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Perrot V, Polichetti M, Varray F, Garcia D. So you think you can DAS? A viewpoint on delay-and-sum beamforming. ULTRASONICS 2021; 111:106309. [PMID: 33360053 DOI: 10.1016/j.ultras.2020.106309] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/29/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Abstract
Delay-and-sum (DAS) is the most widespread digital beamformer in high-frame-rate ultrasound imaging. Its implementation is simple and compatible with real-time applications. In this viewpoint article, we describe the fundamentals of DAS beamforming. The underlying theory and numerical approach are detailed so that users can be aware of its functioning and limitations. In particular, we discuss the importance of the f-number and speed of sound on image quality, and propose one solution to set their values from a physical viewpoint. We suggest determining the f-number from the directivity of the transducer elements and the speed of sound from the phase dispersion of the delayed signals. Simplified Matlab codes are provided for the sake of clarity and openness. The effect of the f-number and speed of sound on the lateral resolution and contrast-to-noise ratio was investigated in vitro and in vivo. If not properly preset, these two factors had a substantial negative impact on standard metrics of image quality (namely CNR and FWHM). When beamforming with DAS in vitro or in vivo, it is recommended to optimize these parameters in order to use it wisely and prevent image degradation.
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Courand PY, Lenoir J, Grandjean A, Garcia D, Harbaoui B, Lantelme P. SCORE underestimates cardiovascular mortality in hypertension: insight from the OLD-HTA and NEW-HTA Lyon cohorts. Eur J Prev Cardiol 2021; 29:136-143. [PMID: 33580796 DOI: 10.1093/eurjpc/zwaa163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/21/2020] [Accepted: 12/16/2020] [Indexed: 11/14/2022]
Abstract
AIMS Current European guidelines recommend the SCORE to estimate 10-year cardiovascular mortality in patients with moderate/low cardiovascular risk. SCORE was derived from the general population. The objective of this study was to investigate the estimated 10-year cardiovascular mortality according to the SCORE in a historic and a contemporary cohort of hypertensive patients. METHODS AND RESULTS After exclusion of secondary prevention and diabetes, 3086 patients were analysed in the OLD-HTA (1969-90) and 1081 in the NEW-HTA (1997-2014) Lyon cohorts. SCORE was calculated using the low and high cardiovascular risk equations and charts, and patients classified as being at low (0%), moderate (1-4%), high (5-9%), and very high (≥10%) risk. In the OLD-HTA cohort, 10-year cardiovascular mortality was higher (1.2%, 5.5%, 17.7%, and 27.0%) than that predicted by the low-risk equation (0%, 1.7%, 6.4%, and 14.8%). In the NEW-HTA cohort, similar results were observed (1.1%, 4.7%, 15.1%, and 15.2% vs. 0%, 1.9%, 6.2%, and 11.7%, respectively). Using the high-risk equation, mortality was underestimated in both cohorts, but the difference was smaller. The diagnostic performance of the high-risk equation was lower than the low-risk equation in both cohorts, considering the SCORE as a continuous or a categorical variable (Likelihood ratio test P < 0.05 for all comparisons in OLD-HTA). Similar results were obtained using SCORE charts. CONCLUSION SCORE underestimates the 10-year cardiovascular mortality risk in hypertensive patients in a historic cohort and in a contemporary one. The algorithm to predict cardiovascular mortality in hypertensive patients needs an update given new information since its creation.
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Lu J, Millioz F, Garcia D, Salles S, Liu W, Friboulet D. Reconstruction for Diverging-Wave Imaging Using Deep Convolutional Neural Networks. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2020; 67:2481-2492. [PMID: 32286972 DOI: 10.1109/tuffc.2020.2986166] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In recent years, diverging wave (DW) ultrasound imaging has become a very promising methodology for cardiovascular imaging due to its high temporal resolution. However, if they are limited in number, DW transmits provide lower image quality compared with classical focused schemes. A conventional reconstruction approach consists in summing series of ultrasound signals coherently, at the expense of frame rate, data volume, and computation time. To deal with this limitation, we propose a convolutional neural network (CNN) architecture, Inception for DW Network (IDNet), for high-quality reconstruction of DW ultrasound images using a small number of transmissions. In order to cope with the specificities induced by the sectorial geometry associated with DW imaging, we adopted the inception model composed of the concatenation of multiscale convolution kernels. Incorporating inception modules aims at capturing different image features with multiscale receptive fields. A mapping between low-quality images and corresponding high-quality compounded reconstruction was learned by training the network using in vitro and in vivo samples. The performance of the proposed approach was evaluated in terms of contrast ratio (CR), contrast-to-noise ratio (CNR), and lateral resolution (LR), and compared with standard compounding method and conventional CNN methods. The results demonstrated that our method could produce high-quality images using only 3 DWs, yielding an image quality equivalent to that obtained with compounding of 31 DWs and outperforming more conventional CNN architectures in terms of complexity, inference time, and image quality.
