Visual Assessment Score Research Articles

Predictors of Chest CT Total Severity Score InCovid-19 Infected Patients In Rwanda

Background: Over 5.54 million COVID-19 deaths occurred worldwide by the January 2021 and COVID-19 pneumonia remains the commonest cause of death. The current study was conducted to investigate predictors of total severity score in patients with COVID-19 pneumonia who underwent chest CT and in turn be used in setting with limited resource to predict TSS as well as prognosis Materials and Methods: The current study retrospectively evaluated the CT findings in COVID-19 patients with clinical severity using a 25-point visual quantitative assessment and total severity score predictors were determined. A sample of 384 COVID-19 patients was used and Statistical analysis was done using SPSS 25.0. Results: The findings of the current study indicate that age (p < 0.001), vaccination status (p = 0.006), and disease status (p < 0.001) are significant predictors of the total severity score on chest CT scans in patients with COVID-19 pneumonia. Specifically, as age increases, the odds of having a higher total severity score also increase. Conversely, individuals who are vaccinated tend to have lower severity scores, suggesting that COVID-19 vaccination is associated with a reduced likelihood of experiencing severe disease. Additionally, patients with severe COVID-19 pneumonia are more likely to exhibit higher severity scores on Chest CT. Conclusion: Chest CT scan total severity score can be predicted with age, immunization status and disease status classified as mild, moderate, severe and critical covid-19 pneumonia and this score can be used to predict clinical outcome. Recommendation: A large multicenter study can be used to validate current study findings and these clinical predictors can be used in resource limited settings where CT scan accessibility is not ensured.

Is initial unilateral revascularization acceptable in pediatric patients with bilateral moyamoya disease with mild contralateral hemodynamic disturbance?

Although asymmetrical vascular involvement between hemispheres is common in pediatric patients with bilateral moyamoya disease, whether hemispheres with mild vascular changes and hemodynamic impairment require immediate surgical revascularization or whether they can be observed until disease progression remains unclear. The authors evaluated the long-term outcomes of their strategy to initially perform unilateral surgery and withhold surgery to the contralateral hemispheres with mild vascular changes and hemodynamic impairment. The authors retrospectively evaluated Japanese pediatric patients (onset age ≤ 15 years) diagnosed with bilateral sporadic moyamoya disease who underwent unilateral revascularization. The authors investigated whether the patient underwent additional collateral surgery and the incidence of ischemic events during follow-up. They also compared visual assessments of arterial spin labeling (ASL) images obtained before initial surgery, before additional contralateral surgery, and at last follow-up. Overall, 30/47 patients (63.8%) experienced progression of hemodynamic impairment in the contralateral hemisphere and underwent additional surgery. The age at initial surgery of the patients who needed additional contralateral surgery was significantly younger than that of the patients who did not require contralateral surgery (mean [SD] 7.0 [3.0] years vs 9.8 [2.6] years, p = 0.002). One patient (age 4 years) developed ischemic stroke before admission for preoperative evaluation 2 months after novel symptom onset, and another patient (age 6 years) experienced ischemic stroke in the contralateral hemisphere while discontinuing antiplatelet agents before surgery; both patients fully recovered from the neurological deficits. In contralateral hemispheres that required additional surgery, the ASL visual assessment scores significantly decreased before the additional contralateral surgery compared to those obtained before the initial surgery (p = 0.008). In pediatric patients with bilateral moyamoya disease, withholding surgery for hemispheres with mild vascular changes and hemodynamic impairment is generally safe. Younger patients were more likely to experience contralateral progression and require additional surgery, so close follow-up is needed. ASL imaging is useful for detecting and following the progression of hemodynamic impairment in conservatively treated hemispheres.

Comparative analysis of visual-thermal perceptions and emotional responses in outdoor open spaces: Impacts of look-up vs. look-forward viewing perspectives.

