Heart failure alters diagnostic yield for pulmonary embolism in patients undergoing computed tomography pulmonary angiogram.

INTRODUCTION: There is limited evidence regarding the effects of a pre-existing heart failure (HF) on the diagnostic yield of pulmonary embolism (PE) evaluation in the Emergency Department (ED). METHODS: Electronic medical record of consecutive adults who underwent a computed tomography pulmonary angiogram (CTPA) in the ED at Loma Linda University Medical Center between June 1, 2019 and March 25, 2022 were reviewed. Repeat studies for the same patient and patients with unspecified HF diagnoses or isolated right ventricular HF were excluded. Key demographics, lab values and vital signs, relevant medications were collected. Primary outcome was the incidence of PE on CTPA compared between patients with and without pre-existing HF. RESULTS: A total of 2846 patients were included in the study (602 patients with HF and 2244 without). In total cohort, 11.7% (n = 334) of patients had PE found on CTPA. The incidence of PE on CTPA was lower among patients with a history of HF than patients without a history of HF (12.5% vs 9%). A history of pre-existing HF was associated with a lower odds ratio for a positive PE study (OR 0.13, 95%CI: 0.03-0.57) in multivariable analyses. CONCLUSIONS: In this study, we observed that the incidence of PE among patients who undergo CTPA was lower among patients with pre-existing HF compared to those without. Further studies should determine if HF is an important mitigating factor when risk stratifying patients for PE.

A novel explanation for the increased conductivity in annealed Al-doped ZnO: an insight into migration of aluminum and displacement of zinc.

A combined experimental and first-principles study is performed to study the origin of conductivity in ZnO:Al nanoparticles synthesized under controlled conditions via a reflux route using benzylamine as a solvent. The experimental characterization of the samples by Raman, nuclear magnetic resonance (NMR) and conductivity measurements indicates that upon annealing in nitrogen, the Al atoms at interstitial positions migrate to the substitutional positions, creating at the same time Zn interstitials. We provide evidence for the fact that the formed complex of AlZn and Zni corresponds to the origin of the Knight shifted peak (KS) we observe in 27Al NMR. As far as we know, the role of this complex has not been discussed in the literature to date. However, our first-principles calculations show that such a complex is indeed energetically favoured over the isolated Al interstitial positions. In our calculations we also address the charge state of the Al interstitials. Further, Zn interstitials can migrate from AlZn and possibly also form Zn clusters, leading to the observed increased conductivity.

Functionalization of Graphene Oxide with 9-aminoanthracene for the Adsorptive Removal of Persistent Aromatic Pollutants from Aqueous Solution.

A novel modified graphene oxide nanocomposite was fabricated via a facial procedure, aiming to removal of the aromatic pollutants from aqueous solution. The graphene oxide (GO) was functionalized with 9-aminoanthracene and produced graphene oxide-9-aminoanthracene (GO-9-AA). FTIR, XRD, TGA, TEM and Raman spectroscopy techniques were used for characterization of the adsorbents. Adsorption of naphthalene (NAP), acenaphthylene (ACN), and phenanthrene (PHN) as a model of polycyclic aromatic hydrocarbons (PAHs) was investigated by GO-9-AA. The adsorbent showed excellent removal efficiency towards PAHs from aqueous solution. Equilibrium data of the adsorption process were successfully fitted with Freundlich model from single solute system, and the maximum adsorption capacities followed the order of NAP > ACN >PHN. The kinetic analysis revealed that the overall adsorption process was fast and successfully fitted with the pseudo-second-order kinetic model. The anthracene ring makes GO-9-AA π-electron rich, thus facilitating π-π EDA interaction between NAP, ACN and PHN with GO-9-AA.

In vivo precision of three HR-pQCT-derived finite element models of the distal radius and tibia in postmenopausal women.

