Non-invasive Investigation Research Articles

Electro-physiological Changes in the Central Nervous System by Visual Evoked Potential in Diabetic Patients.

Increasing sedentary lifestyle in today's world has increased the prevalence of Diabetes Mellitus. Loss of vision due to diabetic retinopathy is a major public health burden. Visual evoked potential identifies the neuronal degenerative changes in chronic metabolic disorders specially Diabetes Mellitus. The study aimed at evaluating changes in visual evoked potential waves in diabetic patients. This is a cross sectional comparative study consisting of 90 participants, out of which 60 were diabetic patients and 30 were non-diabetic control group. Among diabetic patients, 30 were without retinopathy, 10 with mild non-proliferative retinopathy, 10 with moderate non-proliferative retinopathy and 10 with severe non-proliferative retinopathy. Visually evoked potential latencies and amplitudes were compared among diabetic patients and the control group and also among individuals with different grades of retinopathy. Delay in P100 latency and decrease in its amplitude were statistically significant in diabetic patients. The changes in P100 latency, P100 amplitude and N75 latency were also significant in different grades of retinopathy. There are statistically significant changes in visually evoked potential in diabetes patients. Visual evoked potential is a useful, non-invasive investigation which can establish the central nervous system neuropathy in diabetes at an early stage of the disease. So Diabetic retinopathy can be prevented due to early detection of neuropathy by visual evoked potential test Keywords: Diabetes mellitus; diabetic retinopathy; visual evoked potential.

Pathological spectrum of lung lesions diagnosed by sputum cytology: A three years retrospective study in a tertiary health care centre of North India

Sputum Cytology is a cheap and noninvasive investigation contributing significantly to the workload of Cytopathology Laboratories. However, over the years, the use of Sputum Cytology has depreciated. It has been taken over by more advanced procedures like Broncho Alveolar Lavage and Trans Bronchial Needle Aspiration, which are comparatively invasive and expensive requiring a much higher learning curve. Hence, the usefulness of noninvasive samples like Sputum needs to be explored in resource limited settings.To study the spectrum of Lung lesions diagnosed using Sputum Cytology with Histopathological correlation wherever possible.: This was a three years retrospective study. Data of patients who had come with sputum sample was retrieved from the archives of the cytopathology lab between July 2019 and June 2022. Cytology findings were correlated with histopathological diagnosis, wherever possible.Out of the total sample size of 143, 67 showed inflammatory infiltrate, 1 out of which was confirmed to be malignant on biopsy. 17 cases were suspected to be malignant, out of which 15 were confirmed on biopsy. Other samples revealed the presence of fungal infection, dysplasia with no frank malignancy and reactive changes.Our study shows that sputum testing can be quite an accurate method in the early diagnosis of many lung lesions including malignancies. The Sensitivity and Specificity for malignancy was 83.33% and 95% respectively. Therefore, it can be applied as a cheaper, noninvasive ideal screening test for the early detection of lung pathologies especially in resource poor settings.

Left atrial strain in acute myocardial infarction

Background. The ejection fraction (EF), diastolic dysfunction of the left ventricle (LV) and its volumes play the main role for prognosis assessment. Measurement of left atrial strain is a new method of noninvasive investigation of mechanical function.Aim: To investigate the mechanical function of the left atrium in patients with acute myocardial infarction (AMI) with different degrees of left ventricular ejection fraction reduction.Methods. We studied 60 patients with acute ST-segment elevation anterior myocardial infarction. Echocardiography was performed in the first day of acute infarction. The left atrium was assessed by phase volumes, as well as by strain and strain rate using speckle-tracking. 35 healthy subjects were investigated for control. The patients were divided into 4 groups: Group 1 – LV EF 50–60%, Group 2 – LV EF 40–49%, Group 3 – LV EF 30–39%, Group 4 – LV EF 20–29%.Results. There were no significant differences in left atrial volumes between patients in groups 1–3 and healthy patients. Left atrial volume was increased in the fourth group. In the first group, peak longitudinal atrial strain (PALS) was significantly reduced compared with control group (PALS 22% vs 32.4%, p < 0.000). In the second group PALS was 17.41%, in the third group it was 18.19%. In the group with LV EF less than 30%, PALS was 4.43%. In healthy subjects, the strain rate was – 2.14 cm/s-1, in Group 1 – 2.15 cm/s-1 (p < 0.297), in Group 2 – 1.19 cm/s-1(p < 0.000), in Group 3 – 1.58 cm/s-1 (p < 0.000), and in Group 4 – 1.14 cm/s-1(p < 0.000).Conclusion. In patients with AMI with LV EF more than 50%, significant violations of LA strain are detected, which may be a predictor of left heart dysfunction. As the LV EF decreases, LA strain decreases and LA volume increases.

