AI is a machine-based system that can make predictions, recommendations, and decisions influencing real or virtual environments of a given set of human-defined objectives. It is designed to operate with varying levels of autonomy.

Since cardiovascular medicine is rapidly progressing and new technologies are introduced to cardiovascular tools, AI has become valuable in cardiovascular medicine. This narrative review will discuss the general concept of AI and its role in diagnosing cardiovascular diseases, including ECG, echocardiography, cardiac CT, nuclear cardiology, cardiac MRI, cardiac catheterization, electrophysiology, heart failure, clinical decision support system, and face recognition.

Objectives: The purpose of this article is to provide a narrative review on the management of DKA.

Methods: A PubMed search was performed with clinical queries using the key term “diabetic ketoacidosis”. The search strategy included randomized controlled trials, clinical trials, meta-analyses, observational studies, guidelines, and reviews. The search was restricted to English literature and the age range of 18 years and younger. Moreover, we reviewed and compared major guidelines.

Results: Selected international guidelines for DKA, namely International Society for Pediatric and Adolescent Diabetes (ISPAD), National Institute for Health and Care Excellence (NICE), British Society for Paediatric Endocrinology and Diabetes (BSPED), and South Thames Retrieval Service (STRS) were reviewed. There are considerable differences in the management approaches for DKA between different countries. One of the main areas of differences between guidelines is the administration of fluid, with most guidelines adopting a restrictive approach. This is based on the concern over cerebral oedema, a lethal sequela allegedly to be caused by excessive fluid administration. However, recent new clinical studies suggest that there is no causal relationship between intravenous fluid therapy and DKA-related cerebral injury. The British Society of Paediatric Endocrinology updated its guideline in 2020 to adopt a more permissive approach to fluid administration, which has sparked controversy among some paediatricians.

Conclusion: The management of DKA involves early recognition, accurate diagnosis, meticulous fluid and insulin treatment with close monitoring of blood glucose, ketones, electrolytes, renal function, and neurological status. There is still limited clinical evidence to support either a restrictive or permissive approach in the fluid management of paediatric DKA patients. Clinicians should exercise caution when applying different guidelines in their clinical practice, considering the specific circumstances of individual paediatric patients.

Methods: A total of 10 age-matched healthy volunteers and 69 CLD patients were enrolled and underwent 4D flow MRI prospectively. 4D flow MR images were processed by an MD in biomedical engineering working on the GTFlow platform. Portal hemodynamic parameters include net flow (mL/cycle), flow volume per second through the lumen (mL/sec), average flow velocity (cm/sec), and maximum flow velocity (cm/sec). The difference in portal hemodynamic parameters of 4D flow MRI was compared among healthy volunteers, non-cirrhotic CLD patients and patients with cirrhosis by one-way ANOVA or Kruskal-Wallis nonparametric test and post hoc tests.

Results: 10 CLD patients without cirrhosis and 56 patients with cirrhosis were eventually included, along with 10 healthy volunteers who were divided into three groups. 3 patients with cirrhosis whose image quality did not meet the requirements were excluded. There were no significant differences in portal hemodynamic parameters among the three groups except portal average velocity (P > 0.05). There was no statistical difference in all portal hemodynamic parameters of 4D flow MRI between healthy volunteers and patients with cirrhosis (P > 0.05). There were significant differences in portal average velocity between non-cirrhotic CLD patients, healthy volunteers and patients with cirrhosis, respectively (11.44±3.93 vs 8.10±2.66, P=0.013; 11.44±3.93 vs 8.60±2.22, P=0.007).

Conclusion: Portal average velocity obtained by 4D flow MRI can be an auxiliary means to identify cirrhosis in patients with CLD.

Objective: To address this problem, this paper proposes a joint model called mSegResRF-SPECT, which accomplishes for the first time the task of classifying whole-body bone scan images on a public SPECT dataset [BS-80K] for the diagnosis of bone metastases.

Methods: The mSegResRF-SPECT adopts a multi-bone region segmentation algorithm to segment the whole body image into 13 regions, ResNet34 as an extractor to extract the regional features, and a random forest algorithm as a classifier.

Results: The experimental results of the proposed model show that the average accuracy, sensitivity, and F1 score of the model on the BS-80K dataset reached SOTA.

Conclusion: The proposed method presents a promising solution for better bone scan classification methods.

