The Relationship Between Aldosterone and Left Ventricular Hypertrophy in Hypertensive Patients

Background - Aldosterone is a pertinent hormone in naturally elevating blood pressure within the body by increasing fluid retention in the body via electrolyte reabsorption in the kidneys. Consequently, aldosterone can have an indirect effect on the incidence of LVH considering the hormone can reinforce high blood pressure. However, recent studies have suggested that aldosterone and the renin-angiotensin-aldosterone-system (RAAS) may have a direct role in leading to an increase in left ventricular mass. Patients with hyperaldosteronism, otherwise elevated circulating aldosterone, have shown high frequencies of LVH regardless of the presence of hypertension. Furthermore, cardiomyocytes have been seen to contain mineralocorticoid receptors that bind to aldosterone and can be affected by different RAAS inactivating medications. Overall, current research suggests there may be a regression between LVH and aldosterone. Methods and Results – A retrospective model comparing plasma aldosterone levels and left ventricular hypertrophy measurements in a hypertensive cohort of African Americans from the AdDReaCH trial. Follow-up over the course of a year allowed for multivariate analysis to determine whether elevated levels of plasma aldosterone induced changes in left ventricular mass and diastolic function independent of blood pressure and other variables. Left ventricular hypertrophy was assessed through various left ventricular measurements from contrast-aided MRI examinations. Though average LVMI was greater in patients with greater aldosterone-renin ratios, multivariate analysis suggested that plasma aldosterone-renin ratio does not have a significant, independent relationship to the incidence and severity of LVH. Results call for further research on the topic, as the current study confounds results from prior studies

Anterior Cruciate Ligament Reconstruction Does Not Impact Career Earnings After Return to Play in National Basketball Association Athletes

PURPOSE: To quantify the financial impact of an anterior cruciate ligament (ACL) injury on the remaining career earnings of National Basketball Association (NBA) players. METHODS: We performed a retrospective review of all NBA players who had an ACL rupture between 2000 and 2019. Players were matched to healthy controls by age, position, body mass index, and player efficiency rating at the time of injury (index year). Player information collected included demographic information, position, team role, draft pick, date of injury, contract length, and earnings during the 3 years before and 7 years after the index year, as well as new contract length and earnings after injury. RESULTS: A total of 12 players (22%) did not return to play (RTP). No statistically significant difference in annual earnings was present at any time point between cohorts. When we examined the mean difference in earnings between the first 3 post-index seasons and the 3 pre-index seasons, both the ACL and control cohorts showed increased salaries as players\u27 careers progressed, without a significant difference in earnings. When comparing cohorts, we found no significant difference in the length and earnings of contracts during the index year. Furthermore, there was no significant difference in the length or earnings of the first new contract signed after the index year between cohorts. Additionally, NBA players who were able to RTP after ACL reconstruction were more likely to experience increased earnings if they had greater experience and performance prior to their injury (P \u3c .01). CONCLUSIONS: Our study found that NBA players did not experience diminished earnings after RTP from an ACL reconstruction when compared with matched controls. Furthermore, no differences were seen in lengths of new contracts or in contract earnings between cohorts. Players with greater experience and performance prior to injury were more likely to have increased earnings after ACL reconstruction. LEVEL OF EVIDENCE: Level III, retrospective case-control study

Conductive textiles for signal sensing and technical applications

Conductive textiles have found notable applications as electrodes and sensors capable of detecting biosignals like the electrocardiogram (ECG), electrogastrogram (EGG), electroencephalogram (EEG), and electromyogram (EMG), etc; other applications include electromagnetic shielding, supercapacitors, and soft robotics. There are several classes of materials that impart conductivity, including polymers, metals, and non-metals. The most significant materials are Polypyrrole (PPy), Polyaniline (PANI), Poly(3,4-ethylenedioxythiophene) (PEDOT), carbon, and metallic nanoparticles. The processes of making conductive textiles include various deposition methods, polymerization, coating, and printing. The parameters, such as conductivity and electromagnetic shielding, are prerequisites that set the benchmark for the performance of conductive textile materials. This review paper focuses on the raw materials that are used for conductive textiles, various approaches that impart conductivity, the fabrication of conductive materials, testing methods of electrical parameters, and key technical applications, challenges, and future potential

