Predictive value of D-Dimer and thromboplastin time as coagulation indicators for COVID-19 patients.

INTRODUCTION: Coronavirus 2019 symptoms include coagulopathy and thromboembolic risk. Using one parameter to diagnose coagulopathy has little predictive value. OBJECTIVE: This study will examine if D-dimer and APTT testing can predict COVID-19 severity and aid triage and manage patients. METHODS: 214 COVID-19 patients were enrolled and classified into two categories based on their respiratory manifestations; mild (126 cases) and severe (88 cases). Patient data regarding age, gender, D-Dimer level, and APTT level were collected. When both D-Dimer and APTT levels were abnormal, in this study, the patient was considered to have a coagulation disorder. Indicators of coagulation in the COVID-19 patients were collected and compared between the two groups. Chi-square (χ2) tests were used to determine the significant differences between coagulation disorders in the two groups. RESULTS: Our findings showed that patients with coagulopathies were more likely to belong to the severe group. Within the two groups of patients, the rate of coagulation disorders was as follows: mild = 8.8 % within coagulation disorders, 4.8% within the two Groups; severe = 91.2 % within coagulation disorders, 77.8 % within the two Groups. There was a statistically significant relationship between coagulation disorder and severe COVID-19 patients compared to mild patients (p < 0.05). CONCLUSIONS: Coagulation disorders are more likely to occur in severe COVID-19 patients. D-Dimer and APTT tests are significant indicators for predicting COVID-19 severity. Our research found an abnormal pattern of coagulation disorders and COVID-19 severity that should be considered in the COVID-19 treatment protocol.

Systematic Review Between Resting-State fMRI and Task fMRI in Planning for Brain Tumour Surgery.

As an alternative to task-based functional magnetic resonance imaging (T-fMRI), resting-state functional magnetic resonance imaging (Rs-fMRI) is suggested for preoperative mapping of patients with brain tumours, with an emphasis on treatment guidance and neurodegeneration prediction. A systematic review was conducted of 18 recent studies involving 1035 patients with brain tumours and Rs-fMRI protocols. This was accomplished by searching the electronic databases PubMed, Scopus, and Web of Science. For clinical benefit, we compared Rs-fMRI to standard T-fMRI and intraoperative direct cortical stimulation (DCS). The results of Rs-fMRI and T-fMRI were compared and their correlation with intraoperative DCS results was examined through a systematic review. Our exhaustive investigation demonstrated that Rs-fMRI is a dependable and sensitive preoperative mapping technique that detects neural networks in the brain with precision and identifies crucial functional regions in agreement with intraoperative DCS. Rs-fMRI comes in handy, especially in situations where T-fMRI proves to be difficult because of patient-specific factors. Additionally, our exhaustive investigation demonstrated that Rs-fMRI is a valuable tool in the preoperative screening and evaluation of brain tumours. Furthermore, its capability to assess brain function, forecast surgical results, and enhance decision-making may render it applicable in the clinical management of brain tumours.

Fe-nanoparticle effect on polypropylene for effective radiation protection: Simulation and theoretical study.

An evaluation of the gamma-neutron shielding capabilities of polymer nanocomposite materials based on polypropylene and iron nanoparticles is presented in this study. The chemical composition of the materials is (100-x) PP-Fex, (where x = 0.1, 0.3, 0.5, 1, 2 and 5 wt percent). For the proposed polymer samples with photon energies ranging from 30 to 2000 KeV, the mass attenuation coefficient (MAC), a crucial parameter for studying gamma-ray shielding capability, was calculated using the Geant4 Monte Carlo code. Results were compared with those predicted by EpiXS. The values of the Geant4 code and the EpiXS software were both found to be in excellent agreement. Using the mass attenuation coefficient values, we determined the linear attenuation coefficients, electron density, effective atomic number, and half value layer for all the samples. The shielding properties of the polymer samples were also evaluated by estimating both the fast neutron removal cross-section and the mean free path of the fast neutron at energies between 0.25 and 5.5 keV. The study's findings indicate a positive correlation between the Fe nanoparticle content and the gamma-ray shielding performance of PP-Fe polymer samples. Out of the several glasses that were evaluated, it was found that the PP-Fe5 polymer sample demonstrates the highest efficacy in terms of gamma-ray shielding. Moreover, the polymer sample PP-Fe5, which consists of 5 mol% of iron (Fe), exhibits the highest value of ∑R (1.10650 cm-1) and the lowest value of the mean free path for fast neutrons. This indicates that the PP-Fe5 possesses better gamma-neutron shielding efficiency.

