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Neurospine Jun 2024Artificial intelligence (AI) is transforming spinal imaging and patient care through automated analysis and enhanced decision-making. This review presents a clinical...
Artificial intelligence (AI) is transforming spinal imaging and patient care through automated analysis and enhanced decision-making. This review presents a clinical task-based evaluation, highlighting the specific impact of AI techniques on different aspects of spinal imaging and patient care. We first discuss how AI can potentially improve image quality through techniques like denoising or artifact reduction. We then explore how AI enables efficient quantification of anatomical measurements, spinal curvature parameters, vertebral segmentation, and disc grading. This facilitates objective, accurate interpretation and diagnosis. AI models now reliably detect key spinal pathologies, achieving expert-level performance in tasks like identifying fractures, stenosis, infections, and tumors. Beyond diagnosis, AI also assists surgical planning via synthetic computed tomography generation, augmented reality systems, and robotic guidance. Furthermore, AI image analysis combined with clinical data enables personalized predictions to guide treatment decisions, such as forecasting spine surgery outcomes. However, challenges still need to be addressed in implementing AI clinically, including model interpretability, generalizability, and data limitations. Multicenter collaboration using large, diverse datasets is critical to advance the field further. While adoption barriers persist, AI presents a transformative opportunity to revolutionize spinal imaging workflows, empowering clinicians to translate data into actionable insights for improved patient care.
PubMed: 38955525
DOI: 10.14245/ns.2448388.194 -
Nursing in Critical Care Jul 2024Clinical practice guidelines for the prevention of catheter associated urinary tract infection (CAUTI) recommend urinary catheter securement in critical patients...
Effectiveness and safety of a simple catheter securement device aimed at preventing catheter-associated urinary tract infection in intensive care unit patients: A randomized controlled trial.
BACKGROUND
Clinical practice guidelines for the prevention of catheter associated urinary tract infection (CAUTI) recommend urinary catheter securement in critical patients although there is scant research on its effectiveness.
AIM
To analyse whether securement of an indwelling urinary catheter (IUC) reduces the risk of CAUTI and meatal pressure injury among intensive care unit (ICU) patients and assess medical adhesive-related skin injury (MARSI) associated with the securement device.
STUDY DESIGN
Open randomized controlled trial involving patients admitted to two ICUs in Spain. In the intervention group (n = 169 patients), the IUC was secured to the thigh using an in-house device piloted as part of this trial. Controls (n = 181) received standard care, including non-securement of the IUC. Barrier film spray was applied to the securement site with the aim of preventing MARSI. The definitions of the main outcomes were: CAUTI was diagnosed according to the criteria of the European Centre for Disease Prevention and Control, meatal pressure injury was categorized into four grades and MARSI was classified as either erythema or skin tears. Bivariate analysis and multivariate logistic regression were performed. Log-rank and Cox regressions were used to compare risk over time to CAUTI and meatal pressure injury in the two groups.
RESULTS
Data from 350 patients were analysed, 169 (48.29%) from IG and 181 (51.71%) from CG. In the multiple logistic regression analysis, IUC securement was an independent protective factor against both CAUTI (RR = 0.2, 95% CI [0.05, 0.67]) and meatal pressure injury (RR = 0.31, 95% CI [0.15, 0.58]). The incidence of MARSI was 7.1%.
CONCLUSION
Effective IUC securement significantly reduces the risk of CAUTI and meatal pressure injury among ICU patients. The in-house device piloted in the present trial is simple for nurses to use, and the incidence of MARSI was low. These results underline the benefits of IUC securement.
RELEVANCE TO CLINICAL PRACTICE
Indwelling urinary catheter (IUC) securement reduces the risk of urinary tract infection. IUC securement helps prevent meatal pressure injury. IUC securement with in-house devices is safe and effective.
PubMed: 38955490
DOI: 10.1111/nicc.13111 -
CMAJ : Canadian Medical Association... Jul 2024
Review
Topics: Humans; Renal Dialysis; Catheter-Related Infections; Catheters, Indwelling
PubMed: 38955409
DOI: 10.1503/cmaj.231300-f -
American Journal of Veterinary Research Jul 2024To develop an innovative process for stereotactic brain biopsies in dogs and cats that would provide a definitive diagnosis and optimize the management of patients with...