BACKGROUND: The distal radius is the most common osteoporotic fracture site occurring in postmenopausal women. Finite element (FE) modeling is a non-invasive mathematical technique that can estimate bone strength using inputted geometry/micro-architecture and tissue material properties from computed tomographic images. Our first objective was to define and compare in vivo precision errors for three high-resolution peripheral quantitative computed tomography (HR-pQCT, XtremeCT; Scanco) based FE models of the distal radius and tibia in postmenopausal women. Our second objective was to assess the role of scan interval, scan quality, and common region on precision errors of outcomes for each FE model. METHODS: Models included: single-tissue model (STM), cortical-trabecular dual-tissue model (DTM), and one scaled model using imaged bone mineral density (E-BMD). Using HR-pQCT, we scanned the distal radius and tibia of 34 postmenopausal women (74 ± 7 years), at two time points. Primary outcomes included: tissue stiffness, apparent modulus, average von Mises stress, and failure load. Precision errors (root-mean-squared coefficient of variation, CV%RMS) were calculated. Multivariate ANOVA was used to compare the mean of individual CV% among the 3 HR-pQCT-based FE models. Spearman correlations were used to characterize the associations between precision errors of all FE model outcomes and scan/time interval, scan quality, and common region. Significance was accepted at P < 0.05. RESULTS: At the distal radius, CV%RMS precision errors were <9 % (Range STM: 2.8-5.3 %; DTM: 2.9-5.4 %; E-BMD: 4.4-8.7 %). At the distal tibia, CV%RMS precision errors were <6 % (Range STM: 2.7-4.8 %; DTM: 2.9-3.8 %; E-BMD: 1.8-2.5 %). At the radius, Spearman correlations indicated associations between the common region and associated precision errors of the E-BMD-derived apparent modulus (ρ = -0.392; P < 0.001) and von Mises stress (ρ = -0.297; P = 0.007). CONCLUSION: Results suggest that the STM and DTM are more precise for modeling apparent modulus, average von Mises stress, and failure load at the distal radius. Precision errors were comparable for all three models at the distal tibia. Results indicate that the noted differences in precision error at the distal radius were associated with the common scan region, illustrating the importance of participant repositioning within the cast and reference line placement in the scout view during the scanning process.

A practical guide for the design and implementation of the double-spike technique for precise determination of molybdenum isotope compositions of environmental samples.

The isotopic double-spike method allows for the determination of stable isotope ratios by multi-collector inductively coupled plasma-mass spectrometry (MC-ICP-MS) with accuracy and precision in the range of ∼0.02 ‰ amu(-1), but its adoption has been hindered by the perceived difficulties in double-spike calibration and implementation. To facilitate the implementation of the double-spike approach, an explanation of the calibration and validation of a (97)Mo-(100)Mo double-spike protocol is given in more detail than has been presented elsewhere. The long-term external standard reproducibility is 0.05 ‰ on δ(98/95)Mo measurements of standards. δ(98/95)Mo values for seawater and U.S. Geological Survey (USGS) reference materials SDO-1 and BCR-2 measured in this study are 2.13 ± 0.04 ‰ (2 SD, n = 3), 0.79 ± 0.05 ‰ (2 SD, n = 11), and -0.04 ± 0.10 ‰ (2 SD, n = 3) relative to the NIST-SRM-3134. The double-spike method corrects for laboratory and instrumental fractionation which are not accounted for using other mass bias correction methods. Spike/sample molar ratios between 0.4 and 0.8 provide accurate isotope measurements; outside of this range, isotope measurements are inaccurate but corrections are possible when standards and samples are spiked at a similar ratio.

The role of the VZn-NO-H complex in the p-type conductivity in ZnO.

Past research efforts aiming at obtaining stable p-type ZnO have been based on complexes involving nitrogen doping. A recent experiment by (J. G. Reynolds et al., Appl. Phys. Lett., 2013, 102, 152114) demonstrated a significant (∼10(18) cm(-3)) p-type behavior in N-doped ZnO films after appropriate annealing. The p-type conductivity was attributed to a VZn-NO-H shallow acceptor complex, formed by a Zn vacancy (VZn), N substituting O (NO), and H interstitial (Hi). We present here a first-principles hybrid functional study of this complex compared to the one without hydrogen. Our results confirm that the VZn-NO-H complex acts as an acceptor in ZnO. We find that H plays an important role, because it lowers the formation energy of the complex with respect to VZn-NO, a complex known to exhibit (unstable) p-type behavior. However, this additional H atom also occupies the hole level at the origin of the shallow behavior of VZn-NO, leaving only two states empty higher in the band gap and making the VZn-NO-H complex a deep acceptor. Therefore, we conclude that the cause of the observed p-type conductivity in experiment is not the presence of the VZn-NO-H complex, but probably the formation of the VZn-NO complex during the annealing process.

