Differences In Volume Research Articles

Hypofractionated Gamma Knife Radiosurgery in Big Tumors

Objective: This research aimed to determine the most effective dosages and achieve improved outcomes without surgical intervention, discomfort, or blood loss. Its objective was also to regulate the formation of both benign and malignant tumours and reduce tumour size. Patients and Methods: A study involving 50 patients at Dr. Saad Al-Witry Hospital for Neurosciences and Al-Altaj Hospital examined brain tumours using MRI models, CBCT, and a gamma knife device. Patients with large tumours were included, while those receiving single fractions of treatment and pregnant women were excluded. Patients were prepared using Leksell frames, thermoplastic masks, and personalised stereotactic masks. Gamma Knife radiosurgery sessions were administered based on tumour size, location, and patient tolerance. Results: This study analysed the use of hypofractionation gamma knife treatment for six brain tumours: Meningioma, Glioma, Schwannoma, Arteriovenous Malformations (AVM), Pituitary Adenoma, and Metastasis. The mean dose distribution was higher in metastasis, followed by AVM, meningioma, glioma, schwannoma, and pituitary adenoma. The maximum dose was found in metastasis, followed by meningioma, glioma, pituitary adenoma, AVM, and schwannoma. The coverage of the target reached excellent value for metastasis, followed by AVM and pituitary adenoma. The beam on time for the treatment was highest in meningioma. Following six months of treatment, the study found a significant difference in tumour volume before and after six months. The highest reduction was observed in meningioma cases, followed by glioma and vestibular schwannoma. A study involving ten patients showed a significant reduction in tumours after a year of gamma knife treatment, with meningioma cases showing the highest reduction. Conclusion: The study found that metastasis was the most common cancer, followed by meningioma, glioma, schwannoma, AVM, and schwannoma. After six months, meningioma showed the highest reduction, and meningioma showed a better response to hypofractionation, followed by AVM.

Black hole sign under anticoagulant therapy: A retrospective comparison of warfarin and direct oral anticoagulants.

Direct oral anticoagulants (DOAC) have rapidly replaced warfarin. Intracerebral hemorrhage (ICH) is known to be one of the most severe side effects of anticoagulant drugs. The black hole (BH) sign is reportedly a valid radiological sign for predicting hematoma expansion in acute ICH. Here, we hypothesized that the frequency of BH signs might differ between warfarin and DOAC treatment, and critically evaluated the clinical value of the BH sign in acute ICH under warfarin versus DOAC therapy. Patients with acute ICH under anticoagulant therapy were enrolled. Hematoma volumes were measured by ABC/2. Radiologists blinded to the clinical information determined the presence or absence of the BH sign on CT images. This study defined a more than 12.5 ml increase in hematoma volume as cases with "expanded hematoma". We analyzed 111 acute ICH patients under anticoagulant therapy. Among them, 21 patients were treated with antagonists in this cohort. Multivariate logistic regression analysis revealed that the presence of ventricular perforation (p=0.02; adjusted odds ratio (OR): 3.51, 95% confidence interval (CI): 1.32 - 10.2) and the BH sign (p<0.01; adjusted OR: 4.86, 95% CI: 1.73 - 14.3) were significantly different between expanded and non-expanded hematoma cases. Comparison of hematoma volume and the presence of the BH sign between warfarin and DOAC cases indicated significant differences in maximum hematoma volume (p=0.03) and presence of the BH sign (p<0.01). The increase in hematoma volume was significantly greater when the BH sign was present under warfarin therapy (p=0.05). In contrast, the increase in hematoma volume did not differ between cases with and without the BH sign in patients under DOAC therapy (p=0.14) CONCLUSIONS: The BH sign is a useful radiological signature to predict the expansion of acute ICH under anticoagulant therapy. ICH under warfarin tended to present the BH sign more frequently than that under DOAC. The results also showed that the BH sign is more reliable under warfarin than under DOAC therapy in ICH patients. AF = atrial fibrillation; BH = black hole; DOAC = direct oral anticoagulants; HU = Hounsfield Unit; ICH= intracerebral hemorrhage.

