Strong Correlation Research Articles

Abrasion and dental pulp morphological changes in occlusal dysfunction.

The authors set out to assess if the presence and the degree of severity of the abrasion, as a consequence of the occlusal dysfunction, determine further morphological changes in the dental pulp. Study group included teeth dental pulp from 45 cases with occlusal dysfunction, subsequently divided into two subgroups: 24 cases with abrasion (AB) and 21 cases without abrasion (NONAB). The set of morphological parameters of dental pulp were thicknesses of the outer layer, inner layer and entire peripheral pulp zone, the presence of pulpal calcifications and their extent within the dental pulp, the presence of interstitial fibrosis and its extent within the dental pulp and the vascular density (VD) of pulpal capillary network. Tissue samples were fixed in 10% buffered formalin, embedded in paraffin, and sectioned off at 4 μm. Serial slides were stained with Hematoxylin-Eosin (HE), Masson's trichrome (MT) and anti-cluster of differentiation 34 (CD34) antibodies labeled with 3,3'-Diaminobenzidine (DAB) and transformed into virtual slides on which the above-mentioned parameters were studied comparatively with the help of a dedicated in-house software, realized in MATLAB (MathWorks, USA). The numerical values of the assessed parameters were also stratified in classes, thus obtaining score scales for each parameter. Statistical tools used were Lilliefors test, t-test (two-sample assuming equal variances), Mann-Whitney test, Pearson's correlation test, one-way analysis of variance (ANOVA) test and χ² (chi-squared) test. Both peripheral zone (PZ) and its layers individually tended to be thicker in the teeth with abrasion than in those without abrasion. Also, teeth with abrasion tended to develop larger amounts of calcium deposits in their dental pulp than teeth without abrasion. On the other hand, fibrotic tissue in dental pulp had no relationship with the presence or absence of abrasion. PZ as a whole and its layers evolved together in the same way, with a stronger correlation in the group of teeth without abrasion. Deposits of calcium evolved in the opposite direction to both the amount of fibrous tissue and the capillaries density of the dental pulp. Consequently, the amount of fibrous tissue and VD evolved together in the same way, more pronounced in the teeth without abrasion. Our preliminary study pointed out that different components of the dental pulp showed slight to moderate changes depending on the degree of abrasion in teeth with occlusal dysfunction.

Influence of age on the concentrations of perfluoroalkyl acids (PFAA) in the tissues of perch (Percafluviatilis)

Globally, perfluoroalkyl acids (PFAA) are ubiquitous due to their almost unlimited applications in industry and households and are detected in a wide variety of matrices.Aquatic ecosystems are of particular importance due to the spread of PFAA via water fluxes. The majority of published studies describe PFAA concentrations in fish or aquatic mammals, but not the dependence of PFAA concentrations in tissues and organs in fish of different ages. Since this is very important for understanding the accumulation behavior of these substances our study systematically investigates the influence of age on the PFAA concentration in the tissues of 74 perches (Perca fluviatilis), a very popular edible fish. Fish are particularly suitable as indicators of PFAA contamination of water because of their uptake via water (gills and skin) and food (predominantly piscivorous diet). The mean total PFAA concentrations (as the sum of the individual concentrations of 11 compounds) were: 114 μg/kg (kidney), 112 μg/kg (heart), 79.9 μg/kg (liver), 78.4 μg/kg (spleen), 64.6 μg/kg (gills) and 21.7 μg/kg (muscle), with longer-chain compounds accounting for 90% of the substances. Perfluorooctanesulfoic acid (PFOS) accounted for the largest percentage of the total PFAA concentration in all tissues at 43–63%. With the exception of the heart and spleen, a significant increase in total concentrations was observed with increasing age of the perch. The strongest correlation was observed for the kidney, followed by the liver and gills. With regard to their consumption as human nutrition the tolerable weekly PFAA intake of 4.4 ng/kg bodyweight and week for the sum of the 4 EFSA PFAA in adults and children was exceeded many times over (860% and 1600% respectively) with an average fish consumption per week. The maximum PFAA levels set in the E.U. since January 2023 were exceeded five times.

Retrospective analysis of nystagmus characteristics and clinical applications of positional testing in patients with cupulolithiasis of the posterior semicircular canal in benign paroxysmal positional vertigo.