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Evain E, Faraz K, Grenier T, Garcia D, De Craene M, Bernard O. A Pilot Study on Convolutional Neural Networks for Motion Estimation From Ultrasound Images. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2020; 67:2565-2573. [PMID: 32112679 DOI: 10.1109/tuffc.2020.2976809] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In recent years, deep learning (DL) has been successfully applied to the analysis and processing of ultrasound images. To date, most of this research has focused on segmentation and view recognition. This article benchmarks different convolutional neural network algorithms for motion estimation in ultrasound imaging. We evaluated and compared several networks derived from FlowNet2, one of the most efficient architectures in computer vision. The networks were tested with and without transfer learning, and the best configuration was compared against the particle imaging velocimetry method, a popular state-of-the-art block-matching algorithm. Rotations are known to be difficult to track from ultrasound images due to a significant speckle decorrelation. We thus focused on the images of rotating disks, which could be tracked through speckle features only. Our database consisted of synthetic and in vitro B-mode images after log compression and covered a large range of rotational speeds. One of the FlowNet2 subnetworks, FlowNet2SD, produced competitive results with a motion field error smaller than 1 pixel on real data after transfer learning based on the simulated data. These errors remain small for a large velocity range without the need for hyperparameter tuning, which indicates the high potential and adaptability of DL solutions to motion estimation in ultrasound imaging.
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Pokorney S, Garonzik S, Chertow G, Washam J, Mussina K, Bansal N, Gadegbeku C, Garcia D, Lopes R, Mahaffey K, Middleton J, Thadhani R, Thomas K, Winkelmayer W, Granger C. Pharmacokinetics of apixaban in patients with end stage renal disease on hemodialysis and atrial fibrillation: results from the RENAL-AF trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background/Introduction
Apixaban use is increasing for stroke prevention in patients with atrial fibrillation (AF) and end stage renal disease (ESRD) on hemodialysis. There is uncertainty as to the optimal dose in this population in part related to the limited available pharmacokinetic (PK) data.
Purpose
We comprehensively evaluated the PK of apixaban collected over 1 month of apixaban dosing in 63 patients with AF and ESRD on hemodialysis.
Methods
Patients with AF and ESRD on hemodialysis were randomized to warfarin versus apixaban within the RENAL-AF trial with 5 mg BID dosing, except for 2.5 mg BID in those age ≥80 years or weight ≤60 kg. The 5 mg BID dose could be reduced to 2.5mg BID for minor bleeding. Day 1 PK data was collected on all patients pre- and post-hemodialysis. Day 3 and 1 month pre- and post-hemodialysis PK samples were collected in 49 patients. The timing of apixaban dosing and hemodialysis relative to PK samples was recorded. Dosing history, hemodialysis, and PK samples were chronologically integrated with patient specific data such as body size, age, race and gender. This dataset was combined with the ARISTOTLE dataset, and the published PK model from ARISTOTLE describing exposures in the AF population was updated to incorporate an additional clearance term for hemodialysis. The model estimated apixaban exposures (AUC) in RENAL-AF were compared to ARISTOLTE AUC values.
Results
There were 285 PK concentrations collected among 63 patients in the RENAL-AF trial. Patients had median age 69 years with 41% women (N=26) and a median weight of 84 kg (49, 157). The median AUCs for patients with ESRD on hemodialysis were 5,452 and 2,990 for patients treated with 5mg BID and 2.5mg BID doses, respectively. The median AUCs for patients treated with 5mg BID from ARISTOTLE increased from 2,802 for patients with class 1 CKD to 5,863 for class 4 CKD, while they increased from 2,392 for class 1 CKD to 2,881 for class 4 CKD in patients treated with 2.5mg BID. The median AUC for patients with ESRD on hemodialysis were within 50% of the exposure of patients from ARISTOTLE for all classes of CKD for the 2.5mg BID dose and for classes 2, 3A, 3B, and 4 CKD for the 5mg BID dose (Figure).
Conclusions
The steady state apixaban exposure data in patients with AF and ESRD on hemodialysis were modestly higher but consistent with the results of non-ESRD patients from ARISTOTLE, using 5 mg BID unless patients had age ≥80 years or weight ≤60 kg. Additional clinical outcomes data on the use of apixaban in patients with AF and ESRD on hemodialysis are needed.
