Diagnostic efficacy of sonography for diagnosis of ovarian torsion

Objectives: Misdiagnosing ovarian torsion is now suggested as an important issue in clinical setting. The aim of this study was to determine the diagnostic accuracy of sonography for ovarian torsion. Methods: In this study 323 women with acute pelvic pain with highly suspected ovarian torsion signs and symptoms attending Imam Reza Medical Center in Kermanshah between 2011 through 2012 were included and underwent a transabdominal sonography (2-5 MHz probes). Then findings of sonography were compared with laparatomy. Results: The ultrasound correctly diagnosed 72.1% of ovarian torsion and missed 27.9% of them (false negatives). However, one free subject (0.4%) was misclassified as ovarian torsion (false positive). There was a strong correlation between sonography and laparatomy with a kappa value of 84.0%. The sensitivity and specificity of sonography were 72.1% and 99.6%, respectively. Sonography had a positive predictive value of 96.9%, a negative predictive value of 95.9%, and a total accuracy of 96.0% for detection of ovarian torsion. Conclusion: Sonography appears to be an excellent method to evaluate patients with suspected ovarian torsion. Abnormal blood flow detected by sonography is highly predictive of ovarian torsion and is therefore useful in the diagnosis of this phenomenon

Molecular imaging using by diffusion-weighted imaging of brain tumor through signal intensity: Progress in molecular cancer imaging

Introduction: Characterizing the variations of the brain tumors has the significant effect in the treatment process of affected patients. Brain metastatic tumors are usually diagnosed following by the neurological symptoms in patients. The purpose of this thesis is the role of diffusion-weighted-magnetic resonance imaging (DW-MRI) and apparent diffusion coefficient (ADC) values in the evaluation of different benign and malignant brain mass lesions before surgery with histopathological correlation. Materials and Methods: In this study MR examination of 54 patients who with brain metastatic tumor referring to 7th-Tir Hospital were randomly selected and imaged with T2W Multi-echo sequences and GRE-EPI (DWI) in addition to taking the routine sequence of the brain. Results: In analyzing the data for ADCmin values were measured within the tumors and mean values were evaluated regarding statistical differences between groups.9 The ADCmin values of low-grade gliomas(1.09 ± 0.20 × 10−3 mm2/s) were signi=icantly higher (p < .001) than those of other tumors. Generally, ADC value of 0.5613 ± 0.02580 indicates brain metastatic tumors with lung origin, ADC value of 1.009 ± 0.03820 tumors with liver and breast origin, and ADC value of 1.556 ± 0.03500 tumors with colon and prostate origin. Conclusion: According to our results, Diffusion parameters during treatment were evaluated for early noninvasive biomarkers. The ADC changes from mid- to post-treatment suggest such a possible early non-invasive biomarker

Noninvasive Stem Cell Labeling Using USPIO Technique and their Detection with MRI

Background: To date, several imaging techniques to track stem cells are used such as positron emission tomography (PET), single photon emission computed tomography (SPECT), Bioluminescence imaging (BLI), fluorescence imaging, CT scan and magnetic resonance imaging (MRI). Although, overall sensitivity of MRI compared to SPECT and Bioluminescence techniques are lower, but due to high spatial resolution (~100 mm), long term three-dimensional imaging capability, in vivo quick access to images in three different sections, and noninvasiveness it is being used as the method of choice. Methods: The present study is the search results for authors and sources of information in the field of molecular and cellular imaging to examine the problems and perspectives about stem cells labeling with Ultrasmall Super Paramagnetic Iron Oxide (USPIO) and their tracking by MRI. Results: With the advancement of technology, including quantum physics, chemistry, and computer software, MRI with an excellent spatial resolution and contrast, is surpasses other imaging modalities in the analysis of anatomical and pathological features and images of all body tissues. From the other side, advances in the astronomical science, chemistry and nanotechnology, high biocompatibility and cytotoxicity of nanoparticles, and due to analysis in the metabolic pathways of iron made the procedure easier; however, there are still several fundamental questions in understanding the mechanism of biological molecules in the living cells including: 1- How to detect not only the location but also the performance of the labeled cells? Probably combination of USPIO nanoparticles with other reporter genes as contrast agents for MRI and PET can simultaneously be used to overcome these limitations 2) How to trace stem cells from pre-clinical models to translate to humans? Up to now, due to issues of bioethics, little studies have been done in this area. 3) Whether the transplanted stem cells that have reached the target tissue, will remain or migrate? Despite the fact that cell proliferation and exocytosis are two main factors for long term protection of USPIO nanoparticles inside cells, their signals cannot be received for a long time. 4) What mechanisms cause stem cells reaching the target tissue to react with their environment? And 5) what is the number of transplanted cells in live tissue, and what is their half-life? Conclusion: This study showed that USPIO nanoparticles can enter the cell with a clear dose without any adverse biological effects and could be detected by SWI and T2* techniques under MRI (1.5 Tesla) scanner for almost one month. MRI as a secure mean can illustrate with optimal resolution the spatial-resolution and three-dimensional positions of the stem cells. Keywords: Ultrasmall Super Paramagnetic Iron Oxide (USPIO), labeled stem cell, in vivo tracking, MRI