Attitudes toward the Integration of Radiographers into the First-Line Interpretation of Imaging Using the Red Dot System.

The red dot system uses expertise in the identification of anomalies to assist radiologists in distinguishing radiological abnormalities and managing them before the radiologist report is sent. This is a small step on the road to greater role development for radiographers. This practice has existed for more than 20 years in the UK. Today, it is only the UK seeking to legislate radiographer reports. The aim of this paper is to put focus on this issue, determine whether radiographer reports are necessary, and explore whether there are any benefits that can be highlighted to encourage health authorities worldwide to allow radiographers to write clinical reports. Additionally, this study was conducted to evaluate the role of radiographers (non-radiologists) in medical image interpretation, using 95 samples that were collected randomly and a representative sample of radiographers and radiologists of both genders. The SPSS program was used for the statistical analysis of the samples and to scientifically explain the results. We found that radiologists have no objections to the participation of radiographers in diagnosis assistance, interpretation, and clinical reporting through the red dot system. Therefore, there was support for the future implementation of such a system in health care.

A review of ultrasound contrast media.

Efforts have been made over the last five decades to create effective ultrasonic contrast media (UCM) for cardiac and noncardiac applications. The initial UCM was established in the 1980s, following publications from the 1960s that detailed the discovery of ultrasonic contrast enhancement using small gaseous bubbles in echocardiographic examinations. An optimal contrast agent for echography should possess the following characteristics: non-toxicity, suitability for intravenous injection, ability to traverse pulmonary, cardiac, and capillary circulations, and stability for recirculation. Definity, Optison, Sonazoid, and SonoVue are examples of current commercial contrast media. These contrast media have shown potential for various clinical reasons, both on-label and off-label. Several possible UCMs have been developed or are in progress. Advancements in comprehending the physical, chemical, and biological characteristics of microbubbles have significantly improved the visualization of tumor blood vessels, the identification of areas with reduced blood supply, and the enhanced detection of narrowed blood vessels. Innovative advances are expected to enhance future applications such as ultrasonic molecular imaging and therapeutic utilization of microbubbles.

Jordanian women's (studying or working in medical fields) awareness in terms of the use of dental imaging during pregnancy.

BACKGROUND: The anxiety among pregnant women about the imaging of teeth during pregnancy may have an adverse effect on the oral health of both the mother and the fetus too. This research study was conducted to evaluate women's knowledge of the utilization of dental imaging during pregnancy. METHODS: In this research, structured questionnaires were distributed electronically through social media. The questionnaires contained questions focused on the women's (studying or working in medical fields) awareness regarding the ionizing radiation protection that takes place during dental imaging, the safest period for dental imaging, the sort of radiographs that can be required, and the chance of radiation-induced malignant tumor and malformation of the fetal as a result of dental imaging. RESULTS: Overall, 984 participants completed questionnaires that were analyzed after being received. Most of the participants (n = 637; 64.7%) were < 30 years of age. The greater number of the participants (66.8%) had fair knowledge of dental imaging. 25.4% mentioned that pregnant women are able to do dental imaging during the first trimester. And approximately half of the participants thought that cone-beam computed tomography and panoramic images must not be carried out during pregnancy. Moreover, nearly the same percentage of them also believed that the risk of inborn malformation is high due to dental imaging. CONCLUSIONS: The results refer to a low awareness among people who have medical knowledge regarding dental radiograph protection during pregnancy. This needs to be paid attention to among students, graduates, and workers in medical fields by focusing on the courses and lectures related to dental imaging protection during pregnancy.

