scholarly journals COVID-19 Infection-Related Coagulopathy and Viscoelastic Methods: A Paradigm for Their Clinical Utility in Critical Illness

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 817 ◽  
Author(s):  
Argirios E. Tsantes ◽  
Andreas G. Tsantes ◽  
Styliani I. Kokoris ◽  
Stefanos Bonovas ◽  
Frantzeska Frantzeskaki ◽  
...  
Keyword(s):  
Clinical Utility ◽  
Small Sample ◽  
Close Monitoring ◽  
Rotational Thromboelastometry ◽  
Coagulation Tests ◽  
Attractive Option ◽  
Small Sample Sizes ◽  
Fibrinolysis Shutdown ◽  
Insight Into

Hypercoagulability and thrombosis remain a challenge to diagnose and treat in severe COVID-19 infection. The ability of conventional global coagulation tests to accurately reflect in vivo hypo- or hypercoagulability is questioned. The currently available evidence suggests that markedly increased D-dimers can be used in identifying COVID-19 patients who may need intensive care unit (ICU) admission and close monitoring or not. Viscoelastic methods (VMs), like thromboelastography (TEG) and rotational thromboelastometry (ROTEM), estimate the dynamics of blood coagulation. The evaluation of coagulopathy by VMs in severe COVID-19 infection seems an increasingly attractive option. Available evidence supports that COVID-19 patients with acute respiratory failure suffer from severe hypercoagulability rather than consumptive coagulopathy often associated with fibrinolysis shutdown. However, the variability in definitions of both the procoagulant profile and the clinical outcome assessment, in parallel with the small sample sizes in most of these studies, do not allow the establishment of a clear association between the hypercoagulable state and thrombotic events. VMs can effectively provide insight into the pathophysiology of coagulopathy, detecting the presence of hypercoagulability in critically ill COVID-19 patients. However, it remains unknown whether the degree of coagulopathy can be used in order to predict the outcome, establish a diagnosis or guide anticoagulant therapy.

scholarly journals Radiomics for the Diagnosis and Differentiation of Pancreatic Cystic Lesions

Diagnostics ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 505
Author(s):  
Jorge D. Machicado ◽  
Eugene J. Koay ◽  
Somashekar G. Krishna
Keyword(s):  
Predictive Accuracy ◽  
Quantitative Imaging ◽  
Standard Of Care ◽  
Small Sample ◽  
Cystic Lesions ◽  
Current Standard ◽  
Cross Sectional ◽  
Small Sample Sizes ◽  
Insight Into

Radiomics, also known as quantitative imaging or texture analysis, involves extracting a large number of features traditionally unmeasured in conventional radiological cross-sectional images and converting them into mathematical models. This review describes this approach and its use in the evaluation of pancreatic cystic lesions (PCLs). This discipline has the potential of more accurately assessing, classifying, risk stratifying, and guiding the management of PCLs. Existing studies have provided important insight into the role of radiomics in managing PCLs. Although these studies are limited by the use of retrospective design, single center data, and small sample sizes, radiomic features in combination with clinical data appear to be superior to the current standard of care in differentiating cyst type and in identifying mucinous PCLs with high-grade dysplasia. Combining radiomic features with other novel endoscopic diagnostics, including cyst fluid molecular analysis and confocal endomicroscopy, can potentially optimize the predictive accuracy of these models. There is a need for multicenter prospective studies to elucidate the role of radiomics in the management of PCLs.

scholarly journals The Influence of Genetic Variants on Striatal Dopamine Transporter and D2 Receptor Binding after TB

2014 ◽  
Vol 34 (8) ◽  
pp. 1328-1339 ◽  
Author(s):  
Amy K Wagner ◽  
Joelle M Scanion ◽  
Carl R Becker ◽  
Anne C Ritter ◽  
Christian Niyonkuru ◽  
...  
Keyword(s):  
Genetic Variants ◽  
Ventral Striatum ◽  
D2 Receptor ◽  
Variable Number ◽  
Small Sample ◽  
Post Injury ◽  
Positron Emission ◽  
Small Sample Sizes ◽  
Future Work

Dopamine (DA) neurotransmission influences cognition and recovery after traumatic brain injury (TBI). We explored whether functional genetic variants affecting the DA transporter (DAT) and D2 receptor (DRD2) impacted in vivo dopaminergic binding with positron emission tomography (PET) using [11C]βCFT and [11C]raclopride. We examined subjects with moderate/severe TBI ( N = 12) ~1 year post injury and similarly matched healthy controls ( N = 13). The variable number of tandem repeat polymorphism within the DAT gene and the Taql restriction fragment length polymorphism near the DRD2 gene were assessed. TBI subjects had age-adjusted DAT-binding reductions in the caudate, putamen, and ventral striatum, and modestly increased D2 binding in ventral striatum versus controls. Despite small sample sizes, multivariate analysis showed lower caudate and putamen DAT binding among DAT 9-allele carriers and DRD2 A2/A2 homozygotes with TBI versus controls with the same genotype. Among TBI subjects, 9-allele carriers had lower caudate and putamen binding than 10/10 homozygotes. This PET study suggests a hypodopaminergic environment and altered DRD2 autoreceptor DAT interactions that may influence DA transmission after TBI. Future work will relate these findings to cognitive performance; future studies are required to determine how DRD2/DAT1 genotype and DA-ligand binding are associated with neurostimulant response and TBI recovery.