Methods: We searched the literature for studies on Google Scholar and PubMed using the keywords “Segmentation,” “Classification,” “medical image,” and “generative adversarial network.” Specifically, the initial search revealed 5423 publications after the removal of duplicated and non-accessible fulltext publications. Then, after the title and abstract screening, 680 underwent full-text screening. Finally, 121 studies were included in our final analysis after full-text screening.

Results: The date range of the studies covered in this review is from January 1, 2017, to the present. After a thorough screening and qualification assessment, 121 studies involving GAN-based applications in seven areas of medical images were included in the final methodological review. These areas included synthesis, classification, segmentation, conversion, reconstruction, denoising, and lesion detection. We further classified and summarized these papers into clinical applications, classification methods, and imaging modalities.

Conclusion: We thoroughly examined the latest research progress of GAN-based medical image augmentation. These techniques effectively alleviate the challenge of limited training samples for medical image diagnosis and treatment models. Furthermore, several critical issues associated with GANs, such as pattern collapse, instability, and lack of interpretability, require attention in future research.

Objective: This study focuses on the aspects of model design, network structure, and constraints and proposes a novel model that integrates the learning tasks of pulmonary nodule detection, segmentation, and classification under weakly supervised conditions.

Methods: The main innovations include the following three aspects: (1) a two-dimensional sequence detection model based on a ConvLSTM (Convolutional Long Short-Term Memory) network and U-shaped structure network is proposed to obtain the context space features of image slices fully; (2) a differential diagnosis of benign and malignant pulmonary nodules based on multitask learning is proposed, which uses the annotated data of different types of tasks to mine the potential common features among tasks; and (3) an optimization strategy incorporating prior knowledge of computed tomography images and dynamic weight adjustment of multiple tasks is proposed to ensure that each task can efficiently complete training and learning.

Results: Experiments on the LIDC-IDRI and LUNA16 datasets showed that our proposed method achieved a final competition performance metric score of 87.80% for nodule detection and a Dice similarity coefficient score of 83.95% for pulmonary nodule segmentation.

Conclusion: The cross-validation results of the LIDC-IDRI and LUNA16 datasets show that our model achieved 87.80% of the final competition performance metric score for nodule detection and 83.95% of the DSC score for pulmonary nodule segmentation, representing the optimal result for that dataset.

Case Reports: Three hospitalised patients aged 23 to 86 years underwent venous air embolism (VAE) in the right heart system after performing CTPA. One of the patients died from a complication of venous thromboembolic disease (PE, coronary sinus thrombosis, mesenteric venous thrombosis).

Conclusion: CTPA is a procedure that a priori seems innocuous, but it can be a potential cause of death or serious consequences for patients undergoing radiological procedures where the administration of contrast and the use of an injector could be counterproductive. Radiologists and physicians responsible for the patient should be aware of vascular gas embolism after contrast injection in patients undergoing CTPA.

Methods: As a solution to this unmet medical need, we aimed to develop a decision support system based on artificial intelligence, which automatically segments the prostate and any suspect area from the 3D MRI images.

We assessed retrospective data from all patients diagnosed with PCa by MRI-US fusion prostate biopsy, who underwent prostate MRI in our department due to a clinical or biochemical suspicion of PCa (n=33). All examinations were performed using a 1.5 Tesla MRI scanner. All images were reviewed by two radiologists, who performed manual segmentation of the prostate and all lesions. A total of 145 augmented datasets were generated. The performance of our fully automated end-to-end segmentation model based on a 3D UNet architecture and trained in two learning scenarios (on 14 or 28 patient datasets) was evaluated by two loss functions.

Results: Our model had an accuracy of over 90% for automatic segmentation of prostate and PCa nodules, as compared to manual segmentation. We have shown low complexity networks, UNet architecture with less than five layers, as feasible and to show good performance for automatic 3D MRI image segmentation. A larger training dataset could further improve the results.

Conclusion: Therefore, herein, we propose a less complex network, a slim 3D UNet with superior performance, being faster than the original five-layer UNet architecture.

Methods: We compared different super-resolution algorithms to obtain high-resolution MRI images, including SRGAN, SPSR, and LESRCNN. A global skip connection was applied to the original network of LESRCNN to use global semantic information to get better performance.

Results: Experiments reported that our network improved SSMI by 0.8% and also achieved an obvious increase in PSNR, PI, and LPIPS compared to LESRCNN in our dataset. Similar to LESRCNN, our network has a very short running time, the small number of parameters, low time complexity, and low space complexity while ensuring high performance compared to SRGAN and SPSR. Five MRI doctors were invited for a subjective evaluation of our algorithm. All agreed on significant improvements and that our algorithm could be used clinically in remote areas and has great value.

