based on CT-derived extracellular volume fraction to predict pathological grading of hepatocellular carcinoma.

To develop a non-invasive auxiliary assessment method based on CT-derived extracellular volume (ECV) to predict the pathological grading (PG) of hepatocellular carcinoma (HCC). The study retrospectively analyzed 238 patients who underwent HCC resection surgery between January 2013 and April 2023. Six machine learning algorithms were employed to construct predictive models for HCC PG: logistic regression, extreme gradient boosting, Light Gradient Boosting Machine (LightGBM), random forest, adaptive boosting, and Gaussian naive Bayes. Model performance was evaluated using receiver operating characteristic curve analysis, including area under the curve (AUC), sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and F1 score. Calibration plots were used for visual evaluation of model calibration. Clinical decision curve analysis was performed to assess potential clinical utility by calculating net benefit. 166 patients from Hospital A were allocated to the training set, while 72 patients from Hospital B (constituting 30.25% of the total sample) were assigned to the test set. The model achieved an AUC of 1.000 (95%CI: 1.000-1.000) in the training set and 0.927 (95%CI: 0.837-0.999) in the validation set, respectively. Ultimately, the model achieved an AUC of 0.909 (95%CI: 0.837-0.980) in the test set, with an accuracy of 0.778, sensitivity of 0.906, specificity of 0.789, negative predictive value of 0.556, and F1 score of 0.908. This study successfully developed and validated a non-invasive auxiliary assessment method based on CT-derived ECV to predict the HCC PG, providing important supplementary information for clinical decision-making.

Proteomic biomarkers for noninvasive left atrial appendage thrombus prediction in patients with atrial fibrillation

IntroductionThe CHA2DS2-VASc score, used to assess the risk of left atrial appendage thrombus (LAAT) formation in patients with atrial fibrillation (AF), has limited predictive value. Moreover, transesophageal echocardiography imaging, the gold standard diagnostic method to identify thrombi, is semi-invasive. Consequently, there is a need for alternative and noninvasive diagnostic methods for LAAT risk assessment. MethodsDeep proteomic analysis was conducted in plasma samples from 8 patients with nonvalvular AF, divided into thrombus and control groups (4 patients in each group) based on the presence or absence of LAAT. Biomarkers associated with LAAT were validated using an enzyme-linked immunosorbent assay in a cohort of 179 patients with available clinical, transthoracic, and transesophageal echocardiography data. Predictive models were developed to assess the improvement in LAAT identification. ResultsThe LAAT group had higher CHA2DS2-VASc scores, larger LA diameter, and lower LAA flow velocities. Deep proteomic analysis identified 30 differentially expressed proteins, including myosin light chain 4, prenylcysteine oxidase 1 (PCYOX1), and decorin as potential diagnostic biomarkers of LAAT. The model showed that PCYOX1 and decorin provided an area under the curve (AUC) of 0.970 for LAAT prediction compared with 0.672 in a model including the CHA2DS2-VASc score and LAA cauliflower morphology. The incremental value of proteomic biomarkers for LAAT in patients with nonvalvular AF was further confirmed with the net reclassification improvement and integrated discrimination improvement indices. ConclusionsProtein levels of PCYOX1 and decorin improve the predictive performance for LAAT in patients with nonvalvular AF.

Establishment and validation of multiclassification prediction models for pulmonary nodules based on machine learning.

