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Heart (British Cardiac Society) Jun 2024Marfan syndrome (MFS)-associated cardiomyopathy, defined as ventricular dilation and dysfunction unexplained by volume loading, is not well defined in children. This...
OBJECTIVE
Marfan syndrome (MFS)-associated cardiomyopathy, defined as ventricular dilation and dysfunction unexplained by volume loading, is not well defined in children. This study evaluated ventricular size and function in paediatric MFS using cardiac MRI (cMRI).
METHODS
This retrospective cohort study examined patients with MFS <19 years old at first cMRI. Left ventricular (LV) ejection fraction (EF) <55% was considered abnormal, as were z-scores >2. Combined mitral and aortic regurgitation indexed to LV stroke volume <20% defined absent/mild volume load. Biventricular volumes and EF on serial cMRI studies were compared with normative paediatric cMRI values, with measures converted to z-scores as appropriate. Longitudinal changes in volumes and EF were evaluated by mixed linear regression. Associations between ventricular, aortic and mitral characteristics were evaluated.
RESULTS
58 patients (60% male) were evaluated. Median age at initial cMRI was 13.6 years (IQR 10.0-15.8 years). Among patients with absent/mild LV volume load at initial cMRI (n=44, 76%), indexed LV end-diastolic volume (EDV) was significantly increased above normative values (median z-score 1.8, IQR 0.6-3.5, p<0.0001) and LVEF was abnormal in 48% (21/44). In the absence of volume loading, mitral valve prolapse (MVP) was associated with larger ventricular volumes and lower LVEF. Among those with serial cMRIs, LVEF and EDV z-scores did not significantly change over a mean follow-up time between cMRI studies of 1.5 years.
CONCLUSION
Ventricular dilation and reduced EF are common in children with MFS and occur with no/mild LV volume load, suggesting intrinsic cardiomyopathy. MVP may be associated with cardiomyopathy.
Topics: Humans; Marfan Syndrome; Male; Female; Retrospective Studies; Child; Adolescent; Stroke Volume; Ventricular Function, Left; Magnetic Resonance Imaging, Cine; Heart Ventricles; Cardiomyopathies; Ventricular Dysfunction, Left
PubMed: 38816063
DOI: 10.1136/heartjnl-2024-323922 -
International Journal of Radiation... Mar 2024We sought to systematically review and summarize dosimetric factors associated with radiation-induced brachial plexopathy (RIBP) after stereotactic body radiation... (Review)
Review
We sought to systematically review and summarize dosimetric factors associated with radiation-induced brachial plexopathy (RIBP) after stereotactic body radiation therapy (SBRT) or hypofractionated image guided radiation therapy (HIGRT). From published studies identified from searches of PubMed and Embase databases, data quantifying risks of RIBP after 1- to 10-fraction SBRT/HIGRT were extracted and summarized. Published studies have reported <10% risks of RIBP with maximum doses (D) to the inferior aspect of the brachial plexus of 32 Gy in 5 fractions and 25 Gy in 3 fractions. For 10-fraction HIGRT, risks of RIBP appear to be low with D < 40 to 50 Gy. For a given dose value, greater risks are anticipated with point volume-based metrics (ie, D: minimum dose to hottest 0.03-0.035 cc) versus D. With SBRT/HIGRT, there were insufficient published data to predict risks of RIBP relative to brachial plexus dose-volume exposure. Minimizing maximum doses and possibly volume exposure of the brachial plexus can reduce risks of RIBP after SBRT/HIGRT. Further study is needed to better understand the effect of volume exposure on the brachial plexus and whether there are location-specific susceptibilities along or within the brachial plexus structure.
Topics: Humans; Radiosurgery; Brachial Plexus; Brachial Plexus Neuropathies; Radiometry; Radiation Injuries
PubMed: 36682981
DOI: 10.1016/j.ijrobp.2022.11.012 -
Lung Cancer (Amsterdam, Netherlands) Mar 2024Post-therapy pneumonitis (PTP) is a relevant side effect of thoracic radiotherapy and immunotherapy with checkpoint inhibitors (ICI). The influence of the combination of...