Conclusion: The experimental results demonstrated the performance of our algorithm in super-resolution MRI image reconstruction. It allows us to obtain highresolution images in the absence of high-field intensity MRI scanners, which has great clinical significance. The short running time, a small number of parameters, low time complexity, and low space complexity ensure that our network can be used in grassroots hospitals in remote areas that lack computing resources. We can reconstruct high-resolution MRI images in a short time, thus saving time for patients. Our algorithm is biased towards clinical and practical applications, and doctors have affirmed the clinical value of our algorithm.

Methods: In our method, we first verified the effectiveness of the shared matting method for the VHP slices and utilized it to segment a single image. Then, to meet the need for the automatic segmentation of serialized slice images, a method based on the parallel refinement method and flood-fill method was designed. The ROI (region of interest) image of the next slice can be extracted by using the skeleton image of the ROI in the current slice.

Results: Utilizing this strategy, the color slice images of the Visible Human body can be continuously and serially segmented. This method is not complex but is rapid and automatic with less manual participation.

Conclusion: The experimental results show that the primary organs of the Visible Human body can be accurately extracted.

Objective: In this paper we aim to test and compare different pre-trained deep learning models, to find the best model for atherosclerosis detection in coronary CT angiography.

Methods: We experimented with different pre-trained deep learning models and fine-tuned each model to achieve the best classification accuracy. We then used the Haar wavelet decomposition to improve the model’s sensitivity.

Results: We found that the Resnet101 architecture had the best performance with an accuracy of 95.2%, 60.8% sensitivity, and 90.48% PPV. Compared to the state of the art which uses a 3D CNN and achieved 90.9% accuracy, 68.9% Sensitivity and 58.8% PPV, sensitivity was quite low. To improve the sensitivity, we chose to use the Haar wavelet decomposition and trained the CNN model with the module of the three details: Low_High, High_Low, and High_High. The best sensitivity reached 80% with the CNN_KNN classifier.

Conclusion: It is possible to perform atherosclerosis detection straight from CCTA images using a pretrained Resnet101, which has good accuracy and PPV. The low sensitivity can be improved using Haar wavelet decomposition and CNN-KNN classifier.

With an emphasis on lung illnesses, this article will offer an in-depth understanding of dextran-based delivery systems in respiratory illnesses.

Methods: Cardiac function, hemodynamics, and biomarkers were evaluated during the treatment period. Heart weight, myocardial fibrosis, and MI rate were measured eventually.

Results: Compared with the HF groups, groups treated with LCZ696 and different doses of NAD⁺ showed increased ejection fractions, fractional shortening, cardiac output, and stroke volume and decreased end-systolic volume, end-systolic dimension, creatine kinase, and lactic dehydrogenase. LV blood pressure was lower in the HF group than in the control group, but this decrease was significantly greater in the medium and high NAD⁺ dose groups.

Conclusion: The ratios of heart weight indexes, fibrotic areas, and MI rates in the CZ696 and medium and high NAD⁺ dose groups were lower than those in the HF group. Medium and highdose NAD⁺ showed superior positive effects on myocardial hypertrophy, cardiac function, and myocardial fibrosis and reduced the MI rate.

Objectives: This review includes the current progress in the field of microfluidic chips, their advantages and their biomedical applications in diagnosis.

Methods: The various manuscripts were collected in the field of microfluidic chip that have biomedical applications from the different sources like Pubmed,Science direct and Google Scholar, out of which some were relevant and considered for the present manuscript.

Results: Microfluidic channels inside the chip allow for the processing of the fluid, such as blending and physicochemical reactions. Aside from its practical, technological, and physical benefits, microscale fluidic circuits also improve researchers' capacity to do more accurate quantitative measurements while researching biological systems. Microfluidic chips, a developing type of biochip, were primarily focused on miniaturising analytical procedures, especially to enhance analyte separation. Since then, the procedures for device construction and operation have gotten much simpler.

Conclusion: For bioanalytical operations, microfluidic technology has many advantages. As originally intended, a micro total analysis system might be built using microfluidic devices to integrate various functional modules (or operational units) onto a single platform. More researchers were able to design, produce, and use microfluidic devices because of increased accessibility, which quickly demonstrated the probability of wide-ranging applicability in all branches of biology.