Lung cancer is the leading cause of cancer-related death worldwide. This study aimed to establish novel multiclassification prediction models based on machine learning (ML) to predict the probability of malignancy in pulmonary nodules (PNs) and to compare with three published models. Nine hundred fourteen patients with PNs were collected from four medical institutions (A, B, C and D), which were organized into tables containing clinical features, radiologic features and laboratory test features. Patients were divided into benign lesion (BL), precursor lesion (PL) and malignant lesion (ML) groups according to pathological diagnosis. Approximately 80% of patients in A (total/male: 632/269, age: 57.73 ± 11.06) were randomly selected as a training set; the remaining 20% were used as an internal test set; and the patients in B (total/male: 94/53, age: 60.04 ± 11.22), C (total/male: 94/47, age: 59.30 ±9.86) and D (total/male: 94/61, age: 62.0± 11.09) were used as an external validation set. Logical regression (LR), decision tree (DT), random forest (RF) and support vector machine (SVM) were used to establish prediction models. Finally, the Mayo model, Peking University People's Hospital (PKUPH) model and Brock model were externally validated in our patients. The AUC values of RF model for MLs, PLs and BLs were 0.80 (95% CI: 0.73-0.88), 0.90 (95% CI: 0.82-0.99) and 0.75 (95% CI: 0.67-0.88), respectively. The weighted average AUC value of the RF model for the external validation set was 0.71 (95% CI: 0.67-0.73), and its AUC values for MLs, PLs and BLs were 0.71 (95% CI: 0.68-0.79), 0.98 (95% CI: 0.88-1.07) and 0.68 (95% CI: 0.61-0.74), respectively. The AUC values of the Mayo model, PKUPH model and Brock model were 0.68 (95% CI: 0.62-0.74), 0.64 (95% CI: 0.58-0.70) and 0.57 (95% CI: 0.49-0.65), respectively. The RF model performed best, and its predictive performance was better than that of the three published models, which may provide a new noninvasive method for the risk assessment of PNs.

Echocardiographic Features in Patient Rheumatic Mitral Stenosis

Rheumatic mitral stenosis (RMS) is a progressive valvular heart disease that can lead to significant morbidity and mortality, especially in developing countries. Echocardiography plays a crucial role in the diagnosis, assessment, and management of patients with RMS. This study aims to review the utility echocardiography feature in patient RMS. We discuss the key echocardiographic parameters used for assessment and severity of RMS, and associated valvular abnormalities. Additionally, we explore the role of multimodality imaging, such as transesophageal echocardiography in enhancing the diagnostic accuracy and therapeutic decision-making in RMS. A thorough understanding of echocardiographic findings in RMS is essential for clinicians involved in the care of these patients, as it aids in risk stratification, treatment planning, and monitoring of disease progression. Integrating echocardiography is a widely used non-invasive method for comprehensive assessment, monitoring disease progression and evaluating treatment efficacy, ensuring optimal management for patient with RMS. Keyword: Echocardiography, Rheumatic Heart Disease, Mitral Stenosis.

Progress and Prospects of Elastography Techniques in the evaluation of fibrosis in chronic liver disease

The precise assessment of liver fibrosis degree is imperative for monitoring and managing chronic liver diseases. Traditionally, liver biopsy and quantitative blood biomarkers have been the mainstays for fibrosis assessment, albeit each with its inherent limitations. However, the emergence of elastography presents a promising non-invasive alternative, potentially supplanting or complementing traditional biomarkers. In contrast to conventional biomarkers, elastography offers several advantages. Firstly, it is non-invasive, sidestepping the risks and discomfort associated with liver biopsy. Secondly, this technique provides real-time and intuitive fibrosis assessments, characterized by user-friendly operation and high reproducibility. Thirdly, elastography excels in diagnosing moderate to severe fibrosis, vital for determining treatment strategies and monitoring disease progression. Notably, MRE stands out as the most accurate non-invasive method for fibrosis assessment, especially suitable for advanced fibrotic stages. This article provides an overview of the advancements in elastography as a viable quantitative biomarker for chronic liver disease fibrosis burden.