Using a three-dimensional-printed device with the patient's maxillary dental impression allows to perform minimally invasive brain biopsies in dogs and cats: a preliminary study.
OBJECTIVE
To develop an innovative process for stereotactic brain biopsies in dogs and cats that would provide a definitive diagnosis and optimize the management of patients with brain lesions.
ANIMALS
4 dogs and 1 cat diagnosed with 1 or more brain lesion(s) underwent brain biopsies between March 24, 2023, and October 25, 2023.
METHODS
Based on trajectories selected on images of MRI and CT scan performed on each patient, a computerized software program was used to design a 3-D-printed patient-specific device with maxillary dental impression located on a baseplate to secure the patient's head and with insertion ports for the biopsy instrumentations located on a C-arm. As proof of concept, the device was successfully used in 2 cadavers before being used on clinical patients. All biopsy samples were submitted for histopathological examination.
RESULTS
Histological diagnosis was obtained in 80% (4/5) of the cases (choroid plexus tumor, astrocytoma, meningioma, and chronic meningoencephalitis of unknown origin). In 1 patient, the results of biopsy were nondiagnostic; postmortem diagnosis was consistent with a low-grade oligodendroglioma. All the patients were discharged within 24 hours after the procedure without complications. This novel stereotactic system allows the surgeon to perform safe, easy-to-use, inexpensive, and minimally invasive precise brain biopsies in dogs and cats, without complications.
CLINICAL RELEVANCE
This unique technique could be applied to any size and type of skull and for any type of brain lesions and would provide diagnostic information that would be valuable for future treatment planning and prognosis.
PubMed: 38955214
DOI: 10.2460/ajvr.24.04.0122 -
Biomedical Physics & Engineering Express Jul 2024This work aims to improve the post stabilty of reusable potassium iodide hydrogel dosimter. A reusable and low-cost radiochromic dosimeter containing a gel matrix of...
This work aims to improve the post stabilty of reusable potassium iodide hydrogel dosimter. A reusable and low-cost radiochromic dosimeter containing a gel matrix of polyvinyl alcohol, potassium iodide dye, froctose as reducing agent and glutaraldehyde as cross-linking agent was developed for dose calibration in radiotherapy. The gel samples were exposed to different absorbed doses using a medical linear acceleration. UV-Vis Spectrophotometry was utilized to investigate the changes in optical-properties of irradiated gels with regard to peak wavelength of 353 nm. The stability of the gel (one of the most limitation of using this dosimeter) was improved significantly by the addition of certain concentrations of dimethyl sulfoxide. The two-dimensional optical imaging system of charge-coupled-device (CCD) camera with a uniform RGB light-emitting-diode (LED) array source was used for diffusion coefficient purpose using two dimensional gel template. The value of diffusion coefficient reported is significant and highly reduced compared with other dosimeters reported in the literatures. Moreover, heating the improved gels to certain temperatures results in resetting their optical properties, which makes it possible to reuse for multiple times.
PubMed: 38955138
DOI: 10.1088/2057-1976/ad5db0 -
Journal of Chromatography. A Jun 2024This study describes the preparation of a cylindrical polymer foam column termed Chitosan/β-Cyclodextrin/MIL-68(Al) (CS/β-CD/MIL-68(Al)). An ice template-freeze drying...
