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Machine Learning and Deep Learning Methods for Fast and Accurate Assessment of Transthoracic Echocardiogram Image Quality 用于快速准确评估经胸超声心动图图像质量的机器学习和深度学习方法
Pub Date : 2024-06-13 DOI: 10.3390/life14060761
Wojciech Nazar, Krzysztof Nazar, Ludmiła Daniłowicz-Szymanowicz
High-quality echocardiogram images are the cornerstone of accurate and reliable measurements of the heart. Therefore, this study aimed to develop, validate and compare machine learning and deep learning algorithms for accurate and automated assessment of transthoracic echocardiogram image quality. In total, 4090 single-frame two-dimensional transthoracic echocardiogram images were used from apical 4-chamber, apical 2-chamber and parasternal long-axis views sampled from 3530 adult patients. The data were extracted from CAMUS and Unity Imaging open-source datasets. For every raw image, additional grayscale block histograms were developed. For block histogram datasets, six classic machine learning algorithms were tested. Moreover, convolutional neural networks based on the pre-trained EfficientNetB4 architecture were developed for raw image datasets. Classic machine learning algorithms predicted image quality with 0.74 to 0.92 accuracy (AUC 0.81 to 0.96), whereas convolutional neural networks achieved between 0.74 and 0.89 prediction accuracy (AUC 0.79 to 0.95). Both approaches are accurate methods of echocardiogram image quality assessment. Moreover, this study is a proof of concept of a novel method of training classic machine learning algorithms on block histograms calculated from raw images. Automated echocardiogram image quality assessment methods may provide additional relevant information to the echocardiographer in daily clinical practice and improve reliability in clinical decision making.
高质量的超声心动图图像是准确可靠地测量心脏的基石。因此,本研究旨在开发、验证和比较机器学习和深度学习算法,以准确、自动地评估经胸超声心动图图像质量。本研究共使用了 4090 张单帧二维经胸超声心动图图像,分别来自心尖四腔、心尖两腔和胸骨旁长轴切面,样本来自 3530 名成年患者。数据提取自 CAMUS 和 Unity Imaging 开源数据集。对于每张原始图像,都绘制了额外的灰度块直方图。针对块直方图数据集,测试了六种经典的机器学习算法。此外,还为原始图像数据集开发了基于预训练 EfficientNetB4 架构的卷积神经网络。经典机器学习算法预测图像质量的准确率在 0.74 到 0.92 之间(AUC 0.81 到 0.96),而卷积神经网络的预测准确率在 0.74 到 0.89 之间(AUC 0.79 到 0.95)。这两种方法都是准确的超声心动图图像质量评估方法。此外,这项研究还证明了一种新方法的概念,即在原始图像计算出的区块直方图上训练经典的机器学习算法。自动超声心动图图像质量评估方法可为超声心动图医师在日常临床实践中提供更多相关信息,提高临床决策的可靠性。
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引用次数: 0
Outcomes of Mulligan Concept Applications in Obese Individuals with Chronic Mechanical Low Back Pain: A Randomized Controlled Trial 穆里根概念在肥胖慢性机械性腰痛患者中的应用效果:随机对照试验
Pub Date : 2024-06-13 DOI: 10.3390/life14060754
Muhammed Safa Cankaya, Omer Osman Pala
Background: Various treatment modalities have been employed for mechanical low back pain (MLBP), but evidence of their efficacy varies greatly. Objectıve: This randomized controlled trial aimed to assess the outcomes of Mulligan concept applications, including sustained natural apophyseal glides (SNAGS) and natural apophyseal glides (NAGS), in obese patients with MLBP. Methods: The study, conducted between January 2021 and June 2022 at a tertiary hospital, involved randomizing patients into two groups. Both groups underwent six sessions of stretching and strengthening exercises every other day. The Mulligan group received additional intervention with SNAG and NAGS techniques. Measurements were made regarding the Visual Analog Scale (VAS) score, Oswestry Disability Index (ODI) score and range of motion (ROM) for the patients’ MLBP level. Results: Post-interventions, both groups exhibited positive changes in flexion ROM, extension ROM, right and left rotation ROM, right and left lateral flexion ROM, VAS score, and ODI score compared to pre-intervention (p < 0.001 for both groups and variables). The Mulligan group showed a higher increase in ROM and a more significant decrease in VAS and ODI scores. Conclusıons: Mulligan mobilization techniques prove significantly beneficial for enhancing ROM in all directions, reducing pain levels, and alleviating disability in obese individuals with MLBP.
