Shear wave elastography in early diabetic kidney disease

SUMMARY OBJECTIVE: This study aimed to analyze the kidneys among the subjects with early stages of type 2 diabetic kidney disease by shear wave elastography quantitatively. METHODS: A total of 108 patients with type 2 diabetic kidney disease and 17 control subjects were enrolled. According to the estimated glomerular filtration rate and urinary albumin-to-urinary creatinine ratio, patients were classified into stages 1 to 3 diabetic kidney disease. Grayscale ultrasound andshear wave elastography were performed. The sizes, depths, and shear wave elastography values were recorded. These parameters were compared between the diabetic kidney disease and the control subjects. RESULTS: The mean shear wave elastography values were significantly higher in the diabetic kidney disease group (10.156±1.75 kPa vs. 8.241±1.4 kPa; p<0.001). We obtained statistically significantly higher shear wave elastography values in stages 2 and 3 diabetic kidney disease subjects than control subjects and in patients with stage 3 diabetic kidney disease compared to those with stage 1 diabetic kidney disease (p<0.05 for all). We obtained a cutoff value of 9.23 kPa for predicting diabetic kidney disease in early stages, with a sensitivity of 67% and a specificity of 82%. CONCLUSION: Shear wave elastography may be used as a noninvasive, simple, and quantitative method to provide diagnostic information as a part of routine management of patients with type 2 diabetes mellitus, especially in the early stages of diabetic kidney disease.

Shear wave elastography in early diabetic kidney disease.

OBJECTIVE: This study aimed to analyze the kidneys among the subjects with early stages of type 2 diabetic kidney disease by shear wave elastography quantitatively. METHODS: A total of 108 patients with type 2 diabetic kidney disease and 17 control subjects were enrolled. According to the estimated glomerular filtration rate and urinary albumin-to-urinary creatinine ratio, patients were classified into stages 1 to 3 diabetic kidney disease. Grayscale ultrasound andshear wave elastography were performed. The sizes, depths, and shear wave elastography values were recorded. These parameters were compared between the diabetic kidney disease and the control subjects. RESULTS: The mean shear wave elastography values were significantly higher in the diabetic kidney disease group (10.156±1.75 kPa vs. 8.241±1.4 kPa; p<0.001). We obtained statistically significantly higher shear wave elastography values in stages 2 and 3 diabetic kidney disease subjects than control subjects and in patients with stage 3 diabetic kidney disease compared to those with stage 1 diabetic kidney disease (p<0.05 for all). We obtained a cutoff value of 9.23 kPa for predicting diabetic kidney disease in early stages, with a sensitivity of 67% and a specificity of 82%. CONCLUSION: Shear wave elastography may be used as a noninvasive, simple, and quantitative method to provide diagnostic information as a part of routine management of patients with type 2 diabetes mellitus, especially in the early stages of diabetic kidney disease.

Attractive Versus Golden Ratios: Formula of Utopian Beauty through Comparison of Facial Proportions among Worldwide Celebrities and Average People.

INTRODUCTION: Beauty criteria change according to trends, cultures, and expectations. So, the golden ratios are not enough to understand the actual beauty concept. OBJECTIVE: It is aimed to create a method and formula to define beauty in terms of different facial measurements and ratios as variables. METHODS: Frontal view photographs of 50 celebrities and 50 volunteers (female [ n = 70] and male [ n = 30]) were obtained. Thirty-three specific facial points were used. Fifty-nine measurements of distances between those points and ratios of those distances are used as statistical variables. Mean values of those variables for celebrities are compared with all participants.Then, ''total beauty score'' using statically significant differences is defined. Points according to the importance level of interested value are assigned; 1 point for a significance of 0.001 ≤ P < 0.05 and 2 points for P < 0.001. Possible independent variables for the prediction of Utopian Beauty Score were determined using linear regression analysis. Finally, 10 variables (6 measurements and 4 ratios) are used to determine a formula for beauty. RESULTS: In celebrities, the distance between head apex and hair border, lower lip vertical length, the distance between brow medial borders and forehead vertical length were higher than the average population ( P < 0.001, 0.023, 0.034, 0.001, respectively). However, the width of columella, a length between bilateral ala nasi, horizontal face, and vertical nose length, and the distance between brow apexeyelash line were shorter ( P = 0.005, < 0.001, < 0.001, < 0.001, < 0.001, respectively). Some study variables had severely significant correlations with the total beauty point (M29, r = -0.744, P < 0.001; R19, r =-0.745, P < 0.001; and R30, r = -0.735, P < 0.001). The linear regression formula for Utopian Beauty Score was determined according to statistically significant variables as y = 86.5 - 3.6 M5 + 8.1 M14 + 11.1 M20 - 6.4 M25-8.7 M29-10.3 M30-15.6 R19 + 9.3 R20 + 16.4 R25 + 18.3 R26. CONCLUSIONS: A large forehead, small nose with lifted tip, plump lip, brows with lateral apex, well-spaced eyes, and ovoid, elliptical face lines are seem to be more attractive. Additionally, a method to create a formula for beauty with variables of different measurements and ratios of facial points are determined.