Application of allogeneic fibroblast cells in cellular therapy of recessive dystrophic epidermolysis bullosa

Context: Connective tissue cells include fibroblasts, chondrocytes, adipocyte, and osteocytes. These cells are specialized for the secretion of collagenous extracellular matrix and are responsible for the architectural framework of the human body. Evidence Acquisition: Connective tissue cells play a central role in supporting as well as repairing tissues and organs. Fibroblast cell therapy could be used for the treatment of burn wounds, scars, diabetic foot ulcers, acne scars and skin aging. This review focused on biology of fibroblasts and their role in cell therapy of recessive dystrophic epidermolysis bullosa (RDEB). Results: Fibroblasts are known to play a pivotal role in skin structure and integrity, and dermal fibroblasts are believed to promote skin regeneration and rejuvenation via collagen production. Conclusions: Fibroblasts can be used in transplantations to ameliorate an immune system response, in order to reduce antigen production. Human fibroblasts suppress ongoing mixed lymphocyte reactions (MLRs) between lymphocyte cells from two individuals, and supernatant materials from fibroblast cultures suppress MLRs. © 2015, Skin and Stem Cell Journal

Self-dual Spectral Singularities and Coherent Perfect Absorbing Lasers without PT-symmetry

A PT-symmetric optically active medium that lases at the threshold gain also acts as a complete perfect absorber at the laser wavelength. This is because spectral singularities of PT-symmetric complex potentials are always accompanied by their time-reversal dual. We investigate the significance of PT-symmetry for the appearance of these self-dual spectral singularities. In particular, using a realistic optical system we show that self-dual spectral singularities can emerge also for non-PT-symmetric configurations. This signifies the existence of non-PT-symmetric CPA-lasers.Comment: 11 pages, 3 figures, 1 table, accepted for publication in J. Phys.

Analysis of hand-forearm anthropometric components in assessing handgrip and pinch strengths of school-aged children and adolescents: a partial least squares (PLS) approach

Background: The purpose of this study was to examine the influence of hand-forearm anthropometric dimensions on handgrip and pinch strengths among 7�18 years children and adolescents and to investigate the extent to which these variables can be used to predict hand strength. Methods: Four types of hand strengths including handgrip, tip to tip, key, and three-jaw chuck pinches were measured in 2637 healthy children and adolescents (1391 boys and 1246 girls) aged 7�18 years using standard adjustable Jamar hydraulic hand dynamometer and pinch gauge. A set of 17 hand-forearm anthropometric dimensions were also measured with an accurate digital caliper and tape measure. Results: No significant differences were found between the hand strengths of boys and girls up to the age of 10 years. Gender related differences in handgrip and pinches were observed from the age of 11 years onwards, with boys always being stronger. The dominant hand was stronger than the non-dominant hand (8 for handgrip and by about 10 for all three types of pinches). The strongest correlations were found between the hand length and hand strengths (r > 0.83 for handgrip and three all pinches; p < 0.001, 2-tailed). Based on the partial least squares (PLS) analysis, 8 out of 17 anthropometric indices including hand length, hand circumference, thumb length, index finger length, middle finger length, and forearm length had considerable loadings in the PLS analysis, which together accounted for 46 of the total variance. Conclusions: These results may be used by health professionals in clinical settings as well as by designers to create ergonomic hand tools. © 2021, The Author(s)

Fragmented QRS and subclinical left ventricular dysfunction in individuals with preserved ejection fraction: A speckle-tracking echocardiographic study

