RF Valenzuela*, E Duran-Sierra, M Canjirathinkal, B Amini, KE Torres, RS Benjamin, J Ma, WL Wang, KP Hwang, RJ Stafford, C Wu, AM Zarzour, AJ Bishop, S Lo, JE Madewell, R Kumar, WA Murphy Jr and CM Costelloe
Published on: 9th July, 2024
Purpose: This study aimed to determine the relevance of first- and high-order radiomic features derived from Diffusion-Weighted Imaging (DWI) and Apparent Diffusion Coefficient (ADC) maps for predicting treatment response in patients with Undifferentiated Pleomorphic Sarcoma (UPS).Methods: This retrospective study included 33 extremity UPS patients with pre-surgical DWI/ADC and surgical resection. Manual volumetric tumor segmentation was performed on DWI/ADC maps acquired at Baseline (BL), Post-Chemotherapy (PC), and Post-Radiation Therapy (PRT). The percentage of pathology-assessed treatment effect (PATE) in surgical specimens categorized patients into responders (R; PATE ≥ 90%; 16 patients), partial-responders (PR; 89% - 31% PATE; 10 patients), and non-responders (NR; PATE ≤ 30%; 7 patients). 107 radiomic features were extracted from BL, PC, and PRT ADC maps. Statistical analyses compared R vs. PR/NR.Results: Pseudo-progression at PC and universal stability at PRT were observed in R and PR/NR based on RECIST, WHO, and volumetric assessments. At PRT, responders displayed a 35% increase in ADC mean (p = 0.0034), a 136% decrease in skewness (p = 0.0001), and a 363% increase in the 90th percentile proportion (p = 0.0009). Comparing R vs. PR/NR at BL, statistically significant differences were observed in glrlm_highgraylevelrunemphasis (p = 0.0081), glrlm_shortrunhighgraylevelemphasis (p = 0.0138), gldm_highgraylevelemphasis (p = 0.0138), glcm_sumaverage (p = 0.0164), glcm_jointaverage (p = 0.0164), and glcm_autocorrelation (p = 0.0193). At PC, firstorder_meanabsolutedeviation (p = 0.0078), firstorder_interquartilerange (p = 0.0109), firstorder_variance (p = 0.0109), and firstorder_robustmeanabsolutedeviation (p = 0.0151) provided statistically significant differences.Conclusion: Observing a high post-therapeutic ADC mean, low skewness, and high 90th percentile proportion with respect to baseline is predictive of successfully treated UPS patients presenting > 90% PATE. Highly significant higher-order radiomic results include glrlm-highgraylevelrunemphasis (BL) and first-order-mean absolute deviation (PC).
Severe alcoholic hepatitis is an ethical and clinical conundrum, wherein a liver transplant is often recommended. The adequacy of medical treatment versus the risk of recidivism after transplant is often debated. Complete recovery in 26 of 27 patients with severe alcoholic hepatitis was observed, and hence the data was retrospectively analysed.Methods: 27 patients, with severe alcoholic hepatitis, with Maddrey's discriminant function between 59.7 to 165.2 (mean 107.53), from June 2017 to May 2022, were followed up for between 11 months to 6 years. INR ranged from 1.99 to 3.7 (mean 2.709), and bilirubin was between 7.6 to 37.01, (mean 20.859). 8 patients had pre-existing liver cirrhosis. All patients received probiotics, nutritional support, physical rehabilitation, saturated fat (clarified butter/ desi ghee) supplementation, and anti-oxidant support. At 90 days, total bilirubin improved to between 1.0 to 6.8 (mean 2.625). ALT (Alanine Transaminase/ SGPT) ranged from 65 to 550 (mean ALT – 197); and AST (Aspartate Transaminase / SGOT) ranged from 58 to 810 (mean AST – 271.51). Both the AST and ALT were near normal after 90 days. One patient died due to bacterial pneumonia and sepsis; the remaining 26 patients made a complete recovery. All patients including those with diagnosed liver cirrhosis, had complete resolution of their ascites, and near-normal liver function. At the last outpatient visit, none had ascites, edema, or encephalopathy, and had normal albumin levels and INR values. Conclusion: Probiotics, nutrition, a saturated fat diet, and exercise; all have shown benefits in patients with severe alcoholic hepatitis when tested individually. Concomitant use of all the above has not been reported in the treatment of alcoholic hepatitis. The role of nutrition alone versus the contribution of nutritional deficiencies and the role of gut-derived endotoxemia need to be studied in detail. How to identify patients who need a transplant, if it is needed at all, remains a challenge.
