Survey of CT radiation doses and iodinated contrast medium administration: an international multicentric study

ObjectiveTo assess the relationship between intravenous iodinated contrast media (ICM) administration usage and radiation doses for contrast-enhanced (CE) CT of head, chest, and abdomen-pelvis (AP) in international, multicenter settings. MethodsOur international (n = 16 countries), multicenter (n = 43 sites), and cross-sectional (ConRad) study had two parts. Part 1: Redcap survey with questions on information related to CT and ICM manufacturer/brand and respective protocols. Part 2: Information on 3,258 patients (18-96 years; M:F 1654:1604) who underwent CECT for a routine head (n = 456), chest (n = 528), AP (n = 599), head CT angiography (n = 539), pulmonary embolism (n = 599), and liver CT examinations (n = 537) at 43 sites across five continents. The following information was recorded: hospital name, patient age, gender, body mass index [BMI], clinical indications, scan parameters (number of scan phases, kV), IV-contrast information (concentration, volume, flow rate, and delay), and dose indices (CTDIvol and DLP). ResultsMost routine chest (58.4%) and AP (68.7%) CECT exams were performed with 2-4 scan phases with fixed scan delay (chest 71.4%; AP 79.8%, liver CECT 50.7%) following ICM administration. Most sites did not change kV across different patients and scan phases; most CECT protocols were performed at 120-140 kV (83%, 1979/2685). There were no significant differences between radiation doses for non-contrast (CTDIvol 24 [16-30] mGy; DLP 633 [414-702] mGycm) and post-contrast phases (22 [19-27] mGy; 648 [392-694] mGycm) (p = 0.142). Sites that used bolus tracking for chest and AP CECT had lower CTDIvol than sites with fixed scan delays (p < 0.001). There was no correlation between BMI and CTDIvol (r2 <= - 0.1 to 0.1, p = 0.931). ConclusionOur study demonstrates up to ten-fold variability in ICM injection protocols and radiation doses across different CT protocols. The study emphasizes the need for optimizing CT scanning and contrast protocols to reduce unnecessary contrast and radiation exposure to patients. Clinical relevance statementThe wide variability and lack of standardization of ICM media and radiation doses in CT protocols suggest the need for education and optimization of contrast usage and scan factors for optimizing image quality in CECT

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Stabilization of hollow Gaussian beams in nonlinear metamaterial waveguides

Hollow Gaussian beams which possess the dark hollow spatial intensity distribution were found to have interesting applications in trapping nano-sized particles and free-space optical communication. Many applications demand stable dynamics of higher dimensional beams. Here we theoretically study the dynamics of hollow Gaussian beams in cubic and quintic nonlinear negative index metamaterial. We adopt Lagrangian variational analysis and explore the parametric regions characterizing the metamaterial in which the hollow Gaussian beam can execute stable dynamics as well as it can undergo filamentation due to intrinsic collapse. We confirm the analytical results obtained through variational analysis by direct numerical analysis based Crank Nicolson method implemented in Python programming

Metabolomic profiling and antidiabetic potential of Rumex vesicarius seed extract in high-fat diet and streptozotocin-induced diabeticrat

Rumex vesicarius&nbsp;hasbeen extensively used for the management of diabetes in the traditional system of medicine. The current study was designed to investigate antidiabetic and antihyperlipidemic effects of&nbsp;R.vesicarius&nbsp;and also to explore metabolomic profiling using UPLC-QTOF-MS. The effect of extracts was observed by checking the biochemical and histopathological parameters in diabetic rats. The results had shown a significant dose- dependent inhibition potential of aqueous extract of&nbsp;R. vesicarius&nbsp;seed against α-amylase and α-glucosidase along with significant inhibition in DPPH free-radical scavenging activity. Oral administration of&nbsp;R. vesicarius&nbsp;to diabetic rats significantly (&nbsp;p&lt; 0.05) ameliorated blood glucose level. It also improved the function of the liver and kidney as well as ameliorated dyslipidemia in diabetic rats. Histopathological examination of the treatment groups reversed the damage of the pancreas, liver, and kidney tissues confirming the antidiabetic efficacy of&nbsp;R. vesicarius. UPLC- QTOF-MS analysis of the extract revealed a total of 42 bioactive compounds, which might contribute to the antidiabetic activity. Based on our findings, we can conclude that&nbsp;R. vesicarius&nbsp;might be a promising candidate for the management of diabetes

Metabolomic profiling and antidiabetic potential of Rumex vesicarius seed extract in high-fat diet and streptozotocin-induced diabeticrat

Abstract Rumex vesicarius hasbeen extensively used for the management of diabetes in the traditional system of medicine. The current study was designed to investigate antidiabetic and antihyperlipidemic effects of R.vesicarius and also to explore metabolomic profiling using UPLC-QTOF-MS. The effect of extracts was observed by checking the biochemical and histopathological parameters in diabetic rats. The results had shown a significant dose- dependent inhibition potential of aqueous extract of R. vesicarius seed against α-amylase and α-glucosidase along with significant inhibition in DPPH free-radical scavenging activity. Oral administration of R. vesicarius to diabetic rats significantly ( p< 0.05) ameliorated blood glucose level. It also improved the function of the liver and kidney as well as ameliorated dyslipidemia in diabetic rats. Histopathological examination of the treatment groups reversed the damage of the pancreas, liver, and kidney tissues confirming the antidiabetic efficacy of R. vesicarius. UPLC- QTOF-MS analysis of the extract revealed a total of 42 bioactive compounds, which might contribute to the antidiabetic activity. Based on our findings, we can conclude that R. vesicarius might be a promising candidate for the management of diabetes