Introduction: Fragmented QRS (fQRS) complex on routine 12-lead electrocardiogram (ECG) predicts adverse outcomes in patients with cardiovascular diseases. In addition, it has been found to be associated with subclinical myocardial dysfunction in chronic diseases. We sought to investigate the relationship between the presence of fQRS with the myocardial functions in individuals free from known systemic cardiovascular diseases. Methods: In a case-control study, we evaluated normal individuals from March 2017 to February 2018. All participants underwent a 2-dimensional transthoracic echocardiographic examination using tissue Doppler imaging (TDI) and speckle-tracking echocardiography. In addition, all participants were examined using a 12-lead surface ECG, and patients with fQRS and a group of age- and sex-matched controls without fQRS were enrolled in our study. Results: The patients' mean age was 40.3 ± 10.7 and 35.4 ± 11.2 years in fQRS-positive and fQRS-negative groups, respectively (P =.110). Patients with fQRS had significantly lower values of apical left ventricular global longitudinal strain (LV GLS) in 2-chamber (16.9 ± 2.5 vs. 20.5 ± 3.3, P <.001), 4-chamber (16.9 ± 3.4 vs. 20.1 ± 3, P =.001), LAX views (17.7 ± 2.8 vs. 20.8 ± 3.5, P =.001), and averaged LV GLS (17 ± 2.6 vs. 20.4 ± 2.7, P <.001) values compared to patients without fQRS. In a multivariate analysis, averaged LV GLS and smoking history were independent predictors for positive fQRS. Conclusion: The presence of fQRS on 12-lead ECG in healthy population was associated with lower values of LV GLS compared to normal individuals without fQRS. © 2019 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society

The value of standards for health datasets in artificial intelligence-based applications

Artificial intelligence as a medical device is increasingly being applied to healthcare for diagnosis, risk stratification and resource allocation. However, a growing body of evidence has highlighted the risk of algorithmic bias, which may perpetuate existing health inequity. This problem arises in part because of systemic inequalities in dataset curation, unequal opportunity to participate in research and inequalities of access. This study aims to explore existing standards, frameworks and best practices for ensuring adequate data diversity in health datasets. Exploring the body of existing literature and expert views is an important step towards the development of consensus-based guidelines. The study comprises two parts: a systematic review of existing standards, frameworks and best practices for healthcare datasets; and a survey and thematic analysis of stakeholder views of bias, health equity and best practices for artificial intelligence as a medical device. We found that the need for dataset diversity was well described in literature, and experts generally favored the development of a robust set of guidelines, but there were mixed views about how these could be implemented practically. The outputs of this study will be used to inform the development of standards for transparency of data diversity in health datasets (the STANDING Together initiative)

Arterial hypertension and β-amyloid accumulation have spatially overlapping effects on posterior white matter hyperintensity volume: a cross-sectional study

Background: White matter hyperintensities (WMH) in subjects across the Alzheimer’s disease (AD) spectrum with minimal vascular pathology suggests that amyloid pathology—not just arterial hypertension—impacts WMH, which in turn adversely influences cognition. Here we seek to determine the effect of both hypertension and Aβ positivity on WMH, and their impact on cognition. Methods: We analysed data from subjects with a low vascular profile and normal cognition (NC), subjective cognitive decline (SCD), and amnestic mild cognitive impairment (MCI) enrolled in the ongoing observational multicentre DZNE Longitudinal Cognitive Impairment and Dementia Study (n = 375, median age 70.0 [IQR 66.0, 74.4] years; 178 female; NC/SCD/MCI 127/162/86). All subjects underwent a rich neuropsychological assessment. We focused on baseline memory and executive function—derived from multiple neuropsychological tests using confirmatory factor analysis—, baseline preclinical Alzheimer’s cognitive composite 5 (PACC5) scores, and changes in PACC5 scores over the course of three years (ΔPACC5). Results: Subjects with hypertension or Aβ positivity presented the largest WMH volumes (pFDR < 0.05), with spatial overlap in the frontal (hypertension: 0.42 ± 0.17; Aβ: 0.46 ± 0.18), occipital (hypertension: 0.50 ± 0.16; Aβ: 0.50 ± 0.16), parietal lobes (hypertension: 0.57 ± 0.18; Aβ: 0.56 ± 0.20), corona radiata (hypertension: 0.45 ± 0.17; Aβ: 0.40 ± 0.13), optic radiation (hypertension: 0.39 ± 0.18; Aβ: 0.74 ± 0.19), and splenium of the corpus callosum (hypertension: 0.36 ± 0.12; Aβ: 0.28 ± 0.12). Elevated global and regional WMH volumes coincided with worse cognitive performance at baseline and over 3 years (pFDR < 0.05). Aβ positivity was negatively associated with cognitive performance (direct effect—memory: − 0.33 ± 0.08, pFDR < 0.001; executive: − 0.21 ± 0.08, pFDR < 0.001; PACC5: − 0.29 ± 0.09, pFDR = 0.006; ΔPACC5: − 0.34 ± 0.04, pFDR < 0.05). Splenial WMH mediated the relationship between hypertension and cognitive performance (indirect-only effect—memory: − 0.05 ± 0.02, pFDR = 0.029; executive: − 0.04 ± 0.02, pFDR = 0.067; PACC5: − 0.05 ± 0.02, pFDR = 0.030; ΔPACC5: − 0.09 ± 0.03, pFDR = 0.043) and WMH in the optic radiation partially mediated that between Aβ positivity and memory (indirect effect—memory: − 0.05 ± 0.02, pFDR = 0.029). Conclusions: Posterior white matter is susceptible to hypertension and Aβ accumulation. Posterior WMH mediate the association between these pathologies and cognitive dysfunction, making them a promising target to tackle the downstream damage related to the potentially interacting and potentiating effects of the two pathologies. Trial registration: German Clinical Trials Register (DRKS00007966, 04/05/2015)

