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Journal of Vascular Surgery Cases and... Jun 2024Balloon entrapment is a rare complication of angioplasty in calcified or recalcitrant lesions. A 65-year-old man with chronic limb-threatening ischemia underwent balloon...
Balloon entrapment is a rare complication of angioplasty in calcified or recalcitrant lesions. A 65-year-old man with chronic limb-threatening ischemia underwent balloon angioplasty of his heavily calcified tibial arteries with a low-profile, tapered, compliant balloon. The balloon became entrapped within the posterior tibial artery and required multiple endovascular maneuvers to deflate and separate the balloon from the calcified arterial wall. This case report describes several adjunctive techniques for retrieval of an entrapped balloon in small, calcified arteries before consideration of surgical removal. These techniques allow for minimally invasive retrieval and continuation of endovascular treatment thereafter.
PubMed: 38591015
DOI: 10.1016/j.jvscit.2024.101459 -
NeuroImage. Clinical 2024Quantitative susceptibility mapping (QSM) is a quantitative measure based on magnetic resonance imaging sensitive to iron and myelin content. This makes QSM a promising... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Quantitative susceptibility mapping (QSM) is a quantitative measure based on magnetic resonance imaging sensitive to iron and myelin content. This makes QSM a promising non-invasive tool for multiple sclerosis (MS) in research and clinical practice.
OBJECTIVE
We performed a systematic review and meta-analysis on the use of QSM in MS.
METHODS
Our review was prospectively registered on PROSPERO (CRD42022309563). We searched five databases for studies published between inception and 30th April 2023. We identified 83 English peer-reviewed studies that applied QSM images on MS cohorts. Fifty-five included studies had at least one of the following outcome measures: deep grey matter QSM values in MS, either compared to healthy controls (HC) (k = 13) or correlated with the score on the Expanded Disability Status Scale (EDSS) (k = 7), QSM lesion characteristics (k = 22) and their clinical correlates (k = 17), longitudinal correlates (k = 11), histological correlates (k = 7), or correlates with other imaging techniques (k = 12). Two meta-analyses on deep grey matter (DGM) susceptibility data were performed, while the remaining findings could only be analyzed descriptively.
RESULTS
After outlier removal, meta-analyses demonstrated a significant increase in the basal ganglia susceptibility (QSM values) in MS compared to HC, caudate (k = 9, standardized mean difference (SDM) = 0.54, 95 % CI = 0.39-0.70, I = 46 %), putamen (k = 9, SDM = 0.38, 95 % CI = 0.19-0.57, I = 59 %), and globus pallidus (k = 9, SDM = 0.48, 95 % CI = 0.28-0.67, I = 60 %), whereas thalamic QSM values exhibited a significant reduction (k = 12, SDM = -0.39, 95 % CI = -0.66--0.12, I = 84 %); these susceptibility differences in MS were independent of age. Further, putamen QSM values positively correlated with EDSS (k = 4, r = 0.36, 95 % CI = 0.16-0.53, I = 0 %). Regarding rim lesions, four out of seven studies, representing 73 % of all patients, reported rim lesions to be associated with more severe disability. Moreover, lesion development from initial detection to the inactive stage is paralleled by increasing, plateauing (after about two years), and gradually decreasing QSM values, respectively. Only one longitudinal study provided clinical outcome measures and found no association. Histological data suggest iron content to be the primary source of QSM values in DGM and at the edges of rim lesions; further, when also considering data from myelin water imaging, the decrease of myelin is likely to drive the increase of QSM values within WM lesions.
CONCLUSIONS
We could provide meta-analytic evidence for DGM susceptibility changes in MS compared to HC; basal ganglia susceptibility is increased and, in the putamen, associated with disability, while thalamic susceptibility is decreased. Beyond these findings, further investigations are necessary to establish the role of QSM in MS for research or even clinical routine.