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Investigator sponsored grant from Bristol-Myers Squibb and Pfizer
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Cicerchia M, Ochoa J, Cardenas-Reyes I, Fernandez Ferro G, Brogger M, Fernandez X, Garcia Hernandez S, Garcia D, Salazar Mendiguchia J, Ortiz M, Monserrat L. Genotype/Phenotype correlation and prognosis for undescribed ACTC1 missense variants. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Purpose
Establish the genotype/phenotype correlation for missense undescribed variants in ACTC1, and evaluate their prognostic implications.
Methods
A systematic screening for the ACTC1 gene was performed using NGS in 17,683 individuals with inherited cardiovascular disease, 6,984 of them with hypertrophic cardiomyopathy, 3,507 with dilated cardiomyopathy, and 760 left ventricular non-compaction. These phenotypes were clinically diagnosed by each center prior to the genetic study. Frequency of the variants was compared with gene gnomAD and ClinVar databases. A systematic review of the literature was performed to search for previously reported variants.
We evaluated available follow up data and constructed Kaplan-Meier survival curves free from cardiovascular death (sudden death, Heart transplant, heart failure death, appropriate ICD discharge and stroke related death). Log-rank test was used to compare event-free survival time between males and females.
Results
39 missense variants were identified in 283 carriers (125 index cases; 158 first-degree relatives). Twenty-two have not been previously described or identified in public databases. 17 have been reported in gnomAD or Clinvar. Carriers phenotypes were: 120 HCM; 43 LVNC; 16 DCM; three had cardiac septal defect and two had sudden death. Some of the carriers had overlapped or combined phenotypes: 7 HCM and LVNC, 7 septal defects and LVNC, 3 HCM and septal defects, 4 MCD and LVNC. 24 were healthy carriers, and we have no phenotypic data of the remaining individuals. Family studies were performed in 12 families out of the 22 undescribed variants, showing cosegregation in 8 variants. One case was “de novo”.
Interestingly, a rare variant, previously identified as VUS in ClinVar, showed a clearly cosegregation with HCM. The Leu10Met variant with a frequency of 9/282084 alleles in gnomAD (1/15671 individuals) was identified in 20 index cases, which represents 1/884 of all the genotyped (0.11%), and 1/387 patients with HCM (0.35%). We found it in 2/9289 patients with other phenotypes (p<0.001).
51 patients (18%) presented an event during follow up. In several cases, carriers developed early atrial fibrillation.
The survival curve shows adverse events from the first decade of life, with a 10% cumulative rate of events at age 40, 80% survival at age 60, and a 60% survival at age 70. No significant differences in the incidence of cardiovascular death between men and women were observed.
Conclusion
HCM is the most frequent phenotype in carriers of ACTC1 variants, followed by LVNC, and DCM. Septal defects are not rare, and they are usually described in combination with cardiomyopathies.
Disease course seems to have a good prognosis. Sudden death is an exception at early ages and appears to be associated with severe morphological expression.
Given the presence of cosegregation with disease in rare variants, many of the ACTC1 variants may have an incomplete penetrance, and late disease expression.
ACTC1
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Health in Code
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Vixege F, Courand PY, Blanc-Benon P, Mendez S, Nicoud F, Vray D, Garcia D. Intraventricular vector flow mapping 3-D by triplane Doppler echocardiography. Comput Methods Biomech Biomed Engin 2020. [DOI: 10.1080/10255842.2020.1816300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Garcia D, haubrick K. Food Insecurity with an EFNEP Intervention. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.08.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Garcia D. Letter to the Editor concerning "Tracheal injury complicating Sistrunk's thyroglossal cyst surgery". Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:355. [PMID: 32773334 DOI: 10.1016/j.anorl.2020.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Pujol A, Zamora MJ, Obradors A, Garcia D, Rodriguez A, Vassena R. Comparison of two different oocyte vitrification methods: a prospective, paired study on the same genetic background and stimulation protocol. Hum Reprod 2020; 34:989-997. [PMID: 31116386 DOI: 10.1093/humrep/dez045] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/01/2019] [Accepted: 03/08/2019] [Indexed: 01/29/2023] Open
Abstract