Left ventricular systolic function after inhalation of beta-2 agonists in healthy athletes

Inhaled beta-2 adrenoceptor agonists (iβ2A) are routinely used as bronchodilators in the treatment of asthma. However, their cardiac effects in athletes are scarcely examined. Thus, the aim of this study was to evaluate the effects of iβ2A on left ventricular (LV) systolic function (SF) by echocardiography in healthy, non-asthmatic female and male endurance athletes. A randomized, double-blinded, placebo-controlled, balanced, 4-way complete block cross-over study was conducted. Twenty-four healthy athletes (12f/12m: 22.9 ± 2.7/24.4 ± 4.6 years) randomly completed 4 study arms (placebo; salbutamol; formoterol; formoterol + salbutamol). After inhalation of the study medication, the participants performed a 10-min time trial (TT) on a bicycle ergometer. After each TT an echocardiography was performed to determine LVSF. Blood samples were collected pre, post, 3 h and 24 h post TT. In females, total serum concentrations for salbutamol and formoterol were higher. LV ejection fraction (LVEF) and LV global longitudinal strain (LVendoGLS) showed a treatment effect for the whole study group (p < 0.0001) and a sex effect on LVEF (p = 0.0085). In women, there was a significant treatment effect for all medication arms (at least p ≤ 0.01) both on LVEF and LVendoGLS. In men only formoterol and formoterol + salbutamol displayed a treatment effect on LVEF (p = 0.0427, p = 0.0330; respectively), whereas on LVendoGLS only formoterol + salbutamol was significant (p = 0.0473). The iβ2A significantly influenced LVSF after an acute bout of exercise in healthy endurance athletes. These effects were even more pronounced when combining both iβ2A that supports a dose-dependent effect on cardiac function. Moreover, female athletes had higher serum concentrations of β2 agonists and stronger effects on LVSF compared to male athletes. This is mainly explained by differences in body weight and related plasma volume and may indicate a potential risk when increasing dose above the tested concentrations. Trial registration: At the European Union Drug Regulating Authorities Clinical Trials (Eudra CT) with the number 201,500,559,819 (registered prospectively on 09/12/2015) and at the German register for clinical studies (DRKS number 00010574 registered retrospectively on 16/11/2021).

An anatomical analysis of liver volume and quality by ethnicity in a New Zealand population.

Post-hepatectomy liver failure is a major cause of mortality, where future liver remnant (FLR) is the key controllable factor. Recommended minimum FLR is influenced by quality of liver parenchyma. Historical research has often failed to include Māori and Pacific Island (PI) populations despite worse health outcomes. Liver analysis by ethnicity is one such example of this. The aims were to determine digital FLR for various anatomical hepatectomies, investigate any correlations between computed tomography (CT) hepatic textural analysis and body mass index (BMI); and assess the variance of these relationships for different ethnicities. One hundred and fifty-one patients who underwent abdominal CT scans at Burwood Hospital, Christchurch were retrospectively analysed. Māori and PI patients were selectively recruited to represent New Zealand's diversity. Liver volumetry, segmental ratio, and intra-hepatic fat deposits (IHFD) per ethnicity were examined. Median age of the cohort was 66 (19-95) and 75 (50%) were males. 68%, 23% and 9% patients identified as being European, Māori/PI and Asian, respectively. No statistically significant difference in volume or segment/total volume ratio were noted across different ethnicities. Obese patients had higher IHFD compared with overweight and normal BMI groups. When stratified across ethnic groups, higher IHFD were observed in Asian compared with Māori/PI populations, despite lower BMI. No significant variances in liver volumetry were found across different ethnic groups in New Zealand. However association between BMI and IHFD varied across different ethnic cohorts. Consequently, knowledge of liver volumetry is not enough; patient liver quality and ethnicity should considered for hepatic-surgery planning.