Introduction: Pneumothorax is a life-threatening condition that requires prompt recognition and therapy to prevent deterioration. Radiologist workload often precludes rapid assessment of the usual diagnostic modality, the chest radiograph, particularly after hours. The aim was to develop a deep learning model using a segmentation-based Deep Convolutional Neural Network (DCNN) to detect pneumothorax on chest radiographs to provide rapid and accurate pneumothorax diagnosis.Methods: This is a retrospective study of spontaneous pneumothorax at a single center, containing 130 positive and 70 negative radiographs. Subsequent manual contour mapping was performed to draw a mask of the pneumothorax. These image pairs were used to train a DCNN model (a modified AlexNet) after pretraining on the ImageNet dataset.Results: The DCNN achieved an accuracy of 0.83, with sensitivity of 98.1%, and specificity of 68.5%.Conclusion: This segmentation-based DCNN accuracy is comparable to previous categorization-based CDNN models, despite using a smaller sample size for training, while including the benefits of visual representation for clinician feedback. Segmentation-based DCNNs show promise in the development of accurate and clinically useful models for medical imaging.
Nutrition is the process of supplying the organism with substances that have certain useful characteristics for the organism. It is through the process of nutrition that the organism receives the necessary amount of energy required for normal life activity. The cell is a structural and functional unit of the human body, and it is from a set of similar formations that tissue, organ, and organ systems are formed. Consequently, each cell of the body must receive the necessary supply of nutrients in order to continue its normal functioning. Cellular nutrition is the ability of each cell of the human body to consume nutrient molecules in the amount they need. In this case, the object of the study is just that nutrition, which begins with the nourishment of an individual cell. This article presents the results obtained by analyzing the data regarding the process of making the cell's consumption of the right nutrients while taking into account how the transition to cellular nutrition affects the environment and its constituents.
Based on the results obtained in the study of the interaction of geological and biosphere processes, we found out that there is a close relationship between them. It was also found that the gravity of the bodies of the solar system on the Earth plays a significant role in the above relationship. The effect of gravity was demonstrated on the movement of lithosphere plates, on the processes in the atmosphere and hydrosphere, on related climatic cycles, and the biosphere processes, including "living" organisms' evolution and their mass extinctions. The periodicity of these processes due to gravity is shown. It is expressed in the alternation of short-term orogenic periods of the beginning of the processes with long-term geosynclinal periods of their development and completion. Both periods constitute the repetitive orogenic cycles. The relationship of the cycles with the evolution of photosynthesis, as well as with related Organic Matter (OM) accumulation in sediments after mass extinction of organisms, including OM transformation leading to the formation of Hydrocarbon (HC) accumulations, is shown. Biogenic processes accounting for the accumulation and transformation of organic matter in sediments constitute the biogenic pathway of the formation of hydrocarbon accumulations. It is shown that the influence of gravity extends to the processes in the inner geospheres, including the movement of magma in the asthenosphere under the lithosphere shell, to the movement of hydrogen gas coming from the Earth's core, combining with volatile compounds of elements present in magma, as well as to the rifting process. It is shown that rifting processes lead to the formation of gaseous HC accumulations and constitute a pathway called abiogenic. The obtained results shed light on the peculiarities of the formation of HC accumulations by biogenic and abiogenic pathways, allowing prediction of their chemical characteristics. This is essential when searching for oil and gas and planning exploration works.
This paper reviews the transformative impact of Artificial Intelligence (AI) on civil engineering. It explores AI's fundamental concepts and its applications across structural analysis, construction management, transportation, geotechnical engineering, and sustainability. The review highlights AI's role in automating tasks, predicting outcomes, and optimizing designs throughout project lifecycles. Recent advancements in AI-driven technologies for structural health monitoring, predictive maintenance, and risk assessment are discussed, along with challenges like data quality and model interpretability. Future trends such as autonomous construction and digital twins are examined, emphasizing the need for continued research and interdisciplinary collaboration. In conclusion, this paper offers insights for leveraging AI to address evolving challenges and opportunities in civil engineering, fostering innovation, sustainability, and resilience in infrastructure development.