STUDY QUESTION Can two different methods for oocyte vitrification, one using an open tool and the other a closed tool, result in similar oocyte survival rates? SUMMARY ANSWER The oocyte survival rate was found to be higher in the closed method. WHAT IS KNOWN ALREADY Open vitrification is performed routinely in oocyte donation cycles. Closed oocyte vitrification may result in slower cooling rates and thus it is less used, even though it has been recommended in order to avoid the risk of cross-contamination between material from different patients. STUDY DESIGN, SIZE, DURATION This is a prospective cohort study with sibling oocytes carried out in a fertility center between July 2014 and January 2016. The study included 83 oocyte donors each providing a minimum of 12 mature oocytes (metaphase II: MII) at oocyte retrieval. Oocyte survival rate and fertilization rate, as well as reproductive outcomes (biochemical, clinical, ongoing pregnancy and live birth rates) per embryo transfer and also cumulatively between the two methods were compared by Chi2 tests. PARTICIPANTS/MATERIALS, SETTING, METHODS Donor oocytes were denuded and six MII oocytes from each donor were vitrified using an open method and later assigned to one recipient, while another six MII oocytes were vitrified using a closed method and assigned to a different recipient (paired analysis). ICSI was used in all cases and embryo transfer was performed on Day 2-3 in all cases. MAIN RESULTS AND THE ROLE OF CHANCE Oocyte donors were 24.8 years old on average (SD 4.7). Recipient age (average 41.2 years, SD 4.7) and BMI (mean 23.8 kg/m2, SD 4.0) were similar between recipient groups. Oocytes vitrified using the closed method had higher survival rate (94.5% versus 88.9%, P = 0.002), but lower fertilization rate (57.1% versus 69.8%, P < 0.001) compared to the open method. The number of fresh embryos transferred in the two groups was 1.8 on average (SD 0.4). Biochemical (45% closed versus 50% open), clinical (40% versus 50%) and ongoing (37.5% versus 42.5%) pregnancy rates were not different between groups (P > 0.05) and neither were live birth rates (37.5% versus 42.5%, P > 0.05). Cumulative reproductive results (obtained after the transfer of all the embryos) were also similar between groups. LIMITATIONS, REASONS FOR CAUTION The participants of this study were oocyte donors, i.e. young women in good health, and care should be exerted in extending our results to other populations such as infertility patients, oncofertility patients and women freezing oocytes to delay childbearing. WIDER IMPLICATIONS OF THE FINDINGS Our results suggest that, in spite of different survival and fertilization rates, closed and open oocyte vitrification methods should offer similar reproductive outcomes up to cumulative live birth rates. STUDY FUNDING/COMPETING INTEREST(S) The authors report no conflict of interest. Vitrolife provided the media and the closed method tool needed for the study at no cost.
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Mulder F, van Es N, Kraaijpoel N, Di Nisio M, Carrier M, Duggal A, Gaddh M, Garcia D, Grosso M, Kakkar A, Mercuri M, Middeldorp S, Royle G, Segers A, Shivakumar S, Verhamme P, Wang T, Weitz J, Zhang G, Büller H, Raskob G. Corrigendum to “Edoxaban for treatment of venous thromboembolism in patient groups with different types of cancer: Results from the Hokusai VTE Cancer study” [Thromb. Res. vol. 185, January 2020, pages 13–19]. Thromb Res 2020; 191:156-159. [DOI: 10.1016/j.thromres.2020.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Vixege F, Courand P, Nicoud F, Vray D, Garcia D. Intraventricular vector flow mapping by 3-D doppler echo. Comput Methods Biomech Biomed Engin 2020. [DOI: 10.1080/10255842.2020.1713498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Albert A, Alfaro R, Alvarez C, Angeles Camacho JR, Arteaga-Velázquez JC, Arunbabu KP, Avila Rojas D, Ayala Solares HA, Baghmanyan V, Belmont-Moreno E, BenZvi SY, Brisbois C, Caballero-Mora KS, Capistrán T, Carramiñana A, Casanova S, Cotti U, Cotzomi J, Coutiño de León S, De la Fuente E, de León C, Dingus BL, DuVernois MA, Díaz-Vélez JC, Ellsworth RW, Engel K, Espinoza C, Fleischhack H, Fraija N, Galván-Gámez A, Garcia D, García-González JA, Garfias F, González MM, Goodman JA, Harding JP, Hernandez S, Hona B, Huang D, Hueyotl-Zahuantitla F, Hüntemeyer P, Iriarte A, Joshi V, Lara A, Lee WH, León Vargas H, Linnemann JT, Longinotti AL, Luis-Raya G, Lundeen J, López-Coto R, Malone K, Marinelli SS, Martinez-Castellanos I, Martínez-Castro J, Martínez-Huerta H, Matthews JA, Miranda-Romagnoli P, Morales-Soto JA, Moreno E, Nayerhoda A, Nellen L, Newbold M, Nisa MU, Noriega-Papaqui R, Omodei N, Peisker A, Pérez-Pérez EG, Rho CD, Rivière C, Rosa-González D, Rosenberg M, Ruiz-Velasco E, Salazar H, Salesa Greus F, Sandoval A, Schneider M, Schoorlemmer H, Sinnis G, Smith AJ, Springer RW, Surajbali P, Tabachnick E, Tanner M, Tibolla O, Tollefson K, Torres I, Torres-Escobedo R, Weisgarber T, Yodh G, Zepeda A, Zhou H. Constraints on Lorentz Invariance Violation from HAWC Observations of Gamma Rays above 100 TeV. PHYSICAL REVIEW LETTERS 2020; 124:131101. [PMID: 32302173 DOI: 10.1103/physrevlett.124.131101] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/07/2020] [Accepted: 03/04/2020] [Indexed: 06/11/2023]
Abstract
Because of the high energies and long distances to the sources, astrophysical observations provide a unique opportunity to test possible signatures of Lorentz invariance violation (LIV). Superluminal LIV enables the decay of photons at high energy. The high altitude water Cherenkov (HAWC) observatory is among the most sensitive gamma-ray instruments currently operating above 10 TeV. HAWC finds evidence of 100 TeV photon emission from at least four astrophysical sources. These observations exclude, for the strongest of the limits set, the LIV energy scale to 2.2×10^{31} eV, over 1800 times the Planck energy and an improvement of 1 to 2 orders of magnitude over previous limits.