Brain structure and working memory adaptations associated with maturation and aging in mice.

As the population skews toward older age, elucidating mechanisms underlying human brain aging becomes imperative. Structural MRI has facilitated non-invasive investigation of lifespan brain morphology changes, yet this domain remains uncharacterized in rodents despite increasing use as models of disordered human brain aging. Young (2m, n = 10), middle-age (10m, n = 10) and old (22m, n = 9) mice were utilized for maturational (young vs. middle-age) and aging-related (middle-age vs. old mice) comparisons. Regional brain volume was averaged across hemispheres and reduced to 32 brain regions. Pairwise group differences in regional volume were tested using general linear models, with total brain volume as a covariate. Sample-wide associations between regional brain volume and Y-maze performance were assessed using logistic regression, residualized for total brain volume. Both analyses corrected for multiple comparisons. Structural covariance networks were generated using the R package "igraph." Group differences in network centrality (degree), integration (mean distance), and segregation (transitivity, modularity) were tested across network densities (5-40%), using 5,000 (1,000 for degree) permutations with significance criteria of p < 0.05 at ≥5 consecutive density thresholds. Widespread significant maturational changes in volume occurred in 18 brain regions, including considerable loss in isocortex regions and increases in brainstem regions and white matter tracts. The aging-related comparison yielded 6 significant changes in brain volume, including further loss in isocortex regions and increases in white matter tracts. No significant volume changes were observed across either comparison for subcortical regions. Additionally, smaller volume of the anterior cingulate area (χ2 = 2.325, pBH = 0.044) and larger volume of the hippocampal formation (χ2 = -2.180, pBH = 0.044) were associated with poorer cognitive performance. Maturational network comparisons yielded significant degree changes in 9 regions, but no aging-related changes, aligning with network stabilization trends in humans. Maturational decline in modularity occurred (24-29% density), mirroring human trends of decreased segregation in young adulthood, while mean distance and transitivity remained stable. These findings offer a foundational account of age effects on brain volume, structural brain networks, and working memory in mice, informing future work in facilitating translation between rodent models and human brain aging.

Role of Diffusion-Weighted MRI ( DWI) in Differentiating Between Benign and Malignant Nodules of Thyroid Taking Histopathology as Gold Standard

Background: Thyroid gland is a principal endocrine organ, first to develop in embryo, endodermal in origin and producing hormones essential for life. It is a vascular organ inclusive of right and left lobes, surrounded by a capsule and isthmus in the centre. Objective: To determine the role of Diffusion-Weighted MRI ( DWI) in differentiating between benign and malignant thyroid nodules keeping histopathology as the gold standard. Methodology: One hundred and three patients (103) were enrolled. DWI sequence was performed on 1.5 Tesla GE machine at b-values of 0, 50 and 1000 s/mm2 with correlative ADC map and quantitative values were calculated. FNAC of the thyroid nodules was carried out and results were tallied with ADC values. Out of these, five patients lost to follow up and an inadequate sample was obtained in six patients. Results: Mean age of patients (n=92) was 39 years. Out of 92 patients, 26 patients (28.3%) showed restricted diffusion on DWI in malignant thyroid nodules. Mean ADC ( Apparent Diffusion Coefficient) value of benign&#x0D; thyroid nodules (1.43 × 10-3mm2s-1) was significantly greater than malignant thyroid nodules (0.91×10-3mm s-1). For discriminating two types of nodules, cut off ADC value was determined at 1.1×10-3mm2s-1 and its sensitivity, specificity, PPV, NPV and diagnostic accuracy was 84.6, 95.4, 88.8, 91.5 and 92.3% respectively. Conclusion: Diffusion Weighted MRI is a non-invasive imaging investigation without ionizing radiation hazard. Its greater soft tissue differentiation and multiplanar images help in the diagnosis of malignant thyroid nodules with high sensitivity and accuracy. The overload of unnecessary surgeries is thus lowered when pre-operative FNAC is indecisive and aids in making a precise diagnosis.

