Standardized uptake value of normal organs on routine clinical [18F]FDG PET/CT: impact of tumor metabolism and patient-related factors

Background: To evaluate the effect of patient-related factors such as age, gender, body mass index (BMI), blood glucose (BG), diabetes, serum creatinine and injected dose on 18F-Fluorodeoxyglucose ([18F]FDG) uptake of tumor and normal organs, as well impact of [18F]FDG uptake of tumor on normal organs, in clinical positron emission tomography-computed tomography (PET/CT).Material and methods: In this retrospective study, data of 200 patients who underwent clinical [18F]FDG PET/CT with (n = 192) and without (n = 8) intravenous contrast was evaluated. Ten target organs and tumor [18F]FDG uptake were measured with a standardized uptake value maximum (SUVmax). Pearson correlation coefficient was calculated for continuous variables while t-test/Wilcoxon rank sum tests were used to compare continuous outcomes. Multivariate linear regression analysis was done to exclude covariates, followed by posthoc multiple linear regression analysis after adjusting the levels of significance.Results: Significant but weak positive correlation was seen between tumor [18F]FDG uptake with uptake in the pancreas (r = 0.43, p < 0.001) and heart (r = 0.19, p = 0.049), but not other organs. With age, a significant negative correlation was seen with the brain (r = –0.183, p = 0.009) and a positive correlation was seen with the blood pool (r = 0.205, p = 0.003). With BG, significant negative correlation was seen with the brain (r = –0.449, p < 0.0001) and heart (r = –0.15, p = 0.033), while a positive correlation was seen with fat (r = 0.143, p = 0.043). BMI showed a significant positive correlation with [18F]FDG uptake of all organs except the pancreas and heart, as well as tumor. No significant correlation was seen with serum creatinine and injected [18F]FDG dose. Significantly higher uptake was seen in the brain, spleen, and muscles of females. Between obese and non-obese, a significant difference was seen for all organs except for the pancreas and heart, and tumor. Comparison between non-diabetic and diabeticpatients showed significant differences only for bone. Multivariate linear analysis adjusting for cofactors showed only BMI (p = 0.0009) and BG (p = 0.0002) to be independently correlated with [18F]FDG uptake. Post-hoc multiple regression analysis showed a significant positive correlation between [18F]FDG uptake of the brain (β = 0.118, p < 0.001), liver (β = 0.02, p = 0.002), and fat (β = 0.01, p < 0.0006) with BMI, and significant negative correlation of brain uptake with BG (β = 0.03, p < 0.0001).Conclusions: Tumor [18F]FDG uptake has no significant effect on the uptake in organs, except for the pancreas and heart. Age, gender, BMI, and BG, but not creatinine and injected [18F]FDG dose show correlation with uptake in tumor and organs. BG and BMI are independent significant factors, with a positive correlation of BMI with the brain, hepatic and fat uptake, and a negative correlation of BG with brain uptake

Psychological, cultural and neuroendocrine profiles of risk for preterm birth

BACKGROUND: Preterm birth remains a major obstetrical problem and identification of risk factors for preterm birth continues to be a priority in providing adequate care. Therefore, the purpose of this study was to elucidate risk profiles for preterm birth using psychological, cultural and neuroendocrine measures. METHODS: From a cross sectional study of 515 Mexican American pregnant women at 22–24 weeks gestation, a latent profile analysis of risk for preterm birth using structural equation modeling (SEM) was conducted. We determined accurate gestational age at delivery from the prenatal record and early ultrasounds. We also obtained demographic and prenatal data off of the chart, particularly for infections, obstetrical history, and medications. We measured depression (Beck Depression Inventory), mastery (Mastery scale), coping (The Brief Cope), and acculturation (Multidimensional Acculturation Scale) with reliable and valid instruments. We obtained maternal whole blood and separated it into plasma for radioimmunoassay of Corticotrophin Releasing Hormone (CRH). Delivery data was obtained from hospital medical records. RESULTS: Using a latent profile analysis, three psychological risk profiles were identified. The “low risk” profile had a 7.7 % preterm birth rate. The “moderate risk” profile had a 12 % preterm birth rate. The “highest risk” profile had a 15.85 % preterm birth rate. The highest risk profile had double the percentage of total infections compared to the low risk profile. High CRH levels were present in the moderate and highest risk profiles. CONCLUSION: These risk profiles may provide a basis for screening for Mexican American women to predict risk of preterm birth, particularly after they are further validated in a prospective cohort study. Future research might include use of such an identified risk profile with targeted interventions tailored to the Hispanic culture

