Tool For Noninvasive Assessment Research Articles

DOP120 Low-intensity Pulsed Ultrasound Modulates Metabolite Release Reflecting the Inflammatory Status of Colonic Mucosa

Abstract Background Recently, we investigated Low-Intensity Pulsed Ultrasound (LIPUS) as a non-invasive and safe method to identify circulating biomarkers that reflect the colonic mucosal status in experimental colitis models. Here, we evaluate the capability of LIPUS to reveal a wide spectrum of tissue-derived proteins and metabolites as potential biomarkers of colitis. Methods Acute colitis was induced in 10 female C57B6N mice by ad-libitum administration of 2,5% dextran sodium sulfate (DSS) for 7 days. Colon-focused LIPUS stimulation (38 kHz, 150 mW/cm2, 20% duty cycle, 3 minutes) was applied at day 7 of colitic and healthy mice. Blood samples were collected 2 hours post-LIPUS exposure and plasma was analyzed by Olink® proteomics and LC-MS untargeted metabolomics. STRING database and Metabolite Enrichment Analysis Set (MSEA) were used for comprehensive pathway evaluation of proteins and metabolites. Results As expected, DSS-treated murine plasma displayed altered proteomic and metabolomic profiles compared to healthy controls at baseline, with a significant exacerbation of IL-6, IL-17A and TNF-family inflammatory mediators, tryptophan intermediates and microbial metabolites. LIPUS did not alter the cytokine profile observed before stimulation. However, microbiota-associated compounds involved in tryptophan, glutamate and riboflavin pathways, as well as phospatidylcholine (PE) family members, such as Lyso-PE, were significantly enhanced in the blood of colitic mice after LIPUS stimulation, conceiving the inflammatory status of the intestinal mucosa. Conversely, LIPUS stimulation in healthy mice upregulated circulating factors (Tnni3, Dlk1, lgmn and Kitlg) which are expressed by intestinal epithelial cells and that play a role in the epithelial-immune cell crosstalk. Nucleoside precursors of the pyrimidine metabolism and galacturonate involved in the vitamin C synthesis, which are potentially involved in intestinal mucosa homeostasis, were also significantly increased after LIPUS stimulation in healthy mice plasma. Conclusion LIPUS differentially enhances the release of specific metabolites based on the inflammatory status of the colonic mucosa. Thus, uninflamed LIPUS-stimulated intestinal mucosa releases proteins indicative of mucosal health, whilst injured intestinal mucosa readily discharges metabolites associated with the inflammatory process. This suggests the potential utility of LIPUS as a non-invasive diagnostic tool for gut inflammation assessment, improving diagnostic accuracy and efficiency in patients with colonic disorders. Further research is needed to validate these findings in humans for clinical parameter correlation. References ImmUniverse project: this project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No. 853995. The JU receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA. The content provided in this abstract reflects only the author's view and neither the IMI JU nor the European Commission are responsible for any use that may be made of the information it contains.

Prospective Harmonization, Common Data Elements, and Sharing Strategies for Multicenter Pre-Clinical Traumatic Brain Injury Research in the Translational Outcomes Project in Neurotrauma Consortium.

Effective team science requires procedural harmonization for rigor and reproducibility. Multicenter studies across experimental modalities (domains) can help accelerate translation. The Translational Outcomes Project in NeuroTrauma (TOP-NT) is a pre-clinical traumatic brain injury (TBI) consortium charged with establishing and validating noninvasive TBI assessment tools through team science. Here, we present practical approaches for harmonization of TBI research across five centers providing needed vocabulary and structure to achieve centralized data organization and use. This includes data sharing as an essential step that enables validating data between domains, evaluating reproducibility between sites, and performing multimodal analyses. As part of this process, TOP-NT (1) produced a library of TBI-relevant standard operating procedures to coordinate workflow, (2) aligned 481 pre-clinical and clinical common data elements (CDEs), and (3) generated 272 new pre-clinical TBI CDEs. This consortium then (4) connected diverse data types to validate assessments across domains and to allow multivariable TBI phenotyping. Lastly, TOP-NT (5) specified technical quality controls for pre-clinical studies. These harmonization tools can facilitate reproducibility in team science, help distinguish a wide injury spectrum from technical variability, apply quality-controls, and ease higher level data analyses. TOP-NT uses three rat TBI models across four sites. Each site collects primary outcome measures, including magnetic resonance imaging (MRI) protocols and blood biomarkers of neuronal and glial injury, validated by histopathology and behavioral outcomes. Collected data are organized using the 481 TOP-NT pre-clinical CDEs, covering surgical, behavioral, biomarker, MRI, and quantitative histopathological methods. We report data curation steps suited for data storage using the Open Data Commons for TBI as a centralized data repository, allowing unbiased cross-site analysis. This approach leads to introducing a higher level, syndromic understanding of TBI signatures. TOP-NT authors outline a semantic and structural framework suggesting strategies for robust pre-clinical research in multicenter trials to improve translatability for TBI assessments. [Figure: see text].