This study aimed to investigate the characteristics of positional nystagmus in patients with cupulolithiasis of the posterior semicircular canal-benign paroxysmal positional vertigo (PC-BPPV-cu) to improve clinical diagnostic accuracy. This study retrospectively analyzed 128 cases of PC-BPPV-cu and 128 cases of canalolithiasis of BPPV (PC-BPPV-ca). General data, intensity, distribution, and the correlation of positional nystagmus were compared between the two groups. Compared to the PC-BPPV-ca group, more cases from the PC-BPPV-cu group initially presented in the emergency department (P < 0.05). The most frequent positional nystagmus induced by PC-BPPV-cu was torsional-upbeat nystagmus, characterized by the upper pole of the affected eye beating toward the lower ear and vertically upward (387 cases, 59.7%). It was followed by torsional-downbeat nystagmus, characterized by the upper pole of the unaffected eye beating toward the lower ear and vertically downward (164 cases, 25.3%). The former represented posterior canal excitatory nystagmus (PC-EN), while the latter represented posterior canal inhibitory nystagmus (PC-IN). In the PC-BPPV-cu group, PC-EN was most easily caused by the Half Dix-Hallpike (HH) maneuver on the affected side, while PC-IN was most easily induced by a face-down position (FDP) on the unaffected side at approximately 45° angle (45° FDP). The vertical slow phase velocity (v-SPV) of positional nystagmus was more potent in the affected HH than in other positions with PC-EN (all P < 0.05); the v-SPV of positional nystagmus was greater in the 45° FDP than in different positions with PC-IN (all P < 0.05); the v-SPV of the affected Dix-Hallpike (DH) maneuver in the PC-BPPV-ca group was significantly greater than that of the affected HH maneuver in the PC-BPPV-cu group (P < 0.05). The a priori analysis showed that the strongest correlation with HH positional nystagmus was observed in the affected side roll test, followed by the DH maneuver. In the PC-BPPV-cu group, the HH maneuver most easily induced PC-EN on the affected side, and PC-IN was most easily induced by the 45° FDP. In some cases of PC-BPPV-cu, significant nystagmus was not observed to be induced in the DH position on the affected side; however, vertical rotation nystagmus was induced in the roll-test position on the affected side. In such cases, PC-BPPV-cu diagnosis should be considered, and HH and 45° FDP tests should be conducted to support the diagnosis.

Dissecting the vascular-cognitive nexus: energetic vs. conventional hemodynamic parameters.

Blood pressure or flow measurements have been associated withvascular health and cognitive function. We proposed that energetic hemodynamic parameters may provide a more nuanced understanding and stronger correlation with cognitive function, in comparisons with conventional aortic and carotid pressure and flow parameters. The study comprised 1858 participants, in whom we assessed cognitive function via MoCA method, and measured central aortic and carotid pressure and flow waveforms. In addition to various pressure and flow parameters, we calculated energetic hemodynamic parameters through integration of pressure multiplying flow with respect to time. Energetic hemodynamic parameters, particularly aortic and carotid mean and pulsatile energy and pulsatility index (PI), were significantly associated with MoCA score more than any aortic and carotid pressure and flow parameters, after adjusting for age, sex, education, depression score, heart rate, BMI, HDL-cholesterol, and glucose levels. MoCA exhibited a strong positive relationship with carotid mean energy (standardized beta = 0.053, P = 0.0253) and a negative relationship with carotid energy PI (standardized beta = -0.093, P = 0.0002), exceeding the association with all traditional pressure- or flow-based parameters. Aortic pressure reflection coefficient at the aorto-carotid junction was positively correlated with mean carotid energy and negatively correlated with PI. Aortic characteristic impedance positively correlated with carotid energy PI but not mean energy. Our research indicates that energetic hemodynamic parameters, particularly carotid mean energy and carotid energy PI, have a stronger association with MoCA scores than traditional pressure- or flow-based metrics. This correlation with cognitive function is notably influenced by the properties of the aorto-carotid interface.

The mediation role of hope in the relationship of resilience with depression, anxiety, and stress in caregivers of children and adolescents with cancer

This study aimed to determine the mediation role of hope in the relationship of resilience with depression, anxiety, and stress in caregivers of children and adolescents with cancer. This cross-sectional study was conducted on 200 caregivers of children and adolescents with cancer. Adult Hope Scale, Connor-Davidson Resilience Scale, and Depression, Anxiety and Stress (DAS) scales were used for data collection. The mediator and moderator model was tested using the SPSS macro PROCESS (Model 4, and 5). The mediator model (model 4) indicated that DAS significantly correlated with resilience (β = − 0.54, t-value = − 5.01, p < 0.001), and hope (β = − 0.84, t-value = − 3.45, p = 0.0007). Hope mediated the relationship between resilience and DAS among caregivers of children and adolescents with cancer (Effect = − 0.18, SE = 0.06, 95% CI − 0.33 to − 0.06). The mediator and moderator model (model 5) showed that female caregivers had a stronger correlation between resilience and DAS when compared to their male counterparts (β = − 0.56, t-value = − 3.90, p-value = 0.0001); also, hope mediated the relationship between resilience and DAS among caregivers of children and adolescents with cancer (Effect = − 0.20, SE = 0.08, 95% CI − 0.37 to − 0.04). In conclusion, hope was a mediator, and female caregivers were a moderator in the relationship of resilience with depression, anxiety, and stress, and its promotion might be effective among caregivers of children and adolescents with cancer. It seems that resilience, female caregivers, and hope may provide good protection against depression, anxiety, and stress in caregivers of cancer patients.