Developing Standard Treatment Workflows—way to universal healthcare in India

Primary healthcare caters to nearly 70% of the population in India and provides treatment for approximately 80–90% of common conditions. To achieve universal health coverage (UHC), the Indian healthcare system is gearing up by initiating several schemes such as National Health Protection Scheme, Ayushman Bharat, Nutrition Supplementation Schemes, and Inderdhanush Schemes. The healthcare delivery system is facing challenges such as irrational use of medicines, over- and under-diagnosis, high out-of-pocket expenditure, lack of targeted attention to preventive and promotive health services, and poor referral mechanisms. Healthcare providers are unable to keep pace with the volume of growing new scientific evidence and rising healthcare costs as the literature is not published at the same pace. In addition, there is a lack of common standard treatment guidelines, workflows, and reference manuals from the Government of India. Indian Council of Medical Research in collaboration with the National Health Authority, Govt. of India, and the WHO India country office has developed Standard Treatment Workflows (STWs) with the objective to be utilized at various levels of healthcare starting from primary to tertiary level care. A systematic approach was adopted to formulate the STWs. An advisory committee was constituted for planning and oversight of the process. Specialty experts' group for each specialty comprised of clinicians working at government and private medical colleges and hospitals. The expert groups prioritized the topics through extensive literature searches and meeting with different stakeholders. Then, the contents of each STW were finalized in the form of single-pager infographics. These STWs were further reviewed by an editorial committee before publication. Presently, 125 STWs pertaining to 23 specialties have been developed. It needs to be ensured that STWs are implemented effectively at all levels and ensure quality healthcare at an affordable cost as part of UHC

Investigating the role of air-sea forcing on the variability of hydrography, circulation, and mixed layer depth in the Arabian Sea and Bay of Bengal

Summary: An effort is made to understand and quantify the influence of near surface zonal and meridional winds, incoming shortwave radiation, and freshwater flux air-sea forcings on the seasonal variability of the hydrography, circulation, and mixed layer depth of the Arabian Sea (AS) and Bay of Bengal (BoB). Sensitivity experiments using an ocean general circulation model are carried out for this purpose in the Indian ocean around 65°–95°E, 5°–22°N during 1998–2014 (17 years). In the absence of near surface wind forcing, the sea surface temperature of the region greatly increases in all the seasons, whereas, in the absence of incoming shortwave radiation forcing, exactly opposite is the case. The sea surface salinity of the AS and BoB decreases in the absence of wind and shortwave radiation forcings, whereas, in the northern BoB it increases in the absence of freshwater flux forcing. The sub-surface changes in the stratification of temperature and salinity are also investigated. The influence of the air-sea forcings on the mixed layer depth of the region is found to be highly seasonally dependent. The effect of air-sea forcings on the seasonal variability of the upper ocean vertical stability is studied using the vertical shear of the horizontal velocity, buoyancy frequency, and energy required for mixing as quantifiers. The near surface wind forcing has highest contribution in changing the surface circulation of the region. Keywords: Arabian Sea and Bay of Bengal, Air-sea forcing, Ocean general circulation model, Hydrography and circulation, Vertical stabilit

pH-responsive drug release from dependal-M loaded polyacrylamide hydrogels

A study of pH responsive drug release from dependal-M drug loaded polyacrylamide (PAM) hydrogel matrix is reported. PAM hydrogel with different crosslinker concentrations has been taken for the different drug loading capacities. The associative interaction of drug in the polymer network complicates the release pattern of drug, and the release kinetics show a dependence on the cross linker and its ratio. The drug release kinetics in hydrogel with higher cross linker (H1) and less crosslinked hydrogel (H2) are followed by the Higuchi's model and the Korsmeyer–Peppas model, respectively. Drug release mechanism is based on diffusion. Initial burst of drug release was observed at pH 5.8. The calculated diffusion coefficient (D) is 2.57 for H1 and 1.799 for H2

TiO2 nanoparticles alter nutrients acquisition, growth, biomacromolecules, oil composition and modulate antioxidant defense system in Mentha arvensis L.

The current study demonstrates the impact of TiO2 NPs (0–5 µg ml−1) on Mentha arvensis L. (Lamiaceae) cultivated commercially for essential oil. The high concentration of titanium in plant tissues (roots, leaves and stem), presence of Ti peaks in EDS of roots and accumulation of TiO2 NPs along the inner and outer membrane, cytoplasm, intracellular junctions of M. arvensis root cells after TiO2 NPs exposure reveal internalization and upward translocation of TiO2 NPs in M. arvensis. Phytotoxicity of TiO2 NPs manifested in terms of altered nutrients acquisition, reduced biomass, pigments, relative water contents and enhanced oxidative stress markers ( ≥ 2.5 µg ml−1 TiO2 NPs) in roots and leaves. Further, TiO2 NPs incremented the levels of cysteine, non-protein thiols, and proline compared to untreated control. Total phenolic contents also increased (≤1 µg ml−1 TiO2 NPs) in roots and leaves. Modulation of antioxidant enzymes (SOD, catalase, GPX, APX, AO and GST) in roots and leaves was observed to mitigate adverse effects caused by TiO2 NPs induced reactive oxygen species. TiO2 NPs differentially affects cell wall components, lipids and nucleic acids in roots and leaves. The relative peak area (%) of major oil constituents in M. arvensis leaves was significantly altered by TiO2 NPs. A concentration dependent decrement in relative peak area of α-pinene, β- pinene, Sabinene, Limonene, β – Myrcene has been documented in this study compared to unexposed plants. The present study suggests sustainable use of TiO2 NPs in agriculture and other commercial products due to their potential biotoxicity