scholarly journals The relationship between dose and serotonin transporter occupancy of antidepressants—a systematic review

2021 ◽  
Author(s):  
Anders Sørensen ◽  
Henricus G. Ruhé ◽  
Klaus Munkholm
Keyword(s):  
Serotonin Transporter ◽  
Antidepressant Treatment ◽  
Imaging Techniques ◽  
Small Sample ◽  
Short Treatment ◽  
Predicted Values ◽  
Small Sample Sizes ◽  
The Relationship ◽  
Short Treatment Duration

AbstractBrain imaging techniques enable the visualization of serotonin transporter (SERT) occupancy as a measure of the proportion of SERT blocked by an antidepressant at a given dose. We aimed to systematically review the evidence on the relationship between antidepressant dose and SERT occupancy. We searched PubMed and Embase (last search 20 May 2021) for human in vivo, within-subject PET, or SPECT studies measuring SERT occupancy at any dose of any antidepressant with highly selective radioligands ([11C]-DASB, [123I]-ADAM, and [11C]-MADAM). We summarized and visualized the dose-occupancy relationship for antidepressants across studies, overlaying the plots with a curve based on predicted values of a standard 2-parameter Michaelis–Menten model fitted using the observed data. We included seventeen studies of 10 different SSRIs, SNRIs, and serotonin modulators comprising a total of 294 participants, involving 309 unique occupancy measures. Overall, following the Michaelis–Menten equation, SERT occupancy increased with a higher dose in a hyperbolic relationship, with occupancy increasing rapidly at lower doses and reaching a plateau at approximately 80% at the usual minimum recommended dose. All the studies were small, only a few investigated the same antidepressant, dose, and brain region, and few reported information on factors that may influence SERT occupancy. The hyperbolic dose-occupancy relationship may provide mechanistic insight of relevance to the limited clinical benefit of dose-escalation in antidepressant treatment and the potential emergence of withdrawal symptoms. The evidence is limited by non-transparent reporting, lack of standardized methods, small sample sizes, and short treatment duration. Future studies should standardize the imaging and reporting procedures, measure occupancy at lower antidepressant doses, and investigate the moderators of the dose-occupancy relationship.

scholarly journals MicroRNAs as Salivary Markers for Periodontal Diseases: A New Diagnostic Approach?

2016 ◽  
Vol 2016 ◽  
pp. 1-14 ◽  
Author(s):  
Gerhard Schmalz ◽  
Simin Li ◽  
Ralph Burkhardt ◽  
Sven Rinke ◽  
Felix Krause ◽  
...  
Keyword(s):  
Periodontal Diseases ◽  
Small Sample ◽  
In Vivo Studies ◽  
Case Definitions ◽  
Tissue Samples ◽  
Cancer Types ◽  
Small Sample Sizes ◽  
Noninvasive Markers

The aim of this review is to discuss current findings regarding the roles of miRNAs in periodontal diseases and the potential use of saliva as a diagnostic medium for corresponding miRNA investigations. For periodontal disease, investigations have been restricted to tissue samples and five miRNAs, that is, miR-142-3p, miR-146a, miR-155, miR-203, and miR-223, were repeatedly validated in vivo and in vitro by different validation methods. Particularly noticeable are the small sample sizes, different internal controls, and different case definitions of periodontitis in in vivo studies. Beside of that, the validated miRNAs are associated with inflammation and therefore with various diseases. Furthermore, several studies successfully explored the use of salivary miRNA species for the diagnosis of oral cancer. Different cancer types were investigated and heterogeneous methodology was used; moreover, no overlap of results was found. In conclusion, five miRNAs have consistently been reported for periodontitis; however, their disease specificity, detectability, and expression in saliva and their importance as noninvasive markers are questionable. In principle, a salivary miRNA diagnostic method seems feasible. However, standardized criteria and protocols for preanalytics, measurements, and analysis should be established to obtain comparable results across different studies.

scholarly journals The Role of Rotational Thromboelastometry (ROTEM) in Understanding the Coagulation Problems in COVID-19 Associated Critical Illness