Noninvasive investigations of human glymphatic dynamics in a diseased model.

To explore human glymphatic dynamics in a diseased model via a noninvasive technique. Patients with reversible vasoconstriction syndrome (RCVS) presenting with blood-brain barrier disruption, i.e., para-arterial gadolinium leakage on 3-T 3-dimensional isotropic contrast-enhanced T2-fluid-attenuated inversion recovery (CE-T2-FLAIR) magnetic resonance imaging (MRI), were prospectively enrolled. Consecutive 9-min-CE-T2-FLAIR for 5-6 times (early panel) after intravenous gadolinium-based contrast agent (GBCA) administration and one time-varying deferred scan of noncontrast T2-FLAIR (delayed panel) were performed. In Bundle 1, we measured the calibrated signal intensities (cSIs) of 10 different anatomical locations. In Bundle 2, brain-wide measurements of para-arterial glymphatic volumes, means, and medians of the signal intensities were conducted. We defined mean (mCoIs) or median (mnCoIs) concentration indices as products of volumes and signal intensities. Eleven subjects were analyzed. The cSIs demonstrated early increase (9min) in perineural spaces: (cranial nerve [CN] V, p = 0.008; CN VII + VII, p = 0.003), choroid plexus (p = 0.003), white matter (p = 0.004) and parasagittal dura (p = 0.004). The volumes, mCoIs, and mnCoIs demonstrated increasing rates of enhancement after 9 to 18min and decreasing rates after 45 to 54min. The GBCA was transported centrifugally and completely removed within 961-1086min after administration. The exogenous GBCA leaked into the para-arterial glymphatics could be completely cleared around 961 to 1086min after administration in a human model of BBB disruption. The tracer enhancement started variously in different intracranial regions but was eventually cleared centrifugally to brain convexity, probably towards glymphatic-meningeal lymphatics exits. Glymphatic clearance time intervals and the centrifugal directions assessed by a noninvasive approach may have implications for clinical glymphatic evaluation in the near future. • This study aimed to investigate the human glymphatic dynamics in a noninvasive diseased model. • The intracranial MR-detectable gadolinium-based contrast agents were removed centrifugally within 961 to 1086min. • The glymphatic dynamics was demonstrable by enhancing MRI in an in vivo diseased model noninvasively.

New Insight into Liu Kang’s Village Scene (1931): A Non-Invasive Investigation by Technical Imaging

This study examines the intriguing peculiarities of the surface paint layer found in the painting Village scene (1931) by renowned Singapore artist Liu Kang (1911–2004). The incorporation of non-invasive visible light (VIS) and near-infrared (NIR) photography techniques, combined with high-power digital microscopy, revealed unusual features on the surface paint layer. Flattened impastos, clusters of incrusted foreign paint unrelated to the existing paint scheme, and fragments of paper with printed traditional Chinese characters were identified on the painting’s surface. The results of the analyses cross-referenced with the archival photographs enabled the consideration of the specified features of the paint layer as unintentional damage caused by the artist due to inadequate storage and transportation conditions—paradoxically, in his attempt to protect the painting. As these damaged areas pose potential display and conservation problems, three conservation strategies were proposed based on ethical guidelines formulated by various governing bodies for the conservation profession. This study demonstrates that there is no universal conservation solution that can satisfy conflicting aesthetic and ethical opinions. The damage to the paint layer affects the visual properties of the artwork but also provides evidence of its complex history. In light of the above, there may be valid arguments both for returning the painting to its original state and for preserving its current condition. Therefore, good practice would require balanced judgments from conservators and curators, considering Village scene in the broader context of Liu Kang’s early painting practice and the existing archival information about the artist.

