Flow characteristics of the proximal pulmonary arteries and vena cava in patients with chronic thromboembolic pulmonary hypertension: correlation between 3.0 T phase-contrast MRI and right heart catheterization

PURPOSEWe aimed to determine the correlation between flow characteristics of the proximal pulmonary arteries and vena cava obtained by 3.0 T phase-contrast magnetic resonance imaging (MRI) and hemodynamic characteristics by right heart catheterization in patients with chronic thromboembolic pulmonary hypertension.MATERIALS AND METHODSTwenty consecutive patients with chronic thromboembolic pulmonary hypertension and 20 sex- and age-matched healthy volunteers were included prospectively. All patients and controls underwent phase-contrast MRI to determine the flow characteristics including peak velocity, mean velocity, and mean blood flow of the proximal pulmonary artery and vena cava. All patients underwent right heart catheterization to determine the hemodynamics.RESULTSPeak velocity and mean velocity of the proximal pulmonary artery were significantly lower in the patient group. In patients, both peak velocity and mean blood flow were sequentially decreased in the main pulmonary artery, left and right pulmonary arteries, and left and right interlobar pulmonary arteries. Inferior vena cava had higher peak velocity, mean velocity, and mean blood flow than superior vena cava. Peak velocity of the main pulmonary artery correlated with mean and diastolic pulmonary artery pressure. Peak velocity of both inferior and superior vena cava strongly correlated with the pulmonary vascular resistance index (PVRI) (r=-0.68, P < 0.001 and r=-0.74, P < 0.001, respectively). Mean velocity of the main pulmonary artery and right pulmonary artery strongly correlated with PVRI and mean pulmonary artery pressure. Mean velocity of the superior vena cava and mean blood flow of the main pulmonary artery strongly correlated with PVRI and right cardiac work index.CONCLUSIONBlood flow in the proximal pulmonary artery and vena cava evaluated by phase-contrast MRI correlate with hemodynamic parameters of right heart catheterization and can be used to noninvasively evaluate the severity of chronic thromboembolic pulmonary hypertension and, potentially, to follow up the treatment response

CT−based radiomics signature for differentiating pyelocaliceal upper urinary tract urothelial carcinoma from infiltrative renal cell carcinoma

ObjectivesTo develop a CT-based radiomics model and a combined model for preoperatively discriminating infiltrative renal cell carcinoma (RCC) and pyelocaliceal upper urinary tract urothelial carcinoma (UTUC), which invades the renal parenchyma.Materials and methodsEighty patients (37 pathologically proven infiltrative RCCs and 43 pathologically proven pyelocaliceal UTUCs) were retrospectively enrolled and randomly divided into a training set (n = 56) and a testing set (n = 24) at a ratio of 7:3. Traditional CT imaging characteristics in the portal venous phase were collected by two radiologists (SPH and ZXL, who have 4 and 30 years of experience in abdominal radiology, respectively). Patient demographics and traditional CT imaging characteristics were used to construct the clinical model. The radiomics score was calculated based on the radiomics features extracted from the portal venous CT images and the random forest (RF) algorithm to construct the radiomics model. The combined model was constructed using the radiomics score and significant clinical factors according to the multivariate logistic regression. The diagnostic efficacy of the models was evaluated using receiver operating characteristic (ROC) curve analysis and the area under the curve (AUC).ResultsThe RF score based on the eight validated features extracted from the portal venous CT images was used to build the radiomics model. Painless hematuria as an independent risk factor was used to build the clinical model. The combined model was constructed using the RF score and the selected clinical factor. Both the radiomics model and combined model showed higher efficacy in differentiating infiltrative RCC and pyelocaliceal UTUC in the training and testing cohorts with AUC values of 0.95 and 0.90, respectively, for the radiomics model and 0.99 and 0.90, respectively, for the combined model. The decision curves of the combined model as well as the radiomics model indicated an overall net benefit over the clinical model. Both the radiomics model and the combined model achieved a notable reduction in false-positive and false-negativerates, resulting in significantly higher accuracy compared to the visual assessments in both the training and testing cohorts.ConclusionThe radiomics model and combined model had the potential to accurately differentiate infiltrative RCC and pyelocaliceal UTUC, which invades the renal parenchyma, and provide a new potentially non-invasive method to guide surgery strategies

Investigation into a Lightweight Polymeric Porous Sponge with High Magnetic Field and Strain Sensitivity

Recently, flexible sensors have gained significant attention due to their potential applications in soft robotics and biomimetic intelligent devices. However, the successful production of favorable flexible sensors integrated with high flexibility, sensitivity and excellent environment adaptability toward multiple external stimuli is still an enormous challenge. Herein, a lightweight polymeric porous sponge capable of detecting an external magnetic field and strain excitations is proposed by assembling a sodium alginate/chitosan (SA/CHI) porous sponge with micron carbonyl iron and nanoscale Fe3O4 magnetic particles (MPs). Based on the double network structure, the SA/CHI sponge possesses preferable mechanical strength and hydrophilicity, demonstrating its high flexibility and deformability. More importantly, the electrical response of the SA/CHI sponge sensors can display remarkable variation under external magnetic and mechanical stimuli due to their superior magnetic characteristics and electrical conductivity. Meanwhile, their sensing properties can maintain relatively stable recoverability and repeatability towards the periodic excitations and releases. Additionally, a potential mechanism is provided to investigate their stimuli-sensitive behavior. It is highly dependent on the microstructure variations in MPs and conductive multi-walled carbon nanotube (MWCNTs) networks. Due to its exceptional magnetic controllability and appropriate electrical sensitivity, the proposed sensor shows high potential in wearable multi-sensing electronics and intelligent transport devices