In this State-of-the-Art review, we provide comprehensive insights into the complex pathobiology of PAH to provide understanding and insights for the practicing clinician. We review the pathology of PAH and the cells involved and their impact in driving pathological abnormalities (pulmonary artery endothelial cells, smooth muscle cells, fibroblasts and pericytes) as well as the role of the extracellular matrix. Inflammation and immune dysfunction are considered important drivers of PAH and are comprehensively discussed. Another pathway relates to TGFβ/ bone morphogenic protein (BMP) imbalance, which is highlighted, as well as a new novel agent, sotatercept that impacts this imbalance. Genetic factors underlying heritable PAH (HPAH) are addressed, as well as epigenetic influences. Other important pathways highlighted include growth factor signaling, ion channels/channelopathy, hypoxia signaling pathways, and altered metabolism and mitochondrial dysfunction. We also address the “estrogen paradox”, whereby PAH is more common in women but more severe in men. The basis for drug-induced PAH is discussed, including the new methamphetamine epidemic. We briefly provide insights into DNA damage and senescence factors in pathobiology and highlight commonalities between PAH and cancer pathobiology. Furthermore, we provide concluding insights for the treating physician. In conclusion, we need to pose the right questions to motivate novel and effective treatment strategies for the management of PAH based on pathobiological principles and understanding.

Understanding of the disease has improved through registries, classifying it into five distinct groups with similar histology, pathophysiology, and therapeutic approaches. These groups include PAH, with heritable and idiopathic causes, as well as various clinical subsets involving connective tissue disease, HIV, portopulmonary hypertension, congenital heart disease, and schistosomiasis. Long-term responders to calcium channel blockers, PAH with venous/capillaries involvement, and persistent PH of newborns are categorized under Group 1, now re-classified as IPAH.

A comprehensive workup for suspected patients includes various tests like electrocardiogram, pulmonary function testing, autoimmune workup, HIV testing, echocardiogram, right heart catheterization, and cardiopulmonary exercise testing.

This review emphasizes the disease's definition and epidemiology, delving into each subset and providing updated workup guidelines. The subsequent article will focus on risk stratification and treatment strategies.

Methods: A systematic literature search for observational studies using terms related to CVD, cerebrovascular disease, and the HFRS was conducted using 6 databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were appraised using the Newcastle-Ottawa Scale (NOS).

Results: Seventeen observational studies were included, all rated ‘good’ quality according to the NOS. One study investigated 5 different CVD cohorts (atrial fibrillation (AF), heart failure (HF), hypotension, hypertension, and chronic ischemic heart disease), 1 study investigated 2 different CVD cohorts (AF and acute myocardial infarction (AMI)), 6 studies investigated HF, 3 studies investigated AMI, 4 studies investigated stroke, 1 study investigated AF, and 1 study investigated cardiac arrest. Increasing frailty risk category was associated with increased age, female sex, and non-white racial group across all CVD. Increasing frailty risk category is also associated with increased length of hospital stay, total costs, and increased odds of 30-day all-cause mortality across all CVD.

Conclusions: The HFRS is an efficient and effective tool for stratifying frailty in patients with CVD and predicting adverse health outcomes.

Objective: In the present study, we explored the major chemical components and potential molecular mechanisms linked to the anti-angina effects of CDDP through the application of network pharmacology and molecular docking.

Methods: The potential targets of active ingredients in CDDP were sourced from the Traditional Chinese Medicine Systems Pharmacology Database (TCMSP) and the Swiss Target Prediction Database (STPD). Additionally, targets related to angina pectoris (AP) were retrieved from various databases, including Gene Cards, DisGeNET, Dis Genet, the Drug Bank database (DBD), and the Therapeutic Target Database (TDD). Protein- protein interaction networks were also established, and core targets were identified based on their topological significance. GO enrichment analysis and KEGG pathway analysis were conducted using the R software. Interactions between active ingredients and potential targets selected through the above process were investigated through molecular docking.

Results: Seventy-six active ingredients were selected with the following criteria: OB ≥ 30%, DL ≥ 0.18. 383 targets of CDDP and 1488 targets on AP were gathered, respectively. Afterwards, 194 common targets of CDDP and anti-AP targets were defined, of which 12 were core targets. GO enrichment analysis indicated that CDDP acted on AP by response to lipopolysaccharide, regulating the reactive oxygen species and metal ion metabolism, and epithelial cell proliferation. In addition, KEGG enrichment analysis indicated that the signaling pathways were notably enriched in lipid and atherosclerosis, fluid shear stress and atherosclerosis, IL-17 signaling pathway, EGFR tyrosine kinase inhibitor resistance, PI3K-Akt signaling pathway, and TNF signaling pathway. Moreover, the molecular docking manifested excellent binding capacity between the active ingredients and targets on AP.