OBJECTIVES
Post-therapy pneumonitis (PTP) is a relevant side effect of thoracic radiotherapy and immunotherapy with checkpoint inhibitors (ICI). The influence of the combination of both, including dose fractionation schemes on PTP development is still unclear. This study aims to improve the PTP risk estimation after radio(chemo)therapy (R(C)T) for lung cancer with and without ICI by investigation of the impact of dose fractionation on machine learning (ML)-based prediction.
MATERIALS AND METHODS
Data from 100 patients who received fractionated R(C)T were collected. 39 patients received additional ICI therapy. Computed Tomography (CT), RT segmentation and dose data were extracted and physical doses were converted to 2-Gy equivalent doses (EQD2) to account for different fractionation schemes. Features were reduced using Pearson intercorrelation and the Boruta algorithm within 1000-fold bootstrapping. Six single (clinics, Dose Volume Histogram (DVH), ICI, chemotherapy, radiomics, dosiomics) and four combined models (radiomics + dosiomics, radiomics + DVH + Clinics, dosiomics + DVH + Clinics, radiomics + dosiomics + DVH + Clinics) were trained to predict PTP. Dose-based models were tested using physical dose and EQD2. Four ML-algorithms (random forest (rf), logistic elastic net regression, support vector machine, logitBoost) were trained and tested using 5-fold nested cross validation and Synthetic Minority Oversampling Technique (SMOTE) for resampling in R. Prediction was evaluated using the area under the receiver operating characteristic curve (AUC) on the test sets of the outer folds.
RESULTS
The combined model of all features using EQD2 surpassed all other models (AUC = 0.77, Confidence Interval CI 0.76-0.78). DVH, clinical data and ICI therapy had minor impact on PTP prediction with AUC values between 0.42 and 0.57. All EQD2-based models outperformed models based on physical dose.
CONCLUSIONS
Radiomics + dosiomics based ML models combined with clinical and dosimetric models were found to be suited best for PTP prediction after R(C)T and could improve pre-treatment decision making. Different RT dose fractionation schemes should be considered for dose-based ML approaches.
Topics: Humans; Immune Checkpoint Inhibitors; Radiomics; Lung Neoplasms; Radiation Oncology; Pneumonia
PubMed: 38394745
DOI: 10.1016/j.lungcan.2024.107507 -
European Journal of Radiology Feb 2024To investigate the feasibility of dual-energy CT (DECT)-derived extracellular volume (ECV) fraction for characterization of breast tumors, compared to apparent diffusion...
PURPOSE
To investigate the feasibility of dual-energy CT (DECT)-derived extracellular volume (ECV) fraction for characterization of breast tumors, compared to apparent diffusion coefficient (ADC) and validated against histopathological findings.
MATERIAL AND METHODS
The ECV fraction and ADC were prospectively assessed in patients with breast tumors using chest DECT and breast MRI. The diagnostic performance of ECV fraction and ADC was accessed in predicting breast histopathological subtypes and pathological complete response (pCR) status. Histopathological sections were analyzed by digital image analysis. Pearson's correlation analysis was used to correlate between DECT and histopathological ECV fractions.
RESULTS
This study included 271 patients, with 314 breast lesions (61 benign and 253 malignant). The ECV fraction and ADC showed comparable area under the curve (AUC) for distinguishing benign from malignant lesions (p = 0.123) and invasive carcinoma from ductal carcinoma in situ (p = 0.115). There were significant differences in ECV fraction between different hormone receptors and Ki67 states (p = 0.001 ∼ 0.014), while ADC values only differed among various Ki67 states (p < 0.001). The ECV fraction was lower (p = 0.007), ADC was higher (p = 0.013) in pCR than in non-pCR group, with an AUC of 0.748 and 0.730 (p = 0.887), respectively. There was a positive correlation between DECT and histopathological ECV fractions (r = 0.615, p < 0.01).