Horizontal and vertical viewing perspectives exert varying influences on the environmental perceptions and emotional states of college students. Despite this, scant research addresses the impact on this demographic. We selected typical campus open spaces for comprehensive physical parameter assessments, encompassing meteorological and spatial characteristics. A cohort of 36 healthy college students participated in a questionnaire survey designed to ascertain shifts in visual comfort, thermal comfort, and emotional responses when viewing landscapes in look-forward and look-up orientations. Key findings following both viewing modalities included: 1) a notable rise in mean visual comfort vote (MVCV), by 1.22 for look-forward and 1.01 for look-up, with a pronouncedly higher sunlight sensation vote (SSV) for the latter orientation; 2) a significant increase in thermal comfort vote (TCV), although the difference in increments between the two viewing angles was minimal; 3) Positive affect (PA) exhibited considerable improvement in both viewing conditions, while negative affect (NA) was markedly reduced in the look-up condition relative to look-forward viewing; 4) The SSV was predominantly influenced by the trunk ratio and canopy-to-trunk ratio, with substantial weights of 31.47% and 32.15%, respectively. Landscape element diversity emerged as the most critical factor affecting visual comfort vote (VCV) and aesthetic assessment score (AAS), with overwhelming weights of 70.67% and 63.15%, respectively. Moreover, the leaf ratio was identified as the chief determinant of emotional responses. Our results provide insights into the design of campus spaces for enhanced student well-being.

Assessment of Soil Structural Quality Under Area Closure and Open Grazing Land in Hidabu Abote District, North Shewa Zone, Oromia Regional State, Ethiopia

The experiment was conducted at Sire Morise kebele, Hidabu Abote district, to assess soil structural quality of different land management system (area closure and open grazing land). In this study, area closure land management practice was compared with open grazing land management practice in similar slope positions for soil structural quality build up. Soil samples were collected from both land management system at three slope position with three times replication. Totally 36 undisturbed soil blocks were collected from both land management system at 10 and 20 cm sampling depths. The finding of the study showed that the average value of volumetric moisture content and saturated hydraulic conductivity of soil were greater at area closure than open grazing land management system and also higher at bottom slope position than middle and upper slope position. The mean value of air-filled porosity and bulk density were lower at both area closure management practices and bottom slope position. Bulk density, volumetric soil moisture content and saturated hydraulic conductivity at 20 cm sampling depth were shows significantly different with respect to management practices. According to visual assessment in the field, soil physical quality was unfavourable in open grazing land management system and upper part of landscape position soils and the visual assessment scores showed that the soils under area closure had a good soil structural quality. There were strong relations among the three visual field assessment methods and also between visual assessment methods and laboratory determined soil properties of both land management system. In general, the result of the study showed that physical and structural quality of soil in area closure was improved due to good land management system. Based on the result of study it can be conclude that area closure improves soil physical and soil structural qualities and from the technical point of view, open grazing lands in hilly area should be changed to area closure before soil properties and soil nutrient contents are exhausted more.

Comparing Visual and Software-Based Quantitative Assessment Scores of Lungs' Parenchymal Involvement Quantification in COVID-19 Patients.

(1) Background: Computed tomography (CT) plays a paramount role in the characterization and follow-up of COVID-19. Several score systems have been implemented to properly assess the lung parenchyma involved in patients suffering from SARS-CoV-2 infection, such as the visual quantitative assessment score (VQAS) and software-based quantitative assessment score (SBQAS) to help in managing patients with SARS-CoV-2 infection. This study aims to investigate and compare the diagnostic accuracy of the VQAS and SBQAS with two different types of software based on artificial intelligence (AI) in patients affected by SARS-CoV-2. (2) Methods: This is a retrospective study; a total of 90 patients were enrolled with the following criteria: patients' age more than 18 years old, positive test for COVID-19 and unenhanced chest CT scan obtained between March and June 2021. The VQAS was independently assessed, and the SBQAS was performed with two different artificial intelligence-driven software programs (Icolung and CT-COPD). The Intraclass Correlation Coefficient (ICC) statistical index and Bland-Altman Plot were employed. (3) Results: The agreement scores between radiologists (R1 and R2) for the VQAS of the lung parenchyma involved in the CT images were good (ICC = 0.871). The agreement score between the two software types for the SBQAS was moderate (ICC = 0.584). The accordance between Icolung and the median of the visual evaluations (Median R1-R2) was good (ICC = 0.885). The correspondence between CT-COPD and the median of the VQAS (Median R1-R2) was moderate (ICC = 0.622). (4) Conclusions: This study showed moderate and good agreement upon the VQAS and the SBQAS; enhancing this approach as a valuable tool to manage COVID-19 patients and the combination of AI tools with physician expertise can lead to the most accurate diagnosis and treatment plans for patients.