Quantitative Color Doppler Ultrasonography Measurement of Thyroid Blood Flow in Patients with Graves' Disease.

BACKGROUND: Graves' Disease is an autoimmune disorder characterized by increased levels of thyroid hormones correlated with increased thyroid blood flow. Thyroid scintigraphy is an important and conventional method. However, it has limited accessibility, has ionizing radiation, and is expensive. OBJECTIVES: To investigate the thyroid blood flow in patients with Graves' Disease by color Doppler Ultrasonography and a newly developed software Color Quantification. METHODS: Forty-one consecutive subjects with GD and 41 healthy controls were enrolled. Color Doppler ultrasonography parameters of the thyroid arteries and Color Quantification values of the gland were measured by a radiologist. The correlations between thyroid blood flow parameters, levels of 99mTechnetium pertechnetate uptake, thyrotropin, and free thyroxine were evaluated. The diagnostic performances of these parameters were investigated. RESULTS: The peak systolic-end diastolic velocities of thyroid arteries and Color Quantification values were increased in the study group (p < 0.05 for all). We observed negative correlations between thyrotropin levels and peak-systolic and end-diastolic velocities of superior thyroid arteries and Color Quantification values. There were positive correlations between 99mTechnetium uptake levels and thyroid blood flow parameters (p < 0.05 for all). In the diagnostic performance of thyroid blood flow parameters, we observed utilities significantly in peak-systolic and end-diastolic velocities of thyroid arteries and Color Quantification values (p < 0.05 for all). CONCLUSION: The increased peak-systolic and end-diastolic velocities of thyroid arteries, and increased Color Quantification values might be helpful in the diagnosis of Graves' Disease.

A Novel On-Chip Method for Differential Extraction of Sperm in Forensic Cases.

One out of every six American women has been the victim of a sexual assault in their lifetime. However, the DNA casework backlog continues to increase outpacing the nation's capacity since DNA evidence processing in sexual assault casework remains a bottleneck due to laborious and time-consuming differential extraction of victim's and perpetrator's cells. Additionally, a significant amount (60-90%) of male DNA evidence may be lost with existing procedures. Here, a microfluidic method is developed that selectively captures sperm using a unique oligosaccharide sequence (Sialyl-LewisX), a major carbohydrate ligand for sperm-egg binding. This method is validated with forensic mock samples dating back to 2003, resulting in 70-92% sperm capture efficiency and a 60-92% reduction in epithelial fraction. Captured sperm are then lysed on-chip and sperm DNA is isolated. This method reduces assay-time from 8 h to 80 min, providing an inexpensive alternative to current differential extraction techniques, accelerating identification of suspects and advancing public safety.

Reduced Graphene Oxide-GelMA Hybrid Hydrogels as Scaffolds for Cardiac Tissue Engineering.

Biomaterials currently used in cardiac tissue engineering have certain limitations, such as lack of electrical conductivity and appropriate mechanical properties, which are two parameters playing a key role in regulating cardiac cell behavior. Here, the myocardial tissue constructs are engineered based on reduced graphene oxide (rGO)-incorporated gelatin methacryloyl (GelMA) hybrid hydrogels. The incorporation of rGO into the GelMA matrix significantly enhances the electrical conductivity and mechanical properties of the material. Moreover, cells cultured on composite rGO-GelMA scaffolds exhibit better biological activities such as cell viability, proliferation, and maturation compared to ones cultured on GelMA hydrogels. Cardiomyocytes show stronger contractility and faster spontaneous beating rate on rGO-GelMA hydrogel sheets compared to those on pristine GelMA hydrogels, as well as GO-GelMA hydrogel sheets with similar mechanical property and particle concentration. Our strategy of integrating rGO within a biocompatible hydrogel is expected to be broadly applicable for future biomaterial designs to improve tissue engineering outcomes. The engineered cardiac tissue constructs using rGO incorporated hybrid hydrogels can potentially provide high-fidelity tissue models for drug studies and the investigations of cardiac tissue development and/or disease processes in vitro.