Exosomes in Autoimmune Diseases: A Review of Mechanisms and Diagnostic Applications.

Exosomes, small extracellular vesicles secreted by various cell types, have emerged as key players in the pathophysiology of autoimmune diseases. These vesicles serve as mediators of intercellular communication, facilitating the transfer of bioactive molecules such as proteins, lipids, and nucleotide. In autoimmune diseases, exosomes have been implicated in modulating immune responses, oxidative stress, autophagy, gut microbes, and the cell cycle, contributing to disease initiation, progression, and immune dysregulation. Recent advancements in exosome isolation techniques and their molecular characterization have paved the way for exploring their clinical potential as biomarkers and therapeutic targets. This review focuses on the mechanisms by which exosomes influence autoimmune disease development and their potential clinical applications, particularly in diagnosis. The role of exosomes in autoimmune diseases, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), type 1 diabetes mellitus (T1DM), inflammatory bowel disease (IBD), and Sjögren's syndrome (SS), is discussed in relation to their involvements in antigen presentation, T-cell activation, and the induction of inflammatory pathways. Additionally, exosome-based biomarkers offer promising non-invasive diagnostic tools for early diagnostic, disease monitoring, and therapeutic response assessment. However, challenges such as standardization of exosome isolation protocols and validation of their clinical significance remain. This review highlights the potential of exosomes as both diagnostic biomarkers and therapeutic targets in autoimmune diseases, emphasizing the need for further research to overcome current limitations and fully harness their clinical value.

A free association semantic task for fNIRS-based perinatal depression assessment

Perinatal depression (PD) is a highly prevalent psychological disorder that has a detrimental effect on infant and maternal physical and mental health, but effective and objective assessment of PD is still insufficient. In recent years, the functional near-infrared spectroscopy (fNIRS) has been acknowledged as an effective non-invasive tool for clinical assessment of depression. This study proposed a free association semantic task (FAST) paradigm for fNIRS-based assessment of PD. To better address the emotion characteristics of PD, the participants are required to generate a dynamic concept chain based on positive, negative or neutral seed words, while 48-channel fNIRS recordings over frontal and bilateral temporal regions. Results from twenty-two late-pregnant women revealed that, the oxyhemoglobin (oxy-Hb) changes during the FAST with the positive and negative seed words over the frontal region were correlated with PD severity, which was different from the correlation patterns in the FAST with neutral seed word and the classical verbal fluency test (VFT). Furthermore, distinct correlation patterns were also observed in the FAST with the positive and negative seed words, manifested in fNIRS channels corresponding to the right dorsolateral prefrontal cortex (DLPFC) and right inferior frontal gyrus (IFG), respectively. Moreover, regression analyses showed that the FAST with positive and negative seed words can well explain the severity of PD. Our findings suggest the proposed FAST paradigm as a promising approach for PD assessment.

Time-lapse HR-pQCT reliably assesses and monitors local bone turnover in patients with chronic kidney disease.