Recent advances in peritoneal dialysis catheter placement: the association between method of insertion, operator, and prior abdominal surgery and outcomes

Purpose of review Peritoneal dialysis (PD) is associated with comparable outcomes to hemodialysis and is much less expensive to provide in most parts of the world. A well functioning PD catheter is required, but complications are frequent, and while there are guidelines for the placement and care of a PD access, they are based on low-quality evidence. Recent findings Data reporting the outcomes of percutaneous, as compared to surgical pathways for placement of catheters and the role of operator type in determining outcomes are examined. The impact of prior abdominal procedures on patient selection and the prognostic importance of the presence of adhesions at the time of catheter insertion are reviewed. Summary There are conflicting data about the relative merits of percutaneous as compared to surgical placement of catheters that may relate to differences in patient selection, operator experience, or operator volume. Prior abdominal procedures are not associated with worse PD catheter outcomes and likely should not influence patient selection, except in exceptional circumstances. Finally, the presence of adhesions is associated with a higher risk of complications. However, even in the presence of adhesions, the termination of PD therapy and need for re-intervention occurs in &lt;20% of patients.

Sex-specific Genetic Determinants of Right Ventricular Structure and Function.

While sex differences in right heart phenotypes have been observed, the molecular drivers remain unknown. To provide biological insights into sex differences in the structure and function of the right ventricle (RV) using common genetic variation. RV phenotypes were obtained from cardiac magnetic resonance imaging in 18,156 women and 16,171 men from the UK Biobank. Observational analyses and sex-stratified genome-wide association studies were performed. Candidate female-specific loci were evaluated against invasively measured cardiac performance in 479 female patients with idiopathic or heritable pulmonary arterial hypertension (PAH), recruited to the UK NIHR BioResource Rare Diseases study. Sex was associated with differences in RV volumes and ejection fraction in models adjusting for left heart counterparts, blood pressure, lung function and sex hormone levels. Six genome-wide significant loci (13%) revealed heterogeneity of allelic effects between women and men, and significant sex-by-genotype interaction. These included two sex-specific candidate loci present in women only: a locus for RV ejection fraction in BMPR1A and a locus for RV end-systolic volume near DMRT2. Epigenetic data in RV tissue indicate that variation at the BMPR1A locus likely alters transcriptional regulation. In female patients with PAH, a variant located in the promoter of BMPR1A was significantly associated with cardiac index (effect size 0.16 l/min/m2), despite similar RV afterload. BMPR1A has emerged as a biologically plausible candidate gene for female-specific genetic determination of RV function, showing associations with cardiac performance under chronically increased afterload in female patients with PAH.

Density isobar of water and melting temperature of ice: Assessing common density functionals.

We investigate the density isobar of water and the melting temperature of ice using six different density functionals. Machine-learning potentials are employed to ensure computational affordability. Our findings reveal significant discrepancies between various base functionals. Notably, even the choice of damping can result in substantial differences. Overall, the outcomes obtained through density functional theory are not entirely satisfactory across most utilized functionals. All functionals exhibit significant deviations either in the melting temperature or equilibrium volume, with most of them even predicting an incorrect volume difference between ice and water. Our heuristic analysis indicates that a hybrid functional with 25% exact exchange and van der Waals damping averaged between zero and Becke-Johnson dampings yields the closest agreement with experimental data. This study underscores the necessity for further enhancements in the treatment of van der Waals interactions and, more broadly, density functional theory to enable accurate quantitative predictions for molecular liquids.