In situ estimation of effective rock elastic moduli by seismic ambient vibrations

In this study, we performed a non-invasive ambient noise investigation of unsaturated rock structures in the Bohemian Paradise (Bohemian Cretaceous Basin, Czech Republic). Our study focused on two key topics: 1) An in situ elastic moduli estimate of competent, horizontally deposited sandstone layers using ambient noise array measurements. Recordings were processed using an f-k array analysis, from which frequency-dependent Love and Rayleigh wave dispersion curves, as well as Rayleigh wave ellipticity, were retrieved. Data were inverted for the P- and S-wave velocity profiles, from which Young's and shear moduli were successfully estimated. 2) A study of the local response of the Kapelník rock tower. We analysed a dataset of ambient noise recordings obtained from the top of the tower and its foot. Information regarding tower oscillation frequencies and directions, together with amplification ratios, were retrieved from a particle motion polarisation analysis and from site-to-reference spectral ratios. Euler-Bernoulli beam theory was also employed for interpreting measured data using elastic moduli estimated from noise array measurements.

Advancements in Focal Amplification Detection in Tumor/Liquid Biopsies and Emerging Clinical Applications.

Focal amplifications (FAs) are crucial in cancer research due to their significant diagnostic, prognostic, and therapeutic implications. FAs manifest in various forms, such as episomes, double minute chromosomes, and homogeneously staining regions, arising through different mechanisms and mainly contributing to cancer cell heterogeneity, the leading cause of drug resistance in therapy. Numerous wet-lab, mainly FISH, PCR-based assays, next-generation sequencing, and bioinformatics approaches have been set up to detect FAs, unravel the internal structure of amplicons, assess their chromatin compaction status, and investigate the transcriptional landscape associated with their occurrence in cancer cells. Most of them are tailored for tumor samples, even at the single-cell level. Conversely, very limited approaches have been set up to detect FAs in liquid biopsies. This evidence suggests the need to improve these non-invasive investigations for early tumor detection, monitoring disease progression, and evaluating treatment response. Despite the potential therapeutic implications of FAs, such as, for example, the use of HER2-specific compounds for patients with ERBB2 amplification, challenges remain, including developing selective and effective FA-targeting agents and understanding the molecular mechanisms underlying FA maintenance and replication. This review details a state-of-the-art of FA investigation, with a particular focus on liquid biopsies and single-cell approaches in tumor samples, emphasizing their potential to revolutionize the future diagnosis, prognosis, and treatment of cancer patients.

Automated measurements based on artificial intelligence software in pediatric echocardiography: a feasibility study

Abstract Funding Acknowledgements Type of funding sources: None. Background Transthoracic echocardiography is the first-line non-invasive investigation for assessing pediatric patients' cardiac anatomy, physiology, and hemodynamics, based on its accessibility and portability, but complete anatomic and hemodynamic assessment is time-consuming. The study aimed to determine the accuracy and reliability of a new automated artificial intelligence software initially developed for adults for analyzing the main echocardiographic parameters in pediatric patients. Materials and Methods The study was performed at the University Hospital of Bordeaux between August and September 2022 and included 45 patients who underwent a 2D transthoracic echocardiographic examination, mainly for murmur (n=8), post ASD closure evaluation(N=5), chest pain, or arrhythmia as we aimed to have a homogeneous group of patients with normal or near normal heart architecture. We compared AI automatic measurements with manual measurements performed by a senior and junior pediatric cardiologist. Pearson correlation and Bland and Altman analysis were used. As the AI software has been developed for adults, we decided to subclassify our patients into two subgroups: the first group (patients aged between 0–8 years) and the second group (patients over 8 years). The decision was made because pediatric anatomy differs from adults and to see if the dedicated artificial intelligence soft for adults has better reproducibility for pediatric patients older than 8 years. Results The median age was 8.9 years. Comparison between senior and junior pediatric cardiologists for all subgroups was significant (Pearson correlation &amp;gt;0,7 for most measurements performed). For younger patients (&amp;lt;8 years old), we found excellent correlations (Pearson correlation &amp;gt;0.8) for heart chambers measurements measured from A4CH and A2CH views (LV end-diastolic volume, LV end-systolic volume, RV end-diastolic area, and RV area) between AI software and both junior and senior pediatric cardiologist, but poor correlation for the measurements performed from parasternal long axis view (r=0.06 for STJ measurement). We achieved stronger correlations for the measurements evaluation of patients over 8 years old ( r&amp;gt;0.8 for aortic annulus, STJ, E, A, S waves, LV end-diastolic volume in A4CH, LV end-systolic volume in A4CH) for both junior and senior cardiologist in relation to AI measurements. Conclusion In this preliminary study, we found that automated artificial intelligence software provided promising results for measuring mainly volumes (LV end-diastolic volume, LV end-systolic volume) in A4CH and A2CH. The software requires improvements for automated measurements within the parasternal long-axis section to achieve better accuracy. Results obtained with the AI software for patients over 8 years old were significantly improved compared to those obtained for those under 8 years of age.