This study describes the preparation of a cylindrical polymer foam column termed Chitosan/β-Cyclodextrin/MIL-68(Al) (CS/β-CD/MIL-68(Al)). An ice template-freeze drying technique was employed to prepare the CS/β-CD/MIL-68(Al) foam column by embedding MIL-68(Al) in a polymer matrix comprising cross-linked chitosan (CS) and β-cyclodextrin (β-CD). The cylindrical CS/β-CD/MIL-68(Al) foam was subsequently inserted into a syringe to develop a solid phase extraction (SPE) device. Without the requirement for an external force, the sample solution passed easily through the SPE column thanks to the porous structure of the CS/β-CD/MIL-68(Al) foam column. Moreover, the CS/β-CD/MIL-68(Al) foam column was thought to be a superior absorbent for SPE since it included the adsorptive benefits of CS, β-CD, and MIL-68(Al). The SPE was utilized in conjunction with high-performance liquid chromatography to analyze six sulfonamides found in milk, urine, and water. With matrix effects ranging from 80.49 % to 104.9 % with RSD values of 0.4-14.0 %, the method showed high recoveries ranging from 80.6 to 107.4 % for water samples, 93.4-105.2 % for urine, and 87.4-100.9 % for milk. It also demonstrated good linearity in the range of 10-258 ng·mL with the limits of detection ranging from 1.88 to 2.58 ng·mL. The cylindrical CS/β-CD/MIL-68(Al) foam column prepared in this work offered several advantages, including its simple fabrication, excellent water stability, absence of pollutants, biodegradability, and reusability. It is particularly well-suited for SPE. Furthermore, the developed SPE method, employing CS/β-CD/MIL-68(Al) foam column, is straightforward and precise, and its benefits, including affordability, ease of preparation, lack of specialized equipment, and solvent economy, underline its broad applicability for the pretreatment of aqueous samples.
PubMed: 38955130
DOI: 10.1016/j.chroma.2024.465130 -
Diagnostic Microbiology and Infectious... Jun 2024This study evaluates the non-invasive diagnosis of Invasive Aspergillosis Pneumonia (IPA) in mechanically ventilated patients by measuring galactomannan (GM) in exhaled...
This study evaluates the non-invasive diagnosis of Invasive Aspergillosis Pneumonia (IPA) in mechanically ventilated patients by measuring galactomannan (GM) in exhaled breath condensate (EBC). Utilizing a rat model and a novel EBC collection device, we compared GM levels in bronchoalveolar lavage fluid (BALF) and EBC, supplemented by cytokine profiling. Analysis of 75 patients confirmed the device's efficacy, with EBC-GM and BALF-GM showing high diagnostic accuracy (AUC = 0.88). The threshold of 0.235 ng/ml for EBC-GM achieved 92.8 % sensitivity and 66.7 % specificity, with a strong correlation (r = 0.707, P < 0.001) with BALF-GM. This approach offers a safe, effective alternative to invasive diagnostics, enhancing precision with IL-6 and TNF-α measurements. The number registered on clinicaltrails.gov is NCT06333379.
PubMed: 38954860
DOI: 10.1016/j.diagmicrobio.2024.116420 -
Analytical Chemistry Jul 2024Efficient cell manipulation is essential for numerous applications in bioanalysis and medical diagnosis. However, the lack of stability and strength in the secondary...
Efficient cell manipulation is essential for numerous applications in bioanalysis and medical diagnosis. However, the lack of stability and strength in the secondary flow, coupled with the narrow range of practical throughput, severely restricts the diverse applications. Herein, we present an innovative inertial microfluidic device that employs a spiral channel for high-throughput cell manipulation. Our investigation demonstrates that the regulation of Dean-like secondary flow in the microchannel can be achieved through geometric confinement. Introducing ordered microstructures into the ultralong spiral channel (>90 cm) stabilizes and accelerates the secondary flow among different loops. Consequently, effective manipulation of blood cells within a wide cell throughput range (1.73 × 10 to 1.16 × 10 cells/min) and cancer cells across a broad throughput range (0.5 × 10 to 5 × 10 cells/min) can be achieved. In comparison to previously reported technologies, our engineering approach of stabilizing and accelerating secondary flow offers specific performance for cell manipulation under a wide range of high-throughput manner. This engineered spiral channel would be promising in biomedical analysis, especially when cells need to be focused efficiently on large-volume liquid samples.
PubMed: 38954777
DOI: 10.1021/acs.analchem.4c01549 -
PloS One 2024Rice wine, well known for its unique flavor, rich nutritional value, and health benefits, has potential for extensive market development. Rhizopus and Aspergillus are...