背景:机械性腰背痛(MLBP)的治疗方法多种多样,但疗效证据却大相径庭。目标这项随机对照试验旨在评估穆里根概念应用的效果,包括肥胖腰背痛患者的持续自然顶骨滑行(SNAGS)和自然顶骨滑行(NAGS)。研究方法:研究于 2021 年 1 月至 2022 年 6 月在一家三级医院进行,将患者随机分为两组。两组患者均接受六次拉伸和强化训练,每隔一天一次。穆里根组则接受了SNAG和NAGS技术的额外干预。对患者的视觉模拟量表(VAS)评分、Oswestry 失能指数(ODI)评分和 MLBP 水平的活动范围(ROM)进行了测量。结果干预后,与干预前相比,两组患者的屈曲 ROM、伸展 ROM、左右旋转 ROM、左右侧身屈曲 ROM、VAS 评分和 ODI 评分均有积极变化(两组和变量的 p 均小于 0.001)。穆里根组的ROM增加幅度更大,VAS评分和ODI评分的下降幅度更显著。结论:事实证明,穆里根活动技术对提高肥胖 MLBP 患者各个方向的活动度、降低疼痛水平和减轻残疾程度大有裨益。
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引用次数: 0
A Nonclinical Safety Evaluation of Cold Atmospheric Plasma for Medical Applications: The Role of Genotoxicity and Mutagenicity Studies 用于医疗应用的冷大气等离子体的非临床安全性评估:遗传毒性和突变性研究的作用
Pub Date : 2024-06-13 DOI: 10.3390/life14060759
Piimwara Yarangsee, Supakit Khacha-ananda, Pornsiri Pitchakarn, Unchisa Intayoung, Sirikhwan Sriuan, Jirarat Karinchai, Apiwat Wijaikhum, Dhreerawan Boonyawan
Atmospheric nonthermal plasma (ANTP) has rapidly evolved as an innovative tool in biomedicine with various applications, especially in treating skin diseases. In particular, the formation of reactive oxygen species (ROS) and nitrogen species (RNS), which are generated by ANTP, plays an important role in the biological signaling pathways of human cells. Unfortunately, excessive amounts of these reactive species significantly result in cellular damage and cell death induction. To ensure the safe application of ANTP, preclinical in vitro studies must be conducted before proceeding to in vivo or clinical trials involving humans. Our study aimed to investigate adverse effects on genetic substances in murine fibroblast cells exposed to ANTP. Cell viability and proliferation were markedly reduced after exposing the cells with plasma. Both extracellular and intracellular reactive species, especially RNS, were significantly increased upon plasma exposure in the culture medium and the cells. Notably, significant DNA damage in the cells was observed in the cells exposed to plasma. However, plasma was not classified as a mutagen in the Ames test. This suggested that plasma led to the generation of both extracellular and intracellular reactive species, particularly nitrogen species, which affect cell proliferation and are also known to induce genetic damage in fibroblast cells. These results highlight the genotoxic and mutagenic effects of ANTP, emphasizing the need for the cautious selection of plasma intensity in specific applications to avoid adverse side effects resulting from reactive species production.