Performance Evaluation of an Ultrasonic Imaging System Using Tissue-Mimicking Phantoms for Quality Assurance.

Diagnostic ultrasound or sonography is an image that can provide valuable information for diagnosing and treating a variety of diseases and conditions. The aim of this research study is to examine the performance and accuracy of the ultrasonic imaging system for the guarantee of diagnosis quality assurance, and to adjust the penetration settings to minimize the time of repeat scans and maintenance duration during research experiments. Measurements in this experiment included the resolution (axial and lateral) and focal zones. Moreover, the evaluation was done by completing all the measurements at different depths on a multipurpose phantom model 539. The phantom was bought from the market and was not fabricated by the author. The measurements were achieved by applying two different transducers: curved and linear (flat). The ultrasound images were obtained and tested by using calipers (electronic), and the estimations and observations were read by using all the taken measurements and images. As a result, because the phantom depths were different, the penetration settings were different too, indicating that the depth impacted the penetrations of the created ultrasound image. Moreover, after the comparison of the recorded measurements and results, it was found that all measurements were within the accepted (standard) value and that the true value was specified by the production of the phantom.

The Effect of an Energy Window with an Ellipsoid Phantom on the Differential Defect Contrast on Myocardial SPECT Images.

Good quality single-photon emission computed tomography (SPECT) images are required to achieve a perfect diagnosis and determine the severity of defects within the myocardial wall. There are many techniques that can support the diagnosis of defect formations in acquired images and contribute to avoiding errors before image construction. The main aim of this study was to determine the effect of energy width (15%, 20%, and 25%) on defect contrast in myocardial SPECT images correlated with the decentralization of positioning of a phantom. A phantom of polyethylene plastic was used to mimic the myocardial wall of the left ventricle. The phantom consists of two chambers, inner and outer. Two rectangular pieces of plastic were placed in anterior and inferior locations in the mid-region of the myocardial phantom to simulate myocardial infarction (defects). The average defect contrast for all phantom positions using 15% to 20% energy was (1.2, 1.6) for the anterior region and (1.1, 2) for the inferior region, respectively. Additionally, the energy window width was >25% with a large displacement of the positioning off center, leading to loss of the defect contrast in myocardial SPECT images, particularly in the inferior region. The study showed decreasing defect contrast in both locations, anterior and inferior, with increasing energy window width correlated with eccentricity positioning of the phantom on an imaging table.

Assessment of Diagnostic Imaging Sector in Public Hospitals in Northern Jordan.

The most effective diagnostic methods in the medical field are diagnostic imaging techniques such as radiography, computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine, which are used to visualize internal body to diagnose it, determine potential treatment, and evaluate and forecast care results. Therefore, the purpose of this research is to assess the diagnostic imaging sector, at three major public hospitals in the northern part of Jordan, according to regional and global requirements. The assessment approach was based on knowledge of the accessibility of diagnostic imaging equipment and its quality assurance and performance, the quantity and efficiency of radiological technologists, and the design of radiology units and medical imaging chambers in many aspects based on the use of two tools, a questionnaire and checklists, to accomplish a comprehensive evaluation. The response rate of radiological technologists was 66%. The assessment reveals a noticeable increase in the number of radiological technologists in general with high academic qualification level. Additionally, the number of diagnostic imaging equipment in Jordan revealed a large deficiency in the population-device balance, and through checklists that evaluated both CT and MRI units, it was revealed that the rate of following global requirements and occupational health and safety (OHS) standards was high. The basic supplies available in both the CT and MRI units alike were high, which indicates the high quality of healthcare provided in Jordan.