Bone turnover assessment and monitoring are essential for chronic kidney disease (CKD)-associated bone care. Patients with CKD suffer from significantly elevated fracture risk due to abnormally high or low bone turnover, which requires diametrically opposite treatments informed by patient-specific bone turnover data. However, a reliable, accessible, non-invasive bone turnover assessment and monitoring tool remains an unmet clinical need. Combining time-lapse (TL) analysis with high-resolution peripheral quantitative computed tomography (HR-pQCT) scans obtained over time allows for in vivo temporospatial bone remodeling assessment. This study aimed to evaluate the feasibility of applying TL HR-pQCT to assess and monitor local bone formation and resorption in patients with CKD. A customized TL HR-pQCT pipeline was developed on a second-generation HR-pQCT platform and optimized using ex vivo cadaveric phantom and in vivo scan-rescan HR-pQCT images. The annualized least significant change in bone formation and resorption were evaluated using in vivo longitudinal reproducibility images. Finally, the feasibility of the TL HR-pQCT pipeline in assessing and monitoring bone turnover was evaluated in patients with end stage kidney disease (ESKD; n = 9). We found that a 2-month time-lapse period was sufficient for the TL HR-pQCT pipeline to reliably assess and monitor local bone turnover in a cohort of patients with ESKD. We also demonstrated the importance of characterizing TL HR-pQCT precision metrics using longitudinal baseline/follow-up rather than short-term scan-rescan datasets. The TL HR-pQCT pipeline assessed a range of bone formation metrics consistent with the gold standard histomorphometric bone formation reported in the literature for patients with CKD and ESKD. Our findings highlight that TL HR-pQCT holds promise as a "virtual bone biopsy" that reliably assesses and monitors local bone turnover for CKD bone care. Subsequent work will focus on validating this TL HR-pQCT pipeline against the gold standard bone biopsy with quantitative histomorphometry.

Value of Mac-2 Binding Protein Glycosylation Isomer (M2BPGi) in Assessing Liver Fibrosis in Metabolic Dysfunction-Associated Liver Disease: A Comprehensive Review of its Serum Biomarker Role.

Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) is a broad condition characterized by lipid accumulation in the liver tissue, which can progress to fibrosis and cirrhosis if left untreated. Traditionally, liver biopsy is the gold standard for evaluating fibrosis. However, non-invasive biomarkers of liver fibrosis are developed to assess the fibrosis without the risk of biopsy complications. Novel serum biomarkers have emerged as a promising tool for non-invasive assessment of liver fibrosis in MAFLD patients. Several studies have shown that elevated levels of Mac-2 binding protein glycosylation isomer (M2BPGi) are associated with increased liver fibrosis severity in MAFLD patients. This suggests that M2BPGi could serve as a reliable marker for identifying individuals at higher risk of disease progression. Furthermore, the use of M2BPGi offers a non-invasive alternative to liver biopsy, which is invasive and prone to sampling errors. Overall, the usage of M2BPGi in assessing liver fibrosis in MAFLD holds great promise for improving risk stratification and monitoring disease progression in affected individuals. Further research is needed to validate its utility in clinical practice and establish standardized protocols for its implementation.

Non-Invasive Tests of Non-Alcoholic Fatty Liver Disease: Perspective Review

Cirrhosis and hepatocellular carcinoma often develop from Non-Alcoholic Fatty Liver Disease (NAFLD), a progressive condition characterized by hepatic steatosis, inflammation and varying degrees of fibrosis. The increasing incidence of non-alcoholic steatohepatitis (NASH) highlights the need for effective diagnostic and treatment methods. Non-invasive tests (NITs) have emerged as promising tools for evaluating and monitoring NAFLD, offering safer and more cost-effective alternatives to invasive liver biopsies. This review focuses on the current state of NITs in NAFLD management, emphasizing their diagnostic accuracy, prognostic significance, and role in guiding treatment. NITs discussed include transient elastography, magnetic resonance imaging (MRI), magnetic resonance elastography (MRE) and serum biomarker panels such as the NAFLD fibrosis score, Fibro Test, and Enhanced Liver Fibrosis (ELF) test. Recent advancements in MRI and MRE have greatly improved the non-invasive assessment of liver fibrosis and steatosis, enhancing sensitivity and specificity for early detection and risk stratification. Additionally, combined serum biomarker panels have shown promise in predicting disease severity and progression, aiding in the identification of high-risk patients who could benefit from early intervention. By enabling prompt diagnosis, comprehensive risk assessment and monitoring of disease progression, the integration of NITs into standard clinical practice offers significant potential for improving NAFLD management. Ongoing research efforts are focused on developing new NITs and optimizing existing methods to enhance diagnostic precision and prognostic evaluation in NAFLD patients. This evolving landscape of non-invasive assessment tools could revolutionize the approach to managing this increasingly prevalent liver disease. Keywords: Fatty liver, Liver biopsy, Transient Elastography, Serum biomarkers, Hepatic Cell Carcinoma.