Chijioke M Ofomata, Nkiru N Ezeama and Chinelo Ezejiegu*
Published on: 4th July, 2024
Medicines are used to cure and treat ailments, relieve or eliminate disease symptoms, and slow down the disease process. Any attempt to disrupt this natural medicine process, using falsified medications, spells doom to a consumer of such medication. The challenge of fake medicines is a global one and affects developing and developed nations and currently assumes great significance as a result of globalization challenges, which have flattened the entire world, hence removing barriers to the movement of products and services. The cross-sectional survey was conducted, using six local government areas of Anambra State in South-East Nigeria, namely Awka, Nnewi, Onitsha, Aguata, Ogbaru, and Anaocha, among adults aged 18 years and above. A minimum sample size of 500 was calculated and stratified sampling was employed to select respondents in order to ensure that various population groups, the upper class, middle class, and lower class were represented.This research has shown that falsified medicine is an evil wind that blows nobody any good. It negatively affects every aspect of the citizen’s livelihood, ranging from their health, which manifests as treatment failures, deformities, loss of life to death, to loss of confidence in the healthcare providers, revenue losses to individuals, healthcare providers, manufacturers, and finally corruption of the genuine medicines supply chain with fake and adulterated medicines.The study has clearly shown the experiences of residents of Anambra State, South-East Nigeria with fake and adulterated medicines and also services as a wake-up call to medicines regulators like NAFDAC, PCN, the PSN, and Federal Ministry of Health to declare a state of emergency on the fight against fake and adulterated medicines and make enabling laws that are punitive enough towards the fight against this scourge, so that the healthcare and well-being of Nigerians would be assured at all times.
Numerous studies relate differences in microbial communities to humans. The microbiome is fundamental for the human turn of events, invulnerability, and nourishment. The ordinary microbiota has explicit capability in supplement digestion, xenobiotic and drug digestion, upkeep of underlying trustworthiness of the stomach mucosal boundary, immunomodulation, and assurance against microorganisms. Out of nowhere, it assumes a significant part in criminology. In a few criminal examinations, such perceptible changes in the microbiome and mycobiome can decide the reason or the genuine spot of death. The microbial follows found at the crime location can likewise give obvious proof of responsibility. The point of this audit was to study the microbiome and its applications in scientific sciences and to decide the primary lines of examination that are emerging, as well as its potential commitments to the scientific field.’
Nnenna Maureen Ozioko*, Nkiru Mary Okoloagu, Emmanuel Sunday Onah and Catherine
Published on: 8th July, 2024
Background: The establishment of eye clinics in the form of rural outreach centers as a means of educating and providing eye care to rural residents was made necessary by the lack of eye care services in rural areas within Nigeria and the need to increase the cataract surgical rate among ophthalmologists in training. Understanding patterns of eye diseases in rural areas and eye health-seeking behaviors is crucial to achieving the goals of Vision 2020 especially for aspiring ophthalmologists.Aim and objectives: To examine the types of eye conditions observed at Nenwe, a rural outreach post of a tertiary hospital, and to evaluate their distribution.Methodology: A retrospective analysis of all patients who were seen at the community eye clinic during seven years was carried out. Records of patients at the Nenwe outreach eye clinic dating from November 2016 to August 2023 were examined, yielding information on patients examined during the period of study.Results: Glaucoma was the most common eye condition to be diagnosed. Cataracts were the second most common eye condition accounting for 20.8%. Other common eye illnesses were refractive error (9%), pterygium (7%), and allergic eye disease (6%) with 129, 101, and 95 cases, respectively. Retinal detachment (51 cases), prebyopia (47 cases), corneal lesion (58 cases), and dry eye condition (47 cases) were less common.Conclusion: The results show the burden of eye disorders in the Nenwe rural community and the importance of community-based eye care services.
Alia Mousli, Mohamed Aziz Cherif*, Marouen Benna, Ameni Yousfi, Semia Zaraa, Rim Abidi and Chiraz Nasr
Published on: 8th July, 2024
Background: Tailored adjuvant treatment is key to managing endometrial cancer effectively. Understanding prognostic factors of loco-regional failure and the impact of adjuvant treatment can help in treatment de-escalation without compromising survival outcomes.The aim of this study was to assess the pattern of failure in endometrial cancer patients and to determine predicting Loco-Regional Recurrence (LRR) factors.Patients and methods: Data were collected from 214 patients treated for endometrial cancer between 2005 and 2012 in Salah Azaiez Institute in Tunisia. All patients underwent upfront surgery followed by adjuvant brachytherapy with or without external beam radiation. The median follow-up period was 44 months. Univariate and multivariate analyses were performed to identify prognostic factors for LRR.Results: The 5-year overall survival rate was 78.1%, and the 5-year progression-free survival rate was 80.1%. LRR occurred in 25 patients (11.6%), with a median recurrence time of 29 months (range 4 months - 46 months). Pelvic relapse was the most common site, occurring in 10 patients. Vaginal relapses were observed in 9 patients, and retro-peritoneal relapses were observed in 6 cases. FIGO stage, tumor grade, histologic type, Lympho-Vascular Space Invasion (LVSI), and delays in adjuvant treatment were significant predictors of LRR.Conclusion: Identifying prognostic factors for LRR in endometrial cancer is crucial for optimizing adjuvant treatment strategies. Higher FIGO stages and the presence of LVSI were independent predictive factors for LRR. Tailored adjuvant treatment, taking these prognostic factors into account, is essential to improve patient outcomes and minimize unnecessary treatment-related toxicity.
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