A comparative study of macular thickness measurements using spectral domain-optical coherence tomography before and after cataract surgery in patients with diabetes mellitus and their age matched controls

Patients with diabetes mellitus who undergo cataract surgery can be prone for macular edema post-operatively.Aimof this study wasto compare macular thickness in diabetics and non-diabetics, pre and post cataract surgery using SD-OCT. A Cohort study of 50 diabetic and 50 non-diabetic cataract patients who presented to ophthalmology out patient department, aged 50–70 years underwent macular thickness assessment using SD–OCT pre and post cataract surgery.The macular thickness showed a steady increase with time in non-diabetics and diabetics seen at baseline, 1 week post operative and 6 weeks post op. But the mean difference in diabetics was higher with a statistical significance(p&amp;#60;0.05).OCT is a noninvasive investigation which can differentiate between diabetic macular edema and postoperative cystoid macular edema. Preoperative assessment of macular thickness will be useful in the management of macular edema in both conditions, thus improving visual prognosis post cataract surgery.

Nailfold Videocapillaroscopy in Patients with Rheumatoid Arthritis and Psoriatic Arthropathy on ANTI-TNF-ALPHA Therapy

Videocapillaroscopy is a simple, non-invasive investigation that allows the “in vivo” study of the nailfold capillaries. This method is inexpensive, easily accepted by patients and the results can be easily interpreted. It is mainly used in patients with Raynaud’s phenomenon and systemic sclerosis, but this examination can also be performed on patients who are suspected of having microcirculation alterations, such as rheumatoid arthritis and psoriatic arthritis. It may aid in the diagnosis, evaluation and prognosis of other rheumatic diseases, besides systemic sclerosis. The aim of this study is to identify the nailfold videocapillaroscopic abnormalities in rheumatoid arthritis and psoriatic arthritis patients and analyze the correlation between their evolution and 12 months of anti-TNF-α therapy. The abnormal capillaroscopic findings comprised widened, dilated or giant capillaries and the distortion of the normal nailfold architecture, avascular areas, hemorrhages and neoangiogenesis. Overall, capillary density, dilated capillaries, giant capillaries, elongated capillaries and angiogenesis significantly improved after 12 months. Moreover, no avascular areas were found after 12 months of anti-TNF treatment.