The Association of Brain-Derived Neurotrophic Factor Gene Polymorphism with Obstructive Sleep Apnea Syndrome and Obesity.

BACKGROUND: Obesity represents a major risk factor for Obstructive Sleep Apnea Syndrome (OSAS). Brain-derived neurotrophic factor (BDNF) affects the mechanisms that regulate weight, eating behavior, and metabolism. This project aims to investigate the possible association of BDNF gene polymorphism with obesity and OSAS, and to contribute knowledge to the understanding of the pathophysiology of OSAS. METHODS: The subjects included in this study were selected among the individuals who were hospitalized in the Erciyes University Medical School Chest Diseases Sleep Medicine Laboratory. Subjects were divided into four groups based on the presence of OSAS and/or obesity. Group 1 included OSAS+ obesity+ patients, Group 2 included OSAS+ obesity- patients, Group 3 included OSAS- obesity+ patients, and Group 4 included OSAS- obesity- patients. The targeted patient number per each study group was 45, but only 32 patients could be enrolled into Group 3. RESULTS: Out of a total number of 167 subjects, 117 (70.1 %) had BDNF 196G/G, 48 (28.7 %) had BDNF 196G/A, and 2 (1.2 %) had BDNF 196A/A genotype. Of 48 subjects having BDNF 196G/A genotype, 32 (66.6 %) were obese, and 16 (33.3 %) were non-obese. Out of 90 subjects with OSAS, 64 (71.1 %) had BDNF 196G/G, and 25 (27.8 %) had BDNF 196G/A genotype. Out of 77 subjects without OSAS, BDNF 196G/G, and BDNF 196G/A genotypes were detected in 53 (68.8 %) and 23 (29.9 %) subjects, respectively. A statistically significant difference was demonstrated between the four study groups in terms of BDNF rs6265 polymorphism (p = 0.013). This difference was attributed to OSAS+ obesity- Group, in which BDNF 196G/G genotype was more common and BDNF 196G/A polymorphism was less common than the patients in other groups. CONCLUSION: In conclusion, BDNF 196G/A genotype was found to be more frequent among obese patients compared to the non-obese individuals, but it was not significantly related to OSAS in the present study. BDNF196G/G genotype was more common and BDNF 196G/A polymorphism was less common among OSAS+ obesity- subjects compared to the other study groups.

Engineering long shelf life multi-layer biologically active surfaces on microfluidic devices for point of care applications.

Although materials and engineered surfaces are broadly utilized in creating assays and devices with wide applications in diagnostics, preservation of these immuno-functionalized surfaces on microfluidic devices remains a significant challenge to create reliable repeatable assays that would facilitate patient care in resource-constrained settings at the point-of-care (POC), where reliable electricity and refrigeration are lacking. To address this challenge, we present an innovative approach to stabilize surfaces on-chip with multiple layers of immunochemistry. The functionality of microfluidic devices using the presented method is evaluated at room temperature for up to 6-month shelf life. We integrated the preserved microfluidic devices with a lensless complementary metal oxide semiconductor (CMOS) imaging platform to count CD4(+) T cells from a drop of unprocessed whole blood targeting applications at the POC such as HIV management and monitoring. The developed immunochemistry stabilization method can potentially be applied broadly to other diagnostic immuno-assays such as viral load measurements, chemotherapy monitoring, and biomarker detection for cancer patients at the POC.

Printed Flexible Plastic Microchip for Viral Load Measurement through Quantitative Detection of Viruses in Plasma and Saliva.