CONCLUSIONS
Routine chest DECT-derived ECV fraction is a viable quantitative imaging biomarker for predicting histopathological subtypes and pCR in patient with breast tumors, and correlated well with histopathology finding.
Topics: Humans; Female; Ki-67 Antigen; Diffusion Magnetic Resonance Imaging; Breast; Carcinoma, Intraductal, Noninfiltrating; Breast Neoplasms
PubMed: 38159522
DOI: 10.1016/j.ejrad.2023.111268 -
International Journal of Radiation... Jun 2024Reirradiation is increasingly used in children and adolescents/young adults (AYA) with recurrent primary central nervous system tumors. The Pediatric Normal Tissue... (Review)
Review
PURPOSE
Reirradiation is increasingly used in children and adolescents/young adults (AYA) with recurrent primary central nervous system tumors. The Pediatric Normal Tissue Effects in the Clinic (PENTEC) reirradiation task force aimed to quantify risks of brain and brain stem necrosis after reirradiation.
METHODS AND MATERIALS
A systematic literature search using the PubMed and Cochrane databases for peer-reviewed articles from 1975 to 2021 identified 92 studies on reirradiation for recurrent tumors in children/AYA. Seventeen studies representing 449 patients who reported brain and brain stem necrosis after reirradiation contained sufficient data for analysis. While all 17 studies described techniques and doses used for reirradiation, they lacked essential details on clinically significant dose-volume metrics necessary for dose-response modeling on late effects. We, therefore, estimated incidences of necrosis with an exact 95% CI and qualitatively described data. Results from multiple studies were pooled by taking the weighted average of the reported crude rates from individual studies.
RESULTS
Treated cancers included ependymoma (n = 279 patients; 7 studies), medulloblastoma (n = 98 patients; 6 studies), any CNS tumors (n = 62 patients; 3 studies), and supratentorial high-grade gliomas (n = 10 patients; 1 study). The median interval between initial and reirradiation was 2.3 years (range, 1.2-4.75 years). The median cumulative prescription dose in equivalent dose in 2-Gy fractions (EQD2; assuming α/β value = 2 Gy) was 103.8 Gy (range, 55.8-141.3 Gy). Among 449 reirradiated children/AYA, 22 (4.9%; 95% CI, 3.1%-7.3%) developed brain necrosis and 14 (3.1%; 95% CI, 1.7%-5.2%) developed brain stem necrosis with a weighted median follow-up of 1.6 years (range, 0.5-7.4 years). The median cumulative prescription EQD2 was 111.4 Gy (range, 55.8-141.3 Gy) for development of any necrosis, 107.7 Gy (range, 55.8-141.3 Gy) for brain necrosis, and 112.1 Gy (range, 100.2-117 Gy) for brain stem necrosis. The median latent period between reirradiation and the development of necrosis was 5.7 months (range, 4.3-24 months). Though there were more events among children/AYA undergoing hypofractionated versus conventionally fractionated reirradiation, the differences were not statistically significant (P = .46).
CONCLUSIONS
Existing reports suggest that in children/AYA with recurrent brain tumors, reirradiation with a total EQD2 of about 112 Gy is associated with an approximate 5% to 7% incidence of brain/brain stem necrosis after a median follow-up of 1.6 years (with the initial course of radiation therapy being given with conventional prescription doses of ≤2 Gy per fraction and the second course with variable fractionations). We recommend a uniform approach for reporting dosimetric endpoints to derive robust predictive models of late toxicities following reirradiation.
Topics: Humans; Re-Irradiation; Necrosis; Child; Neoplasm Recurrence, Local; Central Nervous System Neoplasms; Adolescent; Brain; Brain Stem; Ependymoma; Young Adult; Child, Preschool; Medulloblastoma; Radiation Injuries
PubMed: 38300187
DOI: 10.1016/j.ijrobp.2023.12.043 -
Analytica Chimica Acta Oct 2023Here, it has been discussed about creating a specific and sustainable analytical technique for monitoring anti-diabetic drugs in order to accurately determine the dosage...