The link between the normalized difference vegetation index in major crops and meteorological factors

Normalized difference vegetation index (NDVI) is frequently used in monitoring of meteorological events. The goal of this study was to establish the relationship between the spatial NDVI with air temperature and precipitation amounts in major crops cultivated in the steppe zone of Ukraine, namely, winter wheat, winter rapeseed, grain corn, soybeans, and sunflower. The study included the croplands of eight regions: the Crimea, Kherson, Mykolaiv, Odesa, Zaporizhzhia, Dnipropetrovsk, Kirovohrad, and Kharkiv. The yield data were retrieved from the official bodies of the State Statistical Service of Ukraine. The meteorological data on monthly air temperature and rainfall were retrieved from regional hydrometeorological centers. The NDVI values were retrieved from the GIMMS Global Agricultural Monitoring System, which provides Terrain MODIS NDVI 8-Day smoothed time series with 250 m resolution. The study was performed for the 2021-2022 for winter rapeseed and sunflower; 2017 and 2020 for grain corn; 2022 for winter wheat; and 2017 for soybeans. We found almost no or weak correlation between monthly NDVI values of the studied crops and rainfall amounts. A stronger correlation was found for air temperature, with the greatest values of the correlation coefficient of 0.76, 0.72, –0.72 for sunflower, soybeans, and winter wheat, respectively. The linear regression models, developed to predict NDVI based on the air temperature for the mentioned crops, provided good prediction accuracy with the relative error within 10–20%. The best overall fit and accuracy was produced by the model of sunflower’s NDVI. Only winter crops were observed to have a negative correlation with air temperature, suggesting that the cultivated varieties of these crops are heat-intolerant.

Relationship between inflammatory laboratory parameters and severity of adolescent idiopathic scoliosis: A pilot study.

Adolescent idiopathic scoliosis is a complex condition whose pathogenesis may include inflammation and signs of joint and bone degeneration. The main objective of this study is to evaluate the relationship between the severity of adolescent idiopathic scoliosis and inflammatory blood parameters. The study recruited patients with adolescent idiopathic scoliosis who attended the Rehabilitation Center of the Apostolo Foundation in Merate (LC). The scoliosis curve (Cobb's angle) was used as a severity index to compare with inflammatory blood parameters (white blood cells subpopulations, immunoglobulins, protein electrophoresis). In addition, the study used an overall severity grading called "Scoliosis Score" which includes all spine angles and Risser's score (bone development index). Thirty-four subjects were recruited (mean age 14years, 2months), 30females and 2males. A significant correlation was found between Cobb's angle and the percentage values of beta-2 globulins in a directly proportional manner (r= 0.42, p= 0.01), and gamma globulins in an inversely proportional manner (r=-0.366, p= 0.04). However, no significant correlation between Cobb's angle and the absolute values of white blood cells and percentage subpopulations was found (r= 0.0821 p= 0.655). A moderate, inverse correlation was found between the Scoliosis Score and the percentage of neutrophils (r=-0.385, p= 0.02), a direct correlation was found between the Scoliosis Score and the percentage of lymphocytes (r= 0.404, p= 0.02). In addition, there was a strong correlation of the Scoliosis Score with alpha-2 globulin (r= 0.564, p= 0.0012), beta-1 globulin (r= 0.478, p= 0.0074), and beta-2 globulin (r= 0.370, p= 0.044) and an inverse relationship with gamma globulin (r=-0.625, p= 0.0002). The main correlations were confirmed by regression analysis. The correlation between beta-2 globulins and gamma globulins with Cobb's angle and the Scoliosis Score suggests a link between spinal curvature and inflammation in scoliosis patients, This link may indicate the significance of these parameters for diagnosing, staging the disease, and monitoring therapies.

Multi-institutional investigation into the robustness of intra-cranial multi-target stereotactic radiosurgery plans to patient setup errors

PurposeThis study aimed to analyse correlations between planning factors including plan geometry and plan complexity with robustness to patient setup errors. MethodsMultiple-target brain stereotactic radiosurgery (SRS) plans were obtained through the Trans-Tasman Radiation Oncology Group (TROG) international treatment planning challenge (2018). The challenge dataset consisted of five intra-cranial targets with a 20 Gy prescription. Setup error was simulated using an in-house tool. Dose to targets was assessed via dose covering 99 % (D99 %) of gross tumour volume (GTV) and 98 % of planning target volume (PTV). Dose to organs at risk was assessed using volume of normal brain receiving 12 Gy and maximum dose covering 0.03 cc of brainstem. Plan complexity was assessed via edge metric, modulation complexity score, mean multi-leaf collimator (MLC) gap, mean MLC speed and plan modulation. ResultsEven for small (0.5 mm/°) errors, GTV D99 % was reduced by up to 20 %. The strongest correlation was found between lower complexity plans (larger mean MLC gap and lower edge metric) and higher robustness to setup error. Lower complexity plans had 1 %–20 % fewer targets/scenarios with GTV D99 % falling below the specified tolerance threshold. These complexity metrics correlated with 100 % isodose volume sphericity and dose conformity, though similar conformity was achievable with a range of complexities. ConclusionsA higher level of importance should be directed towards plan complexity when considering plan robustness. It is recommended when planning multi-target SRS, larger MLC gaps and lower MLC aperture irregularity be considered during plan optimisation due to higher robustness should patient positioning errors occur.

Evaluation of Fasting Glucose-Insulin-C-Peptide-Derived Metabolic Indices for Identifying Metabolic Syndrome in Young, Healthy Adults.