Assessment of serum levels of osteopontin, selenium and prolactin in patients with psoriasis compared with healthy controls, and their association with psoriasis severity.

BACKGROUND: The association between psoriasis and cardiovascular diseases is well documented, but the underlying mechanisms remain unknown. Overexpression of osteopontin (OPN) has been reported in the plasma of patients with psoriasis, with increased cardiovascular risk factors in these patients. Selenium compounds are effective in downregulating OPN expression. OBJECTIVE: We investigated the levels of OPN, selenium and prolactin (PRL) in psoriasis, and their association with metabolic status in patients to identify a possible link between these markers and observed comorbidities. METHODS: Plasma samples from 40 patients with psoriasis and 40 age- and sex-matched healthy controls (HCs) were collected for ELISA. The clinical significance of plasma OPN, selenium and PRL levels in patients compared with controls was analysed in relation to metabolic disorders. RESULTS: There was no significant difference in median serum selenium levels between the two groups. Serum levels of PRL were not significantly different from those of HCs, but levels of OPN were significantly higher in patients with psoriasis than in HCs. CONCLUSIONS: High plasma OPN is a predictor for occurrence of psoriasis. Our study showed that serum selenium and PRL were not decreased in patients with psoriasis, but there was a negative statistically significant correlation between OPN and selenium in all participants.

Effect of supporting membrane on removal of cadmium by the hybrid liquid membrane process.

A hybrid liquid membrane process was used to remove cadmium cation from a solution using bis-(2-ethylhexyl) phosphoric acid as the carrier for the first time. Different polyethersulphone supporting membranes were prepared by a phase inversion technique. The prepared membrane could be efficiently used as the supporting membranes for the proposed process. The effects of porosity and pore size of the supporting membrane on removal efficiency were investigated. In addition, the effects of various operating parameters such as carrier concentration in organic phase, pH of feed phase, acid concentration, and temperature on the performance of the process were also investigated. It was found that the maximum flux of cadmium is obtained using the supporting membrane with 84.5% porosity and the pore size of 132 nm. The optimum carrier concentration is 0.2 M, the optimum pH of the feed phase is 6, and the optimum concentration of acid in the stripping phase is 0.6 M.

The origin of p-type conductivity in ZnM2O4 (M = Co, Rh, Ir) spinels.

ZnM2O4 (M = Co, Rh, Ir) spinels are considered as a class of potential p-type transparent conducting oxides (TCOs). We report the formation energy of acceptor-like defects using first principles calculations with an advanced hybrid exchange-correlation functional (HSE06) within density functional theory (DFT). Due to the discrepancies between the theoretically obtained band gaps with this hybrid functional and the - scattered - experimental results, we also perform GW calculations to support the validity of the description of these spinels with the HSE06 functional. The considered defects are the cation vacancy and antisite defects, which are supposed to be the leading source of disorder in the spinel structures. We also discuss the band alignments in these spinels. The calculated formation energies indicate that the antisite defects ZnM (Zn replacing M, M = Co, Rh, Ir) and VZn act as shallow acceptors in ZnCo2O4, ZnRh2O4 and ZnIr2O4, which explains the experimentally observed p-type conductivity in those systems. Moreover, our systematic study indicates that the ZnIr antisite defect has the lowest formation energy in the group and it corroborates the highest p-type conductivity reported for ZnIr2O4 among the group of ZnM2O4 spinels. To gain further insight into factors affecting the p-type conductivity, we have also investigated the formation of localized small polarons by calculating the self-trapping energy of the holes.

Antioxidant effect of manganese on the testis structure and sperm parameters of formalin-treated mice.