A green QuEChERS syringe filter based micro-solid phase extraction using hydrophobic natural deep eutectic solvent as immobilized sorbent for simultaneous analysis of five anti-diabetic drugs by HPLC-UV.
BACKGROUND
Here, it has been discussed about creating a specific and sustainable analytical technique for monitoring anti-diabetic drugs in order to accurately determine the dosage in patients and reduce side effects, remove them from wastewater (as emerging contaminants), and ultimately abate pharmaceutical pollutants in the environment.
RESULTS
In this research, a green and reproducible Quick Easy Cheap Effective Rugged Safe (QuEChERS) method based on syringe filter based micro-solid phase extraction (SF-μSPE) coupled with HPLC-UV using a green sorbent was developed and optimized for the extraction of five anti-diabetic drugs from wastewater, serum, and plasma real samples. A novel green sorbent composed of a liquid mixture of thymol: menthol ([Thy]:[Men], 1:1) hydrophobic natural deep eutectic solvent (HNADES) and curcumin (Cur) immobilized into the non-toxic and biodegradable polyvinyl alcohol (PVA) electrospun nanofibers' mat was synthesized simply via cheap equipment. Cur was added to enhance the hydrophobicity and functionality of the sorbent. The immobilization process was performed by soaking the mat in the liquid mixture for a specific duration. The correct synthesis and experimental molar ratio of the HNADES components were confirmed by ATR-FTIR and NMR (H and C) spectroscopy. The prepared green sorbent (Cur-HNADES/PVA) was characterized using ATR-FTIR, FE-SEM, EDX/EDX mapping analysis, and water contact angle (WCA) measurement, and it exhibited satisfactory adsorption capacity for the target analytes.
SIGNIFICANCE
Under optimal conditions (pH = 6.0, adsorption cycle = 3, sample volume = 5.0 mL, desorption cycle = 1, type and volume of elution = 80:20 %v/v MeOH/ACN and 500.0 μL), the method was validated in terms of specificity, linear dynamic ranges (LDRs = 0.1-2000.0 μg L and 0.1-1800.0 μg L), limits of detection (LODs = 0.03-0.09 μg L), and precision (within-day RSDs% = 0.32-1.45% and between-day RSDs% = 0.59-2.03%). Evaluation of the greenness aspects of the proposed method was accomplished using the Green Analytical Procedure Index (GAPI) and Analytical GREEnness (AGREE) approaches. It is noteworthy that the conducted research represents the first report of the synthesis and application of this novel and green sorbent for the determination of anti-diabetic drugs in the mentioned real samples.
Topics: Humans; Solvents; Deep Eutectic Solvents; Chromatography, High Pressure Liquid; Wastewater; Solid Phase Extraction; Hydrophobic and Hydrophilic Interactions; Limit of Detection
PubMed: 37827666
DOI: 10.1016/j.aca.2023.341765 -
Quantitative Imaging in Medicine and... Oct 2023Left ventricular (LV) rotational mechanics play a crucial role in LV pump function by strengthening and improving its efficacy. Dependence of LV rotational parameters on...
Left ventricular rotational mechanics and left ventricular volumes: is there a relationship in healthy adults?-three-dimensional speckle-tracking echocardiography-derived insights from the MAGYAR-Healthy Study.
BACKGROUND
Left ventricular (LV) rotational mechanics play a crucial role in LV pump function by strengthening and improving its efficacy. Dependence of LV rotational parameters on left atrial volumes has already been demonstrated. The evaluation of the effect of LV rotational mechanics on LV volumes was purposed in a population of healthy subjects by three-dimensional speckle-tracking echocardiography (STE).
METHODS
The study comprised 175 healthy subjects with a mean age of 32.8±12.2 years (79 males). All subjects underwent a complete physical examination, laboratory assessments, standard 12-lead electrocardiography and two-dimensional Doppler and three-dimensional STE, the results of these examinations were within the normal range.