Metabolic syndrome (MetS) is a condition defined by a cluster of symptoms, including excessive adipose tissue, impaired glucose homeostasis, dyslipidemia, and high blood pressure (BP). We aimed to evaluate the correlation between the MetS criteria (IDF) and fasting glucose-insulin-C-peptide-derived indices in a cohort of 128 healthy young adults who were 20-35 years old at the time of this study. We measured fasting serum glucose, insulin, C-peptide (CP), HDL-cholesterol, triglycerides, and hsCRP; HOMA-IR INS, HOMA-IR CP1, HOMA-IR CP2, HOMA-BETA, HOMA-BETA CP, QUICKI, disposition index (DI), CP index (CPI), and 20/C-peptide*glucose. Significant correlations were found between BMI and all HOMA indices, QUICKI, and CPI; waist circumferences and HOMA-IR INS, HOMA-BETA, and QUICKI (for both sexes); glucose and HOMA-IR INS/CP1/CP2, HOMA-BETA CP, DI, and QUICKI; HDL-cholesterol and HOMA-IR INS, HOMA-BETA, and QUICKI for males and females only with QUICKI; triglycerides and HOMA-IR INS, HOMA-BETA, and QUICKI; systolic BP and HOMA-IR INS, HOMA-BETA; diastolic BP and DI. The cut-off values for HOMA-IR INS, HOMA-BETA, and QUICKI in the combined group (females + males) were 1.855, 82.250, 0.355; 2.115, 106.370, 0.345 for males; 1.805, 71.305, 0.355 for females. A stronger correlation was found between males' indices and hsCRP. In conclusion, CP-derived indices do not add significant information, and the male sex is more predisposed to MetS.

Health Security and Cybersecurity: Analysis of Interdependencies

The development of medical digital platforms with data on patients, medical institutions and medicines, the growing use of IoT devices in medicine, the development of telemedicine accelerated by the COVID-19 pandemic, the growth of big data-based treatment technologies – all this makes it necessary to ensure reliable cyberdefence in the field of public health, maintain the confidentiality of financial information of clinics and health insurance companies, protect databases with patient records from hacking, and ensure secure communication. The article uses economic and mathematical modelling to study the relationship between two well-known international indexes and their components: The Global Health Security Index (GHSI) and the Global Cybersecurity Index (GCSI) for 190 countries in 2021. The input base included 6 cybersecurity subindexes and 7 health security subindexes for 2021. Based on the iterative divisive k-means method, all countries were grouped into 3 clusters. The first cluster includes 55 countries (medium levels of the studied indexes), the second – 49 (high levels), the third – 86 (low levels). The feasibility of dividing into clusters and choosing their optimal number is substantiated by means of variance analysis. Via the methods of Sigma-restricted parameterisation, Univariate Tests of Significance, Pareto Chart of t-Values and correlation analysis, all factors, without exception, proved to be relevant. Due to the OLS method, multiple linear regressions describing the relationships between various components of these indexes and their integral values are generated. The statistical significance of the factors included in the model is confirmed, and the model itself is tested for adequacy and accuracy. On the basis of correlation analysis, existence and magnitude of statistical relationship between the components of these indexes are revealed. The strongest correlations are observed between the integral values of these indexes, as well as between pairs of subindexes: 1) Legal Measures (GHSI component) and Prevention (GCSI component); 2) Technical Measures (GHSI component) and Detection and Reporting (GCSI component). To identify the causal relationship between the groups of factors, a canonical analysis was carried out, which showed the GHSI parameters are causal and the GCSI parameters are resultant. The linear regression model showed a significant positive relationship between the GHSI and GCSI indexes.

P-114 The timing from post-insemination to blastocyst vitrification correlates with ploidy and gender