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment

Transformer based Answer-Aware Bengali Question Generation

Question generation (QG), the task of generating questions from text or other forms of data, a significant and challenging subject, has recently attracted more attention in natural language processing (NLP) due to its vast range of business, healthcare, and education applications through creating quizzes, Frequently Asked Questions (FAQs) and documentation. Most QG research has been conducted in languages with abundant resources, such as English. However, due to the dearth of training data in low-resource languages, such as Bengali, thorough research on Bengali question generation has yet to be conducted. In this article, we propose a system for producing varied and pertinent Bengali questions from context passages in natural language in an answer-aware input format using a series of fine-tuned text-to-text transformer (T5) based models. During our studies with various transformer-based encoder-decoder models and various decoding processes, along with delivering 98% grammatically accurate questions, our fine-tuned BanglaT5 model had the highest 35.77 F-score in RougeL and 38.57 BLEU-1 score with beam search. Our automated and human evaluation results show that our answer-aware QG models can create realistic, human-like questions relevant to the context passage and answer. We also release our code, generated questions, dataset, and models to enable broader question generation research for the Bengali-speaking community

Comparison of Harris Hip Scores and Revision Rates in Metal-on-Metal Versus Non-Metal-on-Metal Total Hip Arthroplasty.

INTRODUCTION: This study compares functional outcome scores and revision rates between metal-on-metal (MoM) and non-MoM total hip arthroplasty patients. METHODS: A cohort of 75 patients who underwent implantation of the same dual modular hip arthroplasty between the years of 2004 and 2010 was enrolled. Patients were subsequently evaluated in 2015 to 2017 for joint revision history and functionality, as measured by the Harris hip score (HHS). Patients requiring a revision arthroplasty were not included in the HHS analysis. RESULTS: A total of 49 patients had MoM implants (65.3%), and 26 patients had non-MoM implants (34.8%). At a mean follow-up of 7.6 years, 10.2% (5/49) of MoM prostheses required revision, whereas 3.8% (1/26) of non-MoM prostheses required revision (P = 0.334). The mean HHS in the MoM cohort was 89.8, compared with 88.1 in the non-MoM cohort (P = 0.69). CONCLUSION: HHSs were not notably different between cohorts. The MoM cohort had three times as many revisions as the non-MoM cohort, but given the numbers available, this difference did not reach significance. Given the clinical importance of these revision data, further study is warranted to determine survivorship of the MoM versus non-MoM total hip arthroplasty at long-term follow-up

Echocardiographic Changes in the Context of Metal-on-Metal Versus Nonmetal-on-Metal Total Hip Arthroplasty

BACKGROUND: The purpose of this study is to determine if there is a difference in echocardiographic results between patients with metal-on-metal (MoM) vs non-MoM total hip arthroplasty (THA) and to determine if a correlation exists between serum metal levels and echocardiographic outcomes. METHODS: Seventy-five patients with the same modular THA enrolled in this prospective cohort study, and 49 had MoM bearings. All patients had serum cobalt, chromium, and titanium levels drawn at 2 study visits with a transthoracic echocardiogram at the second visit. Serum metal concentrations and echocardiographic parameters were compared with 2-way t-tests. Multiple linear regression analyses identified any significant predictors of echocardiographic outcomes. RESULTS: Mean serum cobalt and chromium levels were significantly greater in the MoM group at both time-points (P \u3c .001 and P \u3c .05, respectively). Titanium levels were similar between groups (P \u3e .05). MoM patients had significantly lower global longitudinal strain compared with the non-MoM group (18.4% vs 20.2%; P = .026). Serum cobalt concentration was found to be an independent predictor of tricuspid annular plane systolic excursion (P = .02). CONCLUSION: MoM THA bearings are associated with increased serum cobalt and chromium levels. Patients with MoM THAs had decreased global longitudinal strain, a measure of left ventricular function, but both groups remained within normal range. The clinical impact of the positive association between serum cobalt concentration and tricuspid annular plane systolic excursion, a marker of right ventricular function, deserves further study. These findings can reassure physicians and patients that metal-induced cardiomyopathy is not typical in the setting of MoM THA. LEVEL OF EVIDENCE: Level II, Prospective Cohort Study