Rice wine, well known for its unique flavor, rich nutritional value, and health benefits, has potential for extensive market development. Rhizopus and Aspergillus are among several microorganisms used in rice wine brewing and are crucial for determining rice wine quality. The strains were isolated via Rose Bengal and starch as a combined separation medium, followed by oenological property and sensory evaluation screening. The strain exhibiting the best performance can be screened using the traditional rice wine Qu. The strains YM-8, YM-10, and YM-16, which exhibited strong saccharification and fermentation performance along with good flavor and taste, were obtained from traditional rice wine Qu. Based on ITS genetic sequence analysis, the YM-8, YM-10, and YM-16 strains were identified as Rhizopus microsporus, Rhizopus arrhizus, and Aspergillus oryzae. The optimum growth temperature of each of the three strains was 30°C, 32°C, and 30°C, and the optimum initial pH was 6.0, 6.5, and 6.5, respectively. The activities of α-amylase, glucoamylase, and protease of YM-16 were highest at 220.23±1.88, 1,269.04±30.32, and 175.16±1.81 U/g, respectively. The amino acid content of rice wine fermented in a 20-L bioreactor with the three mold strains was higher than that of the control group, except for arginine, which was significantly lower than that of the control group. The total amino acid content and the total content of each type of amino acid were ranked as YM-16 > YM-8 > YM-10 > control group, and the amino acid content varied greatly among the strains. The control group had a higher content, whereas YM-8 and YM-16 had lower contents of volatile aroma components than the control group and had the basic flavor substances needed for rice wine, which is conducive to the formation of rice wine aroma. This selected strain, YM-16, has strong saccharification and fermentation ability, is a rich enzyme system, and improves the flavor of rice wine, thereby demonstrating its suitability as a production strain for brewing.
Topics: Wine; Oryza; Bioreactors; Fermentation; Rhizopus; Taste; Aspergillus oryzae; Hydrogen-Ion Concentration
PubMed: 38954729
DOI: 10.1371/journal.pone.0300213 -
PloS One 2024Transperineal laser ablation is a minimally invasive thermo-ablative treatment for prostate cancer that requires the insertion of a needle for accurate optical fiber...
Transperineal laser ablation is a minimally invasive thermo-ablative treatment for prostate cancer that requires the insertion of a needle for accurate optical fiber positioning. Needle insertion in soft tissues may cause tissue motion and deformation, resulting in tissue damage and needle positioning errors. In this study, we present a wasp-inspired self-propelled needle that uses pneumatic actuation to move forward with zero external push force, thus avoiding large tissue motion and deformation. The needle consists of six parallel 0.25-mm diameter Nitinol rods driven by a pneumatic actuation system. The pneumatic actuation system consists of Magnetic Resonance (MR) safe 3D-printed parts and off-the-shelf plastic screws. A self-propelled motion is achieved by advancing the needle segments one by one, followed by retracting them simultaneously. The advancing needle segment has to overcome a cutting and friction force, while the stationary needle segments experience a friction force in the opposite direction. The needle self-propels through the tissue when the friction force of the five stationary needle segments overcomes the sum of the friction and cutting forces of the advancing needle segment. We evaluated the prototype's performance in 10-wt% gelatin phantoms and ex vivo porcine liver tissue inside a preclinical Magnetic Resonance Imaging (MRI) scanner in terms of the slip ratio of the needle with respect to the phantom or liver tissue. Our results demonstrated that the needle was able to self-propel through the phantom and liver tissue with slip ratios of 0.912-0.955 and 0.88, respectively. The prototype is a promising step toward the development of self-propelled needles for MRI-guided transperineal laser ablation as a method to treat prostate cancer.
Topics: Needles; Animals; Equipment Design; Male; Humans; Wasps; Printing, Three-Dimensional; Laser Therapy; Swine; Prostatic Neoplasms; Magnetic Resonance Imaging
PubMed: 38954720
DOI: 10.1371/journal.pone.0306411