Using ICG navigation in resection of a horseshoe kidney

BACKGROUND: In this publication, we present a new area of application of indocyanine green (ICG) imaging in pediatric surgery. We used this advanced method to evaluate the resection margins of a functional segment of the horseshoe kidney after intravenous indocyanine green. CLINICAL CASE DESCRIPTION: The article presents a case of treatment of a horseshoe kidney complicated by vesicorenal reflux in the left segment and loss of function of the left segment. Resection of the left half of the horseshoe kidney was performed using fluoroscopic control with intravenous administration of indocyanine green. The surgery was performed using the RUBINA™ endovideosurgical system manufactured by KARL STORZ (Germany). RUBINA™ components offer a variety of ICG in near-infrared fluorescence signal imaging modes. Depending on the surgeon and the application, ICG in near-infrared fluorescence data can be used in different modes: image overlay mode, backup mode, color mapping mode. After confirming the boundaries of the perfused part of the kidney, laparoscopic resection of the functional half was performed at the level of the isthmus. The use of ICG imaging was very important in identifying healthy tissue that stained intensely green 2 minutes after intravenous indocyanine green administration. This margin check verifies the functioning renal parenchyma and allows the correct selection of the nephrectomy margin. The next day after the operation, an ultrasound examination of the renal remnant and perinephric space was performed — the rotation to the right hour of the horseshoe-shaped kidney was good and no accumulation of fluid was detected in the bed of the removed segment. A control ultrasound examination 6 months after the operation showed the preservation of the parenchyma of the right half of the kidney, which indicates the positive effect of the surgical procedure. CONCLUSION: ICG navigation is a promising method for noninvasive assessment of resection margins in patients with horseshoe kidneys.

FTIR spectroscopy for assessment of hair from lung cancer patients and its application in monitoring the chemotherapy treatment effect

Lung cancer is the most common cancer and the leading cause of death in China. The current gold standard for clinical lung cancer diagnosis is based on histopathological examination of tumors, but it has the limitation for easy operation and convenient applications. Therefore, researchers are still striving to develop other tools and methods for non-invasive and rapid assessment of the health conditions of lung cancer patients. Hair, as a reflection of the metabolism of the body, is closely related to human health conditions. In principle, Fourier-transform infrared (FTIR) spectroscopy can probe the major chemical compositions in the hair. However, as indicated by previous studies, there is still the challenge to make good use of FTIR spectroscopy for achieving reliable analysis of hair from cancer patients. In this study, hair samples from 82 lung cancer patients were collected and subjected to FTIR measurements and analysis, which showed the protein content in the hair is closely related to the protein content in the blood serum of patients, and the contents of protein and lipid are statistically lower in the lung cancer patients. Furthermore, we demonstrated that FTIR spectroscopy could be employed to monitor the hair of lung cancer patients undergoing chemotherapy, and confirmed that the FTIR spectra of the hair may reflect the resultant effect of the chemotherapy. As such, this work validates the way of using FTIR spectroscopy in hair analysis for the assistance of medical diagnosis of lung cancer as well as monitoring the conditions of the patients under the medical treatment.

Cardiotoxicity Assessment through a Polymer-Based Cantilever Platform: An Integrated Electro-Mechanical Screening Approach.

Preclinical drug screening for cardiac toxicity has traditionally relied on observing changes in cardiomyocytes' electrical activity, primarily through invasive patch clamp techniques or non-invasive microelectrode arrays (MEA). However, relying solely on field potential duration (FPD) measurements for electrophysiological assessment can miss the full spectrum of drug-induced toxicity, as different drugs affect cardiomyocytes through various mechanisms. A more comprehensive approach, combining field potential and contractility measurements, is essential for accurate toxicity profiling, particularly for drugs targeting contractile proteins without affecting electrophysiology. However, previously proposed platform has significant limitations in terms of simultaneous measurement. The novel platform addresses these issues, offering enhanced, non-invasive evaluation of drug-induced cardiotoxicity. It features eight cantilevers with patterned strain sensors and MEA, enabling real-time monitoring of both cardiomyocyte contraction force and field potential. This system can detect minimum cardiac contraction force of ≈2 µN and field potential signals with 50µm MEA diameter, using the same cardiomyocytes in measurements of two parameters. Testing with six drugs of varied mechanisms of action, the platform successfully identifies these mechanisms and accurately assesses toxicity profiles, including drugs not inhibiting potassium channels. This innovative approach presents a comprehensive, non-invasive method for cardiac function assessment, poised to revolutionize preclinical cardiotoxicity screening.