2021 ◽  
Author(s):  
Natalie Duric ◽  
Tamas Szakmany
Keyword(s):  
Disease Process ◽  
Rotational Thromboelastometry ◽  
Medical Interventions ◽  
Test Parameters ◽  
Bedside Test ◽  
Coagulation Tests ◽  
High Incidence ◽  
The Subject

In critically ill patients with COVID-19, concomitant abnormalities of coagulation have been seen with an unusually high incidence. Standard coagulation tests are limited in their ability accurately to reflect the severity of the pro-thrombotic phenotype observed in severe COVID-19 infections. In this narrative review we consider the role of rotational thromboelastometry (ROTEM) as a near bedside test allowing a more comprehensive assessment of haemostatic function in the context of COVID-19 infection. Comprehensive literature search was conducted on PubMed, revealing 13 publications on the subject. The coagulopathy of this disease process appears to be insufficiently represented with often normal conventional coagulation test parameters. Whilst not the perfect substitute for in vivo coagulation, studies utilising rotational thromboelastometry assays in COVID-19 patients have demonstrated increased maximum clot firmness (consistent with hyper-coagulability) and reduced maximum lysis (consistent with “fibrinolytic shutdown”). ROTEM appears to be a possible tool for risk stratification and to monitor the potential modulation of fibrinogen-dependent coagulation processes with enhanced anti-coagulation strategies. Precisely how these coagulation abnormalities can be modified by optimum, individualised medical interventions to improve clinical outcome, however, remains unclear.

scholarly journals ViSiElse: An innovative R-package to visualize raw behavioral data over time

2019 ◽  
Author(s):  
Elodie M Garnier ◽  
Nastasia Fouret ◽  
Médéric Descoins
Keyword(s):  
R Package ◽  
Group Behavior ◽  
Small Sample ◽  
Time Data ◽  
Raw Data ◽  
New Approach ◽  
Small Sample Sizes ◽  
Single Graph ◽  
Insight Into ◽  
Over Time

The scientific community encourages the use of raw data graphs to improve the reliability and transparency of the results presented in articles. However, the current methods used to visualize raw data are limited to one or two numerical variables per graph and/or small sample sizes. In the behavioral sciences, numerous variables must be plotted together in order to gain insight into the behavior in question. In this paper, we present ViSiElse, an R-package offering a new approach in the visualization of raw data. ViSiElse was developed with the open-source software R to visualize behavioral observations over time based on raw time data extracted from visually recorded sessions of experimental observations. ViSiElse gives a global overview of a process by creating a visualization of the timestamps for multiple actions and all participants into a single graph; individual or group behavior can then be easily assessed. Additional features allow users to further inspect their data by including summary statistics and time constraints.

scholarly journals ViSiElse: an innovative R-package to visualize raw behavioral data over time

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8341
Author(s):  
Elodie M. Garnier ◽  
Nastasia Fouret ◽  
Médéric Descoins
Keyword(s):  
R Package ◽  
Group Behavior ◽  
Small Sample ◽  
Time Data ◽  
Raw Data ◽  
New Approach ◽  
Small Sample Sizes ◽  
Single Graph ◽  
Insight Into ◽  
Over Time

The scientific community encourages the use of raw data graphs to improve the reliability and transparency of the results presented in articles. However, the current methods used to visualize raw data are limited to one or two numerical variables per graph and/or small sample sizes. In the behavioral sciences, numerous variables must be plotted together in order to gain insight into the behavior in question. In this article, we present ViSiElse, an R-package offering a new approach in the visualization of raw data. ViSiElse was developed with the open-source software R to visualize behavioral observations over time based on raw time data extracted from visually recorded sessions of experimental observations. ViSiElse gives a global overview of a process by creating a visualization of the timestamps for multiple actions and all participants into a single graph; individual or group behavior can then be easily assessed. Additional features allow users to further inspect their data by including summary statistics and time constraints.

The Use of DCE-MRI to Evaluate the Blood Supply to the Nipple-Areola Complex: A Study in 245 Asian Women

2021 ◽  
Vol 41 (6) ◽  
pp. NP346-NP354
Author(s):  
Dawei Wang ◽  
Shixuan Xiong ◽  
Tao Ai ◽  
Ning Zeng ◽  
Yuping Ren ◽  
...  
Keyword(s):  
Blood Supply ◽  
Maximum Intensity Projection ◽  
Small Sample ◽  
Asian Women ◽  
Dce Mri ◽  
Nipple Areola Complex ◽  
Areola Complex ◽  
Breast Plastic Surgery ◽  
Small Sample Sizes