Changes in liver health biomarkers following consumption of energy restricted diets containing almonds compared with carbohydrate-rich snack foods for 9 months

Energy restricted diets improve liver function(1) and habitual nut consumption has been associated with a lower prevalence of fatty liver(2). This study examined the effect of incorporating almonds in an energy restricted diet on liver health biomarkers. One Hundred and forty adults (42M:98F, 47.5 ± 10.8 years, BMI 30.7 ± 2.3 kg/m2) enrolled in a 9-month (9M) dietary intervention comprising 3 months (3M) weight loss (30% energy restriction) followed by 6 months (6M) of weight maintenance. Participants were randomly assigned to consume almonds (n = 68, AED) or isocaloric carbohydrate-rich snacks (n = 72, CRD) which provided 15% of total daily energy. At baseline (BL), 3M and 9M, fatty liver index (FLI) scores (0-100)(3) were calculated using body mass index (BMI), waist circumference (WC), fasting serum gamma-glutamyl transferase (GGT) and triglyceride (TAG) levels, and other liver health biomarkers were assessed by ultrasound (volume, visual appearance and elastography (a marker of stiffness due to fibrosis)). Intention to treat analyses were conducted using mixed effects modelling (fixed effects group and time, with participants as the random effect). Significant reductions from BL occurred over time (all p<0.001 for 3M and 9M) with no difference between groups (AED vs CRD, P>0.05) in BMI (3M: −2.44 ± 0.20 vs −2.32 ± 0.20, 9M: −2.83 ± 0.19 vs −2.81 ± 0.19 kg/m2), WC (3M: −8.04 ± 0.79 vs −7.00 ± 0.81, 9M: −8.72 ± 0.83 vs −9.14 ± 0.81 cm), TAG (3M: −0.24± 0.08 vs −0.22 ± 0.09, 9M: −0.37 ± 0.09 vs −0.21 ± 0.09 mmol/L), FLI score (3M: −23.8 ± 2.0 vs −17.6 ± 2.1, 9M: −23.8 ± 2.0 vs −17.6 ± 2.1), and liver volume (3M: −134.56 ± 38.30 vs −100.96 ± 37.25, 9M: −113.68 ± 37.42 vs −110.64 ± 35.47cm3). Significantly greater reductions occurred for AED compared to CRD at 3M and 9M in GGT (p = 0.003) (3M: −9.68 ± 1.93 vs −0.01 ± 2.00, 9M: −7.75 ± 2.06 vs −2.78 ± 2.15 IU/L) and liver visual assessment scores (p = 0.03) (3M: −0.58 ± 0.24 vs −0.45 ± 0.23, 9M: −1.33 ± 0.23 vs −0.50 ± 0.22). There were no significant changes in liver elastography over time or between groups. Energy restriction improved body composition and reduced the extent of fatty liver and liver size but did not change liver stiffness. The inclusion of almonds in an energy restricted diet demonstrated additional benefits to some liver health biomarkers providing support for almonds being incorporated into lifestyle interventions to improve liver function.

Novel 532-nm Q-switched Nd: YAG laser for the treatment of melasma and rejuvenation: a prospective, randomized controlled comparison with 1,064-nm Q-switched Nd: YAG laser.

Melasma is a common pigmentary and photoaging disorder. Although various treatments, including 1,064-nm Q-switched neodymium-doped yttrium aluminum garnet (QS-Nd: YAG) laser toning, are available for melasma, results are often unsatisfactory. We aimed to determine the efficacy and safety of 532-nm QS-Nd: YAG laser (shortwave toning) in patients with melasma and facial rejuvenation. Fifty-two patients were recruited to receive either 1,064-nm QS-Nd: YAG laser or 532-nm QS-Nd: YAG laser every 2 weeks for 8 sessions and a 2-month follow-up visit in a randomized controlled double-blinded study. The primary outcome measure was the Melasma Area and Severity Index (MASI) score. Dermoscope and high-frequency ultrasound (HFUS) were used to assess the improvement of melasma and photoaging. 532-nm QS-Nd: YAG laser achieved significantly higher improvement in the MASI score (P = 0.000). The Dermoscopic melasma score (DMS) displayed significant change and confirmed the improvement. HFUS showed a significant decrease in the thickness of the subepidermal low-echogenic band (SLEB) and increases in dermal thickness and dermal density in both groups (P = 0.000 for all). The rate of very satisfied responses was significantly higher in the 532-nm laser group (P = 0.001). There was no significant difference in the visual analog scale pain assessment score (P = 0.248) and recurrence rate (P = 0.734) between the two groups. 532-nm QS-Nd: YAG laser (shortwave toning) proved to be an effective and safe treatment for melasma and rejuvenation. Shortwave toning was significantly better for pigmentation clearance, while 1,064-nm laser showed better improvement in skin rejuvenation.