We report a biosensing platform for viral load measurement through electrical sensing of viruses on a flexible plastic microchip with printed electrodes. Point-of-care (POC) viral load measurement is of paramount importance with significant impact on a broad range of applications, including infectious disease diagnostics and treatment monitoring specifically in resource-constrained settings. Here, we present a broadly applicable and inexpensive biosensing technology for accurate quantification of bioagents, including viruses in biological samples, such as plasma and artificial saliva, at clinically relevant concentrations. Our microchip fabrication is simple and mass-producible as we print microelectrodes on flexible plastic substrates using conductive inks. We evaluated the microchip technology by detecting and quantifying multiple Human Immunodeficiency Virus (HIV) subtypes (A, B, C, D, E, G, and panel), Epstein-Barr Virus (EBV), and Kaposi's Sarcoma-associated Herpes Virus (KSHV) in a fingerprick volume (50 µL) of PBS, plasma, and artificial saliva samples for a broad range of virus concentrations between 10(2) copies/mL and 10(7) copies/mL. We have also evaluated the microchip platform with discarded, de-identified HIV-infected patient samples by comparing our microchip viral load measurement results with reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) as the gold standard method using Bland-Altman Analysis.

Paper and flexible substrates as materials for biosensing platforms to detect multiple biotargets.

The need for sensitive, robust, portable, and inexpensive biosensing platforms is of significant interest in clinical applications for disease diagnosis and treatment monitoring at the point-of-care (POC) settings. Rapid, accurate POC diagnostic assays play a crucial role in developing countries, where there are limited laboratory infrastructure, trained personnel, and financial support. However, current diagnostic assays commonly require long assay time, sophisticated infrastructure and expensive reagents that are not compatible with resource-constrained settings. Although paper and flexible material-based platform technologies provide alternative approaches to develop POC diagnostic assays for broad applications in medicine, they have technical challenges integrating to different detection modalities. Here, we address the limited capability of current paper and flexible material-based platforms by integrating cellulose paper and flexible polyester films as diagnostic biosensing materials with various detection modalities through the development and validation of new widely applicable electrical and optical sensing mechanisms using antibodies and peptides. By incorporating these different detection modalities, we present selective and accurate capture and detection of multiple biotargets including viruses (Human Immunodeficiency Virus-1), bacteria (Escherichia coli and Staphylococcus aureus), and cells (CD4(+) T lymphocytes) from fingerprick volume equivalent of multiple biological specimens such as whole blood, plasma, and peritoneal dialysis effluent with clinically relevant detection and sensitivity.

Portable lensless wide-field microscopy imaging platform based on digital inline holography and multi-frame pixel super-resolution.

In this paper, an irregular displacement-based lensless wide-field microscopy imaging platform is presented by combining digital in-line holography and computational pixel super-resolution using multi-frame processing. The samples are illuminated by a nearly coherent illumination system, where the hologram shadows are projected into a complementary metal-oxide semiconductor-based imaging sensor. To increase the resolution, a multi-frame pixel resolution approach is employed to produce a single holographic image from multiple frame observations of the scene, with small planar displacements. Displacements are resolved by a hybrid approach: (i) alignment of the LR images by a fast feature-based registration method, and (ii) fine adjustment of the sub-pixel information using a continuous optimization approach designed to find the global optimum solution. Numerical method for phase-retrieval is applied to decode the signal and reconstruct the morphological details of the analyzed sample. The presented approach was evaluated with various biological samples including sperm and platelets, whose dimensions are in the order of a few microns. The obtained results demonstrate a spatial resolution of 1.55 µm on a field-of-view of ≈30 mm2.

Assessment of color Doppler ultrasonography findings in gynecomastia.

AIM: To evaluate the color Doppler ultrasound (US) findings of gynecomastia and compare them with sonographic Tanner staging to determine an additional diagnostic tool. PATIENTS AND METHODS: Eighteen male (mean age 13.87 ± 1.72) patients (36 breasts) with breast enlargement were examined with gray-scale and color Doppler ultrasound (US), and these were used to determine the Tanner stages. In addition, the arterial and venous flow scores were assessed. The resistivity index (RI) values were also measured at the medial, lateral, and retroareolar regions of the breasts, and the mean RI values for each breast were then calculated. RESULTS: Gynecomastia was detected in 30 breasts, and the mean retroareolar thickness was 8.03 mm. Furthermore, arterial and venous flows were detected in 73.3% and 56.7% of the breasts, respectively. However, there was no correlation between the arterial and venous flows and the retroareolar glandular tissue thickness. The average of the mean RI values of the three regions of the breast was 0.62, and there was a statistically significantly positive correlation between the mean RI values of the breasts and the Tanner stages as established by US. Furthermore, there was a strongly significant positive correlation between the arterial and venous flow scores and the Tanner stages. CONCLUSIONS: Our research indicates that vascularity is correlated with breast development in patients with gynecomastia. Additionally, we determined that RI values might be as important as Tanner stages on US.