HybridSPE: A novel technique to reduce phospholipid-based matrix effect in LC-ESI-MS Bioanalysis

When complex biological materials are analyzed without an adequate sample preparation technique, MS signal and response undergo significant alteration and result in poor quantification and assay. This problem generally takes place due to the presence of several endogenous materials component in samples. One of the major causes of ion suppression in bioanalysis is the presence of phospholipids during LC-MS analysis. The phospholipid-based matrix effect was investigated with a commercially available electro spray ionization (ESI) source coupled with a triple quadrupole mass spectrometer. HybridSPE dramatically reduced the levels of residual phospholipids in biological samples, leading to significant reduction in matrix effects. This new procedure that combines the simplicity of precipitation with the selectivity of SPE allows obtaining much cleaner extracts than with conventional procedures. HybridSPE-precipitation procedure provides significant improvement in bioanalysis and a practical and fast way to ensure the avoidance of phospholipids-based matrix effects. The present review outlines the HybridSPE technique to minimize phospholipids-based matrix effects on LC-ESI-MS bioanalysis

Fabrication and Characterization of Acute Myocardial Infarction Myoglobin Biomarker Based on Chromium-Doped Zinc Oxide Nanoparticles

In this article, we describe the fabrication and characterization of a sensor for acute myocardial infarction that detects myoglobin biomarkers using chromium (Cr)-doped zinc oxide (ZnO) nanoparticles (NPs). Pure and Cr-doped ZnO NPs (13 &times; 1017, 20 &times; 1017, and 32 &times; 1017 atoms/cm3 in the solid phase) were synthesized by a facile low-temperature sol-gel method. Synthesized NPs were examined for structure and morphological analysis using various techniques to confirm the successful formation of ZnO NPs. Zeta potential was measured in LB media at a negative value and increased with doping. XPS spectra confirmed the presence of oxygen deficiency in the synthesized material. To fabricate the sensor, synthesized NPs were screen-printed over a pre-fabricated gold-coated working electrode for electrochemical detection of myoglobin (Mb). Cr-doped ZnO NPs doped with 13 &times; 1017 Cr atomic/cm3 revealed the highest sensitivity of ~37.97 &mu;A.cm&minus;2nM&minus;1 and limit of detection (LOD) of 0.15 nM for Mb with a response time of &le;10 ms. The interference study was carried out with cytochrome c (Cyt-c) due to its resemblance with Mb and human serum albumin (HSA) abundance in the blood and displayed distinct oxidation potential and current values for Mb. Cr-doped ZnO NP-based Mb biosensors showed 3 times higher sensitivity as compared to pure ZnO NP-based sensors

Label-Free Myoglobin Biosensor Based on Pure and Copper-Doped Titanium Dioxide Nanomaterials

In this study, using pure and copper-doped titanium dioxide (Cu-TiO2) nanostructures as the base matrix, enzyme-less label free myoglobin detection to identify acute myocardial infarction was performed and presented. The Cu-TiO2 nanomaterials were prepared using facile sol&ndash;gel method. In order to comprehend the morphologies, compositions, structural, optical, and electrochemical characteristics, the pure and Cu-TiO2 nanomaterials were investigated by several techniques which clearly revealed good crystallinity and high purity. To fabricate the enzyme-less label free biosensor, thick films of synthesized nanomaterials were applied to the surface of a pre-fabricated gold screen-printed electrode (Au-SPE), which serves as a working electrode to construct the myoglobin (Mb) biosensors. The interference study of the fabricated biosensor was also carried out with human serum albumin (HSA) and cytochrome c (cyt-c). Interestingly, the Cu-doped TiO2 nanomaterial-based Mb biosensor displayed a higher sensitivity of 61.51 &micro;Acm&minus;2/nM and a lower detection limit of 14 pM with a response time of less than 10 ms

Label-Free Electrochemical Sensor Based on Manganese Doped Titanium Dioxide Nanoparticles for Myoglobin Detection: Biomarker for Acute Myocardial Infarction

A label free electrochemical sensor based on pure titanium oxide and manganese (Mn)-doped titanium oxide (TiO2) nanoparticles are fabricated and characterized for the sensitive detection of myoglobin (Mb) levels to analyze the cardiovascular infarction. Pristine and Mn-doped TiO2 nanoparticles were synthesized via the sol-gel method and characterized in order to understand their structure, morphologies, composition and optical properties. The structural properties revealed that the pure- and doped-TiO2 nanoparticles possess different TiO2 planes. FTIR studies confirm the formation of metal oxide nanoparticles by exhibiting a well-defined peak in the range of 600–650 cm−1. The values of the optical band gap, estimated from UV-Vis spectroscopy, are decreased for the Mn-doped TiO2 nanoparticles. UV-Vis spectra in the presence of myoglobin (Mb) indicated interaction between the TiO2 nanoparticles and myoglobin. The SPE electrodes were then fabricated by printing powder film over the working electrode and tested for label-free electrochemical detection of myoglobin (Mb) in the concentration range of 0–15 nM Mb. The fabricated electrochemical sensor exhibited a high sensitivity of 100.40 μA-cm−2/nM with a lowest detection limit of 0.013 nM (0.22 ng/mL) and a response time of ≤10 ms for sample S3. An interference study with cyt-c and Human Serum Albumin (HSA) of the sensors show the selective response towards Mb in 1:1 mixture