Fabrication of Low-cost Realistic Three-dimensional Static Kidney Phantom for Ultrasound-guided Biopsy Applications.

Background: The rapid growth of using ultrasound-guided interventional procedures, including biopsy and drainage, which considered painful procedures, leads to improving the practice cycle of ultrasound-guided procedures. Fabrication of low-cost tissue-mimicking phantoms that serve as a training tool medium for kidney needle biopsy procedures has dramatically overcome the drawbacks associated with these practices, such as reducing the number of miss lesions, medical errors, and recurrence rate as well as these phantoms are widely available and considered a good substitute for cadavers which were not always available and relativity expensive. However, several drawbacks are associated with current kidney phantom models, mainly the short shelf life and the high fabrication cost. Methods: This study aims to fabricate a realistic three-dimensional static mature human kidney phantom from low cost and available material for training on ultrasound-guided interventional procedures mainly biopsy test; the material used to fabricate our model is the gelatin-agar mixture. Results: This model proved that it is a tissue-mimicking material by measuring their acoustic properties which nearly the same as real human kidney tissue. Conclusion: The results of practicing interventional procedures on our phantom model showed good and easy uses for interventional procedures training as well as make it a preferable and economically affordable model.

An Alternative Radiation Shielding Material Based on Barium-Sulphate (BaSO4)-Modified Fly Ash Geopolymers.

Geopolymers are a new environmentally friendly cementitious material, and the application of geopolymers can reduce the carbon dioxide emissions caused by the development of the cement industry. PURPOSE: This study investigates the radiation shielding capacity of fly ash geopolymers (FAGP) as a viable alternative to conventionally used ordinary Portland cement (OPC) due to the high demand for an environmentally friendly, cost-effective and non-toxic shield material. METHODS: The FAGP material was fabricated and combined with Barium sulphate (BaSO4) at different ratios (0, 5, 10 and 15%). Different thicknesses (3, 6 and 9 cm) of the samples were also prepared. An energy-dispersive X-ray (EDX) was used to determine the elemental percentages of the materials, which were then used to calculate their effective atomic number (Zeff). An ion chamber was used to detect the dose of radiation transmitted through the samples. RESULTS: The lowest radiation dosage (34.68 µGy) and highest Zeff were achieved with FAGP combined with 15% BaSO4 at 9 cm thickness. The decrease in radiation dosage can be attributed to the increase in Zeff with the addition of BaSO4 to FAGP, which in turn increases the density of FAGP. CONCLUSIONS: Thus, the radiation dose can be significantly reduced with a higher ratio of BaSO4 to FAGP. This study shows that FAGP combined with BaSO4 is a promising radiation shielding material, as well as a viable alternative to OPC.

A Review of Blood-mimicking Fluid Properties Using Doppler Ultrasound Applications.

Doppler imaging ultrasound characterization and standardization requires blood that is called blood mimicking fluid for the exam. With recognized internal properties, acoustic and physical features of this artificial blood. Both acoustical and physical merits set in the International Electrotechnical Commission (IEC) scale are determined as regular values, where the components utilized in the artificial blood preparation must have values identical to the IEC values. An artificial blood is commercially available in the medical application and may not be suitable in the mode of ultrasonic device or for rate of new imaging technique. It is sometimes qualified to have the strength to produce sound features and simulate blood configuration for particular implementations. In the current review article, appropriate artificial blood components, fluids, and measurements are described that have been created using varied materials and processes that have modified for medical applications.

The utility of brain CT scan modality in the management of dizziness at the emergency department: A retrospective single-center study.