#6073 MAGNETIC RESONANCE RADIOMIC ANALYSIS FOR THE PREDICTION OF GRAFT FAILURE IN PATIENTS WITH KIDNEY TRANSPLANTATION

Abstract Background and Aims Prediction of future graft failure with non-invasive investigations is a relevant objective for transplant clinicians. We previously demonstrated a promising discrimination capacity for interstitial fibrosis / tubular atrophy (IFTA) &amp;gt;50% in kidney biopsy of a machine learning (ML) based magnetic resonance imaging (MRI) radiomic algorithm. Aim of the present study is to evaluate accuracy of MRI radiomic-based ML algorithms in predicting future graft failure. Method Single-center retrospective observational cohort study on a previously characterized cohort of kidney transplant recipients who underwent graft biopsy and graft MRI imaging within 6 months from biopsy, both on clinical indication, at the “Azienda Ospedaliero-Universitaria di Modena”, Italy, from 1/1/2012 to 1/3/2021. The primary outcome was to identify the best combination of MRI radiomic features for the prediction of graft failure during follow-up. Segmentation of renal parenchyma, cortex and medulla on MRI sequences was performed using the 3DSlicer software. Radiomic features were then extracted using an in-house software based on pyradiomics applying Wavelet and Gaussian filters. LASSO algorithm was employed to select correlated features with outcome and summarize them in a radiomic signature. Using radiomic signature alone and then merged with meaningful clinical data we trained ML-algorithms using 70% of cases for training/validation, with a 10-fold internal cross-validation, and 30% for model testing. Model performance was assessed using AUC with a 95% confidence interval (CI). Results Seventy coupled tests (63 patients) were included and randomly subdivided into a training/validation cohort (n = 50) and a test cohort (n = 20). Median follow-up was 24.73 months (interquartile range 13.64-46.57). Radiomic model had an AUC of 0.88 (95%_CI 0.70-0.97) in training and 0.57 (95%_CI 0.23-0.86) in test cohort. Radiomic-clinical mixed model had an AUC of 0.90 (95%_CI 0.73-0.98) in training and 0.66 (95%_CI 0.33-0.88) in test cohort. Conclusion We produced an MRI radiomic-based ML algorithm with good prediction ability for future graft failure in patients with kidney transplant. Given the limited number of enrolled patients, validation in larger (and ideally prospective) cohorts is required to confirm our findings. Comparison of radiomic-based ML with histological parameters (i.e., IFTA) for the prediction of graft failure in our cohort is currently under assessment.

Non-Invasive Geophysical Investigation of Failure Along a Section of Ago-Iwoye Market Road, Ago-Iwoye, Southwestern Nigeria

Non-Invasive Geophysical Investigation of Failure Along a Section of Ago-Iwoye Market Road, Ago-Iwoye, Southwestern Nigeria

Non-invasive investigation of Polychromophilus parasite infections in bat populations in Serbia using bat flies

BackgroundHaemosporidian parasites of the genus Polychromophilus infect bats worldwide. They are vectored by obligate ectoparasitic bat flies of the family Nycteribiidae. Despite their global distribution, only five Polychromophilus morphospecies have been described to date. The two predominant species, Polychromophilus melanipherus and Polychromophilus murinus, are broadly distributed and mainly infect miniopterid and vespertilionid bats, respectively. In areas where species from different bat families aggregate together, the infection dynamics and ability of either Polychromophilus species to infect other host families is poorly characterized.MethodsWe collected 215 bat flies from two bat species, Miniopterus schreibersii and Rhinolophus ferrumequinum, which sometimes form mixed clusters in Serbia. Miniopterus schreibersii is known to be frequently infected with P. melanipherus, whereas R. ferrumequinum has been observed to be incidentally infected with both Polychromophilus species. All flies were screened for Polychromophilus infections using a PCR targeting the haemosporidian cytb gene. Positive samples were subsequently sequenced for 579 bp of cytochrome b (cytb) and 945 bp of cytochrome oxidase subunit 1 (cox1).ResultsPolychromophilus melanipherus DNA was detected at six out of nine sampling locations and in all three examined bat fly species collected from M. schreibersii (Nycteribia schmidlii, n = 21; Penicillidia conspicua, n = 8; Penicillidia dufourii, n = 3). Four and five haplotypes were found for cytb and cox1, respectively. Evidence for multiple Polychromophilus haplotypes was found in 15 individual flies. These results point to a high diversity of P. melanipherus parasites in Miniopterus hosts and efficient transmission throughout the study area. A single Phthiridium biarticulatum bat fly collected from R. ferrumequinum screened positive for P. melanipherus, but only yielded a partial cox1 sequence fragment. Nevertheless, this result suggests that secondary hosts (both bat and fly species) are regularly confronted with this parasite.ConclusionsThe results of this study provide new insights into the prevalence and distribution of Polychromophilus parasites in European bats and their nycteribiid vectors. The use of bat flies for the non-invasive investigation of Polychromophilus infections in bat populations has proven to be efficient and thus represents an alternative for large-scale studies of infections in bat populations without the need to invasively collect blood from bats.Graphical