Study to evaluate the readability and visual appearance of online resources for blunt chest trauma: an evaluation of online resources using mixed methods

ObjectivesBlunt chest trauma (BCT) is characterised by forceful and non-penetrative impact to the chest region. Increased access to the internet has led to online healthcare resources becoming used by the...

Development of a method for evaluating skin dullness: A mathematical model explaining dullness by the color, optical properties, and microtopography of the skin.

Skin dullness has long been a major concern of Japanese women. It is usually evaluated and judged visually by experts. Although several factors are recognized to play a role, it is unclear to what extent such physiological characteristics contribute to skin dullness. The purpose of this study is to establish an objective method for evaluation, which will assist in developing cosmetics products targeting skin dullness. We conducted a skin measurement study on 50 Japanese women in their 30-50s, where skin dullness was visually assessed by a group of experts to obtain an average dullness score, and several skin parameters were obtained. We then developed a regression model that explains the visual assessment score using these physiological parameters. The results of partial least squares analysis of the dullness perception and physiological characteristics showed that skin dullness can be defined by colorimetric, optical, and skin surface microtopography parameters. Additionally, the contribution of each parameter to the model was determined. Our results suggest that dullness perception is highly affected by the melanin content and yellowness of the skin, followed by skin reddishness, roughness, and translucency score, whereas glossiness has less effect. Strikingly, the contribution ratio of each parameter varied among age groups. Furthermore, we confirmed that the predicted value of skin dullness increases with age. Our results will help the design of cosmetics targeting factors specific to age groups in developing effective solutions for skin dullness.

#5576 SYSTEMATIC REVIEW AND META-ANALYSIS OF THE SAFETY AND EFFICACY OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS FOR THE MANAGEMENT OF POSTPARTUM PAIN

Abstract Background and Aims Effective pain management is critical for postpartum recovery. While commonly prescribed, systematically-reviewed data regarding efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) are limited. Moreover, guidelines suggest avoiding NSAIDs in women with hypertensive disorders of pregnancy (HDP) due to risks of hypertension and adverse events (AE). However, these AE have not been consistently observed in cohort studies and randomised controlled trials (RCTs) following postpartum NSAID use. This systematic review aims to provide further insight into the postpartum safety and efficacy of NSAIDs. Method A systematic review of eight databases and four clinical trial registries was conducted in July 2020 (PROSPERO Protocol CRD42020196054). RCTs which assessed the safety and/or efficacy of NSAIDs in postpartum women after the year 2000 were included. The primary outcome was incidence of hypertension, with secondary outcomes categorised into three groups: hypertension, secondary safety and efficacy. Data were tabulated and analysed using R (version 4.0.2). Due to heterogeneity in study design, NSAIDs were analysed in a single group and compared with other medications (including paracetamol, opioids, and local anaesthetics) grouped based on mechanism to facilitate meta-analysis. Risk of bias was assessed using the RoB 2 tool with a plan to assess quality of evidence for the primary outcome. Results 12,172 records were identified with the inclusion of 92 RCTs. Eight studies, with four that included women with HDP, reported hypertension-related data (Table 1). The primary outcome was included in one RCT. Secondary safety outcomes such as acute kidney injury or eclampsia were not reported. The odds of nausea, vomiting and sedation were similar between groups. NSAIDs were effective when compared with placebo, as assessed by mean differences (MD) in visual assessment scores (VAS) at 12 hours (MD -1.57, 95% confidence intervals (CI) -2.47 to -0.66), 24 hours (MD -0.82, 95% CI -1.42 to -0.22) and need for additional analgesia (odds ratio 0.17, 95% CI 0.05 to 0.61). There were no significant differences in VAS between NSAIDs and other comparators at 12 and 24 hours. Further interpretation of results is limited due to heterogeneity in intervention and comparator groups, inclusion criteria and reported outcomes. Conclusion Our study confirms the efficacy of NSAIDs for postpartum pain, but current data are inconclusive regarding the risk of developing hypertension. Available data do not demonstrate trends toward AE although further research is required to determine long term, clinically-relevant outcomes to guide decision making.

Phenomic and genomic prediction of yield on multiple locations in winter wheat.