Manganese inhibits oxidative stress damage. The aim of this study was to investigate the protective role of manganese on testis structure and sperm parameters in adult mice exposed to formaldehyde (FA). Twenty adult male NMRI mice were selected and randomly divided into four groups: (i) control; (ii) sham; (iii) 'FA'-exposed group; and (iv) 'FA and manganese chloride'-exposed group. The FA-exposed groups received 10 mg kg(-1) FA daily for 14 days, and manganese chloride was just injected intraperitoneally 5 mg kg(-1) on 2nd weeks. Mice were sacrificed, and spermatozoa were collected from the cauda of the right epididymis and analysed for count, motility, morphology and viability. The other testicular tissues were weighed and prepared for histological examination upon removal. Seminiferous tubules, lumen diameters and epithelium thickness were also measured. The findings revealed that FA significantly reduced the testicular weight, sperm count, motility, viability and normal morphology compared with control group (P ≤ 0.05). In addition, seminiferous tubules atrophied and seminiferous epithelial cells disintegrated in the FA group in comparison with the control group (P ≤ 0.05). However, manganese improved the testicular structure and sperm parameters in FA-treated mice testes (P ≤ 0.05). According to the results, manganese may improve and protect mice epididymal sperm parameters and testis structure treated with FA respectively.

Reform in medical and health sciences educational system: a Delphi study of faculty members' views at Shiraz University of Medical Sciences.

Despite the strengths in the Iranian medical and health sciences educational system, areas in need of improvement have been noted. The purpose of this study was to understand the views of faculty members at Shiraz University of Medical Sciences about current and future needs for medical and health sciences education, with the goal of improving the quality of the educational system. The data were collected using a Delphi consensus method. Analysis of the findings identified the following key themes among the factors likely to contribute to medical and health sciences education and training: adding and/or increasing student numbers in higher degrees in preference to associate degrees; providing more interactive, student-centred teaching methods; improving the educational content with more practical and research-based courses tailored to society's needs; and an emphasis on outcome-based student evaluation techniques. These changes aim to respond to health trends in society and enhance the close relationship between medical education and the needs of the Iranian society.

Serum levels of sodium valproate in patients suffering from bipolar disorders: comparing acute and maintenance phases of mania.

OBJECTIVES: Bipolar disorders (BD) are characterized by episodes of mania and depression. There is evidence that states of psychiatric disorders impact on neurotransmitters, endocrine system and membrane transport and, therefore, it is possible that specific phases of BD differentially influence the pharmacokinetics of some drugs. The aim of the present study was to investigate the drug-disease interaction between sodium valproate, one of the major drugs used in the treatment of bipolar disorder, and acute versus maintenance states of manic episodes. METHOD: 37 patients (mean age ± SD = 37.54 ± 11.27 years; 23 males, 14 females) suffering from bipolar disorder completed the study. Blood samples were taken during both acute and maintenance states. RESULTS: Neither the trough concentration (p = 0.567) nor the internal clearances (p = 0.729) of sodium valproate in the acute phase of mania differed statistically or descriptively from those in the maintenance phase. Marginally significant phase by gender interactions were observed. CONCLUSION: No significant effect of the acute phase of mania was observed in bipolar patients and no relationship could be found between drug pharmacokinetics and disease phase. This may be explained by specific pharmacokinetic features of the drug such as low extraction ratio values. However, phase by gender interactions indicate possible gender-related issues.

Blood pressure lowering effect of Nigella sativa L. seed oil in healthy volunteers: a randomized, double-blind, placebo-controlled clinical trial.

Nigella sativa L. seeds (N. sativa) have been used as a traditional remedy for a wide range of diseases including hypertension. The present study was performed to explore the effects of N. sativa oil on blood pressure (BP) in healthy volunteers. In a double-blind, randomized study, 70 healthy volunteers aged 34 to 63 years with systolic BP from 110 to 140 mmHg and diastolic BP from 60 to 90 mmHg were randomly allocated to receive 2.5 mL N. sativa oil or placebo two times a day for 8 weeks. The systolic and diastolic BPs, body mass index and blood levels of aspartate transaminase, alanine transaminase, alkaline phosphatase, creatinine and blood urea nitrogen were determined at baseline and endpoint. Results showed that in N. sativa oil treated group the systolic and diastolic BPs decreased significantly compared with baseline and placebo group at the endpoint. Other parameters did not significantly change in both groups at the endpoint. No adverse effects were reported. In conclusion, oral daily administration of 5 mL N. sativa oil to healthy volunteers for 8 weeks lowers systolic and diastolic BPs without any adverse effects.