大气非热等离子体(ANTP)已迅速发展成为生物医学中的一种创新工具,具有多种应用,尤其是在治疗皮肤病方面。其中,ANTP 产生的活性氧(ROS)和活性氮(RNS)在人体细胞的生物信号通路中发挥着重要作用。遗憾的是,过量的这些活性物种会严重导致细胞损伤和诱导细胞死亡。为确保 ANTP 的安全应用,在进行涉及人体的体内或临床试验之前,必须进行临床前体外研究。我们的研究旨在调查暴露于 ANTP 的小鼠成纤维细胞对遗传物质的不良影响。细胞与血浆接触后,其活力和增殖明显降低。培养基和细胞中的细胞外和细胞内活性物质,尤其是 RNS,在接触血浆后都显著增加。值得注意的是,暴露于血浆的细胞中出现了严重的 DNA 损伤。然而,在艾姆斯试验中,血浆并未被归类为诱变剂。这表明血浆会导致细胞外和细胞内活性物质的产生,特别是氮物质,这些物质会影响细胞增殖,而且已知会诱发成纤维细胞的遗传损伤。这些结果突显了 ANTP 的遗传毒性和致突变效应,强调了在具体应用中谨慎选择血浆强度的必要性,以避免活性物种产生的不良副作用。
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引用次数: 0
A Review of Advances in Molecular Imaging of Rheumatoid Arthritis: From In Vitro to Clinic Applications Using Radiolabeled Targeting Vectors with Technetium-99m 类风湿性关节炎分子成像研究进展综述:使用锝-99m放射性标记靶向载体从体外研究到临床应用
Pub Date : 2024-06-12 DOI: 10.3390/life14060751
Muhammad Ali, V. Benfante, D. Di Raimondo, Riccardo Laudicella, A. Tuttolomondo, A. Comelli
Rheumatoid arthritis (RA) is a systemic autoimmune disorder caused by inflammation of cartilaginous diarthrodial joints that destroys joints and cartilage, resulting in synovitis and pannus formation. Timely detection and effective management of RA are pivotal for mitigating inflammatory arthritis consequences, potentially influencing disease progression. Nuclear medicine using radiolabeled targeted vectors presents a promising avenue for RA diagnosis and response to treatment assessment. Radiopharmaceutical such as technetium-99m (99mTc), combined with single photon emission computed tomography (SPECT) combined with CT (SPECT/CT), introduces a more refined diagnostic approach, enhancing accuracy through precise anatomical localization, representing a notable advancement in hybrid molecular imaging for RA evaluation. This comprehensive review discusses existing research, encompassing in vitro, in vivo, and clinical studies to explore the application of 99mTc radiolabeled targeting vectors with SPECT imaging for RA diagnosis. The purpose of this review is to highlight the potential of this strategy to enhance patient outcomes by improving the early detection and management of RA.
类风湿性关节炎(RA)是一种全身性自身免疫性疾病,由软骨二关节炎症引起,会破坏关节和软骨,导致滑膜炎和脓肿形成。及时发现和有效治疗 RA 对减轻炎症性关节炎的后果至关重要,并有可能影响疾病的进展。使用放射性标记靶向载体的核医学为诊断和评估对治疗的反应提供了一条前景广阔的途径。锝-99m(99mTc)等放射性药物与单光子发射计算机断层扫描(SPECT)和计算机断层扫描(SPECT/CT)相结合,引入了一种更精细的诊断方法,通过精确的解剖定位提高了准确性,代表了混合分子成像在RA评估方面的显著进步。这篇综述讨论了现有的研究,包括体外、体内和临床研究,以探索 99mTc 放射性标记靶向载体与 SPECT 成像在 RA 诊断中的应用。本综述旨在强调这一策略的潜力,即通过改善RA的早期检测和管理来提高患者的预后。
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引用次数: 0
Optimizing Soil Health and Sorghum Productivity through Crop Rotation with Quinoa 通过与藜麦轮作优化土壤健康和高粱产量
Pub Date : 2024-06-12 DOI: 10.3390/life14060745
Guang Li, Aixia Ren, Sumera Anwar, Lijuan Shi, Wenbin Bai, Yali Zhang, Zhiqiang Gao
Crop rotation has been considered a potential solution to mitigate the negative effects of the continuous cropping of sorghum, including soil quality issues, inadequate plant development, and diminished yield and quality. A two-year field experiment was conducted to compare the effects of sorghum–sorghum continuous cropping and quinoa–sorghum rotation on soil properties and sorghum yield. The treatments were arranged in a randomized complete block design with three replicates. Sorghum seeds (Jinza 22) and quinoa seeds (‘Jiaqi 1’ variety) were used. Soil samples were collected before and during the experiment for the analysis of physicochemical properties. The yield traits of sorghum were measured at maturity. The results showed that soil nutrients and organic matter were higher in the top 0–20 cm soil depth compared to 20–40 cm depth, with significant differences observed between cropping systems. Sorghum–quinoa cropping increased soil total N and organic matter, particularly at the jointing and maturity stages of sorghum. However, the available phosphorus was higher under continuous cropping at all growth stages. Crop rotation significantly improved sorghum yield traits, including spike fresh weight, spike dry weight, grain weight per spike, and grain yield per hectare. A correlation analysis revealed positive relationships between soil total N, organic matter, and sorghum yield. Overall, sorghum–quinoa rotation demonstrated potential for improving soil fertility and enhancing crop productivity compared to continuous cropping, although further studies are needed to explore the long-term effects and optimize management practices.