Genomic selection has recently become an established part of breeding strategies in cereals. However, a limitation of linear genomic prediction models for complex traits such as yield is that these are unable to accommodate Genotype by Environment effects, which are commonly observed over trials on multiple locations. In this study, we investigated how this environmental variation can be captured by the collection of a large number of phenomic markers using high-throughput field phenotyping and whether it can increase GS prediction accuracy. For this purpose, 44 winter wheat (Triticum aestivum L.) elite populations, comprising 2,994 lines, were grown on two sites over 2years, to approximate the size of trials in a practical breeding programme. At various growth stages, remote sensing data from multi- and hyperspectral cameras, as well as traditional ground-based visual crop assessment scores, were collected with approximately 100 different data variables collected per plot. The predictive power for grain yield was tested for the various data types, with or without genome-wide marker data sets. Models using phenomic traits alone had a greater predictive value (R2 = 0.39-0.47) than genomic data (approximately R2 = 0.1). The average improvement in predictive power by combining trait and marker data was 6%-12% over the best phenomic-only model, and performed best when data from one full location was used to predict the yield on an entire second location. The results suggest that genetic gain in breeding programmes can be increased by utilisation of large numbers of phenotypic variables using remote sensing in field trials, although at what stage of the breeding cycle phenomic selection could be most profitably applied remains to be answered.

COMPARISON OF ANTEGRADE PERCUTANEOUS VERSUS RETROGRADE URETEROSCOPIC LITHOTRIPSY FOR MANAGEMENT OF UPPER URETERIC CALCULUS.

Background: Technical advancements in urology have profoundly changed the management of upper ureteric calculus, however, its optimal management remains controversial. Methods: To compare antegrade percutaneous nephrolithotripsy (PCNL) and retrograde ureteroscopic lithotripsy (URSL) for management of upper ureteric calculus by measuring stone clearance rates, morbidity and complications. A prospective, observational, single centre, study including patients of either sex presenting with upper ureteric stone [size>8 mm and >800 Hounseld Unit (HU)]. Patients underwent either antegrade PCNL or retrograde ureteroscopic lithotripsy with follow up on outpatient (OPD) basis at 1 week, 1 month and 3 months post-surgery with Visual Assessment Score (VAS) and radiological investigations. Results: Stone clearance rate for antegrade PCNL was 89.1 % and 72.7% for retrograde ureteroscopic lithotripsy which is a statistically signicant difference. Incidence of pain in antegrade PCNL at 1st and 4th week follow-up was 10.9 % and 1.8% respectively compared to 5.5% and 0% for retrograde ureteroscopic lithotripsy. Two patients (1.8%) who underwent PCNL developed segmental artery pseudoaneurysm; one was managed conservatively while other required angioembolization. One patient in the antegrade PCNLgroup and two in retrograde ureteroscopic lithotripsy group had post operative urine culture proven urinary tract infection (UTI) and were treated with antibiotics. Conclusion:As compared to retrograde ureteroscopic lithotripsy, PCNLis a safer and more effective procedure with higher stone-free rates and acceptable complication rates to treat patients with large impacted upper ureteral stones.

Feasibility study of direct CT lymphangiography in mice: comparison with interstitial CT/MR lymphangiography

ObjectivesTo establish a CT lymphangiography method in mice via direct lymph node puncture.MethodsWe injected healthy mice (n = 8) with 50 µl of water-soluble iodine contrast agent (iomeprol; iodine concentration, 350 mg/mL) subcutaneously into the left-rear foot pad (interstitial injection) and 20 µl of the same contrast agent directly into the popliteal lymph node (direct puncture) 2 days later. Additionally, we performed interstitial MR lymphangiography on eight mice as a control group. We calculated the contrast ratio for each lymph node and visually assessed the depiction of lymph nodes and lymphatic vessels on a three-point scale.ResultsThe contrast ratios of 2-min post-injection images of sacral and lumbar–aortic lymph nodes were 20.7 ± 16.6 (average ± standard deviation) and 17.1 ± 12.0 in the direct puncture group, which were significantly higher than those detected in the CT or MR interstitial lymphangiography groups (average, 1.8–3.6; p = 0.008–0.019). The visual assessment scores for sacral lymph nodes, lumbar–aortic lymph nodes, and cisterna chyli were significantly better in the direct puncture group than in the CT interstitial injection group (p = 0.036, 0.009 and 0.001, respectively). The lymphatic vessels between these structures were significantly better scored in direct puncture group than in the CT or MR interstitial lymphangiography groups at 2 min after injection (all p ≤ 0.05).ConclusionsIn CT lymphangiography in mice, the direct lymph node puncture provides a better delineation of the lymphatic pathways than the CT/MR interstitial injection method.Key Points•The contrast ratios of 2-min post-injection images in the direct CT lymphangiography group were significantly higher than those of CT/MR interstitial lymphangiography groups.•The visibility of lymphatic vessels in subjective analysis in the direct CT lymphangiography group was significantly better in the direct puncture group than in the CT/MR interstitial lymphangiography groups.•CT lymphangiography with direct lymph node puncture can provide excellent lymphatic delineation with contrast being maximum at 2 min after injection.