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Hodzic A, Garcia D, Saloux E, Ribeiro PAB, Ethier A, Thomas JD, Milliez P, Normand H, Tournoux F. Echocardiographic evidence of left ventricular untwisting-filling interplay. Cardiovasc Ultrasound 2020; 18:8. [PMID: 32075637 PMCID: PMC7029574 DOI: 10.1186/s12947-020-00190-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 02/07/2020] [Indexed: 11/11/2022] Open
Abstract
Background Left ventricular untwisting generates an early diastolic intraventricular pressure gradient (DIVPG) than can be quantified by echocardiography. We sought to confirm the quantitative relationship between peak untwisting rate and peak DIVPG in a large adult population. Methods From our echocardiographic database, we retrieved all the echocardiograms with a normal left ventricular ejection fraction, for whom color Doppler M-Mode interrogation of mitral inflow was available, and left ventricular untwisting rate was measurable using speckle tracking. Standard indices of left ventricular early diastolic function were assessed by Doppler (peaks E, e’ and Vp) and speckle tracking (peak strain rate Esr). Load dependency of DIVPG and untwisting rate was evaluated using a passive leg raising maneuver. Results We included 154 subjects, aged between 18 to 77 years old, 63% were male. Test-retest reliability for color Doppler-derived DIVPG measurements was good, the intraclass correlation coefficients were 0.97 [0.91–0.99] and 0.97 [0.67–0.99] for intra- and inter-observer reproducibility, respectively. Peak DIVPG was positively correlated with peak untwisting rate (r = 0.73, P < 0.001). On multivariate analysis, peak DIVPG was the only diastolic parameter that was independently associated with untwisting rate. Age and gender were the clinical predictive factors for peak untwisting rate, whereas only age was independently associated with peak DIVPG. Untwisting rate and DIVPG were both load-dependent, without affecting their relationship. Conclusions Color Doppler-derived peak DIVPG was quantitatively and independently associated with peak untwisting rate. It thus provides a reliable flow-based index of early left ventricular diastolic function.
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Abeysekara AU, Albert A, Alfaro R, Angeles Camacho JR, Arteaga-Velázquez JC, Arunbabu KP, Avila Rojas D, Ayala Solares HA, Baghmanyan V, Belmont-Moreno E, BenZvi SY, Brisbois C, Caballero-Mora KS, Capistrán T, Carramiñana A, Casanova S, Cotti U, Cotzomi J, Coutiño de León S, De la Fuente E, de León C, Dichiara S, Dingus BL, DuVernois MA, Díaz-Vélez JC, Ellsworth RW, Engel K, Espinoza C, Fleischhack H, Fraija N, Galván-Gámez A, Garcia D, García-González JA, Garfias F, González MM, Goodman JA, Harding JP, Hernandez S, Hinton J, Hona B, Huang D, Hueyotl-Zahuantitla F, Hüntemeyer P, Iriarte A, Jardin-Blicq A, Joshi V, Kaufmann S, Kieda D, Lara A, Lee WH, León Vargas H, Linnemann JT, Longinotti AL, Luis-Raya G, Lundeen J, López-Coto R, Malone K, Marinelli SS, Martinez O, Martinez-Castellanos I, Martínez-Castro J, Martínez-Huerta H, Matthews JA, Miranda-Romagnoli P, Morales-Soto JA, Moreno E, Mostafá M, Nayerhoda A, Nellen L, Newbold M, Nisa MU, Noriega-Papaqui R, Peisker A, Pérez-Pérez EG, Pretz J, Ren Z, Rho CD, Rivière C, Rosa-González D, Rosenberg M, Ruiz-Velasco E, Salesa Greus F, Sandoval A, Schneider M, Schoorlemmer H, Sinnis G, Smith AJ, Springer RW, Surajbali P, Tabachnick E, Tanner M, Tibolla O, Tollefson K, Torres I, Torres-Escobedo R, Villaseñor L, Weisgarber T, Wood J, Yapici T, Zhang H, Zhou H. Multiple Galactic Sources with Emission Above 56 TeV Detected by HAWC. PHYSICAL REVIEW LETTERS 2020; 124:021102. [PMID: 32004015 DOI: 10.1103/physrevlett.124.021102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 11/21/2019] [Indexed: 06/10/2023]
Abstract
We present the first catalog of gamma-ray sources emitting above 56 and 100 TeV with data from the High Altitude Water Cherenkov Observatory, a wide field-of-view observatory capable of detecting gamma rays up to a few hundred TeV. Nine sources are observed above 56 TeV, all of which are likely galactic in origin. Three sources continue emitting past 100 TeV, making this the highest-energy gamma-ray source catalog to date. We report the integral flux of each of these objects. We also report spectra for three highest-energy sources and discuss the possibility that they are PeVatrons.