Conclusion: This study comprehensively illustrated the bioactive, potential targets, and molecular mechanisms of CDDP against AP, offering fresh perspectives into the molecular mechanisms of CDDP in preventing and treating AP.

Objective: Abuse of alcohol does not occur suddenly. People becoming addicted to various alcoholic beverages is a problem that results from months and years of irresponsible drinking. The process of recovering from the issue in turn includes targeted, particular methods for raising awareness of the negative effects of alcohol usage.

Conclusion: Due to the heightened risks for one's bodily and mental health along with the social issues it generates, alcohol consumption results in these costs. We discuss the three areas of the epidemiology of alcohol's impact on health and diseases, the public health approach for treating problems related to alcohol use, and advancements in alcohol science.

Case Presentation: In early childhood, a patient had portal hypertension associated with cavernous transformation of the portal vein. It was successfully treated by reno-splenic surgery. At the age of 20 years, this patient experienced increased dyspnea at minimal physical activity after the hepatic biopsy due to a hepatocellular adenoma. The examination in the specialized unit showed PAH, which was evaluated as associated with portal hypertension (PAH-PoH). The specific two-drug combination therapy was started with prominent improvement in patient’s state. Successful surgical tumor treatment was provided some months later. The practical and clinical approaches to the diagnosis and treatment of PAH-PoH are discussed. It was emphasized that not all patients with portal hypertension have pulmonary hypertension, which needs to be treated. A lot of evidence gaps exist in management of these patients.

Conclusion: All patients, even with past history of portal hypertension, should be monitored closely and screened for PAH earlier, for better results of treatment.

Objectives: This article aims to evaluate the cumulative studies and insights on the topic of CoQ₁₀ functions in human health, focusing on a potential role in maintaining physical activity and extending the life cycle.

Results: Although supplementation with CoQ₁₀ offers many benefits to patients with cardiovascular disease, it appears to add little value to patients suffering from statin-associated muscular symptoms. This may be attributed to substantial heterogeneity in doses and treatment regimens used.

Conclusion: Therefore, there is a need for further studies involving a greater number of patients to clarify the benefits of adjuvant therapy with CoQ₁₀ in a range of health conditions and diseases.

Methods: 120 patients with STEMI and DM treated with pPCI were randomly divided into an observation group (n=60) and a control group (n=60). The observation group and the control group were intravenously injected with a bolus of tirofiban preoperatively or intraoperatively, respectively; both groups were then given an intravenous infusion over 24 h at 0.15 μg/kg/min. Thrombolysis in myocardial infarction (TIMI) grade flow, myocardial perfusion index, and functional heart parameters, as well as major adverse cardiovascular events and bleeding, were compared between the two groups.

Results: Functional heart parameters, including left ventricular ejection fraction and cardiac output, were significantly improved in the observation group 6 months after discharge. Thrombus aspiration, inflammatory factors, and cardiac troponin I (cTNI) were more significantly decreased in the observation group than in the control group. The sum-ST-segment elevation at 2 h after pPCI treatment in the observation group was better than that in the control group. There was no significant difference in the incidence of adverse reactions and bleeding between the two groups.

Conclusion: The administration of tirofiban before reperfusion therapy compared with after reperfusion therapy is more effective in reducing the hyperthrombotic load, thrombus aspiration, inflammatory factors, and cTNI and can effectively improve myocardial perfusion and heart function.

Some studies have reported alterations in right ventricular contractility in patients with rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and juvenile idiopathic arthritis, which may contribute to the known outcome of increased cardiovascular risk. However, there is not much information available on the causes that generate these alterations, the most likely being small vessel damage and fibrosis due to subclinical inflammation.1-5 In this sense, the disease in which the alterations of the right ventricle have been more studied is systemic sclerosis, specifically at the changes induced due to pulmonary arterial hypertension, this being one of the main causes of death in this group of patients after the significant decrease in mortality associated with the sclerodermic renal crisis with the treatment of angiotensin-converting enzyme inhibitors.

In this review, we will focus on explaining the structural and functional changes that occur in the right ventricle of patients with systemic sclerosis, from early alterations to late complications. In this context, it is necessary to distinguish between right heart alterations that occur in patients with systemic sclerosis and pulmonary arterial hypertension and those that occur without pulmonary arterial hypertension and that can be attributed to other causes such as microvascular damage or myocardial fibrosis.