Methods to assess dermal exposures in occupational settings: a scoping review.

The dermal exposure route is expected to become increasingly significant relative to total worker exposure as inhalational exposure limits continue to decrease. However, standardization of occupational exposure assessment methods and scientific consensus are needed. This is the first scoping review mapping the literature across all dermal exposure assessment methods and their targeted substances/chemicals in occupational settings. Eligibility criteria broadly included studies reporting any noninvasive dermal exposure assessment method in an occupational setting. The literature search (Web of Science and MEDLINE) was restricted to peer-reviewed, primary literature published in the last 20 years (2002-2022). Titles/abstracts were dual independently screened. Data charting was performed by a single reviewer using standard template. All stages were pilot tested. The JBI (formerly, the Joanna Briggs Institute) scoping review methods and PRISMA-ScR checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) were used. In total, 493 articles were data charted and categorized by 4 study types: methods development (22%), exposure assessment (51%), health outcomes (21%), and controls assessment (6%). Fourteen types of dermal exposure assessment methods were charted with biomarkers (51%), dosimeters (21%), and qualitative assessments such as questionnaires or surveys (17%) most common. Seventeen different chemicals/substances were charted; pesticides (28%) and polycyclic aromatic hydrocarbons (PAHs) (22%) associated with crude oil products and combustion were most common. Mapping between substances and exposure assessment method categories, pesticide dosimeters (11%), and PAH biomarker studies (14%) were most reported. Literature gaps were identified for cleaning agents, hair dyes, glycol ether, N,N-dimethylformamide/N-methyl-2-pyrrolidone, dioxins, and bisphenol A. To foster scientific consensus, standardization across study reporting is needed for describing: (i) exposure assessment methods used, (ii) worker tasking/conditions, (iii) targeted substances and substance state, and (iv) targeted exposure routes. Overall, this review categorizes, maps, and defines the scope of literature for occupational dermal exposure assessment methods.

The influence of selected factors on wool cortisol concentration in alpacas (Vicugna pacos)

Several internal and external factors can influence animals’ hormonal activity. Cortisol level in hair and wool determines chronic stress, which is connected with the long-term HPA axis effect. Wool cortisol levels in alpacas have never been determined to this time. The study aimed to assess the influence of selected factors on wool cortisol concentration in alpacas. The study included 36 alpacas. Wool samples were collected during shearing in June 2021, cut with an electric clipper from the right shoulder and the rump. Wool samples were fragmented into proximal (winter-spring regrowth) and distal (summer-fall regrowth) segments. Alpacas’ Heat Stress Index (HSI) for the summer of 2020 was 139.4, and 116 for the winter of 2021. The cortisol levels in the wool samples were determined with the General Cortisol ELISA Kit assay.The most significant differences in wool cortisol concentrations were caused by two factors: the wool segment (P < 0.001; η2 = 0.889) and the region on the body (P < 0.001; η2 = 0.876). Wool cortisol level was higher in the distal segment (referring to the summer-fall season) than in the proximal one (referring to the winter-spring season). It is suggested that alpacas can feel heat stress in summer (HSI = 139.4), which could influence higher cortisol levels in the distal segment. The wool cortisol level was higher in the rump samples than the shoulder ones. Therefore, it is essential in future studies that wool samples from all tested animals should be completed from the same body region. Differences among age and sex groups were also observed. Wool cortisol level was higher in older animals, as differences between age groups were observed in samples from the rump in the distal and proximal segments (distal, the rump younger*older: P < 0.001; η2 = 0.321; proximal, the rump older*younger: P = 0.007; η2 = 0.195). Males showed higher cortisol levels than females, as a difference between sexes was observed in samples from the rump in the proximal segment (P = 0.001, η2 = 0.271). This study emphasizes that various factors may significantly influence wool cortisol levels, which can be helpful in alpacas’ welfare estimation using this hormonal indicator as a noninvasive long-term stress assessment method.