轮作一直被认为是一种潜在的解决方案,可以减轻高粱连作带来的负面影响,包括土壤质量问题、植株发育不良、产量和质量下降等。为了比较高粱-高粱连作和藜麦-高粱轮作对土壤特性和高粱产量的影响,我们进行了一项为期两年的田间试验。试验采用随机完全区组设计,设三个重复。采用高粱种子(金莎 22 号)和藜麦种子("佳琪 1 号 "品种)。实验前和实验过程中均采集了土壤样本,用于理化性质分析。对高粱成熟期的产量性状进行了测定。结果表明,土壤养分和有机质在土壤表层 0-20 厘米处高于 20-40 厘米处,不同种植系统之间存在显著差异。高粱-藜麦种植增加了土壤全氮和有机质,尤其是在高粱的拔节期和成熟期。然而,在所有生长阶段,连作的可利用磷都更高。轮作显著提高了高粱的产量性状,包括穗鲜重、穗干重、每穗粒重和每公顷谷物产量。相关分析表明,土壤全氮、有机质和高粱产量之间存在正相关关系。总体而言,与连作相比,高粱-藜麦轮作具有改善土壤肥力和提高作物产量的潜力,但仍需进一步研究其长期效果并优化管理措施。
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引用次数: 0
Bridging Discoveries and Treatments: The New Landscape of Breast Cancer Research 连接发现与治疗:乳腺癌研究的新格局
Pub Date : 2024-06-12 DOI: 10.3390/life14060747
Taobo Hu, Lei Wang, Riccardo Autelli, M. Long
Welcome to our Special Issue, “Advances in Breast Cancer Research and Treatment” of Life, where we have embarked on a comprehensive exploration of groundbreaking studies that advance our understanding and management of breast cancer [...]
欢迎阅读我们的《生命》特刊 "乳腺癌研究与治疗进展",我们在这一期特刊中全面探讨了推动我们对乳腺癌的理解和治疗的突破性研究 [...] 。
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引用次数: 0
The Effect of Stress-Reducing Interventions on Heart Rate Variability in Cardiovascular Disease: A Systematic Review and Meta-Analysis 减压干预对心血管疾病患者心率变异性的影响:系统回顾与元分析
Pub Date : 2024-06-12 DOI: 10.3390/life14060749
Ouahiba El-Malahi, Darya Mohajeri, Alexander Bäuerle, Raluca Mincu, Korbinian Rothenaicher, Greta Ullrich, C. Rammos, M. Teufel, T. Rassaf, J. Lortz
Stress is recognized as a significant trigger and exacerbator of various medical conditions, particularly in the field of cardiovascular disease (CVD). Given that heart rate variability (HRV) offers insight into the functioning of the autonomic nervous system and has been identified as a predictive factor for increased cardiovascular mortality, exploring the correlation between stress and HRV is pertinent. We systematically reviewed trials where researchers investigated the effects of stress-reducing interventions on biomarkers and time-domain/frequency-domain parameters of HRV in CVD. Eligible studies underwent meta-analysis utilizing a random-effects model. The meta-analysis showed overall beneficial effects of stress-reducing interventions on HRV for the standard deviation of Normal-to-Normal intervals (SDNN) in short-term and 24 h assessments, as well as for the low-frequency power (LF) in short-term assessment. Overall effect sizes were notably high and showed significant p-values (short-term SDNN: MD = 6.43, p = 0.01; 24 h SDNN: MD = 10.92, p = 0.004; short-term LF: MD = 160.11, p < 0.001). Our findings highlight the significant impact of stress-reducing interventions in modulating HRV by influencing short-term SDNN and LF parameters, as well as the 24 h assessment of SDNN. These results emphasize the importance of stress-reducing measures in lowering the risk of further progression in CVD and improving patient outcomes.