Topics: Humans; Multiple Sclerosis; Magnetic Resonance Imaging; Gray Matter; Brain
PubMed: 38582068
DOI: 10.1016/j.nicl.2024.103598 -
Skin Research and Technology : Official... Apr 2024Considering the pathogenesis of psoriasis and also the anti-oxidant, immunomodulatory, and anti-inflammatory properties of rosuvastatin and melatonin, the current... (Randomized Controlled Trial)
Randomized Controlled Trial
Efficacy and safety of topical rosuvastatin & melatonin vs. placebo in patients with mild to moderate plaque psoriasis: A preliminary randomized double-blinded clinical trial.
BACKGROUND
Considering the pathogenesis of psoriasis and also the anti-oxidant, immunomodulatory, and anti-inflammatory properties of rosuvastatin and melatonin, the current clinical trial aimed to evaluate the efficacy of topical rosuvastatin and melatonin in patients with mild to moderate psoriasis.
METHODS
The current randomized placebo-controlled clinical trial was conducted using a 3-arm parallel group included 77 adult patients (≥18 years old) with mild to moderate plaque psoriasis. Patients were randomized into a 1:1:1 ratio to one of three groups to receive one of the three interventions: melatonin cream, 5.0% (w/w), rosuvastatin cream, 5.0% (w/w), or placebo cream with a similar transparent appearance twice a day for 12 weeks. The primary outcome was severity of the disease using Psoriasis Area Severity Index (PASI). The secondary outcomes included the Dermatological Sum Score (DSS) to assess the erythema, scaling, and plaque elevation and the Dermatology Life Quality Index (DLQI). Photographs of the lesions were also taken at the baseline and at different periodic intervals thereafter.
RESULTS
Among 77 randomized patients, 52 (mean (SD) age, 40.67 (10.85) years; 22 (42.30%) men) completed the study. A significant reduction of 45% (mean (SD) of 2.67 (0.98) to 1.74 (1.12)) and 70% (mean (SD) of 2.67 (0.98) to 1.31 (1.13)) in PASI score, and 46% (mean (SD) of 2.91(1.85) to 1.57 (1.11)) and 77% (mean (SD) of 2.91 (1.85) to 0.87 (0.67)) in DSS score on days 30 and 60 with rosuvastatin cream, 5% w/w (P < 0.001) compared with baseline was observed, respectively. Also a significant decrease of 35% (mean (SD) of 2.67 (0.98) to 1.74 (1.12)) and 51% (mean (SD) of 2.67 (0.98) to 1.31 (1.13)) in PASI score, and 40% (mean (SD) of 5.00 (1.58) to 3.00 (1.76))and 61% (mean (SD) of 5.00 (1.58) to 1.92 (1.71)) in DSS score on days 30 and 60 with melatonin cream, 5% w/w (P < 0.001) compared with baseline were observed, respectively. In each of the melatonin or rosuvastatin groups, DLQI improved significantly on days 30 (P < 0.0001) and 60 (P < 0.001) while the changes in the control group were not significant.
CONCLUSION
The results of this clinical trial demonstrated that topical melatonin and rosuvastatin diminished the severity of mild to moderate plaque psoriasis with a satisfactory safety profile. Future clinical trials should assess both the long-term efficacy and safety of melatonin and rosuvastatin creams in larger study populations.
Topics: Adult; Male; Humans; Adolescent; Female; Melatonin; Rosuvastatin Calcium; Psoriasis; Anti-Inflammatory Agents; Treatment Outcome; Severity of Illness Index; Double-Blind Method
PubMed: 38563131
DOI: 10.1111/srt.13689 -
Frontiers in Endocrinology 2024To develop and validate an artificial intelligence diagnostic model based on fundus images for predicting Carotid Intima-Media Thickness (CIMT) in individuals with Type...
OBJECTIVE
To develop and validate an artificial intelligence diagnostic model based on fundus images for predicting Carotid Intima-Media Thickness (CIMT) in individuals with Type 2 Diabetes Mellitus (T2DM).