Evaluating the integration of Thermal Quasi-Reflectography in manuscript imaging diagnostic protocols to improve non-invasive materials investigation

Multispectral imaging techniques applied to book heritage are useful to scholars to obtain information on the materials under investigation. The novel introduction of Thermal Quasi-Reflectography (TQR) technique, operating in the medium wave infrared (MWIR) spectral range, can flank conventional diagnostic techniques such as UV-based methods and IR imaging techniques in the 850–1700 nm range on manuscript acquisition. As proof of concept, this work investigates the application of TQR on the Ms. XL (38) palimpsest, known as Vergilius Veronensis, of the Biblioteca Capitolare of Verona. While investigating the manuscript with full-field imaging technique, this work focuses its application to improve the mapping of conservation materials. The manuscript contains several traces of reagents and conservation treatments applied during its conservation history. The study compared the manuscript materials response obtained with TQR with the response collected using UV-induced visible fluorescence (UVL), UV reflected imaging (UVR), and NIR imaging in the 850–1050 nm and 900–1700 nm bands. Being the TQR technique sensitive to surface materials with MWIR reflectance features, it may especially provide more accurate documentation of the restoration history of the object. TQR imaging discriminated non-homogeneities of products in the surface layer thanks to an enhanced MWIR contrast. The TQR image response on manuscript materials should be further investigated and compared to reflectance spectroscopic data. The results of this study demonstrate the added value of TQR imaging for manuscript diagnostics, for which integration of the TQR technique in the standard protocol is desirable.

Strain Rate Changes during Stress Echocardiography Are the Most Accurate Predictors of Significant Coronary Artery Disease in Patients with Previously Treated Acute Coronary Syndrome.

Dobutamine stress echocardiography (DSE) is a well-established non-invasive investigation for the detection of ischemic myocardial dysfunction. The aim of this study was to evaluate the accuracy of myocardial deformation parameters measured by speckle tracking echocardiography (STE) in predicting culprit coronary artery lesions in patients with prior revascularization and acute coronary syndrome (ACS). We prospectively studied 33 patients with ischemic heart disease, a history of at least one episode of ACS and prior revascularization. All patients underwent a complete stress Doppler echocardiographic examination, including the myocardial deformation parameters of peak systolic strain (PSS), peak systolic strain rate (SR) and wall motion score index (WMSI). The regional PSS and SR were analyzed for different culprit lesions. The mean age of patients was 59 ± 11 years and 72.7% were males. At peak dobutamine stress, the change in regional PSS and SR in territories supplied by the LAD showed smaller increases compared to those in patients without culprit LAD lesions (p < 0.05 for all). Likewise, the regional parameters of myocardial deformation were reduced in patients with culprit LCx lesions compared to those with non-culprit LCx lesions and in patients with culprit RCA legions compared to those with non-culprit RCA lesions (p < 0.05 for all). In the multivariate analysis, the △ regional PSS (1.134 (CI = 1.059-3.315, p = 0.02)) and the △ regional SR (1.566 (CI = 1.191-9.013, p = 0.001)) for LAD territories predicted the presence of LAD lesions. Similarly, in a multivariable analysis, the △ regional PSS and the △SR predicted LCx culprit lesions and RCA culprit lesions (p < 0.05 for all). In an ROC analysis, the PSS and SR had higher accuracies compared to the regional WMSI in predicting culprit lesions. A △ regional SR of -0.24 for the LAD territories was 88% sensitive and 76% specific (AUC = 0.75; p < 0.001), a △ regional PSS of -1.20 was 78% sensitive and 71% specific (AUC = 0.76, p < 0.001) and a △ WMSI of -0.35 was 67% sensitive and 68% specific (AUC = 0.68, p = 0.02) in predicting LAD culprit lesions. Similarly, the △ SR for LCx and RCA territories had higher accuracies in predicting LCx and RCA culprit lesions. The myocardial deformation parameters, particularly the change in regional strain rate, are the most powerful predictors of culprit lesions. These findings strengthen the role of myocardial deformation in increasing the accuracy of DSE analyses in patients with prior cardiac events and revascularization.