Spring-Assisted Cranioplasty in Unicoronal Synostosis: Analysis of Outcomes

Background: Spring-assisted cranioplasty and successful long-term outcomes for sagittal synostosis has been well described in recent literature. However, there is a paucity of data regarding the application of springs to unicoronal synostosis. Unicoronal synostosis (UCS) presents unique challenges in its causation of skull base scoliosis and orbital asymmetry. Many surgeons feel that the fronto-orbital advancement and vault remodeling is the most effective and reliable strategy to counteract these changes. Here we present our experience and outcomes with spring cranioplasty for unicoronal synostosis. Materials and methods: A retrospective review of non-syndromic unicoronal synostosis patients undergoing spring-assisted cranioplasty was performed. Preoperative and postoperative intracranial volume (ICV), orbital volume (OV), orbital height (OH), orbital width (OW), midface twist (MFT), and skull-base twist (SBT) were measured from DICOM CT data. Analysis was performed with Materialize software (Leuven, Belgium). Paired t-tests were performed using Excel. Results: Ten patients (5 females, 5 males) had springs placed at 100.1 days (avg). Average ICV: preop: 608.2 ± 101.4 cc, postop: 995.2 ± 166.1 cc. Differences in orbital volume and height in the preop affected orbit versus non-affected orbit was significant ( P = .01, P ≤ .001 respectively) whereas no significant difference between the two sides postoperatively was observed ( P = .19, P = .58 respectively). Average preop MFT was 81.1 ± 2° and postop was 87.6 ± 2.6° and preop SBT was 171.9 ± 2.7° and postop was 177.6 ± 2.6°; both showing significant improvement after spring cranioplasty (both P ≤ .001). Conclusion: Our experience and early outcomes with spring cranioplasty for UCS demonstrates that when used in younger patients (&lt;5 months) cranial springs can be a safe and effective strategy to minimize skull base scoliosis, facial scoliosis, and orbital asymmetry, as well as increase intracranial volume. Although long-term data needs to be assessed, we are optimistic that early correction of cranial base scoliosis will translate to stable results as patients reach dentoskeletal maturity.

Gray matter volumetric changes in tinnitus: The impact of hearing loss and severity

Tinnitus is a phantom auditory sensation that commonly co-occurs with hearing loss. Both tinnitus and hearing loss can impact the quality of life, emotional well-being, and cognitive functioning of the affected individuals. While previous studies have highlighted structural alterations in hearing loss and/or tinnitus, the fundamental neural mechanisms underpinning tinnitus severity remain poorly understood. In this study, we conducted a voxel-based morphometry to investigate gray matter (GM) volume differences among groups of participants with varying tinnitus severity and hearing status, and controls within a large sample. We observed reduced GM volume in the left anterior insula and right planum polare in participants with hearing loss, regardless of their tinnitus status, compared to normal hearing controls. We noted decreased GM volume in the bilateral anterior and posterior insula for those with tinnitus and normal hearing compared to a normal hearing control group. Further, the tinnitus with hearing loss group showed decreased GM volume in the left planum polare, left inferior temporal gyrus, bilateral anterior temporal gyri, and right superior frontal gyrus compared to the normal hearing control group, suggesting a combined effect of hearing loss and tinnitus. While tinnitus severity did not show a significant overall effect, there was a significant positive correlation between tinnitus distress and GM volume in bilateral planum polare. Our findings enhance the understanding of structural brain changes related to hearing loss and tinnitus, and advance the overall knowledge of tinnitus pathophysiology, which can contribute to the development of more effective treatments for tinnitus.

A coordinate-based meta-analysis of grey matter volume differences between adults with obsessive-compulsive disorder (OCD) and healthy controls

According to the cortico-striato-thalamo-cortical (CSTC) model of obsessive-compulsive disorder (OCD), the striatum plays a primary role in its neuropathophysiology. Hypothesising that volumetric alterations are more pronounced in subcortical areas of patients within the CSTC circuit compared to healthy controls (HCs), we conducted a coordinate-based meta-analysis of magnetic resonance imaging (MRI) studies. We included 26 whole-brain MRI studies, comprising 3,010 subjects: 1,508 patients (788 men, 720 women; mean age: 30.26 years, SD = 8.16) and 1,502 HCs (801 men, 701 women; mean age: 29.47 years, SD = 7.88). This meta-analysis demonstrated significant grey matter volume increases in the bilateral putamen, lateral globus pallidus, left parietal cortex, right pulvinar, and left cerebellum in adults with OCD, alongside decreases in the right hippocampus/caudate, bilateral medial frontal gyri, and other cortical regions. Volume increases were predominantly observed in subcortical areas, with the exception of the left parietal cortex and cerebellar dentate, while volume decreases were primarily cortical, aside from the right hippocampus/caudate. Further exploration of these neuropathophysiological correlates could inform specific prevention and treatment strategies, advancing precision mental health in clinical applications.