Abstract Study question Which morphology parameter of blastocysts has the strongest correlation with the euploid rate? Summary answer The vitrification times post-insemination and trophectoderm grade (TE) are more predictive parameters for euploid blastocysts, and female blastocysts require less time for vitrification. What is known already In current ART, the use of preimplantation genetic tests for aneuploidy (PGT-A) has increased by 2 to 25 percent in different countries. PGT-A analyses have helped patients achieve an increased pregnancy rate, choose the gender of the embryo and prevent miscarriages. Moreover, the potential for blastocyst euploid is strongly correlated with the developmental speed and morphology grades. However, for patients without PGT-A, the criteria for selecting transferred blastocysts are mostly based on morphology and the day of the blastocyst. Therefore, it is essential to clarify which parameter is more predictive of euploid embryos during elective FET cycles. Study design, size, duration This retrospective analysis included 713 blastocysts from 417 patients treated at the Ojinmed IVF Center, Mongolia, between May 2019 and June 2023. The morphology parameters (morphology grade, blastocyst formation time, vitrification time and inner diameter) were compared between the PGT-A results and the control results. Blastocyst quality was evaluated with the Gardner and Schoolcraft grading system, and the inner diameter of the blastocyst was measured. Participants/materials, setting, methods All patients underwent a clomiphene-based minimal ovarian stimulation protocol or drug-free natural cycle of IVF treatment. When the blastocyst diameter exceeded 160 μm, a trophectoderm (TE) biopsy was taken, and the blastocyst was immediately vitrified using the Cryotop method. The time of vitrification and formation of the blastocyst were recorded from the insemination. The patients were analyzed using high-resolution NGS PGT-A (10 Mb resolution for copy number variations and 30%-70% for mosaicism). Main results and the role of chance The PGT-A analysis reported euploid, aneuploid, and mosaic rates. Euploid, aneuploid, and mosaic rates were significantly correlated with blastocyst formation time (114.78 ± 4.49 h, 116.12 ± 6.42 h and 116.33 ± 6.87 h, p = 0.003) and vitrification blastocyst time (126.65 ± 9.8 h, 131.57 ± 10.8 h and 130.44 ± 11.19 h, p &amp;lt; 0.001), along with women’s age (34.9 ± 4.32, 38.14 ± 3.77, and 35.84 ± 4.5, p &amp;lt; 0.001). In logistic regression analysis, aneuploid rates were significantly lower in blastocysts with A and B grade of ICM (OR 0.36, CI 95% 0.24-0.32, p &amp;lt; 0.01 and OR 0.45, CI 95% 0.32-0.63, p &amp;lt; 0.01) and A and B grade of TE (OR 0.20, CI 95% 0.11-0.37, p &amp;lt; 0.01 and OR 0.20, CI 95% 0.25-0.48, p &amp;lt; 0.01) compared to C grades, respectively. The AUCs for prediction of euploid were maternal age 0.66 (95% CI 0.62-0.70), TE grade 0.64 (95% CI 0.57-0.64), blastocyst vitrification time 0.62 (95% CI 0.58-0.66), ICM grade 0.60 (95% CI 0.61-0.68), blastocyst formation time 0.55 (95% CI 0.51-0.59) and inner diameter 0.46 (95% CI 0.42-0.5). Although blastocyst vitrification time is correlated with blastocyst gender (female blastocyst 127.9 ± 10.25h vs male blastocyst 129.68 ± 10.84h, p = 0.02). Limitations, reasons for caution The results of the retrospective study are limited to data from a single IVF center and conventional incubators were used in this study. Wider implications of the findings These findings might help non PGT-A patients in deciding on embryo selection for transfer. The vitrification time and TE grade of blastocysts are strongly correlated with euploid rate than the ICM, inner diameter and formation time. Also, female blastocysts take less time to vitrification time than male blastocysts. Trial registration number *

241 Predictors of Post-Radioiodine Ablation Outcomes in Thyroid Cancer: Analysis of Four Years of Data from a Regional Centre

Abstract Aim To assess correlations between patient demographics, tumour and lymph node pathology and outcomes for patients with non-metastatic thyroid cancer. Outcomes examined were evidence of post-ablation residual disease on blood testing or ultrasound or thyroid cancer recurrence. Method Electronic records for thyroid cancer patients at a regional centre undergoing thyroidectomy followed by Radioiodine-131 ablation in the years 2018-2021 were reviewed with 191 records contributing to the analysis. Patient demographics, tumour characteristics, numbers of positive lymph nodes and radioiodine dosages were compared against patient outcomes. Results Increasing age, T stage of the tumour and lymph node involvement demonstrated the strongest correlations with negative outcomes. Age appeared to be a strong risk factor for thyroid cancer recurrence with 70% of the patient’s experiencing recurrence aged over 60 despite patients over 60 making up only 33% of the sample. Removal of over 4 metastatic lymph nodes has previously been found to predict poorer patient outcomes. The findings support this however over 50% of positive nodes removed had a stronger correlation with negative outcomes compared with raw numbers retrieved. 52.2% of patients with over 50% positive lymph nodes experienced poorer outcomes compared with 40.1% who had over 4 positive nodes removed. The correlation was stronger still for those with over 4 positive nodes of which over 50% were positive of whom 57.9% demonstrated poor outcomes. Conclusions Rather than raw numbers of lymph nodes removed, proportion of metastatic nodes of those harvested or a combination of total numbers and proportion appeared to give a better indicator of prognosis.

Intravascular Ultrasound Enhances the PETTICOAT Technique in Endovascular Therapy for Complicated Type B Aortic Dissection with Malperfusion Syndrome