Epigenetic Memory of COVID-19 in Innate Immune Cells and Their Progen-itors--

Abstract Through epigenetic mechanisms, systemic inflammation may trigger innate immune memory and persistent changes in hematopoietic cells; however, it has been difficult to investigate these phenotypes in the context of human disease, such as severe coronavirus disease 2019 (COVID-19). We developed a new workflow to isolate circulating hematopoietic stem and progenitor cells (HSPC) from peripheral blood, combining single-cell RNA/ATAC-seq. With this method, we were able to capture the diversity of circulating HSPC as seen in bone marrow, allowing for the non-invasive investigation of hematopoiesis as well as epigenomic changes after COVID-19. Following severe COVID-19, we observed both transcriptomic and epigenetic changes in HSPC and its progeny innate immune cells, and they persisted for months to a year. Different transcription factor activities (including IRF, AP-1, and CTCF) were associated with these alterations, which altered the regulation of inflammatory programs. Severe COVID-19 patients’ HSPC displayed long-lasting increases in myelopoiesis and granulopoiesis, and circulating monocytes responded more strongly to subsequent stimulation. We found that epigenomic changes in HSPC were retained and passed onto differentiated progeny innate immune cells. In addition, we demonstrate that administration of an anti-IL-6 blockade during acute severe COVID-19 can normalize the persistent phenotypes, suggesting that IL-6 plays a role in the development of epigenetic memory. In conclusion, epigenetic reprogramming of HSPC may underlie altered immune function subsequent to infection and has broad applicability, particularly for millions of COVID-19 survivors with incomplete recovery.

Exploring the Potential of Artificial Intelligence in Pediatric Echocardiography-Preliminary Results from the First Pediatric Study Using AI Software Developed for Adults.

(1) Background: Transthoracic echocardiography is the first-line non-invasive investigation for assessing pediatric patients' cardiac anatomy, physiology, and hemodynamics, based on its accessibility and portability, but complete anatomic and hemodynamic assessment is time-consuming. (2) Aim: This study aimed to determine whether an automated software developed for adults could be effectively used for the analysis of pediatric echocardiography studies without prior training. (3) Materials and Methods: The study was conducted at the University Hospital of Bordeaux between August and September 2022 and included 45 patients with normal or near normal heart architecture who underwent a 2D TTE. We performed Spearman correlation and Bland-Altman analysis. (4) Results: The mean age of our patients at the time of evaluation was 8.2 years ± 5.7, and the main reason for referral to our service was the presence of a heart murmur. Bland-Altman analysis showed good agreement between AI and the senior physician for two parameters (aortic annulus and E wave) regardless of the age of the children included in the study. A good agreement between AI and physicians was also achieved for two other features (STJ and EF) but only for patients older than 9 years. For other features, either a good agreement was found between physicians but not with the AI, or a poor agreement was established. In the first case, maybe proper training of the AI could improve the measurement, but in the latter case, for now, it seems unrealistic to expect to reach a satisfactory accuracy. (5) Conclusion: Based on this preliminary study on a small cohort group of pediatric patients, the AI soft originally developed for the adult population, had provided promising results in the evaluation of aortic annulus, STJ, and E wave.

Non-invasive particle-scale investigation of the effects of blade speed and particle properties on mixture homogeneity evolution using X-ray CT

A binary system of particles was mixed in a vertically bladed mixer and mixture homogeneity wasreported usingX-ray computed tomography (CT) and a particle-scale mixing index. The effects of particledensity, size, and volume fraction,as well as mixer blade speedonmixture homogeneity evolution were investigated.For same sized particles, mixture homogeneity was found todeteriorate with increasingdifference in particle densities. However, this could be countered by controlling for percolation, e.g., mixing heavier particles of larger size with smaller/lighter particles to improve mixing. Increasing blade speeds from 10 rpm to 30 rpm,deteriorated mixing,however, furtherincreases from 30 rpm to 60 rpm resulted in improvements, indicating possible flow regime changes at different rotational speeds. Increases in the volume fraction oflarge/light particles increased the penetration of these particles to the bottom layers dueto overall flowchanges,which in turnappeared to improve mixing.