Differences in Primary Total Shoulder Arthroplasty Volume, Reimbursement, Practice Styles, and Patient Populations Based on Surgeon Gender: A Temporal Analysis

BackgroundOrthopedic surgery has previously been shown to have a shortage of female physicians and a gender pay gap. However, this has not been thoroughly evaluated in the setting of shoulder surgery. The primary purpose of this study was to evaluate differences in total shoulder arthroplasty (TSA) volume, reimbursement, surgeon billing practices, and patient populations between male and female surgeons from 2013 to 2021. MethodsThe Medicare Physician and Other Practitioners database, a publicly available dataset that includes 100% of services billed to Medicare Part B was utilized. The database was queried for all billing episodes of Current Procedural Terminology (CPT) code 23472, which encompasses both anatomic and reverse primary TSA. Procedural volume, average inflation-adjusted reimbursement per TSA, physician billing information, and the patient demographics of each surgeon who performed TSAs were collected. Welch’s t-test and Kruskal-Wallis were utilized to compare male and female surgeons each year between 2013 and 2021. ResultsBetween 2013 and 2021, the proportion of TSAs performed by female surgeons nationally increased from 1.8% to 2.9% (+1.1%). This increase was greatest in the Northeast (2.0% to 6.1%), while a decrease was seen in the Midwest (1.9% to 1.6%). In 2021, there was no significant difference between male and female surgeons in the average inflation-adjusted reimbursement per TSA ($1,144.00 vs $1,143.00, p=0.792) and the average number of TSAs performed per surgeon (26.6 vs 23.1, p=0.105). Female TSA surgeons, on average, had less Medicare beneficiaries (348 vs 462, p<0.001), performed fewer annual services (1,817 vs 3,630, p<0.001), and performed fewer unique services (60 vs 76, p<0.001) compared to male surgeons. A higher proportion of female surgeon’s patient populations were non-White (24% vs 22%, p=0.028), female (61% vs 59%, p=0.001), and dual enrolled Medicare-Medicaid patients (13% vs 10%, p<0.001). However, there was no difference in the average patient complexity between male and female TSA surgeons based on hierarchical condition category (HCC) score (1.0783 vs 1.0732, p=0.228). ConclusionFemale representation within TSA surgery is increasing nationally, with the greatest representation in the Northeast and West and the lowest representation in the South and Midwest. Although female TSA surgeons perform a similar number of TSAs, receive comparable reimbursement per TSA, and have a similarly complex patient population as their male counterparts, they perform significantly fewer total and unique billable services annually. Additionally, female TSA surgeons tend to see more non-White, women, and dual Medicare-Medicaid enrolled patients.

6-Year Follow-Up of a World Record Breaking Master Marathon Runner.

Endurance performance declines with advancing age. Of the three main physiological factors that determine endurance running performance (maximal oxygen consumption [V̇O2max], lactate threshold, and running economy [RE]), V̇O2max appears to be most affected by age. While endurance performance declines with age, recently, endurance performance has rapidly improved in master athletes as the number of master athletes competing in endurance events has increased. Master athletes represent an intriguing model to study healthy aging. In this case study, we reassessed the physiological profile of a 76-year-old distance runner who broke the marathon world record for men over 70 years of age in 2018. This runner was tested a few months before breaking the world record and retested in 2024. Between 2018 and 2024, his marathon running velocity decreased significantly. Therefore, the purpose of this case study was to determine the physiological changes that explain his performance decline. RE remained similar to 2018, and while there was not a clear breakpoint in blood lactate, he still likely runs marathons at a high percentage (~90%) of his V̇O2max. However, V̇O2max declined by 15.1%. HRmax declined by 3.2% and maximal O2 pulse declined by 12.4%, suggesting that maximal stroke volume and/or arteriovenous O2 difference decreased. Altogether, although this marathoner continues to compete at an elite level, his performance has declined since his record-breaking marathon due to a reduction in V̇O2max. This is likely caused by reductions in maximal stroke volume and/or arteriovenous O2 difference. We speculate that these changes reflect primarily age-related processes.

Local calcium chloride infusion after pulsed field ablation enhances acute efficacy of cardiac electroporation.