NECTIN-4 PET FOR OPTIMIZING ENFORTUMAB VEDOTIN DOSE-RESPONSE IN UROTHELIAL CARCINOMA.

The optimization of dosing strategies is critical for maximizing efficacy and minimizing toxicity in drug development, particularly for drugs with narrow therapeutic windows such as antibody-drug conjugates (ADCs). This study demonstrates the utility of Nectin-4-targeted positron emission tomography (PET) imaging using [68Ga]AJ647 as a non-invasive tool for real-time assessment of target engagement in enfortumab vedotin (EV) therapy for urothelial carcinoma (UC). By leveraging the specificity of [68Ga]AJ647 for Nectin-4, we quantified dynamic changes in target engagement across preclinical models and established its correlation with therapeutic outcomes. PET imaging revealed dose-dependent variations in Nectin-4 engagement, with suboptimal EV doses resulting in incomplete Nectin-4 engagement and reduced tumor growth. Importantly, target engagement measured by PET emerged as a more reliable predictor of therapeutic efficacy than dose or baseline Nectin-4 expression alone. Receiver operating characteristic (ROC) analysis identified a target engagement threshold that is determinant of response, providing a quantitative benchmark for dose optimization. Furthermore, PET imaging measures provide a promising framework to account for key challenges in ADC development, including tumor heterogeneity, declining drug-to-antibody ratios over time, and limitations of systemic pharmacokinetic measurements to account for tumor-drug interactions. These findings underscore the transformative potential of integrating PET pharmacodynamic measures as early biomarkers to refine dosing strategies, improve patient outcomes, and accelerate the clinical translation of next-generation targeted therapeutics.

Stem subsidence in total hip arthroplasty: retrospective investigation of a short stem using a simple measurement approach

BackgroundUncemented total hip arthroplasty (THA) is a successful treatment for advanced hip joint diseases. More recently, short stems became increasingly popular, but stem subsidence remains a concern. This study investigates early short stem subsidence in a large patient cohort using a simple measurement approach for everyday practice.MethodsThis retrospective, single center, single implant design study included 1000 patients with primary THA. Subsidence was evaluated using standardized weight-bearing radiographs taken 3–5 days and 2–3 weeks postoperatively with full weight-bearing (FWB). A novel Subsidence Index (SID) was introduced to quantify stem subsidence in a simple and reproducible manner. The SID is calculated by averaging four distinct linear measurements between defined anatomical landmarks on the femur and the implant, captured on standard radiographs without additional software.ResultsOut of all analyzed patients 6% (60/1000) had subsidence of more than 3 mm. The mean subsidence was 1.3 mm (range, 0 to 16.25 mm).There were 0.6% (6) who underwent stem revision for symptomatic subsidence. Men and obese patients had greater subsidence. However, patient age, BMI, stems without lateral bone contact and other demographic factors were not associated with subsidence.ConclusionEarly subsidence is relatively frequent with this uncemented short stem, however revisions are rare. Patients with risk factors should be counseled regarding FWB and radiographic controls should be performed. The SID provides an easy, non-invasive and inexpensive tool for early subsidence assessment; however, its simplicity limits its accuracy. Further research is needed in comparison to more elaborate methods.

Prognostic Role of Lung-Ultrasound Score in Acute Bronchiolitis Patients Treated With High Flow Nasal Cannula: A Prospective Study.