Abstract Background Understanding the main blood supply to the nipple-areola complex (NAC) is important for breast plastic surgery. However, previous reports have involved studies of cadavers and small sample sizes. Objectives This study aimed to identify and classify the in vivo blood supply to the NAC based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Methods DCE-MRI images of 393 breasts in 245 Asian women obtained from March 2012 to October 2019 were included retrospectively. Axial, coronal, and sagittal maximum-intensity projection images were evaluated to identify all vessels supplying the NAC. Blood supply to the NAC was classified into 9 anatomic zones: superomedial (Ia), medial (Ib), inferomedial (Ic), superolateral (IIa), lateral (IIb), inferolateral (IIc), central (III), inferior (IV), and superior (V). Results A total of 637 source vessels were identified in 393 breasts. Of the 393 breasts, 211 (53.7%) were supplied by a single zone, 132 (33.6%) by 2 zones, 38 (9.7%) by 3 zones, and 12 (3.1%) by 4 zones. Of the 637 vessels, 269 (42.2%) vessels were in zone Ia, 180 (28.3%) vessels were in zone IIa, and <10% of vessels were in the other zones. The number of NAC perfusion zones (P = 0.093) and the distribution of source vessels (P = 0.602) did not differ significantly between the left and right breasts. Conclusions DCE-MRI provides a clear indication of the blood supply to the NAC. Blood vessels from the superomedial and superolateral zones were the predominant sources of blood supplying the NAC.

A Perspective on Tachibana's Eta-Squared Analyses of the Results of the Nctr Collaborative Behavioral Teratology Study

1989 ◽  
Vol 65 (3) ◽  
pp. 819-823 ◽  
Author(s):  
Charles V. Vorhees
Keyword(s):  
Small Sample ◽  
Independent Experiment ◽  
Pregnant Rats ◽  
Treatment Groups ◽  
Large Numbers ◽  
Eta Squared ◽  
Behavioral Teratology ◽  
Small Sample Sizes ◽  
Strength Of Association ◽  
Insight Into

The NCTR Collaborative Behavioral Teratology Study (CBTS) data have been reanalyzed by Tachibana (1989) using the strength of association statistic η2 as a means of examining the reliability of the data. This is an important issue, because determining the reliability of behavioral teratological measures was one of the CBTS's principal aims. The η2 approach is a useful one, but its value is critically dependent on the assumption that it is applied to the data appropriately. The CBTS was a project which involved large numbers of pregnant rats and their offspring, tested postnatally on a large number of physical and behavioral tests. The project was conducted in six laboratories and involved two experiments with four treatment groups/experiment, 16 dams/group, and 8 offspring/dam. For practical more than theoretical reasons, each of these large experiments was conducted in balanced replicates of 4 dams/group. Since this had to be done, replicate was included in the statistical models used to evaluate the data. Tachibana (1989) has performed a series of η2 analyses on the CBTS data as if each replicate constituted an independent experiment and concluded that the reproducibility of the CBTS data was not particularly good. Tachibana's η2 analyses are discussed as problematic because the data should have been analyzed as intended, by experiment ( n = 16/group), not by replicates. There are well-known problems associated with the reliability of small sample sizes in any experiment and Tachibana's conclusion, based as it is on replicates, offers little insight into the reproducibility of behavioral teratogenicity data generally or from the CBTS project specifically.

Does Spending Money on Others Promote Happiness?: A Registered Replication Report

2020 ◽  
Author(s):  
Lara Beth Aknin ◽  
Elizabeth Warren Dunn ◽  
Jason Douglas Edward Proulx ◽  
Iris Lok ◽  
Michael I. Norton
Keyword(s):  
Prosocial Behavior ◽  
Small Sample ◽  
Task Engagement ◽  
Sample Sizes ◽  
Null Results ◽  
Prosocial Spending ◽  
Low Levels ◽  
Momentary Happiness ◽  
Small Sample Sizes ◽  
Insight Into

Research indicates that spending money on others—prosocial spending—leads to greater happiness than spending money on oneself (e.g., Dunn, Aknin, & Norton, 2008; 2014). These findings have received widespread attention because they offer insight into why people engage in costly prosocial behavior, and what constitutes happier spending more broadly. However, most studies on prosocial spending (like most research on the emotional benefits of generosity) utilized small sample sizes (n<100/cell). In light of new, improved standards for evidentiary value, we conducted high-powered registered replications of the central paradigms used in prosocial spending research. In Experiment 1, 712 students were randomly assigned to make a purchase for themselves or a stranger in need and then reported their happiness. As predicted, participants assigned to engage in prosocial (vs. personal) spending reported greater momentary happiness. In Experiment 2, 1950 adults recalled a time they spent money on themselves or someone else and then reported their current happiness; contrary to predictions, participants in the prosocial spending condition did not report greater happiness than those in the personal spending condition. Because low levels of task engagement may have produced these null results, we conducted a replication with minor changes designed to increase engagement; in this Experiment 3 (N = 5,199), participants who recalled a prosocial (vs. personal) spending memory reported greater happiness but differences were small. Taken together, these studies support the hypothesis that spending money on others does promote happiness, but demonstrate that the magnitude of the effect depends on several methodological features.

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