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Parsons RG, Kowal R, LeBlond D, Yue VT, Neargarder L, Bond L, Garcia D, Slater D, Rogers P. Multianalyte assay system developed for drugs of abuse. Clin Chem 2019. [DOI: 10.1093/clinchem/39.9.1899] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A simple, 10-min immunoassay system has been developed that simultaneously screens for five different classes of drugs of abuse in a urine sample. This system tests for amphetamines, cannabinoids, cocaine metabolites, opiates, and phencyclidine, and each assay has a specific preset cutoff concentration. Accuracy is > 99% for reporting positive or negative results for samples with 200% or 50%, respectively, of the cutoff concentrations of the drugs. Tests of a panel of 96 compounds yielded only three cases of nonspecific reactivity (at a drug concentration of 100 mg/L). Another panel of 12 compounds that could normally be found in urine samples was also evaluated and no interferences were observed. Concordance was > 95% between this system and the comparable automated immunoassays for detecting drugs of abuse. Greater than 98% of GC/MS-confirmed positive samples gave positive results with this assay system.
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Mulder FI, van Es N, Kraaijpoel N, Di Nisio M, Carrier M, Duggal A, Gaddh M, Garcia D, Grosso MA, Kakkar AK, Mercuri MF, Middeldorp S, Royle G, Segers A, Shivakumar S, Verhamme P, Wang T, Weitz JI, Zhang G, Büller HR, Raskob G. Edoxaban for treatment of venous thromboembolism in patient groups with different types of cancer: Results from the Hokusai VTE Cancer study. Thromb Res 2019; 185:13-19. [PMID: 31733403 DOI: 10.1016/j.thromres.2019.11.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND The safety and efficacy of edoxaban and dalteparin is unclear for several cancer groups. METHODS We evaluated the occurrence of the primary outcome in large cancer groups. The primary outcome was the composite of recurrent VTE or major bleeding over 12 months. RESULTS In patients with gastrointestinal cancer, the primary outcome occurred in 19.4% patients given edoxaban and in 15.0% given dalteparin (risk difference [RD], 4.4%; 95%-CI, -4.1% to 12.8%). The corresponding rates for edoxaban and dalteparin were 10.4% and 10.7% for lung cancer (RD, -0.3%; 95%-CI, -10.0% to 9.5%), 13.6% and 12.5% for urogenital cancer (RD, 1.1; 95%-CI, -10.1-12.4), 3.1% and 11.7% for breast cancer (RD, -8.6; 95%-CI, -19.3-2.2), 8.9% and 10.9% for hematological malignancies (RD, -2.0; 95%-CI, -13.1-9.1), and 10.4% and 17.4% for gynecological cancer (RD, -7.0; 95%-CI, -19.8-5.7). In the subgroup of gastrointestinal cancer, edoxaban was associated with a 3.5% lower absolute risk of recurrent VTE and a 7.9% higher risk of major bleeding. CONCLUSION Edoxaban has a similar risk-benefit ratio to dalteparin in most cancer groups. In those with gastrointestinal cancer, the lower risk of recurrent VTE and the advantages of oral therapy need to be balanced against the increased risk of major bleeding.