METHODS
In total, 1236 patients with T2DM who had both retinal fundus images and CIMT ultrasound records within a single hospital stay were enrolled. Data were divided into normal and thickened groups and sent to eight deep learning models: convolutional neural networks of the eight models were all based on ResNet or ResNeXt. Their encoder and decoder modes are different, including the standard mode, the Parallel learning mode, and the Siamese mode. Except for the six unimodal networks, two multimodal networks based on ResNeXt under the Parallel learning mode or the Siamese mode were embedded with ages. Performance of eight models were compared via the confusion matrix, precision, recall, specificity, F1 value, and ROC curve, and recall was regarded as the main indicator. Besides, Grad-CAM was used to visualize the decisions made by Siamese ResNeXt network, which is the best performance.
RESULTS
Performance of various models demonstrated the following points: 1) the RexNeXt showed a notable improvement over the ResNet; 2) the structural Siamese networks, which extracted features parallelly and independently, exhibited slight performance enhancements compared to the traditional networks. Notably, the Siamese networks resulted in significant improvements; 3) the performance of classification declined if the age factor was embedded in the network. Taken together, the Siamese ResNeXt unimodal model performed best for its superior efficacy and robustness. This model achieved a recall rate of 88.0% and an AUC value of 90.88% in the validation subset. Additionally, heatmaps calculated by the Grad-CAM algorithm presented concentrated and orderly mappings around the optic disc vascular area in normal CIMT groups and dispersed, irregular patterns in thickened CIMT groups.
CONCLUSION
We provided a Siamese ResNeXt neural network for predicting the carotid intimal thickness of patients with T2DM from fundus images and confirmed the correlation between fundus microvascular lesions and CIMT.
Topics: Humans; Artificial Intelligence; Diabetes Mellitus, Type 2; Carotid Intima-Media Thickness; Neural Networks, Computer; Algorithms
PubMed: 38549767
DOI: 10.3389/fendo.2024.1364519 -
Quantitative Imaging in Medicine and... Mar 2024Disease diagnosis in chest X-ray images has predominantly relied on convolutional neural networks (CNNs). However, Vision Transformer (ViT) offers several advantages...
BACKGROUND
Disease diagnosis in chest X-ray images has predominantly relied on convolutional neural networks (CNNs). However, Vision Transformer (ViT) offers several advantages over CNNs, as it excels at capturing long-term dependencies, exploring correlations, and extracting features with richer semantic information.
METHODS
We adapted ViT for chest X-ray image analysis by making the following three key improvements: (I) employing a sliding window approach in the image sequence feature extraction module to divide the input image into blocks to identify small and difficult-to-detect lesion areas; (II) introducing an attention region selection module in the encoder layer of the ViT model to enhance the model's ability to focus on relevant regions; and (III) constructing a parallel patient metadata feature extraction network on top of the image feature extraction network to integrate multi-modal input data, enabling the model to synergistically learn and expand image-semantic information.
RESULTS
The experimental results showed the effectiveness of our proposed model, which had an average area under the curve value of 0.831 in diagnosing 14 common chest diseases. The metadata feature network module effectively integrated patient metadata, further enhancing the model's accuracy in diagnosis. Our ViT-based model had a sensitivity of 0.863, a specificity of 0.821, and an accuracy of 0.834 in diagnosing these common chest diseases.
CONCLUSIONS
Our model has good general applicability and shows promise in chest X-ray image analysis, effectively integrating patient metadata and enhancing diagnostic capabilities.
PubMed: 38545066
DOI: 10.21037/qims-23-1280 -
Frontiers in Plant Science 2024Rapid and accurate identification and timely protection of crop disease is of great importance for ensuring crop yields. Aiming at the problems of large model parameters...