EVALUATION OF CLINICAL VARIABLES, RADIOLOGICAL VISUAL ANALOG SCORING, AND RADIOMICS FEATURES ON CT ENTEROGRAPHY FOR CHARACTERIZING SEVERE INFLAMMATION AND FIBROSIS IN STRICTURING CROHN’S DISEASE

Abstract PURPOSE 25% of patients with Crohn’s disease (CD) develop severe stricturing disease which is non-responsive to standard-of-care medication. Early and non-invasive determination of the extent of inflammation and fibrosis within the stricture via CT enterography (CTE) could facilitate the selection of targeted therapy or earlier surgical resection to improve patient outcomes; but currently there is no validated and reliable approach for this differentiation. We present initial results for machine-reader evaluation of severe inflammation and fibrosis in CD strictures via quantitative radiomic features and expert radiologist scoring on CTE. METHODS AND MATERIALS IRB approved, retrospective, single center study. 100 patients (n=66 for discovery; n=34 for hold-out validation) confirmed with stricturing CD on histopathology and CTE within 15 weeks of surgery. Histopathological Stenosis Therapy & Research (STAR) scoring of specimens (range 0-100, scores > 50 =severe) used as reference standard for inflammation and fibrosis each. An expert radiologist annotated the resected strictures on CTE and provided a global assessment of inflammation and chronic non-inflammatory findings (fibrosis) using a 0-100 visual analog score (VAS). Radiomics features to capture severe inflammation and fibrosis were separately extracted from the annotated strictures. Radiomics models and VAS scores evaluated against pathology-defined severe inflammation and fibrosis, via ROC analysis. RESULTS Two distinct sets of radiomic features capturing textural heterogeneity (patterns, wavelets, local entropy) within strictures were significantly associated (p<0.01) with severe inflammation and severe fibrosis; across both discovery (AUC=0.69, 0.69) and hold-out validation (AUCs =0.72,0.67). Radiological VAS had an AUC=0.64 for identifying severe inflammation and AUC =0.62 for identifying severe fibrosis (Figure 1). Clinical variables including sex, age, Montreal classification and stricture type were not significantly associated with severe inflammation or fibrosis, across discovery and validation groups (Table 1). CONCLUSIONS Radiomic analysis shows improved performance in identifying severe inflammation and severe fibrosis in CD strictures on CTE compared to radiological visual assessment scoring. Supplementing radiological visual assessment with quantitative radiomics could enable more accurate phenotyping of CD strictures potentially improving outcomes by personalizing treatment pathways.

The Safety and Efficacy of 1-Monoeicosapentaenoin Isolated from the Trebouxiophyceae Micractinium on Anti-Wrinkle: A Split-Face Randomized, Double-Blind Placebo-Controlled Clinical Study.

The skin aging process is governed by intrinsic and extrinsic factors causing skin wrinkles, sagging, and loosening. The 1-monoeicosapentaenoin (1-MEST) is a component isolated from Micractinium, a genus of microalgae (Chlorophyta, Trebouxiophyceae). However, the anti-wrinkle effects of 1-MEST are not yet known. This study aimed to evaluate the anti-wrinkle effects of 1-MEST in vitro and in clinical trials. The cytotoxicity of 1-MEST was investigated in vitro using the MTS assay in human epidermal keratinocytes (HEKs). Expression of matrix metalloproteinase (MMP)-1 and MMP-9 was determined by ELISA in HEKs irradiated with UVB after treatment with 1-MEST. A split-face randomized, double-blind, placebo-controlled study was conducted to evaluate the safety and efficacy of 1-MEST. The study evaluated wrinkle parameters and visual assessment, self-efficacy and usability questionnaires, and adverse events. The study showed that the 1-MEST was not cytotoxic in HEKs, suppressed MMP-1 secretion and MMP-9 protein expression in HEKs irradiated with UVB. The wrinkle parameters and mean visual assessment score were significantly decreased in the test group after 12 weeks and differed from the control group. There were no significant differences in efficacy and usability. Adverse effects were also not observed. The 1-MEST showed anti-wrinkle properties to slow down or prevent skin aging.