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Bosch-Barrera J, Priego N, Puigdemont M, Sais E, Quer N, Izquierdo A, Hernandez A, Cuyàs E, Carbó A, Teixidor E, Verdura S, Garcia D, Roselló A, Garriga V, Pedraza S, Brunet J, Calvo A, Menéndez J, Valiente M. P2.01-49 Targeting STAT3-Positive Reactive Astrocytes with Silibinin in the Therapeutic Landscape of Non-Small-Cell Lung Cancer with Brain Metastases. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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AlTurki A, Yuri P, Garcia D, Montemezzo M, Al-Dosari A, Vidal A, Toscani B, Diaz S, Bernier M, Hadjis T, Joza J, Essebag V. IMPROVED ELECTRICAL SYNCHRONY BY CARDIAC RESYNCHRONIZATION THERAPY REPROGRAMMING AND ECHOCARDIOGRAPHIC RESPONSE IN PATIENTS WITH EXISTING DEVICES. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Badescu E, Garcia D, Joos P, Bernard A, Augeul L, Ferrera R, Viallon M, Petrusca L, Friboulet D, Liebgott H. Comparison Between Multiline Transmission and Diverging Wave Imaging: Assessment of Image Quality and Motion Estimation Accuracy. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2019; 66:1560-1572. [PMID: 31251183 DOI: 10.1109/tuffc.2019.2925581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
High frame rate imaging is particularly important in echocardiography for better assessment of the cardiac function. Several studies showed that diverging wave imaging (DWI) and multiline transmission (MLT) are promising methods for achieving a high temporal resolution. The aim of this study was to compare MLT and compounded motion compensation (MoCo) DWI for the same transmitted power, same frame rates [image quality and speckle tracking echocardiography (STE) assessment], and same packet size [tissue Doppler imaging (TDI) assessment]. Our results on static images showed that MLT outperforms DW in terms of resolution (by 30% on average). However, in terms of contrast, MLT outperforms DW only for the depth of 11 cm (by 40% on average), the result being reversed at a depth of 4 cm (by 27% on average). In vitro results on a spinning phantom at nine different velocities showed that similar STE axial errors (up to 2.3% difference in median errors and up to 2.1% difference in the interquartile ranges) are obtained with both ultrafast methods. On the other hand, the median lateral STE estimates were up to 13% more accurate with DW than with MLT. On the contrary, the accuracy of TDI was only up to ~3% better with MLT, but the achievable DW Doppler frame rate was up to 20 times higher. However, our overall results showed that the choice of one method relative to the other is therefore dependent on the application. More precisely, in terms of image quality, DW is more suitable for imaging structures at low depths, while MLT can provide an improved image quality at the focal point that can be placed at higher depths. In terms of motion estimation, DW is more suitable for color Doppler-related applications, while MLT could be used to estimate velocities along selected lines of the image.
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Shenouda K, Rubin F, Garcia D, Badoual C, Bonfils P, Laccourreye O. Evaluation of robotic surgery for transoral resection of T1-2 squamous cell carcinoma of the tonsillar fossa. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 137:31-36. [PMID: 31561975 DOI: 10.1016/j.anorl.2019.09.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
GOAL To evaluate transoral robotic surgery (TORS) for isolated previously untreated squamous cell carcinoma (SCC) of the tonsillar fossa classified as T1-2. METHOD Retrospective analysis of two cohorts of isolated untreated T1-2 tonsillar fossa SCC consecutively operated on by a transoral approach, with (R=21) and without (NR=24) robotic assistance, in the period 2006-2014. Three main (survival, local control, and operative morbidity) and three secondary (pathologic data, incidence and duration of tracheotomy and nasogastric intubation, and hospital stay) endpoints were compared between groups. The significance threshold was set at P< .005. RESULTS Three- and five-year actuarial survival estimates were 80.2% and 74.5% respectively in group R, and 91.5% and 82.5% respectively in group NR (NS: P=.34). Three- and five-year actuarial local control estimates were 90% and 90% respectively in group R, and 95.8% and 91% respectively in group NR (NS: P=.81). There were no significant differences in morbidity, tracheotomy/nasogastric intubation time, or hospital stay. Positive resection margins (R1) were noted in 38.1% and 16.7% in groups R and NR, respectively (NS: P=.05) without significant impact on 5-year actuarial local control (P=0.78). CONCLUSION Robotic assistance in transoral lateral oropharyngectomy for T1-2 tonsillar fossa SCC did not significantly impact oncologic or functional outcome.