压力被认为是各种疾病的重要诱因和加重因素,尤其是在心血管疾病(CVD)领域。鉴于心率变异性(HRV)有助于深入了解自律神经系统的功能,并已被确定为心血管死亡率增加的预测因素,因此探索压力与心率变异性之间的相关性非常重要。我们系统回顾了研究人员调查减压干预对心血管疾病中心率变异的生物标志物和时域/频域参数影响的试验。符合条件的研究采用随机效应模型进行了荟萃分析。荟萃分析表明,在短期和24小时评估中,减压干预对心率变异的正常与正常间期标准差(SDNN)以及短期评估中的低频功率(LF)具有总体有益效应。总体效应大小明显较高,并显示出显著的 p 值(短期 SDNN:MD = 6.43,p = 0.01;24 h SDNN:MD = 10.92,p = 0.004;短期 LF:MD = 160.11,p < 0.001)。我们的研究结果凸显了减压干预对短期 SDNN 和 LF 参数以及 24 小时 SDNN 评估的影响,从而对心率变异的调节产生了重大影响。这些结果强调了减压措施在降低心血管疾病进一步恶化的风险和改善患者预后方面的重要性。
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引用次数: 0
Exploring Trichoderma Species in Industrial Wastewater: Morphological and Molecular Insights from Isolates 探索工业废水中的毛霉菌种:来自分离菌株的形态学和分子学见解
Pub Date : 2024-06-12 DOI: 10.3390/life14060750
Syeda Bint-e-Zahira, Abdul Nasir Khalid, N. Yousaf, Muhammad Iqbal, Tauseef Anwar, Huma Qureshi, S. Salmen, Mohamad Javed Ansari
The genus Trichoderma holds economic significance due to its widespread distribution and diverse applications, including biological control, enzyme production, and various biotechnological uses. The accurate identification of Trichoderma species is crucial given their close association with human activities. Despite previous efforts in classification, a comprehensive analysis combining morphological and molecular approaches is necessary. This study focuses on the isolation of four Trichoderma species from industrial wastewater in Pakistan, expanding on the known diversity in the region; isolation involved collecting samples from industrial wastewater effluents at specific sites in Punjab, Pakistan. Trichoderma strains were cultured and purified on solid media, with subsequent biomass production for bisorptional activity. Morphological characterization included colony features and microscopic examinations. DNA extraction, polymerase chain reaction (PCR), and sequencing of the internal transcribed spacer (ITS) region were conducted for molecular analysis. Phylogenetic analysis was performed using the Maximum Likelihood Algorithm. The study identified three Trichoderma species, viz. T. citrinoviride, T. erinaceum, and T. longibrachiatum. Each species was characterized morphologically and supported by molecular–phylogenetic analysis. Illustrations of microscopic features and a phylogenetic tree based on the ITS-nrDNA region were recorded. T. citrinoviride and T. longibrachiatum, isolated from steel mill and tanneries wastewater, respectively, were differentiated based on morphological characteristics such as phialides and conidia. The combination of morphological and molecular techniques enhances the accuracy of species identification. The study highlights the significance of Trichoderma in industrial wastewater environments and underscores the need for continued research in this area. Future research should focus on exploring the ecological roles and potential applications of the newly identified Trichoderma species. Additionally, further investigations into the biotechnological potential of these species, including enzyme production and bioremediation capabilities, would contribute to their practical applications.