Impact of Alignment and Alignment Correction on Outcomes Following Robotic Medial Unicompartmental Knee Arthroplasty

BACKGROUND: The purpose of this study was to retrospectively examine the relationship between preoperative and postoperative alignment in robotic unicompartmental knee arthroplasty (UKA) and postoperative patient-reported outcome measures. METHODS: A retrospective review of 374 patients who underwent robotic-assisted UKA was conducted. Patient demographics, history, and preoperative and postoperative Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR) scores were obtained via chart review. Average follow-up period was 2.4 years (range: 0.4 to 4.5 years) to chart review and 9.5 months (range: 6 to 48 months) to latest KOOS-JR. Preoperative and postoperative robotically-measured knee alignment was obtained from operative reports. Incidence of conversion to total knee arthroplasty (TKA) was determined by review of a health information exchange tool. RESULTS: Multivariate regressions showed no statistically significant relationship between preoperative alignment, postoperative alignment, or degrees of alignment correction and change in KOOS-JR score or achievement of KOOS-JR minimal clinically important difference (MCID) (P \u3e .05). Patients who had \u3e8 degrees of postoperative varus alignment had on average a 20% lower achievement of KOOS-JR MCID compared to patients who hadalignment; however, this difference was not statistically significant (P \u3e .05). There were 3 patients who required conversion to TKA in the follow-up period, with no significant relationship to alignment variables (P \u3e .05). CONCLUSION: There was no significant difference in KOOS-JR change for those patients who had a larger or smaller degree of deformity correction, and correction did not predict MCID achievement

Comparison of Postoperative Instability and Acetabular Cup Positioning in Robotic Assisted versus Traditional Total Hip Arthroplasty

BACKGROUND: Robotic-assisted total hip arthroplasty (R-THA) affords precision yet uncertain clinical benefits. This study compares dislocation rates and related revisions between R-THA and manual total hip arthroplasty (M-THA). Secondarily we evaluated cup position, patient-reported outcome measures (PROMs), and postoperative complications. METHODS: A three-surgeon cohort study was conducted on 2,247 consecutive patients (1724 M-THA and 523 R-THA) who received a primary THA between January 2014 and June 2020 at a single hospital. Demographics, PROMs, emergency department visits, readmissions, and 90-day complications were collected via the Michigan Arthroplasty Registry Collaborative Quality Initiative. Chart review yielded instability occurrence with average follow-up of 4 years. Multivariate regression analysis was performed and a sample of 368 radiographs including all dislocations were assessed. RESULTS: There were significantly lower rates of dislocation in R-THA (0.6%) versus M-THA (2.5%; Multivariate odds ratio 3.74, p \u3c .046). All cases of unstable R-THA were successfully treated conservatively, whereas 46% of unstable M-THA were revised for recurrent instability. Cup anteversion (25.6° ± 5.4° R-THA vs. 20.6° ± 7.6° M-THA) was greater and cup inclination (42.5° ± 5.3° R-THA vs. 47.0° ± 6.7° M-THA) was lower in the R-THA group (p \u3c .05). No significant differences were noted for demographics, PROMs, or other complications (p \u3e .05). CONCLUSION: R-THA resulted in less than one-fourth the dislocation rate compared to M-THA and no revision for instability. It was associated with no difference in PROMs or other early complications. The influence of R-THA on stability goes beyond simply cup positioning and deserves further study