Objective: To better understand the physicochemical regularities of these proteins, it is necessary to carry out a computational multiparametric study of the amino acid sequences of envelope proteins expressed by the dengue fever virus and obtain a bioinformatics method that can use the subsequences of the training protein group to figure out the preponderant function of a protein, up to its sequence.

Methods: Essentially, at the amino acid level, various computational programs were applied to the sequences expressing the dengue virus envelope glycoproteins to determine the PIM 2.0 v profile and the Protein Intrinsic Disorder Predisposition (PIDP) profile of each protein, and then, at the nucleotide level, a set of programs for genomic analysis was applied. Finally, these results were contrasted with statistical tests.

Results: The re-creation of structural morphological similarities provided by specific regularities in the PIM 2.0 v profile and PIDP of the proteins from diverse dengue fever virus envelopes made it possible to propose a computer method that employs the PIM 2.0 v profile to identify this group of proteins based on their sequences; based on our findings, this method is a \"fingerprint\" of this protein group.

Conclusion: The typical PIM 2.0 v profiles of the dengue fever virus proteins might be reproduced by computational tools. This knowledge will be helpful in gaining a better understanding of the newly discovered virus. Moreover, the method introduced here can identify, from the sequence, the predominant function of the protein.

Objectives: An attempt has been made to summarise the prenatal interventions, if available, the optimal route, mode and time of delivery and discuss the minimum delivery room preparations that should be made if expecting to deliver a fetus with a congenital anomaly.

Methods: The recent literature related to the perinatal management of the fetus with prenatally detected common congenital anomalies was searched in English peer-reviewed journals from the PubMed database to work out an evidence-based approach for their management.

Results: Fetuses with prenatally detected congenital anomalies should be delivered at a tertiary care centre with facilities for neonatal surgery and paediatric intensive care if needed. There is no indication for preterm delivery in the majority of cases. Only a few congenital malformations, like highrisk sacrococcygeal teratoma, congenital lung masses with significant fetal compromise, fetal cerebral lesions or neural tube defects with Head circumference >40 cm or the biparietal diameter is ≥12 cm, gastroschisis with extracorporeal liver, or giant omphaloceles in the fetus warrant caesarean section as the primary mode of delivery.

Conclusion: The prognosis of a fetus with congenital anomalies can be significantly improved if planning for delivery, including the place and time of delivery, is done optimally. A multidisciplinary team should be available for the fetus to optimize conditions right from when it is born.

Methods: Studies on risk prediction models and prognostic factors for HFpEF were systematically searched in relevant databases including PubMed and Embase. The retrieval time was from inception to February 1, 2023. The Quality in Prognosis Studies (QUIPS) tool was used to assess the risk of bias in included studies. The predictive value of risk prediction models for end outcomes was evaluated by sensitivity, specificity, the area under the curve, C-statistic, C-index, etc. In the literature screening process, potential novel prognostic factors with high value were explored.

Results: A total of 21 eligible HFpEF risk prediction models and 22 relevant studies were included. Except for 2 studies with a high risk of bias and 2 studies with a moderate risk of bias, other studies that proposed risk prediction models had a low risk of bias overall. Potential novel prognostic factors for HFpEF were classified and described in terms of demographic characteristics (age, sex, and race), lifestyle (physical activity, body mass index, weight change, and smoking history), laboratory tests (biomarkers), physical inspection (blood pressure, electrocardiogram, imaging examination), and comorbidities.

Conclusion: It is of great significance to explore the potential novel prognostic factors of HFpEF and build a more convenient and efficient risk prediction model for improving the overall prognosis of patients. This review can provide a substantial reference for further research.

Aim: The study aimed to assess the proportion of associated complications with COVID-19 and the underlying pathophysiology in pregnant women.

Methods: The MedLine and Embase databases were searched for studies relevant to the study topic.

Results: Preterm delivery and C-section have been found to be the most frequently reported complications. Approximately, 28.55% of pregnant women with symptomatic COVID-19 have been reported to require a C-section and 8.8% preterm delivery. In addition, anxiety and depression have also been frequently reported in 57% and 37% of pregnant women, respectively.

Conclusion: Symptomatic pregnant women with COVID-19 have a high risk of preterm labor, mortality and morbidity rates, and C-section requirements. The underlying pathophysiology of COVID-19-associated complications during pregnancy includes homeostatic disturbances of the immune system, pulmonary system, and hemostatic system. In addition to endothelial dysfunction, excessive immune response, coagulopathy, hypoxemia, and hypotension are involved in the pathogenesis that negatively affects neonates' health outcomes.