毛霉菌属分布广泛,用途多样,包括生物防治、酶生产和各种生物技术用途,因此具有重要的经济意义。由于毛霉与人类活动密切相关,因此准确鉴定毛霉物种至关重要。尽管以前在分类方面做出了努力,但仍有必要结合形态学和分子方法进行综合分析。本研究的重点是从巴基斯坦的工业废水中分离出四个毛霉菌种,扩大了该地区已知的多样性;分离工作包括从巴基斯坦旁遮普省特定地点的工业废水中收集样本。毛霉菌株在固体培养基上进行培养和纯化,随后生产生物质以获得双吸附活性。形态特征包括菌落特征和显微镜检查。进行了 DNA 提取、聚合酶链反应(PCR)和内部转录间隔区(ITS)测序,以进行分子分析。利用最大似然法进行了系统发育分析。研究确定了三种毛霉,即 T. citrinoviride、T. erinaceum 和 T. longibrachiatum。每个物种都有形态特征,并得到分子系统学分析的支持。记录了显微特征图和基于 ITS-nrDNA 区域的系统发生树。根据分生孢子梗和分生孢子等形态特征,区分了分别从炼钢厂和制革厂废水中分离出来的 T. citrinoviride 和 T. longibrachiatum。形态学和分子技术的结合提高了物种鉴定的准确性。这项研究强调了毛霉菌在工业废水环境中的重要性,并强调了在这一领域继续开展研究的必要性。未来的研究应侧重于探索新发现的毛霉物种的生态作用和潜在应用。此外,进一步研究这些物种的生物技术潜力,包括酶的生产和生物修复能力,将有助于它们的实际应用。
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引用次数: 0
Malnutrition and the Post-Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Multi-Institutional Population-Based Propensity Score-Matched Analysis 营养不良与严重急性呼吸系统综合征冠状病毒 2 感染的急性后遗症:基于多机构人群的倾向得分匹配分析
Pub Date : 2024-06-12 DOI: 10.3390/life14060746
Cheng-Ya Lee, Yung-Chun Liang, W. Hsu, Y. Tsai, Ting-Hui Liu, Po-Yu Huang, Min-Hsiang Chuang, K-C Hung, Mei-Chuan Lee, Tsung Yu, Chih-Cheng Lai, Tzu-Chieh Weng, Jheng-Yen Wu
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a global health crisis, exacerbating issues like malnutrition due to increased metabolic demands and reduced intake during illness. Malnutrition, a significant risk factor, is linked to worse outcomes in patients with COVID-19, such as increased mortality and extended hospital stays. This retrospective cohort study investigated the relationship between malnutrition and clinical outcomes within 90–180 days using data obtained from the TriNetX database. Patients aged >18 years diagnosed with COVID-19 between 1 January 2022, and 31 March 2024 were enrolled in the study. The propensity score-matching (PSM) method was used to match patients with malnutrition (malnutrition group) and those without malnutrition (control group). The primary composite outcome was the cumulative hazard ratio (HR) for post-COVID-19 condition, all-cause hospitalization, and all-cause mortality between 90 days and 180 days after COVID-19 diagnosis. The secondary outcomes were the individual components of the primary outcomes. Two cohorts, each consisting of 15,004 patients with balanced baseline characteristics, were identified using PSM. During the 90–180-day follow-up period, the malnutrition group exhibited a higher incidence of all-cause hospitalization, mortality, or post-COVID-19 condition (HR = 2.315, 95% confidence interval: 2.170–2.471, p < 0.0001). Compared with patients with COVID-19 without malnutrition, those with malnutrition may be associated with a higher risk of adverse clinical outcomes.