Lung ultrasound (LUS) has emerged as a reliable, noninvasive tool for bedside assessment of acute bronchiolitis (AB) in infants. Its role in guiding therapeutic decisions is increasingly recognized. This study aimed to determine the predictive value of LUS in identifying infants with AB at risk of HFNC therapy failure. This prospective, single-center study was conducted in the pediatric department of Fattouma Bourguiba Hospital in Monastir from January 2022 to March 2024. Infants under 12 months hospitalized with moderate to severe AB and requiring HFNC therapy were enrolled. LUS was performed within 3-6 h of HFNC initiation and repeated 24 h later. Clinical and laboratory data, including the Wang score and LUS findings, were analyzed to predict HFNC failure. Among 124 enrolled infants, 98 (79%) responded successfully to HFNC therapy, while 26 (21%) failed. Baseline characteristics, including age, weight, and clinical symptomes, were comparable between groups, except for a higher Wang score in the failure group (p = 0.008). LUS scores were significantly higher in the failure group on both day 1 and day 2 (p < 0.001), with a more pronounced score progression (p < 0.001). ROC analysis identified a LUS score > 7 on day 1 and > 9 on day 2 as predictive thresholds for HFNC failure. Multivariate analysis confirmed the day 2 LUS score as an independent predictor of HFNC failure (p = 0.022). LUS is a valuable prognostic tool in infants with AB undergoing HFNC therapy. Incorporating LUS into routine clinical assessments may help predict therapy failure early, allowing timely escalation of care.

Through the Lens of Age: Using Dog Photographs to Uncover Welfare and Stress

This study evaluated the potential of using dogs’ apparent age, judged from photographs, as a non-invasive tool for assessing their welfare. Traditional welfare assessment methods often rely on behavioral and physiological indicators, which can be resource-intensive and invasive. This research explored whether apparent age, a measure used in humans to predict health and longevity, can also serve as an indicator of welfare in dogs by investigating its association with relative telomere length (RTL), a biomarker of biological aging. Photographs of 60 domestic dogs were evaluated by canine specialists and general volunteers via the citizen science platform Zooniverse. Participants estimated the age of 20 dogs from three different age categories: young (0–2 years), adult (2–5 years), and senior (6+ years). The accuracy of these predictions was compared to the dogs’ chronological ages and RTLs. Generalized linear models were used to assess factors influencing prediction accuracy, including the dogs’ age, sex, and origin. Results indicated that both specialists and volunteers reliably estimated the age of senior dogs, with no significant differences in accuracy between groups. Dogs with accurate apparent age estimates had RTLs matching their chronological age, while those with premature aging signs had shorter RTLs. This suggests apparent age could be a practical, non-invasive welfare assessment tool, offering a potentially accessible method for new welfare assessment protocols.

Developing a peripheral blood RNA-seq based NETseq ensemble classifier: A potential novel tool for non-invasive detection and treatment response assessment in neuroendocrine tumor patients receiving 177Lu-DOTATATE PRRT.

Neuroendocrine tumors (NETs) are presented with metastases due to delayed diagnosis. We aimed to identify NET-related biomarkers from peripheral blood. The development and validation of a multi-gene NETseq ensemble classifier using peripheral blood RNA-Seq is reported. RNA-Seq was performed on peripheral blood samples from 178 NET patients and 73 healthy donors. Distinguishing gene features were identified from a learning cohort (59 PRRT-naïve GEP-NET patients and 38 healthy donors). Ensemble classifier combining the output of five machine learning algorithms viz. Random Forest (RF), Extreme Gradient Boosting (XGBOOST), Gradient Boosting Machine (GBM), Support Vector Machine (SVM), and Logistic Regression (LR) were trained and independently validated in the evaluation cohort (n = 106). The response to PRRT was evaluated in the PRRT cohort (n = 46) and the PRRT response monitoring cohort (n = 16). The response to 177Lu-DOTATATE PRRT was assessed using RECIST 1.1 criteria. The Ensemble classifier trained on 61 gene features, distinguished NET from healthy samples with 100% accuracy in the learning cohort. In an evaluation cohort, the classifier achieved 93% sensitivity (95% CI: 87.8%-98.03%) and 91.4% specificity (95% CI: 82.1%-100%) for PRRT-naïve GEP-NETs (AUROC = 95.4%). The classifier returned >87.5% sensitivity across different tumor characteristics and outperformed serum Chromogranin A sensitivity (χ2 = 21.89, p = 4.161e-6). In the PRRT cohort, RECIST 1.1 responders showed significantly lower NETseq prediction scores after 177Lu-DOTATATE PRRT, in comparison to the non-responders. In an independent response monitoring cohort, paired samples (before PRRT and after 2nd or 3rd cycle of PRRT) were analyzed. The NETseq prediction score significantly decreased in partial responders (p = .002) and marginally reduced in stable disease (p = .068). The NETseq ensemble classifier identified PRRT-naïve GEP-NETs with high accuracy (≥92%) and demonstrated a potential role in early treatment response monitoring in the PRRT setting. This blood-based, non-invasive, multi-analyte molecular method could be developed as a valuable adjunct to conventional methods in the detection and treatment response assessment in NET patients.

