Imaging Trends in Acute Venous Thromboembolic Disease: 2000 to 2015.

PURPOSE: To measure diffusion of new knowledge and correlate imaging utilization for suspected acute venous thromboembolism (VTE) with d-dimer utilization, landmark publications, and institutional guidelines. MATERIALS: Between 2000 and 2015, the number of CT pulmonary angiograms (CTPAs), CTPA combined with indirect CT venography (CTV), ventilation-perfusion (VQ) scans, and lower extremity venous Doppler ultrasound (US) examinations were obtained for inpatients and emergency department (ED) patients and correlated with d-dimer utilization, landmark publications regarding radiation and VTE imaging, and an institutional inpatient best-practice alert requiring VTE prophylaxis assessment (2008). Volume data were normalized per 1,000 patients. RESULTS: CTPA and d-dimer utilization were correlated (ED: r = 0.94, inpatient: r = 0.87; P < .001). VQ volume peaked in 2004 to 2005 (20 of 1,000 ED patients; 14 of 1,000 inpatients) and decreased since to a low of 1 of 1,000 and 3 of 1,000, respectively. US volume increased since 2002 and was higher than CT volume for inpatients (annual mean 149 of 1,000 patients [US], 46 of 1,000 patients [CT]), but not ED patients (annual mean 18 of 1,000 patients [US], 35 of 1,000 patients [CT]). For ED patients, CTPA volume peaked in 2008 at 57 of 1,000 patients, declined through 2012 to 30 of 1,000 patients, and rose annually since to 37 of 1,000 patients (2015). For inpatients, CTPA volume also peaked in 2008 at 70 of 1,000, but continued to decline through 2015 to 27 of 1,000 patients. CONCLUSION: After the Prospective Investigation of Pulmonary Embolism II and Brenner and Hall publications, there was a transient 4-year decline in ED CTPA utilization. The decline was sustained in inpatients, where a best-practice VTE prophylaxis alert was implemented. Best-practice alerts may sustain the impact of new knowledge.

Quasi-Two-Dimensional Metal Oxide Semiconductors Based Ultrasensitive Potentiometric Biosensors.

Ultrasensitive field-effect transistor-based biosensors using quasi-two-dimensional metal oxide semiconductors were demonstrated. Quasi-two-dimensional low-dimensional metal oxide semiconductors were highly sensitive to electrical perturbations at the semiconductor-bio interface and showed competitive sensitivity compared with other nanomaterial-based biosensors. Also, the solution process made our platform simple and highly reproducible, which was favorable compared with other nanobioelectronics. A quasi-two-dimensional In2O3-based pH sensor showed a small detection limit of 0.0005 pH and detected the glucose concentration at femtomolar levels. Detailed electrical characterization unveiled how the device's parameters affect the biosensor sensitivity, and lowest detectable charge was extrapolated, which was consistent with the experimental data.

Establishing baseline rod electroretinogram values in achromatopsia and cone dystrophy.

PURPOSE: To establish the normal range of values for rod-isolated b-wave amplitudes in achromatopsia and cone dystrophies. METHODS: We reviewed charts of 112 patients with various types of cone dystrophy, and compared their standardized electroretinographic rod b-wave amplitudes with age-matched normal controls. Twenty-six patients had known mutations in achromatopsia and cone dystrophy genes, while 53 were characterized by their inheritance pattern since they had yet to have their gene identified. Visual acuity information and scotomata were documented. RESULTS: We found that patients with achromatopsia and cone dystrophy had rod b-wave amplitudes that were significantly lower than age-matched controls, but found no evidence of rod amplitude progression nor loss of peripheral visual fields in the study group. CONCLUSIONS: We found that cone dystrophy patients of all types had depressed rod-isolated ERGs across the board. If typical diagnostic criteria are used, these patients might be considered to have "abnormal" rod-isolated electroretinographic values, and might be called "cone-rod dystrophy", even though the waveforms are stable for years. Patients with cone-rod dysfunction patterns on ERG can be better understood by also performing kinetic (Goldmann) visual fields, which will help to distinguish cone dystrophies from progressive cone-rod dystrophies by central scotomata size and progression over time in many forms of cone-rod dystrophy.