Morphological and hemodynamical alterations in brachial artery and cephalic vein. An image‐based study for preoperative assessment for vascular access creation

The current study aims to computationally evaluate the effect of right upper arm position on the geometric and hemodynamic characteristics of the brachial artery (BA) and cephalic vein (CV) and, furthermore, to present in detail the methodology to characterise morphological and hemodynamical healthy vessels. Ten healthy volunteers were analysed in two configurations, the supine (S) and the prone (P) position. Lumen 3D surface models were constructed from images acquired from a non-contrast MRI sequence. Then, the models were used to numerically compute the physiological range of geometric (n = 10) and hemodynamic (n = 3) parameters in the BA and CV. Geometric parameters such as curvature and tortuosity, and hemodynamic parameters based on wall shear stress (WSS) metrics were calculated with the use of computational fluid dynamics. Our results highlight that changes in arm position had a greater impact on WSS metrics of the BA by altering the mean and maximum blood flow rate of the vessel. Whereas, curvature and tortuosity were found not to be significantly different between positions. Inter-variability was associated with antegrade and retrograde flow in BA, and antegrade flow in CV. Shear stress was low and oscillatory shear forces were negligible. This data suggests that deviations from this state may contribute to the risk of accelerated intimal hyperplasia of the vein in arteriovenous fistulas. Therefore, preoperative conditions coupled with post-operative longitudinal data will aid the identification of such relationships

A randomized controlled trial of dapagliflozin on left ventricular hypertrophy in people with type two diabetes:The DAPA-LVH Trial

AIM: We tested the hypothesis that dapagliflozin may regress left ventricular hypertrophy (LVH) in people with type 2 diabetes (T2D). METHODS AND RESULTS: We randomly assigned 66 people (mean age 67 ± 7 years, 38 males) with T2D, LVH, and controlled blood pressure (BP) to receive dapagliflozin 10 mg once daily or placebo for 12 months. Primary endpoint was change in absolute left ventricular mass (LVM), assessed by cardiac magnetic resonance imaging. In the intention-to-treat analysis, dapagliflozin significantly reduced LVM compared with placebo with an absolute mean change of −2.82g [95% confidence interval (CI): −5.13 to −0.51, P = 0.018]. Additional sensitivity analysis adjusting for baseline LVM, baseline BP, weight, and systolic BP change showed the LVM change to remain statistically significant (mean change −2.92g; 95% CI: −5.45 to −0.38, P = 0.025). Dapagliflozin significantly reduced pre-specified secondary endpoints including ambulatory 24-h systolic BP (P = 0.012), nocturnal systolic BP (P = 0.017), body weight (P < 0.001), visceral adipose tissue (VAT) (P < 0.001), subcutaneous adipose tissue (SCAT) (P = 0.001), insulin resistance, Homeostatic Model Assessment of Insulin Resistance (P = 0.017), and high-sensitivity C-reactive protein (hsCRP) (P = 0.049). CONCLUSION: Dapagliflozin treatment significantly reduced LVM in people with T2D and LVH. This reduction in LVM was accompanied by reductions in systolic BP, body weight, visceral and SCAT, insulin resistance, and hsCRP. The regression of LVM suggests dapagliflozin can initiate reverse remodelling and changes in left ventricular structure that may partly contribute to the cardio-protective effects of dapagliflozin. CLINICALTRIALS.GOV IDENTIFIER: NCT0295681

Radiomics approach to the detection of prostate cancer using multiparametric MRI:a validation study using prostate-cancer-tissue-mimicking phantoms

Over the last few years, a number of studies have quantified the role of radiomics, dynamic contrast enhancement and standard MRI (T2WI + DWI) in detecting prostate cancer; however, the aim of this paper was to assess the advantage of combining radiomics with other multiparametric magnetic resonance imaging (mpMRI) (T2-DWI-DCE) in improving the detection of prostate cancer. This study used 10 prostate-cancer-tissue-mimicking phantoms to obtain preclinical data. We then focused on 46 patients who underwent mpMRI and Transrectal Ultrasound (TRUS) guided biopsy between September 2016 and December 2017. The texture analysis parameters combined with the mpMRI and compared with the histopathology of TRUS biopsy have been assessed statistically by principal component analysis (PCA) and discriminant component analysis (DCA). The prediction model and goodness-of-fit were examined with the Akaike information criterion (AIC) and McFadden pseudo-R-squared. In the PCA, there was a higher separation between cancerous and noncancerous tissue in the preclinical compared with the clinical data. Both AIC and R2 showed an improvement in the model in cancer prediction by adding the radiomics to mpMRI. The discriminant analysis showed an accuracy of cancer prediction of 81% compared with 100% in the pre-clinical phantom data. Combining radiomics with mpMRI showed an improvement in prostate cancer prediction. The ex vivo experiments validated the findings of this study

An Alumni survey of the School of Social Work, Portland State University

The alumni survey conducted at Portland State University School of Social Work by second year students had two purposes. One purpose was to fulfill the research practicum requirements of a Masters of Social Work degree by providing experience in the area of applied survey research. The other was to provide a data base for future alumni research at the school

A RECENTLY DISCOVERED CACHE CAVE IN THE BACKCOUNTRY OF SANTA BARBARA COUNTY, CALIFORNIA

In February 2015, a cache cave was discovered in the remote backcountry of Santa Barbara County. An investigation of the cache was carried out by the authors. Three baskets, a cave stick, and cordage were identified from the cache, which was mapped using 3D scanning and photogrammetry. A decorated storage basket appears to be the largest known from the Chumash area. The implications of this cache, and its relationship to other nearby caches and rock art sites, are discussed