Rapid and accurate identification and timely protection of crop disease is of great importance for ensuring crop yields. Aiming at the problems of large model parameters of existing crop disease recognition methods and low recognition accuracy in the complex background of the field, we propose a lightweight crop leaf disease recognition model based on improved ShuffleNetV2. First, the repetition number and the number of output channels of the basic module of the ShuffleNetV2 model are redesigned to reduce the model parameters to make the model more lightweight while ensuring the accuracy of the model. Second, the residual structure is introduced in the basic feature extraction module to solve the gradient vanishing problem and enable the model to learn more complex feature representations. Then, parallel paths were added to the mechanism of the efficient channel attention (ECA) module, and the weights of different paths were adaptively updated by learnable parameters, and then the efficient dual channel attention (EDCA) module was proposed, which was embedded into the ShuffleNetV2 to improve the cross-channel interaction capability of the model. Finally, a multi-scale shallow feature extraction module and a multi-scale deep feature extraction module were introduced to improve the model's ability to extract lesions at different scales. Based on the above improvements, a lightweight crop leaf disease recognition model REM-ShuffleNetV2 was proposed. Experiments results show that the accuracy and F1 score of the REM-ShuffleNetV2 model on the self-constructed field crop leaf disease dataset are 96.72% and 96.62%, which are 3.88% and 4.37% higher than that of the ShuffleNetV2 model; and the number of model parameters is 4.40M, which is 9.65% less than that of the original model. Compared with classic networks such as DenseNet121, EfficientNet, and MobileNetV3, the REM-ShuffleNetV2 model not only has higher recognition accuracy but also has fewer model parameters. The REM-ShuffleNetV2 model proposed in this study can achieve accurate identification of crop leaf disease in complex field backgrounds, and the model is small, which is convenient to deploy to the mobile end, and provides a reference for intelligent diagnosis of crop leaf disease.
PubMed: 38529064
DOI: 10.3389/fpls.2024.1342123 -
European Journal of Translational... Mar 2024Scientific conferences increasingly suffer from the need for short presentations in which speakers like to dwell on the details of their work. A mitigating factor is to...
Scientific conferences increasingly suffer from the need for short presentations in which speakers like to dwell on the details of their work. A mitigating factor is to encourage discussion and planning of collaborations by organizing small meetings in a hotel large enough to host all attendees. This extends discussions' opportunities during morning breakfasts, lunches, dinners and long evenings together. Even if the vast majority of participants will not stay for the entire duration of the Conference, the possibilities for specialists to interact with specialists who are even very distant in terms of knowledge increase enormously. In any case, the results in terms of new job opportunities for young participants outweigh the costs for the organizers. Thirty years of Padova Muscle Days offer many examples, but the authors of this report on the state of the art of Mobility Medicine testify that this also happened in the 2024 Five Days of Muscle and Mobility Medicine (2024Pdm3) hosted at the Hotel Petrarca, Thermae of Euganea Hills and Padua, Italy which is in fact a valid countermeasure to the inevitable tendencies towards hyperspecialization that the explosive increase in scientific progress brings with it.
PubMed: 38526419
DOI: 10.4081/ejtm.2024.12492 -
Leukemia May 2024The presence of supernumerary chromosomes is the only abnormality shared by all patients diagnosed with high-hyperdiploid B cell acute lymphoblastic leukemia (HD-ALL)....
The presence of supernumerary chromosomes is the only abnormality shared by all patients diagnosed with high-hyperdiploid B cell acute lymphoblastic leukemia (HD-ALL). Despite being the most frequently diagnosed pediatric leukemia, the lack of clonal molecular lesions and complete absence of appropriate experimental models have impeded the elucidation of HD-ALL leukemogenesis. Here, we report that for 23 leukemia samples isolated from moribund Eμ-Ret mice, all were characterized by non-random chromosomal gains, involving combinations of trisomy 9, 12, 14, 15, and 17. With a median gain of three chromosomes, leukemia emerged after a prolonged latency from a preleukemic B cell precursor cell population displaying more diverse aneuploidy. Transition from preleukemia to overt disease in Eμ-Ret mice is associated with acquisition of heterogeneous genomic abnormalities affecting the expression of genes implicated in pediatric B-ALL. The development of abnormal centrosomes in parallel with aneuploidy renders both preleukemic and leukemic cells sensitive to inhibitors of centrosome clustering, enabling targeted in vivo depletion of leukemia-propagating cells. This study reveals the Eμ-Ret mouse to be a novel tool for investigating HD-ALL leukemogenesis, including supervision and selection of preleukemic aneuploid clones by the immune system and identification of vulnerabilities that could be targeted to prevent relapse.