ObjectiveTo present the value of intravascular ultrasound (IVUS) in diagnosis and treatment of complicated type B aortic dissection (TBD) with malperfusion (MP). Especially the value of IVUS regarding the treatment strategy, reoperation rate, acute kidney injury (AKI) and false lumen thrombosis (FLT) was investigated. MethodsRetrospective analysis of 25 TBD cases with MP treated with endovascular therapy from April 2019 to August 2022. In 17 cases angiography & IVUS were applied during the operation (IVUS group) and in 8 cases angiography was used without IVUS (control group) for final intraoperative control. IVUS was used to assess the true lumen collapse and to decide if additional bare stenting was necessary or not. Details from patients’ charts and documentation from surgeries were analyzed. The endovascular technique included thoracic endovascular aortic repair (TEVAR) with primary entry sealing and -if needed- bare stenting of the true lumen distal of the entry tears using the PETTICOAT (Provisional Extension To Induce Complete Attachment) technique. ResultsAll patients presented with pain localized mostly (48%) in thorax and abdomen. In all patients the proximal entry tear of the dissection was covered using TEVAR. The PETTICOAT technique was applied in 13 cases (52%), whereas most combined procedures were applied in the IVUS group (12 compared to 1; p=0,02). A total of 3 patients (1 in the control group; 12,5% and 2 in the IVUS group; 11,8%) underwent a bowel resection. Totally 8 patients (32%) underwent a reoperation in aorta (3 during the hospital stay). There were no statistical differences between IVUS and control group regarding the preoperative findings, the reoperation rates and the postoperative complications. 5 patients died (4 during the hospital stay), 1 in control and 4 in IVUS group; p=0,53. The follow up included a clinical and a computed tomography angiography (CTA) examination. No statistically significant difference regarding occurrence and extension of FLT was observed between the two groups. ConclusionsThe IVUS and control groups showed no difference in survival rates. The use of IVUS extended the indication for PETTICOAT technique with statistically significant difference. A milder form of AKI presented in the IVUS group compared to the control group. In addition, a stronger correlation between IVUS and the avoidance of an aorta reoperation was observed, though it did not reach statistical significance.

Filling the "GAP" in Real-World Assessment of Psoriatic Arthritis Disease Activity: Performance Characteristics of a Global/Pain Composite Endpoint.

Some retrospective data sources, such as electronic health records in the USA, report composite outcome measures not fully validated in psoriatic arthritis (PsA). However, they often contain global assessments, such as a Physician Global Assessment (PhGA) and Patient Global Assessment (PatGA), along with patient-reported pain scores, which individually are considered validated in PsA. This research described the performance characteristics of a 3-item global assessment and pain (GAP) composite endpoint using data from the ixekizumab phase3 PsA clinical trial program. Discrimination of GAP was assessed by comparing placebo to active treatment arms. The magnitude of treatment effect and responsiveness were compared to Disease Activity Index for PsA (DAPSA), clinical DAPSA, DAPSA28, and Psoriatic Arthritis Disease Activity Score (PASDAS) using effect size (ES) and standardized response mean (SRM), respectively. Construct validity was evaluated through correlation among the composite endpoints, and with other physician- and patient-reported outcomes. Change in GAP was compared in patients who reached low disease activity (LDA) levels based on DAPSA, cDAPSA, and PASDAS vs those who did not. GAP discriminated between active treatment and placebo with statistically significant separation as early as week1. The largest ES/SRM was seen with GAP (2.29/1.74) and PASDAS (2.47/1.68). GAP had the strongest correlation with PASDAS (0.81-0.92) and showed moderate correlations with patient-assessed physical function, low correlations with physician-assessed skin and nail psoriasis, and low to moderate correlation with physician-assessed enthesitis. A significantly greater improvement in GAP was seen in the groups achieving LDA states compared to those not (p < 0.001). The GAP composite, an abbreviated endpoint comprising measures common in electronic health records, has promising performance characteristics and could be used to address important clinical questions regarding outcomes and impact of PsA in existing datasets. CLINTRIALS. NCT01695239; NCT02349295.

Estimation of Serum TLR-9,TNF-α, and IL-6 Levels in the Iraqi Patients Diagnosed as Acute Myelogenous Leukemia

إن ابيضاض الدم النقوي الحاد (AML) هو مجموعة متنوعة من الأمراض التي تتضمن تغايرات حيوية وسريرية. تتميز بالتكاثر السريع للخلايا الشاذة في نخاع العظام، والتي تتداخل مع تكوين خلايا الدم الطبيعية. يتم إطلاق السيتوكينات بواسطة العديد من أنواع الخلايا استجابةً للمنبهات المختلفة ، وهي تؤثر على الاستجابة المناعية. تظهر العديد من الدراسات أن السيتوكينات التي تطلقها خلايا سرطان الدم بطريقة autocrine أو paracrine تؤثر على تكاثر خلايا AML. صُممت دراستنا لتقييم مستوى البروتين لـ TLR-9 و TNF-α و IL-6 في مرضى AML. تم إجراء الدراسة عن طريق تقنية المقايسة الإمتصاصية المناعية المرتبطة بالإنزيم (ELISA). اظهرت النتائج وجود فروق معنوية عالية في مستوى المصل لـكل من TLR-9 و TNF-α و IL-6 . يظهر الارتباط بين المعلمات المناعية لهذه الدراسة باستخدام معامل ارتباط بيرسون وللمرضى أن هناك علاقة ضعيفة بين TLR-9 وكلا من TNF- α, IL-6 مع (P- value) 0.47) و 0.23( على التوالي ، مما قد يشير إلى البيئة المعقدة الناتجة عن الالتهاب. ومع ذلك ، هناك علاقة قوية بين TNF- α و IL-6 بقيمة P=0.001)) مما يشير إلى أن إفراز هذه السيتوكينات كان مرتفعًا عند المرضى.تم تقييم جميع المعلمات المناعية (TLR-9 و TNF- α و IL-6) للمرضى باستخدام منحنى خصائص تشغيل المستلم (ROC) لإثبات أن أيًا منهم يمكن استخدامه كواسم حيوي لتحديد الالتهاب وامكانية تتبع اعراض المرض لمرضى ابيضاض الدم النقوي الحاد. كشفت نتائج منحنى ROC أن جميع المتغيرات لديها حساسية وخصوصية جيدة للكشف عن الالتهاب ونشاط المرض لدى مرضى ابيضاض الدم النقوي الحاد. وفقًا لنتائج الدراسة الحالية ، فأن مرض ابيضاض الدم النقوي الحاد مرتبطًا بأرتفاع مستويات البروتين لكل من TLR-9 و TNF-α و IL-6. قد يؤدي زيادة إنتاج هذه السيتوكينات في المرضى إلى تحفيز وزيادة الخطر على تطور المرض وربما قلة الاستجابة للعلاج مما يؤثر سلبا على المرضى .