Effect of oral N-acetyl cysteine on eradication of Helicobacter pylori in patients with dyspepsia.

AIM: Using mucolytic agents that decrease viscosity of the gastric mucous and therefore, increase the permeability of antibiotics through gastric membrane has been offered as an additive treatment to achieve a higher rate of eradication of Helicobacter pylori (H. Pylori) infection. The aim of this study was to determine the efficacy of oral N-acetyl cysteine (NAC) on eradication of H. pylori infections in patients suffering from dyspepsia. METHODS: In this randomized double-blinded clinical trial, 60 H. pylori positive patients who were suffering from dyspepsia were included. They were divided into two groups. Both groups received three-drug regimen including pantoprazole 40 mg BD, ciprofloxacin 500 mg BD and bismuth subcitrate 120 mg two tablets BD. Experimental group (30 cases) received 600 mg of NAC besides three-drug regimen. Control group received placebo. The results of therapy were tested by 14C-UBT and were compared with each other two months after the first visit. RESULTS: H. pylori infection was eradicated in 21 (70%) and 17 (60.7%) patients in experimental and control groups, respectively (P=0.526). Regarding clinical and endoscopic variables, no significant difference was observed between the two groups except for erosive gastritis (0.041) and erosive esophagitis (0.031). CONCLUSION: Our findings offer that NAC has an additive effect on H. pylori triple therapy with pantoprazole, ciprofloxacin and bismuth subcitrate. Although NAC does not have any known activity against H. pylori, it can reduce the thickness of the mucus layer and increase the permeability of antibiotics at the site of infection. To evaluate this effect, more studies with larger sample size should be performed.

Noninvasive Colorimetric Detection of Acetic Acid in Human Breath Based on an Alginate/Ni-Al-LDH/Dye Composite Film.

Alginate/Ni-Al-layered double hydroxide/dye (Alg/Ni-Al-LDH/dye) composite films were fabricated using the solution casting method. The dyes used included methyl red, phenol red, thymol blue, bromothymol blue, m-cresol purple, methyl orange, bromocresol purple (BP), and bromocresol green (BG) in the overall pH range of 3.8 to 9.6. The chemical composition and morphology of the Alg/Ni-Al-LDH/dye composite film structure were investigated by Fourier transform infrared spectroscopy, FESEM, atomic force microscopy, and X-ray diffraction. The Alg/Ni-Al-LDH/dye composite films were semitransparent and mechanically flexible. Acetic acid was investigated as a respiratory biomarker related to gastrointestinal diseases. The parameters studied included color volume, response time, Ni-Al-LDH nanosheet volume, reusability, and drawing of the calibration curve along with statistical features including standard deviation, relative standard deviation, limit of detection, and limit of quantitation. Colorimetric indicators BP and BG in the presence of acetic acid produce color changes that are almost visible to the naked eye. However, other used indicators have shown almost no change. Therefore, it can be reported that the sensors made in the presence of BP and BG act selectively in relation to acetic acid.

Estimating the parameters of a dependent model and applying it to environmental data set.

In this paper, a new dependent model is introduced. The model is motivated using the structure of series-parallel systems consisting of two series-parallel systems with a random number of parallel sub-systems that have fixed components connected in series. The dependence properties of the proposed model are studied. Two estimation methods, namely the moment method, and the maximum likelihood method are applied to estimate the parameters of the distributions of the components based on observing the system's lifetime data. A Monte Carlo simulation study is used to evaluate the performance of the estimators. Two real data sets are used to illustrate the proposed method. The results are useful for researchers and practitioners interested in analyzing bivariate data related to extreme events.

Scenic routing navigation using property valuation.