Topics: Animals; Mice; Disease Models, Animal; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma; Aneuploidy; Humans; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Centrosome; Diploidy
PubMed: 38519798
DOI: 10.1038/s41375-024-02221-x -
Biochimie Mar 2024Inflammation and autoimmunity are known as central processes in many skin diseases, including psoriasis. It is therefore important to develop pre-clinical models that...
Inflammation and autoimmunity are known as central processes in many skin diseases, including psoriasis. It is therefore important to develop pre-clinical models that describe disease-related aspects to enable testing of pharmaceutical drug candidates and formulations. A widely accepted pre-clinical model of psoriasis is the imiquimod (IMQ)-induced skin inflammation mouse model, where topically applied IMQ provokes local skin inflammation. In this study, we investigated the abundance of a subset of matrix metalloproteinases (MMPs) in skin from mice with IMQ-induced skin inflammation and skin from naïve mice using targeted proteomics. Our findings reveal a significant increase in the abundance of MMP-2, MMP-7, MMP-8, and MMP-13 after treatment with IMQ compared to the control skin, while MMP-3, MMP-9, and MMP-10 were exclusively detected in the IMQ-treated skin. The increased abundance and broader representation of MMPs in the IMQ-treated skin provide valuable insight into the pathophysiology of skin inflammation in the IMQ model, adding to previous studies on cytokine levels using conventional immunochemical methods. Specifically, the changes in the MMP profiles observed in the IMQ-treated skin resemble the MMP patterns found in skin lesions of individuals with psoriasis. Ultimately, the differences in MMP abundance under IMQ-induced inflammation as compared to non-inflamed control skin can be exploited as a model to investigate drug efficacy or performance of drug delivery systems.
PubMed: 38513823
DOI: 10.1016/j.biochi.2024.03.011 -
European Journal of Radiology Open Jun 2024The objective of this study was to implement a 5-minute MRI protocol for the shoulder in routine clinical practice consisting of accelerated 2D turbo spin echo (TSE)...
PURPOSE
The objective of this study was to implement a 5-minute MRI protocol for the shoulder in routine clinical practice consisting of accelerated 2D turbo spin echo (TSE) sequences with deep learning (DL) reconstruction at 1.5 and 3 Tesla, and to compare the image quality and diagnostic performance to that of a standard 2D TSE protocol.
METHODS
Patients undergoing shoulder MRI between October 2020 and June 2021 were prospectively enrolled. Each patient underwent two MRI examinations: first a standard, fully sampled TSE (TSE) protocol reconstructed with a standard reconstruction followed by a second fast, prospectively undersampled TSE protocol with a conventional parallel imaging undersampling pattern reconstructed with a DL reconstruction (TSE). Image quality and visualization of anatomic structures as well as diagnostic performance with respect to shoulder lesions were assessed using a 5-point Likert-scale (5 = best). Interchangeability analysis, Wilcoxon signed-rank test and kappa statistics were performed to compare the two protocols.
RESULTS
A total of 30 participants was included (mean age 50±15 years; 15 men). Overall image quality was evaluated to be superior in TSE versus TSE (p<0.001). Noise and edge sharpness were evaluated to be significantly superior in TSE versus TSE (noise: p<0.001, edge sharpness: p<0.05). No difference was found concerning qualitative diagnostic confidence, assessability of anatomical structures (p>0.05), and quantitative diagnostic performance for shoulder lesions when comparing the two sequences.
CONCLUSIONS
A fast 5-minute TSE MRI protocol of the shoulder is feasible in routine clinical practice at 1.5 and 3 T, with interchangeable results concerning the diagnostic performance, allowing a reduction in scan time of more than 50% compared to the standard TSE protocol.
PubMed: 38495213
DOI: 10.1016/j.ejro.2024.100557