Arterial hypertension and β-amyloid accumulation have spatially overlapping effects on posterior white matter hyperintensity volume: a cross-sectional study

Background White matter hyperintensities (WMH) in subjects across the Alzheimer’s disease (AD) spectrum with minimal vascular pathology suggests that amyloid pathology—not just arterial hypertension—impacts WMH, which in turn adversely influences cognition. Here we seek to determine the effect of both hypertension and Aβ positivity on WMH, and their impact on cognition. Methods We analysed data from subjects with a low vascular profile and normal cognition (NC), subjective cognitive decline (SCD), and amnestic mild cognitive impairment (MCI) enrolled in the ongoing observational multicentre DZNE Longitudinal Cognitive Impairment and Dementia Study (n = 375, median age 70.0 [IQR 66.0, 74.4] years; 178 female; NC/SCD/MCI 127/162/86). All subjects underwent a rich neuropsychological assessment. We focused on baseline memory and executive function—derived from multiple neuropsychological tests using confirmatory factor analysis—, baseline preclinical Alzheimer’s cognitive composite 5 (PACC5) scores, and changes in PACC5 scores over the course of three years (ΔPACC5). Results Subjects with hypertension or Aβ positivity presented the largest WMH volumes (pFDR < 0.05), with spatial overlap in the frontal (hypertension: 0.42 ± 0.17; Aβ: 0.46 ± 0.18), occipital (hypertension: 0.50 ± 0.16; Aβ: 0.50 ± 0.16), parietal lobes (hypertension: 0.57 ± 0.18; Aβ: 0.56 ± 0.20), corona radiata (hypertension: 0.45 ± 0.17; Aβ: 0.40 ± 0.13), optic radiation (hypertension: 0.39 ± 0.18; Aβ: 0.74 ± 0.19), and splenium of the corpus callosum (hypertension: 0.36 ± 0.12; Aβ: 0.28 ± 0.12). Elevated global and regional WMH volumes coincided with worse cognitive performance at baseline and over 3 years (pFDR < 0.05). Aβ positivity was negatively associated with cognitive performance (direct effect—memory: − 0.33 ± 0.08, pFDR < 0.001; executive: − 0.21 ± 0.08, pFDR < 0.001; PACC5: − 0.29 ± 0.09, pFDR = 0.006; ΔPACC5: − 0.34 ± 0.04, pFDR < 0.05). Splenial WMH mediated the relationship between hypertension and cognitive performance (indirect-only effect—memory: − 0.05 ± 0.02, pFDR = 0.029; executive: − 0.04 ± 0.02, pFDR = 0.067; PACC5: − 0.05 ± 0.02, pFDR = 0.030; ΔPACC5: − 0.09 ± 0.03, pFDR = 0.043) and WMH in the optic radiation partially mediated that between Aβ positivity and memory (indirect effect—memory: − 0.05 ± 0.02, pFDR = 0.029). Conclusions Posterior white matter is susceptible to hypertension and Aβ accumulation. Posterior WMH mediate the association between these pathologies and cognitive dysfunction, making them a promising target to tackle the downstream damage related to the potentially interacting and potentiating effects of the two pathologies. Trial registration German Clinical Trials Register (DRKS00007966, 04/05/2015)