Fatty liver index as an independent predictor of all-cause and disease-specific mortality.

This study aims to assess the prognostic value of the fatty liver index (FLI), a noninvasive tool for hepatic steatosis assessment, in predicting all-cause and disease-specific mortality. We linked data from the National Health and Nutrition Examination Survey III (1988-1994) with Public-Use Mortality Files, forming a cohort of 11 297 participants with a median follow-up period of 26.25 years. Cox proportional hazards models were used to evaluate the association between FLI and all-cause mortality, while Fine and Gray's models assessed the relationship between FLI and disease-specific mortality. The FLI ≥ 60 was independently associated with an increased risk of all-cause mortality (hazard ratio = 1.24, P < 0.001), as well as mortality from malignant neoplasms (hazard ratio = 1.18, P = 0.048), diabetes (hazard ratio = 2.62, P = 0.001), and cardiovascular diseases (CVDs) (hazard ratio = 1.18, P = 0.018), compared to FLI < 30. No significant associations were found with Alzheimer's disease, influenza and pneumonia, chronic lower respiratory diseases, or renal disorders. Subgroup analyses indicated that individuals who were females aged 40-60 (hazard ratio = 1.67, P = 0.003), non-overweight (hazard ratio = 1.75, P = 0.007), or without abdominal obesity (hazard ratio = 1.75, P = 0.007) exhibited a stronger association between FLI ≥ 60 and all-cause mortality. These findings support the prognostic value of the FLI for predicting mortality from all causes, malignant neoplasms, diabetes, and CVDs. Targeted attention is needed in postmenopausal women, non-overweight, and non-abdominally obese populations.

VExUS score improvement is associated with better outcomes in acute decompensated heart failure

Abstract Background Venous Excess Ultrasound Score (VExUS) has recently emerged as a non-invasive tool for venous congestion assessment in acute decompensated heart failure (ADHF). Although VExUS is associated with cardiorenal syndrome, the prognostic role regarding hard outcomes in ADHF is still unknown. Purpose To evaluate whether dynamic changes in VExUS within 72 hours after Cardiovascular Intensive Care Unit (CICU) admission is associated with in-hospital mortality in ADHF patients. Methods Prospective cohort study enrolling consecutive patients with ADHF admitted to CICU of a tertiary public hospital. VExUS evaluations ranging from 0 (no congestion) and 3 (severe congestion) and assessing the inferior vena cava, hepatic, and portal veins flow, were initially performed within 24 hours of admission and re-evaluated at 72 hours (third day) after treatment initiation. Changes in VExUS scores were compared between these two time points. Mann-Whitney test and logistic regression was performed to evaluate VExUS improvement association with mortality. Results Between October 2022 and January 2024, 81 patients were admitted to the CICU due to ADHF. Following the exclusion of 10 patients who were not assessed within the first 24 hours, 71 patients were included in the final analysis. Mean age was 65 ± 13.3 years, with 66.7% being male. Ischemic etiology was identified in 40.7%, and atrial fibrillation was present in 34.6%. Mean left ventricular ejection fraction was 27.4% ± 12.2, and 64.2% had right ventricular dysfunction. Upon admission, 73.2% were classified as B and 23.9% as C hemodynamic profiles. Overall in-hospital mortality was 25.9%. In-hospital mortality across VExUS categories assessed in the third day was 16.7%, 12.5%, 28.6% e 40%, for VExUS 0-3, respectively. The median VExUS variation between the two time points was greater in patients who survived [-1 vs. 0; p=0.030] and VExUS improvement at 72 hours was associated with a 46% decrease in hospital mortality for each class reduction (OR=0.536; 95% CI 0.29-0-81; p=0.043 - Figure 1). Conclusion Improvement in VExUS score between admission and 72 hours is associated with reduced in-hospital mortality. This finding highlights the potential role of dynamic VExUS monitoring for identifying delayed treatment response patients. Thus, changes in VExUS emerged as a prognostic tool offering a pathway to potentially intensify treatment strategies for high-risk patients with ADHF.VExUS score changes within 72 hours

Platelet counts to spleen diameter ratio: A promising noninvasive tool for predicting esophageal varices in cirrhosis patients.