OBJECTIVES: This study examines the usefulness of computed tomography (CT) scans in evaluating patients with dizziness in the emergency department (ED). METHODS: Medical records of patients presented with complaints of dizziness or vertigo to the ED of a tertiary university hospital and underwent head CT scans from July 2015 to June 2018 were reviewed. The patients' demographic information, presenting symptoms, and final head CT scan and Magnetic resonance imaging (MRI) results were collected. Stepwise logistic regressions were used to analyze data. RESULTS: A total of 326 dizzy patients were included in this study. The majority of the patients (83.1%) were older than 44 years. Acute vertigo pattern of dizziness was detected among 50.6% of the patients and was more common among females than males (p < 0.001). Of these 326 patients who underwent head CT scans, 49 (15%) had abnormal findings with acute ischemic stroke was the most common one. A total of 191 patients underwent follow-up studies. MRI accounted for 70% of the follow-up studies. Of the 134 patients who received MRI of the brain, 36 (27%) had abnormal findings. A significant correlation of RBCs level, presence of other symptoms, and frequency of episodes with the presence of vertigo (p < 0.001) was found. CONCLUSION: The study's findings indicate low effectiveness of head CT scan compared to MRI for dizziness management. Future studies are suggested to provide more insights into the cost-effectiveness and utility of head CT scans and MRI in providing valuable findings.

Focused role of nanoparticles against COVID-19: Diagnosis and treatment.

The 2019 novel coronavirus (2019-nCoV; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) has witnessed a rapid and global proliferation since its early identification in patients with severe pneumonia in Wuhan, China. As of 27th May 2020, 2019-nCoV cases have risen to >5 million, with confirmed deaths of 350,000. However, Coronavirus disease (COVID-19) diagnostic and treatment measures are yet to be fully unraveled, given the novelty of this particular coronavirus. Therefore, existing antiviral agents used for severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) were repurposed for COVID-19, taking their biological features into consideration. This study provides a concise review of the current and emerging detection and supervision technologies for SARS-CoV-2, which is the viral etiology of COVID19, and their performance characteristics, with emphasis on the novel Nano-based diagnostic tests (protein corona sensor array and magnetic levitation) and treatment measures (treatment protocols based on nano-silver colloids) for COVID-19.

Performance Evaluation of Ultrasonic Imaging System (Part I).

BACKGROUND: Diagnostic ultrasound or sonography is an image which can provide valuable information for diagnosing and treating a variety of diseases and conditions. This experiment was done to check the performance and evaluate the ultrasonic imaging system. There were three tests performed in this experiment: dead zone (transducer ring-down), vertical measurement calibration, and horizontal measurement calibration. METHODS: The evaluation was made by performed all the tests with different depth on two different multipurpose phantom model #539. The tests were also performed by two different probes which were curved and flat (linear probe). The images were taken, and the measurements were made by electronic calipers on the ultrasound machine system. Observations and evaluations were done via all images and measurements taken. RESULTS: The images formed by two various probes were different. The penetration settings were different since the depths were different. The depth influenced the penetrations to the formed image. From the comparison of all results and measurements recorded were all under the accepted value of the standard that was given by the manufacture of the phantom. CONCLUSION: Therefore, it can be concluded that the measurements were all not exceeding 2% of the standard value given based on the result that we get.

A Brief Review for Common Doppler Ultrasound Flow Phantoms.

In this review, the flow phantoms and the wall-less flow phantoms with recognized acoustic features (attenuation and speed of sound), interior properties, and dimensions of tissue were prepared, calibrated, and characterized by Doppler ultrasound (US) scanning which demands tissue-mimicking materials (TMMs). TMM phantoms are commercially available and readymade for medical US applications. Furthermore, the commercial TMM phantoms are proper for US purpose or estimation of diagnostic imaging techniques according to the chemical materials used for its preparation.

Dynamic Hepatocellular Carcinoma Model Within a Liver Phantom for Multimodality Imaging.