RESULTS
Increased basal LV rotation was associated with increased LV volume measured in end-systole and impaired LV ejection fraction. Increased apical LV rotation was associated with reduced LV volumes assessed in end-diastole and in end-systole and increased ejection fraction of the LV. Elevated basal LV rotation showed associations with increased LV mass. In case of increasing basal LV rotation, apical LV rotation showed a decreasing tendency and LV twist showed a tendency of increasing. Similarly, lower basal LV rotation and increased LV twist were seen with increasing apical LV rotation. Increasing LV end-diastolic volume was associated with increasing LV volume measured in end-systole and preserved ejection fraction of the LV. Increasing LV end-systolic volume was associated with increasing LV end-diastolic volume and reduction of LV ejection fraction. Increasing LV volumes were associated with increasing LV mass. While increased LV volumes were associated with reduced apical LV rotation and twist, basal LV rotation did not show significant changes.
CONCLUSIONS
LV rotational mechanics are strongly associated with LV volumes in healthy adults suggesting its volume-dependence.
PubMed: 37869328
DOI: 10.21037/qims-23-178 -
Materials (Basel, Switzerland) May 2024Silicon carbide (SiC) exhibits intriguing thermo-physical properties such as higher heat capacity and conductivity, as well as a lower density than Ti6Al4V(ELI). These...
A Comparative Analysis of Low and High SiC Volume Fraction Additively Manufactured SiC/Ti6Al4V(ELI) Composites Based on the Best Process Parameters of Laser Power, Scanning Speed and Hatch Distance.
Silicon carbide (SiC) exhibits intriguing thermo-physical properties such as higher heat capacity and conductivity, as well as a lower density than Ti6Al4V(ELI). These properties make SiC a good candidate for the reinforcement of Ti6Al4V(ELI) with respect to its use as a heat shield in aero turbines to increase their efficiency. The traditional materials used in aircraft structures were required to have a combination of good mechanical properties such as strength, stiffness, and hardness and low weight, as well as low thermo-physical properties such as coefficient of thermal expansion (CTE) and thermal conductivity. The alloy Ti6Al4V(ELI) has a density of 4.45 g/cm, which is lower than that of structural steel (7.4 g/cm) and higher than that of aluminium (2.5 g/cm). Lower density benefits light weighting. Aluminium is the lightest of the traditional materials used but has relatively low strength. The CTE of SiC of 4.6 × 10/K is lower than that of Ti6Al4V(ELI) of 8.6 × 10/K, while the density of SiC of 3.21 g/cm is lower than that of Ti6Al4V(ELI) of 4.45 g/cm. Therefore, from the theory of composites, SiC/Ti6Al4V(ELI) composites are expected to have lower densities and CTEs than those of Ti6Al4V(ELI), thus providing for lightweighting and less thermal related buckling or separation at their joints with carbon/epoxy resin panels. The specific strength, stiffness, and Knoop hardness of SiC of 75-490 kNm/kg, 132 MNm/kg, and 600-3800 GPa, respectively, are generally larger than those of Ti6Al4V(ELI) of 211 KNm/kg, 24 MNm/kg, and 880 GPa, respectively. Therefore, investigating reinforcement of Ti6Al4V(ELI) with SiC particles is worthwhile as it will lead to the formation of composites that are stronger, stiffer, harder, and lighter, with lower values of CTE. For additive manufacturing, this requires initial studies to optimise the process parameters of laser power and scanning speed for single tracks. To print single tracks in the present work, different laser powers ranging from 100 W to 350 W and scanning speeds ranging from 0.3 m/s to 2.7 m/s were used for different SiC volume fraction values of values. To print single layers, different values of hatch distance were used together with the best values of laser power and scanning speed determined elsewhere by the authors for different volume fractions of SiC. Through optical microscopy, the built tracks and their cross sections were examined. By using laser power and scanning speeds of 200 W and 1.2 m/s, and 150 W and 0.8 m/s, respectively, the best tracks at 5% and 10% volume fractions were obtained, whereas the best tracks at 25% volume fraction were achieved using a laser power of 200 W and a scanning speed of 0.5 m/s. Furthermore, the results showed that the maximum SiC volume percentage of 30% resulted in limited or no penetration. Therefore, it is concluded from the study that parts with improved mechanical properties can be produced at SiC volume fractions ranging from 5% to 25%, while parts produced at the high volume fraction of 30% would have unacceptable mechanical qualities for the final part.