Liver cirrhosis is the end stage of progressive liver fibrosis as a consequence of chronic liver inflammation, wherein the standard hepatic architecture is replaced by regenerative hepatic nodules, which eventually lead to liver failure. Cirrhosis without any symptoms is referred to as compensated cirrhosis. Complications such as ascites, variceal bleeding, and hepatic encephalopathy indicate the onset of decompensated cirrhosis. Gastroesophageal varices are the hallmark of clinically significant portal hypertension. To determine the accuracy of the platelet count-to-spleen diameter (PC/SD) ratio to evaluate esophageal varices (EV) in patients with cirrhosis. This retrospective observational study was conducted at Tikur Anbessa Specialized Hospital and Adera Medical Center from January 1, 2019, to December 30, 2023. Data were collected via chart review and direct patient interviews using structured questionnaires. The data were exported to the SPSS software version 26 for analysis and clearance. A receiver operating characteristic curve was plotted for splenic diameter, platelet count, and PC/SD ratio to obtain sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio. Of the 140 participants, 67% were men. Hepatitis B (38%) was the most common cause of cirrhosis, followed by cryptogenic cirrhosis (28%) and hepatitis C (16%). Approximately 83.6% of the participants had endoscopic evidence of EV, whereas 51.1% had gastric varices. Decompensated cirrhosis and PC were associated with the presence of EV with adjusted odds ratios of 12.63 (95%CI: 3.16-67.58, P = 0.001) and 0.14 (95%CI: 0.037-0.52, P = 0.004), respectively. A PC/SD ratio < 1119 had a sensitivity of 86.32% and specificity of 70% with area under the curve of 0.835 (95%CI: 0.736-0.934, P < 0.001). A PC/SD ratio < 1119 predicts EV in patients with cirrhosis. It is a valuable, noninvasive tool for EV risk assessment in resource-limited settings.

Non-invasive assessment of intracranial pressure through the eyes: current developments, limitations, and future directions.

Detecting and monitoring elevated intracranial pressure (ICP) is crucial in managing various neurologic and neuro-ophthalmic conditions, where early detection is essential to prevent complications such as seizures and stroke. Although traditional methods such as lumbar puncture, intraparenchymal and intraventricular cannulation, and external ventricular drainage are effective, they are invasive and carry risks of infection and brain hemorrhage. This has prompted the development of non-invasive techniques. Given that direct, non-invasive access to the brain is limited, a significant portion of research has focused on utilizing the eyes, which uniquely provide direct access to their internal structure and offer a cost-effective tool for non-invasive ICP assessment. This review explores the existing non-invasive ocular techniques for assessing chronically elevated ICP. Additionally, to provide a comprehensive perspective on the current landscape, invasive techniques are also examined. The discussion extends to the limitations inherent to each technique and the prospective pathways for future advancements in the field.

The role of miRNAs as biomarkers in cancer

MicroRNAs (miRNAs), a class of non-coding RNAs, play a critical role in regulating gene expression and have demonstrated significant potential as biomarkers in cancer research. This review explores the role of miRNAs in tumorigenesis, invasion, and metastasis, highlighting their altered regulation in various cancers, including lung, breast, liver, colorectal, and prostate cancer. miRNA expression patterns analysis helps clinicians in early cancer diagnosis, classification, and therapeutic monitoring. The stability of miRNAs in body fluids makes them ideal candidates for liquid biopsy, offering a non-invasive tool for cancer detection and prognosis assessment. Despite the promising clinical applications, challenges remain in the standardization of detection methods and integration of multi-omics data. Results are variable because different detection platforms, including qPCR, microarray and sequencing methods which have varying sensitivity and specificity. However, integrating multi-omics data comes with additional technological challenges because it calls for sophisticated bioinformatics tools to manage intricate and huge datasets. Further advancements are expected to establish miRNAs as a robust foundation for personalized cancer therapy.

Diagnostic accuracy of transcranial ultrasonography for detecting stenosis in patients with acute ischaemic stroke: a systematic review and meta-analysis.