INTRODUCTION: Hepatocellular carcinoma (HCC) is one of the most common cancer in the world, and the effectiveness of its treatment lies in its detection in its early stages. The aim of this study is to mimic HCC dynamically through a liver phantom and apply it in multimodality medical imaging techniques including magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound. METHODS AND MATERIALS: The phantom is fabricated with two main parts, liver parenchyma and HCC inserts. The liver parenchyma was fabricated by adding 2.5 wt% of agarose powder combined with 2.6 wt% of wax powder while the basic material for the HCC samples was made from polyurethane solution combined with 5 wt% glycerol. Three HCC samples were inserted into the parenchyma by using three cylinders implanted inside the liver parenchyma. An automatic injector is attached to the input side of the cylinders and a suction device connected to the output side of the cylinders. After the phantom was prepared, the contrast materials were injected into the phantom and imaged using MRI, CT, and ultrasound. RESULTS: Both HCC samples and liver parenchyma were clearly distinguished using the three imaging modalities: MRI, CT, and ultrasound. Doppler ultrasound was also applied through the HCC samples and the flow pattern was observed through the samples. CONCLUSION: A multimodal dynamic liver phantom, with HCC tumor models have been fabricated. This phantom helps to improve and develop different methods for detecting HCC in its early stages.

Chemical Characteristics, Motivation and Strategies in choice of Materials used as Liver Phantom: A Literature Review.

Liver phantoms have been developed as an alternative to human tissue and have been used for different purposes. In this article, the items used for liver phantoms fabrication are mentioned same as in the previous literature reviews. Summary and characteristics of these materials are presented. The main factors that need to be available in the materials used for fabrication in computed tomography, ultrasound, magnetic resonance imaging, and nuclear medicine were analyzed. Finally, the discussion focuses on some purposes and aims of the liver phantom fabrication for use in several areas such as training, diagnoses of different diseases, and treatment planning for therapeutic strategies - for example, in selective internal radiation therapy, stereotactic body radiation therapy, laser-induced thermotherapy, radiofrequency ablation, and microwave coagulation therapy. It was found that different liver substitutes can be developed to fulfill the different requirements.

Compatibility and Validation of a Recent Developed Artificial Blood through the Vascular Phantom Using Doppler Ultrasound Color- and Motion-mode Techniques.

BACKGROUND: Doppler technique is a technology that can raise the predictive, diagnostic, and monitoring abilities in blood flow and suitable for researchers. The application depends on Doppler shift (shift frequencies), wherein the movement of red blood cells away from the probe is determined by the decrease or increase in the ultrasound (US) frequency. METHODS: In this experiment, the clinical US (Hitachi Avious [HI] model) system was used as a primary instrument for data acquisition and test the compatibility, efficacy, and validation of artificial blood (blood-mimicking fluid [BMF]) by color- and motion-mode. This BMF was prepared for use in the Doppler flow phantom. RESULTS: The motion of BMF through the vessel-mimicking material (VMM) was parallel and the flow was laminar and in the straight form (regular flow of BMF inside the VMM). Moreover, the scale of color velocity in the normal range at that flow rate was in the normal range. CONCLUSION: The new BMF that is being valid and effective in utilizing for US in vitro research applications. In addition, the clinical US ([HI] model) system can be used as a suitable instrument for data acquisition and test the compatibility, efficacy, and validation at in vitro applications (BMF, flow phantom components).

Chemical Items Used for Preparing Tissue-Mimicking Material of Wall-Less Flow Phantom for Doppler Ultrasound Imaging.

The wall-less flow phantoms with recognized acoustic features (attenuation and speed of sound), interior properties, and dimensions of tissue were prepared, calibrated, and characterized of Doppler ultrasound scanning demands tissue-mimicking materials (TMMs). TMM phantoms are commercially available and ready-made for medical ultrasound applications. Furthermore, the commercial TMM phantoms are proper for ultrasound purpose or estimation of diagnostic imaging techniques according to the chemical materials used for its preparation. However, preparing a desirable TMM for wall-less flow phantom using a specific chemical material according to the specific applications is required for different flow. In this review, TMM and wall-less flow phantoms prepared using different chemical materials and methods were described. The chemical materials used in Doppler ultrasound TMM and wall-less flow phantoms fabricated over the previous decades were of high interest in this review.