Pulsed field ablation (PFA) has emerged as an innovative therapy for cardiac arrhythmias. Drawing parallels with PFA's application in solid tumors, calcium chloride (CaCl2) as an adjuvant therapy, known as calcium electroporation, may amplify PFA's apoptotic effects. We propose that PFA in the atrium could enhance calcium uptake through PFA-created pores, thereby increasing ablation efficacy even at reduced power levels by exploiting PFA's permeabilization effects. We conducted in vivo ablations on the atria of seven pigs using low PFA power (250 V, 20 μs for 50 pulses at 200 ms intervals). Post-PFA, we randomly administered an infusion of either 200 mg/2 ml CaCl2 (calcium group) or saline (control) directly to the ablation site via the catheter tip. We evaluated reduction in electrogram voltage amplitude, electrocardiography (ECG) parameters, ablation lesion parameters, and histology after PFA. Nineteen lesions from control and calcium groups were examined. Control lesions showed no voltage decrease post-PFA, whereas calcium-treated lesions exhibited a significant voltage reduction. Gross pathology indicated marked differences in maximum lesion surface diameter, depth, and volume between the lesion groups. Histologically, calcium group lesions were characterized by a more severe acute PFA response with contraction band necrosis, myocytolysis and nuclear pyknosis in adjacent myocardium, in addition to microhemorrhages. Infusing calcium chloride locally after PFA markedly improves the immediate efficacy of electroporation in porcine atria. This study suggests that calcium electroporation could bolster PFA outcomes without higher energy levels, potentially diminishing associated risks. These preliminary findings warrant further research into the long-term efficacy and potential clinical application of calcium electroporation in PFA.

Maternal vascular indices and hemodynamic parameters at 36 weeks' gestation in gestational and pre-existing diabetes mellitus.

To compare maternal vascular indices and hemodynamic parameters at 35-37 weeks' gestation in pregnancies complicated by gestational diabetes mellitus (GDM), those with pre-existing diabetes mellitus (DM) and those without GDM or pre-existing DM. This was a prospective observational study in women with a singleton pregnancy attending for a routine hospital visit at 35 + 0 to 36 + 6 weeks' gestation. The visit included recording of maternal demographic characteristics and medical history, and measurement of vascular indices and hemodynamic parameters using a non-invasive operator-independent device. These included carotid-to-femoral pulse-wave velocity, augmentation index, cardiac output, stroke volume, central systolic and diastolic blood pressure, total peripheral resistance and heart rate. The values in the GDM and pre-existing DM groups were compared to those in the unaffected group. We examined 6746 women, of whom 396 were excluded because they had chronic hypertension or developed pre-eclampsia or gestational hypertension. The study population of 6350 pregnancies contained 99 (1.6%) with pre-existing Type-I or Type-II DM and 617 (9.7%) that developed GDM, including 261 (42.3%) that were treated with diet alone, 239 (38.7%) treated with metformin alone and 117 (19.0%) treated with insulin with or without metformin. Among women with GDM and those with pre-existing DM, compared to those without GDM or pre-existing DM, there was a higher median cardiac output and heart rate, central systolic and diastolic blood pressure and pulse-wave velocity, but there was no significant difference in stroke volume and total peripheral resistance. There were no significant differences within the GDM group according to treatment type, except for higher heart rate in women treated with metformin alone compared to the group treated with diet alone. Women with GDM and those with pre-existing DM have evidence of early vascular disease in the third trimester, and this may contribute to their increased long-term cardiovascular risk. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.

Analysis of the Development of Micro, Small, and Medium Enterprises (MSMEs) Before and After Receiving Murabaha Financing from PT BPRS Rahmah Hijrah Agung Kota Lhokseumawe