PubMed: 38893871
DOI: 10.3390/ma17112606 -
Journal of Environmental Management Oct 2023The objective of this study was to enrich the nutrient content of compost and to investigate the passivation and solubilization of plant micronutrients (Fe, Al, Cu, Ni,...
The objective of this study was to enrich the nutrient content of compost and to investigate the passivation and solubilization of plant micronutrients (Fe, Al, Cu, Ni, Zn, Na, Mn), macroelements (P, K, Mg, Ca), and heavy metals (Cr, Cd, Pb) during sewage sludge composting with nutrient-rich biomass ash additives. T0: 0%, T1: 3.5%, T2: 7.0%, and T3: 14.0% dry weight (DW), weight/weight (w/w) biomass ash was added to the sewage sludge + sawdust mixture (volume, 1:1) to obtain the final NPK content and monitored over a 45-day period. Sawdust was used as auxiliary material. The sequential extraction method was used to determine the elemental species. Cr, Cd and Pb showed higher affinity to the residual fraction and occluded in the oxide fraction, which decreased the bioavailability factor (BF) (<1% BF-Cr, 21% BF-Cd and 9% BF-Pb) compared to the control treatment (46% BF-Cr, 47% BF-Cd and 80% BF-Pb). As the amount of biomass ash increased (T1-T3), the percentages of residual Cr (Res-Cr) (10-65%), exchangeable Cd (Exc-Cd) and organically bound Cd (Org-Cd) (14% and 21%), and oxides-Pb (Oxi-Pb) (20-61%) increased. In all composts, Fe, Al, and Cu were associated with organically bound and oxides-entrapped fractions. More than 50% of total Mn and Mg were concentrated mainly in exchangeable fractions, suggesting high mobility and bioavailability (42% BF-Mn and 98% BF-Mg). Ni, Zn, and Na tended to be present in oxide-bound, organically bound, and residual fractions, while K and P were associated with exchangeable and organically bound fractions. The overall results suggest that composting sewage sludge with biomass ash may be the best strategy and technique to overcome soil application bottlenecks because it passivates heavy metals and improves the bioavailability of plant nutrients.
Topics: Sewage; Composting; Biomass; Cadmium; Lead; Metals, Heavy; Soil; Oxides
PubMed: 37327636
DOI: 10.1016/j.jenvman.2023.118330 -
Materials (Basel, Switzerland) Oct 2023We have particularly investigated the correlation law of the effect of different carbon black fillings on the hyper-elastic mechanical behavior of natural rubber by...
We have particularly investigated the correlation law of the effect of different carbon black fillings on the hyper-elastic mechanical behavior of natural rubber by conducting uniaxial tensile tests over a wide range of deformations with different volume fractions of carbon black fillings (0%, 4.7%, 8.9%, 12.8%, 16.4%, 19.7%, 22.7% and 25.2%). The results show that the stress-strain curve for carbon black filled rubber increases with the amount of filling, meaning that the rubber gradually becomes "harder". We explore the correlation between the carbon black filling volume and the parameters of the Yeoh constitutive model by examining the Yeoh constitutive model to characterize the hyper-elastic mechanical behavior of rubber with different carbon black fillings. A quantitative relationship between the material parameters and the carbon black filling volume in the Yeoh constitutive model is presented. A method for calculating the material parameters of the Yeoh constitutive model is developed, and it predicts the correlation between the hyper-elastic properties of rubber and the volume fraction of the carbon black filling.
PubMed: 37834697
DOI: 10.3390/ma16196561