Mild encephalitis/encephalopathy with reversible splenial lesion (MERS) in adults-a case report and literature review

Abstract Background Mild encephalitis/encephalopathy with reversible splenial lesion (MERS) is a rare clinico-radiological entity characterized by the magnetic resonance imaging (MRI) finding of a reversible lesion in the corpus callosum, sometimes involved the symmetrical white matters. Many cases of child-onset MERS with various causes have been reported. However, adult-onset MERS is relatively rare. The clinical characteristics and pathophysiologiccal mechanisms of adult-onset MERS are not well understood. We reviewed the literature on adult-onset MERS in order to describe the characteristics of MERS in adults and to provide experiences for clinician. Methods We reported a case of adult-onset MERS with acute urinary retension and performed literature search from PubMed and web of science databases to identify other adult-onset MERS reports from Januarary 2004 to March 2016. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed on selection process. And then we summarized the clinico-radiological features of adult-onset MERS. Results Twenty-nine adult-onset MERS cases were reviewed from available literature including the case we have. 86.2% of the cases (25/29) were reported in Asia, especially in Japan. Ages varied between 18 and 59 years old with a 12:17 female-to-male ratio. The major cause was infection by virus or bacteria. Fever and headache were the most common clinical manifestation, and acute urinary retention was observed in 6 patients. All patients recovered completely within a month. Conclusion Adult-onset MERS is an entity with a broad clinico-radiological spectrum because of the various diseases and conditions. There are similar characteristics between MERS in adults and children, also some differences

Flow characteristics of the proximal pulmonary arteries and vena cava in patients with chronic thromboembolic pulmonary hypertension: correlation between 3.0 T phase-contrast MRI and right heart catheterization

As nurses deal with these changes in the health care system, they are also called upon to respond to changes related to tecnologic and scientilic advances in health care.xxxi, 584 hlm.: ilus.; 27 c

Eco-Friendly Flame-Retardant Phase-Change Composite Films Based on Polyphosphazene/Phosphorene Hybrid Foam and Paraffin Wax for Light/Heat-Dual-Actuated Shape Memory

Multiactuated shape memory materials are a class of promising intelligent materials that have received great interest in the fields of self-healing, anticounterfeiting, biomedical, soft robotic, and smart thermal management applications. To obtain a light/heat-dual-actuated shape memory material for thermal management applications in fire safety, we have designed a type of halogen-free flame-retardant phase-change composite film based on polyaryloxyphosphazene (PDAP)/phosphorene (PR) hybrid foam as a support material and paraffin wax (PW) as a phase-change material (PCM). PDAP was synthesized as a flexible foam matrix through the ring-opening polymerization of hexachlorocyclotriphosphazene, followed by a substitution reaction of aryloxy groups. The porosity of the PDAP foam is improved by introducing PR nanosheets, facilitating a high latent heat capacity of the PDAP–PR/PW composite films for thermal management applications. The PDAP–PR/PW composite films can implement rapid shape recovery within 65 s in the heating process, which is much shorter than that of the corresponding film without PR nanosheets (185 s). Furthermore, the PDAP–PR/PW composite films also exhibit light-actuated shape memory behavior thanks to their good solar-to-thermal energy absorption and conversion contributed by PR nanosheets as a highly effective photothermal material. More importantly, the presence of PR nanosheets imparts an excellent flame-retardant property to the PDAP–PR/PW composite films. The PDAP–PR/PW composite film can be self-extinguished within 2 s after the flame. Through an innovative integration of flexible polyphosphazene foam, PR nanosheets, and solid–liquid PCM to obtain a sensitive actuating response to light and heat, this study offers a new approach for developing multiactuated and eco-friendly flame-retardant shape memory materials to meet the requirement of applications with a requirement of fire safety in soft actuators, thermal therapy, control devices, and so on

Eco-Friendly Flame-Retardant Phase-Change Composite Films Based on Polyphosphazene/Phosphorene Hybrid Foam and Paraffin Wax for Light/Heat-Dual-Actuated Shape Memory

Multiactuated shape memory materials are a class of promising intelligent materials that have received great interest in the fields of self-healing, anticounterfeiting, biomedical, soft robotic, and smart thermal management applications. To obtain a light/heat-dual-actuated shape memory material for thermal management applications in fire safety, we have designed a type of halogen-free flame-retardant phase-change composite film based on polyaryloxyphosphazene (PDAP)/phosphorene (PR) hybrid foam as a support material and paraffin wax (PW) as a phase-change material (PCM). PDAP was synthesized as a flexible foam matrix through the ring-opening polymerization of hexachlorocyclotriphosphazene, followed by a substitution reaction of aryloxy groups. The porosity of the PDAP foam is improved by introducing PR nanosheets, facilitating a high latent heat capacity of the PDAP–PR/PW composite films for thermal management applications. The PDAP–PR/PW composite films can implement rapid shape recovery within 65 s in the heating process, which is much shorter than that of the corresponding film without PR nanosheets (185 s). Furthermore, the PDAP–PR/PW composite films also exhibit light-actuated shape memory behavior thanks to their good solar-to-thermal energy absorption and conversion contributed by PR nanosheets as a highly effective photothermal material. More importantly, the presence of PR nanosheets imparts an excellent flame-retardant property to the PDAP–PR/PW composite films. The PDAP–PR/PW composite film can be self-extinguished within 2 s after the flame. Through an innovative integration of flexible polyphosphazene foam, PR nanosheets, and solid–liquid PCM to obtain a sensitive actuating response to light and heat, this study offers a new approach for developing multiactuated and eco-friendly flame-retardant shape memory materials to meet the requirement of applications with a requirement of fire safety in soft actuators, thermal therapy, control devices, and so on