Tensor Ring Decomposition Guided Dictionary Learning for OCT Image Denoising.

Optical coherence tomography (OCT) is a non-invasive and effective tool for the imaging of retinal tissue. However, the heavy speckle noise, resulting from multiple scattering of the light waves, obscures important morphological structures and impairs the clinical diagnosis of ocular diseases. In this paper, we propose a novel and powerful model known as tensor ring decomposition-guided dictionary learning (TRGDL) for OCT image denoising, which can simultaneously utilize two useful complementary priors, i.e., three-dimensional low-rank and sparsity priors, under a unified framework. Specifically, to effectively use the strong correlation between nearby OCT frames, we construct the OCT group tensors by extracting cubic patches from OCT images and clustering similar patches. Then, since each created OCT group tensor has a low-rank structure, to exploit spatial, non-local, and its temporal correlations in a balanced way, we enforce the TR decomposition model on each OCT group tensor. Next, to use the beneficial three-dimensional inter-group sparsity, we learn shared dictionaries in both spatial and temporal dimensions from all of the stacked OCT group tensors. Furthermore, we develop an effective algorithm to solve the resulting optimization problem by using two efficient optimization approaches, including proximal alternating minimization and the alternative direction method of multipliers. Finally, extensive experiments on OCT datasets from various imaging devices are conducted to prove the generality and usefulness of the proposed TRGDL model. Experimental simulation results show that the suggested TRGDL model outperforms state-of-the-art approaches for OCT image denoising both qualitatively and quantitatively.

Association study of NAFLD with pericoronary adipose tissue and pericardial adipose tissue: Diagnosis of stable CAD patients with NAFLD based on radiomic features

Background and aimNonalcoholic fatty liver disease (NAFLD) is prone to complicated cardiovascular disease, and we aimed to identify patients with NAFLD who are prone to developing stable coronary artery disease (CAD). Methods and resultsWe retrospectively recruited adults who underwent coronary computed tomography angiography (CTA). A total of 127 NAFLD patients and 127 non-NAFLD patients were included in this study. Clinical features and imaging parameters were analysed, mainly including pericardial adipose tissue (PAT), pericoronary adipose tissue (PCAT), and radiomic features of 6792 PCATs. The inflammatory associations of NAFLD patients with PAT and PCAT were analysed. Clinical features (model 1), CTA parameters (model 2), the radscore (model 3), and a composite model (model 4) were constructed to identify patients with NAFLD with stable CAD.The presence of NAFLD resulted in a greater inflammatory involvement in all three coronary arteries (all P < 0.01) and was associated with increased PAT volume (r = 0.178**, P < 0.05). In the presence of NAFLD, the mean CT value of the PAT was significantly correlated with the fat attenuation index (FAI) in all three vessels and had the strongest correlation with the RCA FAI (r = 0.55, p < 0.001). A total of 9 radiomic features were screened by LASSO regression to calculate radiomic scores. In the model comparison, model 4 had the best performance of all models (AUC 0.914 [0.863–0.965]) and the highest overall diagnostic value of the model (sensitivity: 0.814, specificity: 0.941). ConclusionsNAFLD correlates with PAT volume and PCAT inflammation. Furthermore, combining clinical features, CTA parameters, and radiomic scores can improve the efficiency of early diagnosis of stable CAD in patients with NAFLD.

Pelvic Bone Marrow Sparing Intensity Modulated Radiation Therapy Reduces the Bone Mineral Density Loss of Patients With Cervical Cancer

PurposeTo test the efficacy and feasibility of pelvic bone marrow sparing intensity modulated radiotherapy (PBMS-IMRT) in reducing bone density loss for patients with cervical cancer undergoing pelvic radiotherapy (RT). Methods and MaterialsNon-surgical cervical cancer patients with Stage Ib2–IIIc cancer were randomly allocated into the PBMS group or the control group. The PBMS group additionally received PBM dose constraint. Computed tomography (CT) imaging sets were acquired at baseline and at 1, 3, 6, 9, and 12 months after treatment. Radiation dose and Hounsfield unit (HU) were registered. Bone density loss rates and fracture events at different follow-up time points were recorded. ResultsData from 90 patients in the PBMS group and 86 patients in the control group were used for statistical analysis, which included 30 and 26 patients with extended-field RT (EFR), respectively. The median follow-up for all patients was 12 months. Compared to baseline, the bone density of all bones at the last follow-up had decreased by 43% and 53% in the PBMS and control groups, respectively, with the most significant decline at 1 month after treatment. Although patients without extended-field radiation received minimal irradiation in the upper lumbar spine, a 22.33% decrease in bone density was detected. In the group of patients with EFR, the decrease was 51.18% (P < 0.01). Lumbar or pelvic fracture incidence rates of patients in the PBMS and control groups were 7.8% and 12.79%, respectively. Among the dosimetric parameters, mean dose had the strongest correlation with bone density loss. ConclusionIn patients undergoing pelvic RT, the loss of bone density can begin to appear early after RT, and it can occur either inside or outside of the irradiation field. Results of this study showed that PBMS-IMRT reduced bone mineral density loss compared with IMRT alone.