Extensive prior work has provided methods for the optimization of routing based on weights assigned to travel duration, and/or travel cost, and/or the distance traveled. Routing can be in various modalities, such as by car, on foot, by bicycle, via public transit, or by boat. A typical method of routing involves building a graph comprised of street segments, assigning a normalized weighted value to each segment, and then applying the weighted-shorted path algorithm to the graph in order to find the best route. Some users desire that the routing suggestion include consideration pertaining to the scenic-architectural quality of the path. For example, a user may seek a leisure walk via what they might deem as visually attractive architecture. Here, we are proposing a method to quantify such user preferences and scenic quality and to augment the standard routing methods by giving weight to the scenic quality. That is, instead of suggesting merely the time and cost-optimal route, we will find the best route that is tailored towards the user's scenic quality preferences as an additional criterion to the time and cost. The proposed method uniquely weighs the scenic interest or residential street segments based on the property valuation data.

Dual-Centre Harmonised Multimodal Positron Emission Tomography/Computed Tomography Image Radiomic Features and Machine Learning Algorithms for Non-small Cell Lung Cancer Histopathological Subtype Phenotype Decoding.

AIMS: We aimed to build radiomic models for classifying non-small cell lung cancer (NSCLC) histopathological subtypes through a dual-centre dataset and comprehensively evaluate the effect of ComBat harmonisation on the performance of single- and multimodality radiomic models. MATERIALS AND METHODS: A public dataset of NSCLC patients from two independent centres was used. Two image fusion methods, namely guided filtering-based fusion and image fusion based on visual saliency map and weighted least square optimisation, were used. Radiomic features were extracted from each scan, including first-order, texture and moment-invariant features. Subsequently, ComBat harmonisation was applied to the extracted features from computed tomography (CT), positron emission tomography (PET) and fused images to correct the centre effect. For feature selection, least absolute shrinkage and selection operator (Lasso) and recursive feature elimination (RFE) were investigated. For machine learning, logistic regression (LR), support vector machine (SVM) and AdaBoost were evaluated for classifying NSCLC subtypes. Training and evaluation of the models were carried out in a robust framework to offset plausible errors and performance was reported using area under the curve, balanced accuracy, sensitivity and specificity before and after harmonisation. N-way ANOVA was used to assess the effect of different factors on the performance of the models. RESULTS: Support vector machine fed with selected features by recursive feature elimination from a harmonised PET feature set achieved the highest performance (area under the curve = 0.82) in classifying NSCLC histopathological subtypes. Although the performance of the models did not significantly improve for CT images after harmonisation, the performance of PET and guided filtering-based fusion feature signatures significantly improved for almost all models. Although the selection of the image modality and feature selection methods was effective on the performance of the model (ANOVA P-values <0.001), machine learning and harmonisation did not change the performance significantly (ANOVA P-values = 0.839 and 0.292, respectively). CONCLUSION: This study confirmed the potential of radiomic analysis on PET, CT and hybrid images for histopathological classification of NSCLC subtypes.

Microtensile bond strength of self-etch adhesives in different surface conditionings.

AIM: Self-etch bonding systems have been introduced recently and have the advantage of reduced operating time. Because of patient management and isolation difficulties in children, the present study aimed to evaluate microtensile bond strength of two self-etch bonding systems (AdheSE and Xeno® III) on cleaned only, ground and sandblasted enamel. MATERIALS AND METHODS: Thirty intact primary molars were selected and randomly divided into two groups according to the type of bonding used (Xeno® III and AdheSE). The teeth were divided into three subgroups according to enamel surface conditioning method: prophylaxis with pumice, grinding with coarse finishing and polishing disc, and sandblasting with aluminum oxide particles. Tetric Ceram composite then was applied. Samples were sectioned coronally and axially. The interface area of dental sticks was measured and specimens were subjected to a tensile force of 0.5 mm/min until failure. RESULTS: Microtensile bond strength of Xeno® III-sandblasting, AdheSE-sandblasting, AdheSE-grinding, and AdheSE- cleaned only were 25.5±7.7, 21.2±2.3, 12.9±2.2, and 9.1±1.1, respectively. During sectioning, all specimens of Xeno® III-cleaned only and Xeno® III-grinding groups were fractured. CONCLUSIONS: Two step AdheSE yields higher mTBS in comparison to one step Xeno ® III. In regard to surface conditioning, sandblasting increases the mTBS relative to grinding with finishing and polishing disc, and the cleaned-only enamel has the lowest mTBS.