This study aims to analyze the development of Micro, Small, and Medium Enterprises (MSMEs) before and after receiving Murabaha financing from PT BPRS Rahmah Hijrah Agung. MSMEs play a crucial role in Indonesia's economy, significantly contributing to community development and job creation. However, they often face various challenges, particularly in accessing financing. The Murabaha financing offered by BPRS, a sharia financial institution, provides an alternative for MSMEs to obtain business capital without the burden of high interest rates and complicated requirements typically associated with conventional banks. This research examines the differences in sales turnover, order volume, market reach, product quality, business profits, employment opportunities, financial management, and competitive ability of MSMEs before and after receiving financing from BPRS. The data used in this study is sourced from MSMEs that have received Murabaha financing during the period of 2020-2023. The research findings indicate a significant improvement in various aspects studied after MSMEs received Murabaha financing. These results suggest that the sharia financing products from BPRS play a crucial role in supporting the growth of MSMEs in Indonesia, particularly in enhancing their business capacity and competitiveness in the market. This study also highlights the importance of socialization and education regarding sharia financing products to improve MSME actors' understanding of the available financing options.

Associations between parental rearing style and amygdala and hippocampal subfield abnormalities in drug-naive females with anorexia nervosa

BackgroundAltered volumes in the hippocampus and amygdala have been linked to anorexia nervosa (AN). This study aimed to investigate amygdala and hippocampal subfields volume abnormalities in AN patients, and their associations with parental rearing practices and clinical psychological characteristics.MethodsThis study included twenty-nine drug-naive females with AN from West China Hospital of Sichuan University, China, and fifty-nine age- and gender-matched healthy controls (HCs) recruited through advertisement. All participants underwent T1-weighted imaging. Amygdala and hippocampal subfields volume was calculated using FreeSurfer 7.0. The Core Self-Evaluation Scale (CSES) and Rosenberg Self-Esteem Scale (RSES) were used to assess the psychological characteristics of AN patients. The Egna Minnen av Barndoms Uppfostran (EMBU) was employed to evaluate parental rearing practices. Group differences in brain volumes were analyzed with covariates like age and total intracranial volume (TIV). Partial correlation analysis explored the correlations between brain region volumes and clinical psychological characteristics.ResultsAN patients exhibited lower RSES and CSES scores, and more adverse parental rearing style than healthy norms. After adjusting for covariates, AN patients showed decreased gray matter volume (GMV) in the left medial (Me) and cortical (Co) nucleus, as well as in the right hippocampal-amygdala transition area (HATA). GMV in the left Me was correlated with years of education among HCs but not among AN patients. GMV in the right HATA was positively correlated with paternal penalty and severity, as well as maternal overinterference.ConclusionThis study supports structure abnormalities in amygdala and hippocampus in AN patients and suggests that parental rearing practices may be associated with hippocampal abnormalities, potentially contributing to the pathophysiology of AN. Addressing appropriate parental rearing styles may offer a positive impact on AN.

COVID-19 related cognitive, structural and functional brain changes among Italian adolescents and young adults: a multimodal longitudinal case-control study

Coronavirus disease 2019 (COVID-19) has been associated with brain functional, structural, and cognitive changes that persist months after infection. Most studies of the neurologic outcomes related to COVID-19 focus on severe infection and aging populations. Here, we investigated the neural activities underlying COVID-19 related outcomes in a case-control study of mildly infected youth enrolled in a longitudinal study in Lombardy, Italy, a global hotspot of COVID-19. All participants (13 cases, 27 controls, mean age 24 years) completed resting-state functional (fMRI), structural MRI, cognitive assessments (CANTAB spatial working memory) at baseline (pre-COVID) and follow-up (post-COVID). Using graph theory eigenvector centrality (EC) and data-driven statistical methods, we examined differences in ECdelta (i.e., the difference in EC values pre- and post-COVID-19) and Volumetricdelta (i.e., the difference in cortical volume of cortical and subcortical areas pre- and post-COVID) between COVID-19 cases and controls. We found that ECdelta significantly between COVID-19 and healthy participants in five brain regions; right intracalcarine cortex, right lingual gyrus, left hippocampus, left amygdala, left frontal orbital cortex. The left hippocampus showed a significant decrease in Volumetricdelta between groups (p = 0.041). The reduced ECdelta in the left amygdala associated with COVID-19 status mediated the association between COVID-19 and disrupted spatial working memory. Our results show persistent structural, functional and cognitive brain changes in key brain areas associated with olfaction and cognition. These results may guide treatment efforts to assess the longevity, reversibility and impact of the observed brain and cognitive changes following COVID-19.