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Tsui J, Garcia D, Samuel M, Riopel A, Royal-Preyra B, Matassa V, Bernier M, Alfieri J. Radiotherapy and Cardiovascular Implantable Electronic Devices – A Single-Institution Evidence-Based Guideline. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Tibúrcio BD, Liang D, Almeida J, Garcia D, Vistas CR. Dual-rod pumping concept for TEM 00-mode solar lasers. APPLIED OPTICS 2019; 58:3438-3446. [PMID: 31044840 DOI: 10.1364/ao.58.003438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 04/04/2019] [Indexed: 06/09/2023]
Abstract
We propose here a novel concept to a large improvement in TEM00-mode side-pumped solar laser collection, conversion efficiencies, and brightness figure of merit by pumping two thin laser rods simultaneously, each rod being pumped by half of the solar collector area instead of today's one thick rod scheme pumped by the full solar collector area. A semicylindrical fused silica lens allows an efficient focusing of the concentrated solar power from the focal zone of the parabolic mirror into the two thin laser rods mounted within two compound parabolic concentrator-semicylindrical pump cavities within the same laser head. 17.2 W continuous-wave TEM00-mode solar laser power was numerically calculated, corresponding to 11.0 W/m2 solar laser collection efficiency, 1.31% incoming solar power-to-TEM00-mode laser power conversion efficiency, and 14.3 W brightness figure of merit, being 1.39, 1.23, and 2.21 times, respectively, higher than the previous state-of-the-art experimental records.
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Faurie J, Baudet M, Poree J, Cloutier G, Tournoux F, Garcia D. Coupling Myocardium and Vortex Dynamics in Diverging-Wave Echocardiography. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2019; 66:425-432. [PMID: 29993542 DOI: 10.1109/tuffc.2018.2842427] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Echocardiography is widely used to provide critical left ventricular indices describing myocardial motion and blood inflow velocity. Tissue motion and blood flow are strongly connected and interdependent in the ventricle. During cardiac relaxation, rapid filling leads to the formation of a vortical blood flow pattern. In this paper, we introduce a high-frame-rate method to track vortex dynamics alongside myocardium motion, in a single heartbeat. Cardiac triplex imaging (B-mode + tissue Doppler + color Doppler) was obtained by insonating the left ventricle with diverging waves. We used coherent compounding with integrated motion compensation to obtain high-quality B-mode images. Tissue Doppler was retrieved and the septal and lateral velocities of the mitral annulus were deduced. A rate of ~80 triplex images/s was obtained. Vortex dynamics was analyzed by Doppler vortography. Blood vortex signature maps were used to track the vortex and compute core vorticities. The sequence was implemented in a Verasonics scanner with a 2.5-MHz phased array and tested in vivo in 12 healthy volunteers. Two main peaks appeared on the vorticity curves. These peaks were synchronized with the mitral inflow velocities with a small delay. We observed a relationship between the tissue and vortex waveforms, though also with a delay, which denoted the lag between the wall and the flow motion. Clinical diastolic indices combining basal and mitral inflow velocities (E/A ratio and E/ e' ratio) were determined and compared with those measured using a conventional ultrasound scanner; a good correlation was obtained ( r2 = 0.96 ). High-frame-rate Doppler echocardiography enabled us to retrieve time-resolved dynamics of the myocardium and vortex flow within the same cardiac cycle. Coupling wall-flow analysis could be of clinical relevance for early diagnosis of filling impairment.
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Díaz Nieto CH, Granero AM, Garcia D, Nesci A, Barros G, Zon MA, Fernández H. Development of a third-generation biosensor to determine sterigmatocystin mycotoxin: An early warning system to detect aflatoxin B 1. Talanta 2019; 194:253-258. [PMID: 30609527 DOI: 10.1016/j.talanta.2018.10.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 01/15/2023]
Abstract
A third-generation enzymatic biosensor was developed to quantify sterigmatocystin (STEH). It was based on a glassy carbon electrode modified with a composite of the soybean peroxidase enzyme (SPE) and chemically reduced graphene oxide. The optimal conditions to construct the biosensor were obtained through an experimental design based on the response surfaces methodology. The experiments were performed in 0.1 mol L-1 phosphate buffer solution, pH 5. Amperometric measurements were carried out at - 0.09 V vs Ag/AgCl (3 mol L-1 NaCl). The biosensor showed a lineal response in the concentration range from 6.9 × 10-9 to 5.0 × 10-7 mol L-1. The limit of detection was 2.3 × 10-9 mol L-1 for a signal: noise ratio of 3: 1. Values of the apparent Michaellis-Menten constant, KMapp, obtained by using both Lineweaver-Burk and Eadi-Hofstee methods were (1.5 ± 0.2) × 10-6 and (1.2 ± 0.2) × 10-6 mol L-1, respectively. STEH was analyzed in corn samples spiked with STEH, with an average recovery of 96.5%. The biosensor was also used to determine STEH in corn samples inoculated with the Aspergillus flavus fungus, which is an aflatoxins producer. Considering that STEH is a precursor of aflatoxin B1 (AFB1) in its biological transformation, its decrease over time was related to the production of AFB1. The STEH concentration determined using the biosensor was in very good agreement with that determined by HPLC.
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