Phase Angle as a Nutritional Assessment Method in Patients with Hip Fractures: A Cross-Sectional Study.

Phase angle, which is associated with cellular health, has attracted attention as a noninvasive and objective method for nutritional assessment. However, the association between malnutrition and phase angle in older inpatients with hip fractures has not been reported. Therefore, this study investigated this association in older inpatients (aged ≥65 years) with hip fractures and determined the cutoff phase angle for determining malnutrition. This cross-sectional study retrospectively analyzed the data of 96 inpatients with hip fractures who were hospitalized in rehabilitation units after surgery (male, 29.4%; mean age, 82.4±6.2 years). Nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI), with malnutrition defined as a GNRI ≥98. Bioelectrical impedance analysis was used to measure phase angles. The phase angle was associated with malnutrition (B=-1.173; odds ratio=0.310; 95% confidence interval 0.58-0.83; p=0.015). The area under the receiver operating characteristic curve was 0.71. The cutoff phase angle for malnutrition was 3.96° (sensitivity=0.85, specificity=0.63). Phase angle could be an indicator of malnutrition in older inpatients with hip fractures. Our findings will help formulate rehabilitation strategies for these patients.

Fluorescence spectroscopic profiling of urine samples for predicting kidney transplant rejection

Rejection is the primary factor affecting the functionality of a kidney post-transplant, where its prompt prediction of risk significantly influences therapeutic strategies and clinical outcomes. Current graft health assessment methods, including serum creatinine measurements and transplant kidney puncture biopsies, possess considerable limitations. In contrast, urine serves as a direct indicator of the graft's degenerative stage and provides a more accurate measure than peripheral blood analysis, given its non-invasive collection of kidney-specific metabolite. This research entailed collecting fluorescent fingerprint data from 120 urine samples of post-renal transplant patients using hyperspectral imaging, followed by the development of a learning model to detect various forms of immunological rejection. The model successfully identified multiple rejection types with an average diagnostic accuracy of 95.56 %.Beyond proposing an innovative approach for predicting the risk of complications post-kidney transplantation, this study heralds the potential introduction of a non-invasive, rapid, and accurate supplementary method for risk assessment in clinical practice.

Estimation of Salivary Bone Specific Alkaline Phosphatase as a Biomarker for Assessing Skeletal Maturity Indicator

ABSTRACT Background: Evaluation of skeletal maturation plays a substantial role in selection of orthodontic treatment strategies. Recently, new noninvasive methods of assessing biological mediators have been introduced to assess skeletal maturity. There is a marked rise in the value of these mediators during pubertal growth spurts. When these mediators emerge as the assessment tool for skeletal maturity determination, it can reduce radiation exposure and beneficial to the patient. Hence, the goal of this study is to validate the calculation of salivary alkaline phosphatase (ALP) as a noninvasive skeletal maturity indicator by estimating the Bone Alkaline Phosphatase (B-ALP) level in whole unstimulated saliva at different stages of skeletal maturity and correlating B-ALP level with different stages of skeletal development using cervical vertebral maturation index (CVMI) and hand-wrist MP3 (third finger middle phalanx). Materials and Methods: The test group included 90 subjects aged between 8 and 18 years requiring orthodontic treatment. The salivary samples were collected and examined by ALP kit following the manufacturer’s instructions and assessed using photo-spectrometer at 405 nm. The skeletal age was assessed using handwrist radiographs; skeletal age was determined by modified MP3 staging. Lateral cephalograms of each individual were also collected and tracing done for assessing skeletal age with CVM staging. The collected data were analyzed statistically with analysis of variance for intergroup comparison of ALP levels and Kruskal–Wallis test for intergroup comparison of CVM and MP3 stages. Results and Conclusion: Salivary ALP activity during the peak pubertal period was markedly increased when compared to pre- and post-peak values. Salivary ALP activity was in correlation with the cervical vertebral maturation and MP3 stages showing peak values at the pubertal stages. Thus, salivary B-ALP can serve as a noninvasive method of skeletal maturity assessment as an adjunct to conventional skeletal maturity indicators.