Contrasting the Penultimate Glacial Maximum and the Last Glacial Maximum (140 and 21 ka) using coupled climate–ice sheet modelling

Abstract. The configuration of the Northern Hemisphere ice sheets during the Penultimate Glacial Maximum differed to the Last Glacial Maximum. However, the reasons for this are not yet fully understood. These differences likely contributed to the varied deglaciation pathways experienced following the glacial maxima and may have had consequences for the interglacial sea level rise. To understand the differences between the North American Ice Sheet at the Last and Penultimate glacial maxima (21 and 140 ka), we perform two perturbed-physics ensembles of 62 simulations using a coupled atmosphere–ice sheet model, FAMOUS-ice, with prescribed surface ocean conditions, in which the North American and Greenland ice sheets are dynamically simulated with the Glimmer ice sheet model. We apply an implausibility metric to find ensemble members that match reconstructed ice extent and volumes at the Last and Penultimate glacial maxima. We use a resulting set of “plausible” parameters to perform sensitivity experiments to decompose the role of climate forcings (orbit, greenhouse gases) and initial conditions on the final ice sheet configurations. This confirms that the initial ice sheet conditions used in the model are extremely important in determining the difference in final ice volumes between both periods due to the large effect of the ice–albedo feedback. In contrast to evidence of a smaller Penultimate North American Ice Sheet, our results show that the climate boundary conditions at these glacial maxima, if considered in isolation, imply a larger Penultimate Glacial Maximum North American Ice Sheet than at the Last Glacial Maximum by around 6 m sea level equivalent. This supports the notion that the growth of the ice sheet prior to the glacial maxima is key in explaining the differences in North American ice volume.

A-143 Comparative Evaluation of K2EDTA Performance in Multinational Vacutainers: A Case Study of “DBO” by Schraubg and “BD” by Becton, Dickinson

Abstract Background This research paper presents a thorough comparison of the anticoagulant properties of K2EDTA in two multinational vacutainer brands, “DBO” by Schraubg and “BD” by Becton, Dickinson, with a specific focus on critical hematological parameters. The study encompassed the analysis of 50 samples, spanning a wide range of values from 60 fl to 110 fl, evaluating key parameters such as Hemoglobin (Hb), Hematocrit (HCT), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin Concentration (MCHC), and Red Blood Cell (RBC) count. Methods Peripheral blood samples were gathered from 50 outpatient participants using the specified tubes. The samples underwent assessment for six hematological analytes, including RBC Count, hemoglobin, HCT, MCV, MCH, and MCHC. Comparative analysis was performed using the paired t-test. Differences exceeding the total allowable error were considered clinically significant. To assess stability, initial results were compared with those obtained from samples preserved for a duration of 2 hours Results Our findings indicate that the use of “DBO” vacutainers resulted in slightly higher values for Hb, HCT, MCV, MCHC, and RBC count compared to the “BD” vacutainers. Notably, the statistical significance was observed in MCV, HCT, and MCHC across nearly all samples, while Hb and RBC parameters showed no significant changes. Given the crucial role of K2EDTA as an anticoagulant in maintaining the hypotonicity of Red Blood Cells (RBCs), ensuring accurate hematological analyses is imperative. Conclusions Although the T-value for Hemoglobin did not exhibit statistical significance, the study identified notable differences in Hematocrit (HCT) and Mean Corpuscular Volume (MCV). This underscores the importance of selecting the appropriate vacutainer brand to ensure reliability and accuracy in hematological measurements, particularly when assessing MCV, where even slight variations can carry clinical implications. The results underscore the necessity for clinicians and laboratories to carefully consider the choice of vacutainers based on their specific requirements and the critical nature of the hematological parameters under analysis.

Retrospective analysis of volumes of manually expressed colostrum among healthy postnatal mothers at a tertiary care referral unit in South India. Not enough milk or not enough patience?

IntroductionThe volumes of colostrum have been quantified as 5 mL and 25 mL per feed on days 1 and 3, respectively, as per the data described about 20 years ago....