Methods: In this prospective observational study conducted in the Department of Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, sonographic evaluation of inferior vena cava and the right subclavian vein was carried out at three time points for hypotensive patients admitted to the emergency department. The study population was divided into two groups: responders and non-responders, based on a ≥ 15% increase in stroke volume following fluid bolus.

Results: Among 45 recruited patients, 33 patients were responders. The area under the ROC curve for SCV CI at baseline to predict fluid responsiveness was 0.745 (95% confidence interval: 0.549 – 0.941; p = 0.014). An SCV-CI of 46% predicted fluid responsiveness in a hypotensive patient in terms of change in stroke volume by 15% following fluid bolus with a sensitivity of 87.88% (95% confidence interval: 71.80% to 96.60%) and specificity of 66.67% (95% confidence interval: 34.89% to 90.08%). Spearman’s correlation coefficient between IVC CI and SCV CI was 0.59 (p < 0.001, n = 135).

Conclusion: The results of the study demonstrated that right subclavian vein respiratory variation has the ability to predict fluid responsiveness in a spontaneously breathing patient in circulatory shock and correlates with the inferior vena cava collapsibility index. The subclavian vein can be an alternative to the inferior vena cava in predicting fluid responsiveness in spontaneously breathing patients.

Methods: Three hundred and eighty-two COVID-19 patients, recruited between March and April 2020, were divided into three groups according to their outcome: (1) hospital ward group (patients who entered the hospital wards and survived); (2) intensive care unit (ICU) group (patients who attended the ICU and survived); (3) the deceased group (patients admitted to ICU with a fatal outcome). We investigated routine laboratory parameters such as albumin, glycemia, hemoglobin amylase, lipase, AST, ALT, GGT, LDH, CK, MGB, TnT-hs, IL-6, ferritin, CRP, PCT, WBC, RBC, PLT, PT, INR, APTT, FBG, and D-dimer. Blood withdrawal was carried out at the beginning of the hospitalization period.

Results: ANOVA and ROC data evidenced that the concomitant presence of alterations in albumin, lipase, AST, ALT, LDH, MGB, CK, IL-6, ferritin in women, CRP and D-dimer is an early sign of fatal outcomes.

Conclusion: The present study confirms and extends the validity of routine laboratory biomarkers (i.e., lipase, AST, ALT, LDH, CK, IL-6, ferritin in women, CRP and D-dimer) as indicators of COVID-19 morbidity and mortality. Furthermore, the investigation suggests that both gross changes in albumin and MGB, markers of liver and heart damage, may early disclose COVID-19 fatal outcomes.

Objectives: The current study aimed to evaluate the technetium-99m-sestamibi (^99mTc-MIBI) gated myocardial perfusion imaging (GMPI) characteristics of lupus patients without cardiovascular symptoms, and the relationships between GMPI characteristics and biochemical markers of myocardial injury, and to explore the role of GMPI in assessing myocardial involvement.

Methods: Thirty patients were studied with rest myocardial perfusion imaging, and summed rest score (SRS), summed motion score (SMS), and summed thickening score (STS) were calculated automatically. Biomarkers, including N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and creatine-kinase-MB (CK-MB), were detected simultaneously. GMPI parameters, LV functions and biomarkers were compared between two NT-proBNP groups. The relationships between these parameters were studied by correlation analysis.

Results: SMS, STS, and glomerular filtration rate (eGFR) were the main influencing factors of NTproBNP level (p = 0.001, <0.001, 0.042, respectively). Thirteen patients with an evaluated concentration of NT-proBNP had the lower left ventricular ejection fraction (LVEF), peak filling rate (PFR), eGFR and higher levels of CK-MB (in all comparisons, p < 0.05), and SRS was the only influencing factor of NT-proBNP (p = 0.007). Within thirteen patients with SRS≥2, there was a significant correlation between SRS and NT-proBNP (p < 0.001).

Conclusion: ^99mTc-MIBI GMPI could evaluate the left ventricular function and prompt the cardiomyocyte function at the cellular level. SMS and STS were the main influencers for plasma NT-proBNP, and SRS was the independent factor for elevated NT-proBNP. This radionuclide imaging method could provide additional diagnostic information on myocardial involvement in patients with SLE.

Objective: This research sought to investigate the potential diagnostic and therapeutic targets for recurrent arrhythmias in patients with coronary restenosis and reocclusions after coronary stenting.