Efficacy and safety of diode laser for facial hair reduction in hirsutism-a clinico-trichoscopic evaluation.

Hirsutism is the presence of excessive terminal hair on androgen-dependent sites of the body. Lasers like Alexandrite, diode, and Nd:Yag lasers have been used for hair reduction with varying efficacy. Trichoscopy of hair is a simple noninvasive method of hair assessment. However, it has not been used in the assessment of diode laser hair reduction. This study aimed to assess the efficacy and safety of diode laser hair reduction in skin color with the help of clinical and trichoscopic assessment. This prospective observational study included 73 patients of hirsutism recruited in 18-month period. All participants received sessions of 805 nm diode laser at monthly intervals up to six sessions. Clinical and trichoscopic evaluation along with photographs were obtained at each visit. Side effects, if any, were noted in every sitting. All patients were females of Fitzpatrick skin types III-V. All clinical parameters showed statistically significant hair reduction when compared with baseline. Trichoscopic parameters of hair reduction like total hair count, terminal hair count, and terminal/vellus hair ratio showed reduction compared to baseline which was statistically significant (P < 0.05). The most common side effect noted in our study was pain followed by erythema and perifollicular edema. Diode laser is an effective and safe procedure for the reduction of unwanted facial hair, even in darker skin types. We also wish to emphasize that trichoscopy for the assessment of laser hair reduction is a recent, noninvasive, simple, and underutilized tool. No serious adverse events were noted in our study.

Feasibility of ultrasound measurement of tracheal diameter in patients undergoing severe scoliosis orthopedic surgery: A randomized trial

Objective To explore the feasibility of ultrasound measurement of the transverse diameter of the cervical trachea at its narrowest point in patients undergoing severe scoliosis orthopedic surgery. Methods A total of 110 patients, aged 18-65, who scheduled for elective orthopedic surgery for severe scoliosis were included. Prior to surgery, all patients underwent two types of tracheal inner diameter measurements: (1) CT measurement of the anteroposterior diameter (Dmin,AP) and transverse diameter (Dmin,T) of the cervical trachea at its narrowest point; and (2) ultrasound measurement of Dmin,T. Based on the measurement results, the patients were randomly divided into two groups, the CT group ( n = 55) and the ultrasound group ( n = 55). We compared the Dmin,AP and Dmin,T measured by CT for all patients. Then, we compared CT and ultrasound measurements of Dmin,T. Furthermore, we conducted an analysis to determine the correlation and consistency between the two methods. Additionally, we examined the success rate of first-attempt tracheal intubation and the occurrence rate of tracheal tube being too wide or too narrow between the two groups, and assessed the occurrence of postoperative 24-h pharyngeal pain and hoarseness. Results When comparing the Dmin,AP and Dmin,T measured by CT in all patients, a statistically significant difference was observed ( p &lt; .001). When comparing the measurements of Dmin,T between CT and ultrasound in all patients, no statistically significant differences were found ( p &gt; .05). The correlation coefficient (r) between CT and ultrasound measurements of Dmin,T was 0.849 ( p &lt; .001). The mean difference in Dmin,T was 0.19 mm, and the limits of agreement (LoA) were −2.24 mm to 2.62 mm. Conclusions Ultrasound measurement of Dmin,T in severe scoliosis patients is feasible and provides valuable guidance for the selection of endotracheal tube sizes. It serves as a non-invasive and bedside auxiliary examination method for perioperative airway assessment.