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.

Expired EBT3 Films' Sensitivity for the Measurement of X-ray and UV Radiation: An Optical Analysis.

The aim of this study is to compare the optical responses of external beam therapy 3 (EBT3) films exposed to X-rays and solar ultraviolet rays (SUV-rays), as a dose control technique in the clinical sector for various radiation types, energies, and absorbed doses up to 4 Gy. In this study, EBT3 films with three different expiry dates were prepared and cut into pieces of size 2 by 2 cm2. The first group was exposed to 90 kVp X-rays, while the second group was exposed to the SUV-rays at noon. The analysis was performed using a visible Jaz spectrometer and an EPSON Perfection V370 Photo scanner to obtain the absorbance, the net reflective optical density (ROD) and the red-green-blue (RGB) values of the samples. The results have shown that spectroscopic measurements of the exposed expired EBT3 films with these radiation sources are able to produce primary peaks and secondary peaks at λ = 641.74 nm and λ = 585.98 nm for X-rays, and at λ = 637.93 nm and λ = 584.45 nm for SUV-rays, respectively. According to these findings, compared to 2021 films that expired shortly before the trial start date; 2018 films responded better to the absorbed dose than 2016 films when exposed to both X-ray and SUV-rays. In terms of energy dependence, the expired EBT3 2018 had the largest net ROD value. Using L*a*b* indices extracted from the RGB data, and despite that EBT3 films have expiry dates according to the manufacturer; all the films exhibited a substantial colour change, indicating that these films are still usable for clinical and research purposes.

Adult Congenital Heart Disease: Current Early Expectations After Cardiac Transplantation.

BACKGROUND: Early mortality has plagued the otherwise good outcomes of heart transplantation in patients with adult congenital heart disease (ACHD), but perioperative care is improving. This study sought to identify risk factors for 1-year mortality currently and examine the results of patients without those risk factors compared with patients who did not have ACHD (nACHD). METHODS: The United Network of Organ Sharing database was searched for all adult (>17 years of age) heart transplant recipients from 2000 to 2018. They were divided into an early era and a late era. A multivariate analysis identified risk factors for 1-year mortality in the late era. Patients without these risk factors were compared with the nACHD group by Kaplan-Meier analysis. RESULTS: A total of 495 patients with ACHD were identified from 2000 to 2008, and 666 were identified from 2009 to 2018. The recent era had better 1-year survival (P <.001) and overall survival (P = .003) than did the era from 2000 to 2008. Patients with ACHD were different from the nACHD population in age (37 years vs 57 years), body mass index greater than 25 kg/m2 (45% vs 66%), incidence of renal dysfunction (23% vs 28%) and liver dysfunction (29% vs 23%), sensitization (38% vs 29%), and ischemic times (3.5 hours vs 3.1 hours). Multivariate analysis identified body mass index greater than 25 kg/m2 (hazard ratio [HR], 1.79), renal dysfunction (HR, 1.85), liver dysfunction (HR, 1.69), and longer ischemic time (HR, 1.46) as risk factors for early mortality. Patients with only 1 of the first 3 categorical risk factors had 1-year survival comparable to that reported in patients with nACHD. CONCLUSIONS: Patients with ACHD had better early and long-term outcomes in the recent era. When only 1 of 3 pretransplant risk factors for early mortality was present, patients had survival equal to that of nACHD patients and perhaps better long-term survival.

Using hepatitis C and B virus-infected donor organs for pediatric heart transplantation.

OBJECTIVE: High-risk donors for patients with end-stage cardiac or pulmonary disease awaiting transplantation represent an opportunity for access to more organs and therefore can significantly decrease the waiting list mortality. The objective of this study is to investigate the use of hepatitis B virus core antibody positive or hepatitis C virus seropositive donors for pediatric heart transplantation. METHODS: Data were reviewed from the United Network of Organ Sharing database (June 2008 to June 2015). A total of 3 hepatitis C seropositive and 9 hepatitis B core antibody positive donor hearts were identified for transplantation. Factors of age, underlying diagnosis, transplant year, extracorporeal membrane oxygenation, inotrope support, hepatitis C virus serostatus, and hepatitis B virus surface antigen status were used for 2 separate propensity score models. Standardized difference was evaluated for these variables before and after match. Survival was compared between the matched cohorts. RESULTS: Post-transplant graft survivals for recipients of hepatitis C virus positive donors and hepatitis B virus core antibody positive donors were similar to matched recipients of hepatitis C virus negative and hepatitis B virus core antibody negative donors, respectively. CONCLUSIONS: The study has a small cohort to derive any significant conclusions, but the results are encouraging and consistent with the current trends among adult thoracic and pediatric kidney transplantation and demonstrates that hepatitis C virus positive and hepatitis B virus core antibody positive donors are not often used for pediatric heart transplantation.