Quantification of tongue coating using quantitative light-induced fluorescence-digital image analysis and its correlation with visual evaluation.

The tongue coating is a grayish-white deposit that quickly reflects the state of health or disease of the human body. Quantitative light-induced fluorescence (QLF) is a novel digital imaging system that objectively quantifies tongue coating. The present study aims to evaluate the correlation between the visual assessment of tongue coating and tongue coating by analysis of QLF-digital (QLF-D) images. This was an in vivo explorative study. Fifty children aged 11-13 years with clinically visible tongue coating were selected for the study. Tongue coating was assessed clinically by the Tongue Coating Index (Shimizu et al., 2007) and digitally by QLF-D Biluminator™ 2, C3 software. Data obtained were subjected to statistical analysis using SPSS 23.0 software. Spearman's rho correlation test was done, and P < 0.05 was considered statistically significant. A statistically significant correlation was found between the visual assessment scoring and the QLF image analysis for the evaluation of tongue coating. The Digital QLF tongue imaging system was found to be reliable due to its correlation with the clinical score and objective nature.

Effects of Multimodal Therapy, Blinding, and Multi-laboratory Protocol Conduct on the Robustness of the Rat Model of Adjuvant Induced Arthritis.

The aim of this study was to investigate the effects of multimodal therapy comprising buprenorphine (BUP) and indomethacin (IND) on key translational parameters in the rat adjuvant induced arthritis (AIA) model. Furthermore, we investigated the difference between visual assessment scores and histology scores generated by blinded and non-blinded assessors and the robustness and generalizability of results by conducting a multi-laboratory study. The experiment was terminated on day 26 after 11 days (days 15-25) of voluntarily ingested buprenorphine and 7 days of gavage delivered indomethacin treatment (days 19-25). The treatment effects were assessed on the last day of the study, relying on body weight assessment, serum concentrations of α1- acid glycoprotein, and assessment of affected hind paws swelling, in-life and post mortem. Across two laboratories, the combined analgesic treatments had minimal effects on the measured model parameters indicating that multimodal treatment did not affect the translatability of the model. We found an improvement in clinical scores (a negative change in scores) in nearly all medicated animals when scored informed, whereas it was essentially 50:50 for the blinded scorings and no difference between the blinded and informed histological scoring. The present results support the use of more effective analgesic treatment regimens and the good practice recommendations advocating blinding as a mandatory practice in conduct of preclinical in vivo efficacy studies. In spite of minor differences between results obtained at the two sites, there was good agreement between them indicating robustness of the AIA model.

Pulsed radiofrequency applied to the suprascapular nerve before rotator cuff tear arthroscopic repair: A prospective randomized clinical trial

Background: clinical studies have demonstrated the efficacy of pulsed radiofrequency (PRF) in treating many pain syndromes. PRF energy is delivered via a percutaneous needle under an image guide to reach the suprascapular nerve as it supplies more than 70% of the shoulder sensation. PRF was introduced as a non-destructive minimally invasive procedure in comparison with arthroscopic management of rotator cuff injury. However, there is a controversy regarding both measures in treating shoulder pain in rotator cuff injuries as standard methods. Objective: to evaluate the ability of PRF to produce shoulder pain relief by applying of PRF to the suprascapular nerve and measure the pain relief by VAS score at various time intervals prior to arthroscopic repair for rotator cuff injuries. The study should be in comparison with control group undergo arthroscopic repair without attacking of the suprascapular nerve by PRF. Methods: a prospective randomised controlled trial study including 40 patients divided as PRF or (P) group and control group (C) group equally. Each patient in our study whom their history and examination were fulfilled quietly including pain assessment by Visual Assessment Score (VAS). In The (P) group, a needle is inserted through a well-known point in the shoulder leading directly to the suprascapular notch (where the nerve is hooked above it) under image guidance. Radiofrequency waves at 2Hz of 20 milliseconds and 42 C in the pattern of three cycles each one lasting for 120 seconds. VAS score was assessed postoperatively for 7 time intervals starting from immediate postoperative (after arthroscopic repair) up to 3 months. Result: Pulsed radiofrequency produced dramatic progressive pain relief throughout our study time. In the 1st 48 hours, the VAS score dropped about 30% in (P) group with comparison to 22% in control group. At 3 months interval the VAS score was reduced by 45% from the preoperative period in comparison to 23% of the control group (P=0.000) Conclusion PRF is the safest, optimally invasive method to treat shoulder joint pain in rotator cuff injuries especially in unfitted patients for surgeries.