Simultaneous plasma and interstitial profiles of hormones and metabolites using URHYTHM: a novel ambulatory collection device

Increasing the sampling resolution when examining plasma hormone and metabolite profiles will more accurately describe diurnal/circadian rhythms and expose previously undiscovered ultradian rhythms that underpin metabolic physiology(1). In human research studies this must be tempered by the practical, ethical and safety concerns of repeated cannulation/blood draws. Here we examine the correlation between hormone and metabolite profiles present in interstitial fluid microdialysate(2), and plasma to help solve this dilemma.Hormonal markers of circadian phase (melatonin, cortisol) and metabolites will show similar profiles in plasma and interstitial fluid.Compare time-series hormone and metabolite profiles collected in interstitial fluid using a novel ambulatory microdialysis collection device (U-RHYTHM) with simultaneously drawn plasma samples.All study protocols were reviewed by Health Sciences Faculty Research Ethics Committee, University of Bristol. Fasted healthy male volunteers aged 18-35 (n=3) were fed a standardised breakfast (08:00), lunch (13:00), dinner (19:00) and snack (22:00) (2225kCal [83g protein, 273g carbohydrate, 83g fat, 27g fibre]). Participants remained on the study bed, lights off/sleep occurred between 23:00-07:00 (&lt;4 lux).A 20kDa cutoff 30 mm linear microdialysis membrane was placed in periumbilical subcutaneous tissue, perpendicular to the midline. The membrane was perfused at 1µl/min and the microdialysate collected every 20 minutes for 25 hours into discrete samples using a portable fraction collector (URHYTHM) worn around the waist. Time-matched blood samples were obtained from an antecubital fossa canula.All samples were stored at -80°C prior to analysis. Hormones and metabolites were measured via targeted UPLC-MS/MS metabolomics, for the metabolites the AbsoluteIDQ® p180 kit (Biocrates Life Sciences AG)) was used with 10µL of plasma(3) and 15µL of microdialysate.Simultaneous time-courses of n = 24 metabolites were detected in plasma and interstitial microdialysate: alanine, arginine, asparagine, citrulline, glutamine, glutamate, glycine, histidine, isoleucine, leucine, lysine, methionine, ornithine, phenylalanine, proline, serine, threonine, tryptophan, tyrosine, valine, trans-4-Hydroxyproline, taurine, carnitine and acetylcarnitine.Spearman rank cross correlation identified the time shift that was required to reach highest correlation between the plasma and microdialysate profiles. Excluding taurine, microdialysate profiles were delayed by 32.3 minutes (range 0-130) and 12.9 minutes (range 0-50) for participant 1 and 2, respectively (p &lt;0.05), only 3/20 metabolite profiles were correlated for participant 3. Trans4-hydroxyproline had the strongest correlation (rs 0.890, 0.814 and 0.808), with only participant 3 displaying a time shift (50 minutes). Taurine had the weakest correlation in all 3 participants. (rs 0.096, 0.182, 0.325).These data demonstrate that our novel approach can be used to comprehensively detect hormone and metabolite profiles in interstitial fluid. Thus, the U-RHYTHM would serve as a useful tool, not only to increase sampling resolution in controlled laboratory studies but would prove particularly useful for examining circadian/ultradian profiles for chronobiology and nutrition studies in free-living individuals.

Alexithymia as a mediator between adverse childhood events and the development of psychopathology: a meta-analysis.

Victims of child abuse have an elevated risk of developing mental health issues later in life. Several variables have been suggested as mediators of this correlation, but little is known about the possible influence of alexithymia. Alexithymia is a sub-clinical personality trait that manifests as difficulties recognizing and verbalizing emotions. In this study, two separate meta-analyses were conducted using questionnaire data, and Pearson correlations for overall effects were estimated. The correlation between child abuse and alexithymia showed to be significant (r = .26), as did the correlation between alexithymia and general psychopathology (r = .44). Further analyses revealed no indication for possible publication bias. When investigating differences between various subtypes of child maltreatment, each subtype significantly correlated with alexithymia. Emotional abuse, emotional neglect, and physical neglect had stronger correlations than physical and sexual abuse. These results suggest that alexithymia plays a mediating role, at least in part, in the relationship between experiences of child abuse and general psychopathology in adulthood. Therefore, alexithymia may be relevant to further research and deserves attention in the prevention of and therapy for mental health issues in victims of child abuse.