由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的冠状病毒病 2019(COVID-19)已导致全球健康危机,由于代谢需求增加和患病期间摄入量减少,营养不良等问题更加严重。营养不良是一个重要的风险因素,与 COVID-19 患者的不良预后有关,如死亡率增加和住院时间延长。这项回顾性队列研究利用 TriNetX 数据库中的数据,调查了营养不良与 90-180 天内临床预后之间的关系。研究招募了2022年1月1日至2024年3月31日期间确诊为COVID-19的年龄大于18岁的患者。研究采用倾向得分匹配法(PSM)对营养不良患者(营养不良组)和无营养不良患者(对照组)进行匹配。主要综合结果是COVID-19确诊后90天至180天内COVID-19后病情、全因住院和全因死亡率的累积危险比(HR)。次要结果是主要结果的各个组成部分。采用 PSM 方法确定了两个队列,每个队列由 15004 名基线特征均衡的患者组成。在 90-180 天的随访期间,营养不良组的全因住院率、死亡率或 COVID-19 后病情发生率更高(HR = 2.315,95% 置信区间:2.170-2.471,P < 0.0001)。与没有营养不良的COVID-19患者相比,营养不良患者可能面临更高的不良临床结局风险。
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引用次数: 0
Cardiac Computed Tomography Identification of the Septal Vein—A Small Retrospective Study 心脏计算机断层扫描识别房间隔静脉--一项小型回顾性研究
Pub Date : 2024-06-12 DOI: 10.3390/life14060748
M. Chon, Ki-Seok Choo, June-Hong Kim
Background: The advancement of medical interventions towards minimally invasive procedures highlights the crucial role of precise pre-procedural evaluation, particularly in catheter-based treatments for heart and cardiovascular conditions. This study investigates innovative techniques such as mitral loop cerclage (MLC) and transcatheter intramyocardial radiofrequency ablation (TIRA), emphasizing the importance of preprocedural cardiac CT scans for accurate anatomical guidance in these emerging therapies. Purpose: The objective of this study was to assess the cardiac cycle through examination of the proximal septal vein (ps) for mitral loop cerclage and the distal septal vein (ds) for transcatheter intramyocardial radiofrequency ablation. Materials and Methods: Forty patients (mean age 59.4 ± 14.7 years) undergoing third-generation dual-source computed tomography (DSCT) for chest pain evaluation were enrolled. CT scans, utilizing dual-energy CT (DECT) with iopamidol and saline, encompassed the carina to the heart base. A noise-optimized linear blended image was reconstructed at 10% intervals throughout the cardiac cycle, and the presence of ps and ds in each phase was noted by two radiologists. Results: This study identified ps in 62.5% and ds in 72.5% of patients, with both present in 45% of cases. The observation of septal veins occurred more frequently in the sequence of 70, 60, 40, 80, 30, 20, and 10% for ps, and 60, 70, 40, 80, 30, 90, 20, and 10% for ds, respectively. Conclusions: DECT in cardiac imaging is instrumental in assessing septal vein frequency. The 70% phase is optimal for MLC, while the 60% phase is preferred for TIRA.
背景:医疗干预向微创手术发展,这凸显了精确术前评估的关键作用,尤其是在以导管为基础的心脏和心血管疾病治疗中。本研究调查了二尖瓣环形钳夹术(MLC)和经导管心肌内射频消融术(TIRA)等创新技术,强调了在这些新兴疗法中术前心脏 CT 扫描对准确解剖引导的重要性。目的:本研究的目的是通过检查二尖瓣环钳术的室间隔近端静脉(ps)和经导管心内膜射频消融术的室间隔远端静脉(ds)来评估心动周期。材料和方法:40 名患者(平均年龄 59.4 ± 14.7 岁)接受第三代双源计算机断层扫描(DSCT)进行胸痛评估。使用碘帕米多和生理盐水的双能量 CT(DECT)进行 CT 扫描,扫描范围从心窝到心底。在整个心动周期中,以 10% 的间隔重建噪声优化的线性混合图像,并由两名放射科医生记录每个阶段中是否出现 ps 和 ds。结果:这项研究发现,62.5% 的患者存在 ps,72.5% 的患者存在 ds,其中 45% 的病例同时存在 ps 和 ds。室间隔静脉的观察频率分别为:ps 70、60、40、80、30、20、10%,ds 60、70、40、80、30、90、20、10%。结论DECT 在心脏成像中有助于评估室间隔静脉频率。70% 相位是 MLC 的最佳相位,而 60% 相位则是 TIRA 的首选相位。
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引用次数: 0
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