Histopathological changes due to osteoarthritis in articular cartilages of the knee

Introduction: The bony ends of a synovial joint are lined by a specialised hyaline cartilage termed the articular cartilage. Articular cartilage can be affected with degenerative diseases such as osteoarthritis. Knee being one of the larger joints built for weight bearing is the commonest site for osteoarthritis. The aim of this study was to describe the macroscopic and microscopic features of articular cartilages of the knee joint in patients diagnosed with primary osteoarthritis.Methods: Seventy-two articular cartilages removed during total knee replacement surgery were observed for macroscopic damage and graded according to the direct visual assessment score. Thirty specimens randomly selected were processed for histology and stained with Safranin-O-fast green-iron hematoxylin and observed and scored using the Mankins histological and histochemical grading system.Results: majority of specimens showed severe damage in the medial compartment and much less damage in the lateral compartment. In the tibia the damage was greatest on the medial most edge where the articular cartilage was absent leaving the bone exposed. Anteromedial area was relatively spared. In the femur the middle part of the medial condyle was seen to be more severely damaged. A similar pattern was observed in 19 (63.3%) of the specimens and showed exposure of bone. In the lateral compartment worst damage was observed in the middle of the lateral femoral condyle, with the rest of the lateral compartment being well persevered. This pattern was observed in 26 (86.6%) of the knee specimens.Conclusion: OA of the medial compartment causes the two cartilage surfaces to grind together, mechanically denuding the cartilage layers, while the lateral compartment which receives much less mechanical stress is well preserved.

An evaluation of the readability and visual appearance of online patient resources for fibroadenoma.

Fibroadenomas are benign lesions found in the breast tissue. Widespread access to and use of the internet has resulted in more individuals using online resources to better understand health conditions, their prognosis and treatment. The aim of this study was to investigate the readability and visual appearance of online patient resources for fibroadenoma. We searched GoogleTM, BingTM and YahooTM on 6 July 2022 using the search terms "fibroadenoma", "breast lumps", "non-cancerous breast lumps", "benign breast lumps" and "benign breast lesions" to identify the top ten websites that appeared on each of the search engines. We excluded advertised websites, links to individual pdf documents and links to blogs/chats. We compiled a complete list of websites identified using the three search engines and the search terms and analysed the content. We only selected pages that were relevant to fibroadenoma. We excluded pages which only contained contact details and no narrative information relating to the condition. We did not assess information where links were directed to alternative websites. We undertook a qualitative visual assessment of each of the websites using a framework of pre-determined key criteria based on the Centers for Medicare and Medicaid Services toolkit. This involved assessing characteristics such as overall design, page layout, font size and colour. Each criterion was scored as: +1- criterion achieved; -1- criterion not achieved; and 0- no evidence, unclear or not applicable (maximum total score 43). We then assessed the readability of each website to determine the UK and US reading age using five different readability tests: Flesch Kincaid, Gunning Fog, Coleman Liau, SMOG, and the Automated Readability Index. We compared the readability scores to determine if there were any significant differences across the websites identified. We also generated scores for the Flesh Reading Ease as well as information about sentence structure (number of syllables per sentence and proportion of words with a high number of syllables) and proportion of people the text was readable to. We identified 39 websites for readability and visual assessment. The visual assessment scores for the 39 websites identified ranged from -19 to 31 points out of a possible score of 43. The median readability score for the identified websites was 8.58 (age 14-15), with a range of 6.69-12.22 (age 12-13 to university level). There was a statistically significant difference between the readability scores obtained across websites (p<0.001). Almost half of the websites (18/39; 46.2%) were classified as very difficult by the Flesch Reading Ease score, with only 13/39 (33.33%) classified as being fairly easy or plain English. We found wide differences in the general appearance, layout and focus of the fibroadenoma websites identified. The readability of most of the websites was also much higher than the recommended level for the public to understand. Fibroadenoma website information needs to be simplified to reduce the use of jargon and specificity to the condition for individuals to better comprehend it. In addition, their visual appearance could be improved by changing the layout and including images and diagrams.