Transcranial ultrasonography, including transcranial doppler (TCD) and transcranial colour-coded duplex/sonography (TCCD/TCCS), offers potential benefits in the evaluation of cerebrovascular patency, but its accuracy remains under scrutiny. Hence, this study aims to investigate the diagnostic accuracy of transcranial ultrasonography for detecting stenosis in acute ischaemic stroke patients. We systematically reviewed the databases such as CINAHL, SCOPUS, EMBASE, MEDLINE, Cochrane Library, Google Scholar, and ScienceDirect from inception till June 2023. Studies were eligible if they compared the diagnostic role of transcranial ultrasonography with established techniques, and reported accuracy parameters such as sensitivity, specificity, positive and negative likelihood ratios. Subgroup analysis was performed for TCD and TCCD/TCCS. Seventeen studies involving 1496 participants were included. The pooled sensitivity and specificity of transcranial ultrasonography were 90% and 95% respectively. For TCD, the sensitivity and specificity were 87% and 93% respectively. TCCD/TCCS showed sensitivity 98% and specificity 97%. High clinical value was evident in both TCD and TCCD/TCCS, with heterogeneity across studies but no observable publication bias. Transcranial ultrasonography, including both TCD and TCCD/TCCS, demonstrates high diagnostic accuracy in detecting stenosis in patients with acute ischaemic stroke. These findings support the utility of these methods as reliable, non-invasive tools for cerebrovascular assessment.

Mitochondrial oxidative phosphorylation capacity in skeletal muscle measured by ultrafast Z-spectroscopy (UFZ) MRI at 3T.

To investigate the feasibility of rapid CEST MRI acquisition for evaluating oxidative phosphorylation (OXPHOS) in human skeletal muscle at 3T, utilizing ultrafast Z-spectroscopy (UFZ) combined with MRI and the Polynomial and Lorentzian line-shape Fitting (PLOF) technique. UFZ MRI on muscle was evaluated with turbo spin echo (TSE) and 3D EPI readouts. Five healthy subjects performed in-magnet plantar flexion exercise (PFE) and subsequent changes of amide, PCr, and partial PCr mixed Cr (Cr+) CEST dynamic signals post-exercise were enabled by PLOF fitting. PCr/Cr CEST signal was further refined through pH correction by using the ratios between PCr/Cr and amide signals, named PCAR/CAR, respectively. UFZ MRI with TSE readout significantly reduces acquisition time, achieving a temporal resolution of <50 s for collecting high-resolution Z-spectra. Following PFE, the recovery/decay times (τ) for both PCr and Cr in the gastrocnemius muscle of the calf were notably longer when determined using PCr/Cr CEST compared to those after pH correction with amideCEST, namely = 87.1 ± 15.8 s and = 98.1 ± 20.4 s versus = 32.9 ± 19.7 s and = 43.0 ± 13.0 s, respectively. obtained via 31P MRS ( = 50.3 ± 6.2 s) closely resemble those obtained from pH-corrected PCr/Cr CEST signals. The outcomes suggest potential of UFZ MRI as a robust tool for non-invasive assessment of mitochondrial function in skeletal muscles. pH correction is critical for the reliable OXPHOS measurement by CEST.

Development and Validation of a Portable EIT System for Real-Time Respiratory Monitoring.

This work contributes to the improvement of novel medical technologies for the prevention and treatment of diseases. Electrical impedance tomography (EIT) has gained attention as a valuable tool for non-invasive monitoring providing real-time insights. The purpose of this work is to develop and validate a novel portable EIT system with a small form factor for respiratory monitoring. The device uses a 16-electrode architecture with adjacent stimulation and measurement patterns, an integrated circuit current source and a single high-speed ADC operating with multiplexers to stimulate and measure across all electrodes. Tests were conducted on 25 healthy subjects who performed a pulmonary function test with a flowmeter while using the EIT device. The results showed a good performance of the device, which was able to recognize all respirations correctly, and from the EIT signals and images, correlations of 96.7% were obtained for instantaneous respiratory rate and 96.1% for tidal volume prediction. These results validate the preliminary technical feasibility of the EIT system and demonstrates its potential as a reliable tool for non-invasive respiratory assessment. The significance of this work lies in its potential to democratize advanced respiratory monitoring technologies, making them accessible to a wider population, including those in remote or underserved areas.