Methods: We examined whether oxidative stress, proinflammatory microparticles, and proinflammatory cytokines could have effects that lead to recurrent arrhythmias in elderly patients with coronary restenosis and reocclusions. We measured the levels of malondialdehyde (MDA), CD31 + endothelial microparticle (CD31 EMP), CD62E + endothelial microparticle (CD62E + EMP), high-sensitivity C-reactive protein (hs-CRP), interleukin- 1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α), as well as oxidized low-density lipoprotein (OX-LDL), and assessed the effects of relationship between oxidative stress, proinflammatory microparticles, and proinflammatory cytokines on recurrent atrial and ventricular arrhythmias in elderly patients with coronary restenosis and reocclusions after coronary stenting.

Results: The levels of CD31 + EMP, CD62E + EMP, MDA, hs-CRP, IL-1β, IL-6, IL-8, TNF-α and OX-LDL were found to be increased significantly in coronary restenosis + recurrent atrial arrhythmia group compared to without coronary restenosis and coronary restenosis + without recurrent atrial arrhythmia groups, respectively (P < 0.001). Patients in the coronary reocclusion + recurrent ventricular arrhythmia group also exhibited significantly increased levels of CD31 + EMP, CD62E + EMP, MDA, hs-CRP, IL-1β, IL-6, IL-8, TNF-α and OXLDL compared to without coronary reocclusion and coronary reocclusion + without recurrent ventricular arrhythmia groups, respectively (P < 0.001).

Conclusion: Proinflammatory microparticles, proinflammatory cytokines, and oxidative stress might act as potential targets for recurrent arrhythmias in patients with coronary restenosis and reocclusions after coronary stenting.

Objective: To evaluate the prognostic role of risk factors and biomarkers in patients hospitalized for CRS.

Methods: In this observational cohort study, 100 consecutive patients hospitalized for CRS were enrolled. Socio-demographic characteristics, personal medical history, and prior medication use were recorded upon admission, and echocardiography was performed. Moreover, an array of blood markers were measured. The endpoint of interest was a composite of death or dialysis dependence at discharge.

Results: Patients were classified into two groups; Group 1 (N= 52): discharged being dialysis-independent, Group 2 (N=48): death/dialysis dependence at discharge. No significant differences were detected in baseline characteristics between the two groups. Group 2 patients used renin-angiotensin-aldosterone system blockers (RAASb) less often and more frequently presented with oliguria/anuria. Group 2 patients had significantly lower hemoglobin, serum albumin, and 25-hydroxy-vitamin D (25(OH)D). At the same time, serum phosphate, potassium, and parathyroid hormone (PTH) were significantly higher in Group 2 patients. In a multivariate regression analysis, lack of prior RAASb and lower 25(OH)D levels were independently associated with an increased risk of death or dialysis dependence at discharge. 25(OH)D/PTH ratio was the most accurate predictor of the composite endpoint (Sensitivity: 79.4%, Specificity: 70.4%).

Conclusion: Lack of prior RAASb use, high PTH, low 25(OH)D levels, and low 25(OH) D/PTH ratio are associated with a poor prognosis in patients hospitalized for CRS.]]> https://www.benthamscience.comarticle/123545Introduction: Ultrasound imaging is a standard examination during pregnancy that can measure specific biometric parameters towards prenatal diagnosis and estimating gestational age. Fetal head circumference (HC) is a significant factor in determining fetus growth and health.

Methods: This paper proposes a multi-task deep convolutional neural network for automatic segmentation and estimation of HC (Fetal head circumference) ellipse by minimizing a compound cost function composed of segmentation dice score and MSE of ellipse parameters. Ultrasoundbased fetal biometric measurements, such as head circumference (HC) and biparietal diameter (BPD (Biparietal Diameter)), are commonly used to evaluate the gestational age and diagnose fetal central nervous system (CNS) pathology. Since manual measurements are operator-dependent and time-consuming, there have been numerous researches on automated methods. However, existing computerized methods still are not satisfactory in terms of accuracy and reliability, owing to difficulties in dealing with various artefacts in ultrasound images.

Results: This paper focuses on fetal head biometry and develops a deep-learning-based method for estimating HC (Fetal head circumference) and BPD (Biparietal Diameter) with a high degree of accuracy and reliability.

Conclusion: The proposed method effectively identifies the head boundary by differentiating tissue image patterns concerning the ultrasound propagation direction. The proposed method was trained with 102 labelled data set and tested to 70 ultrasound images. We achieved a success rate of 92.31% for HC (Fetal head circumference) and BPD (Biparietal Diameter) estimations and an accuracy of 87.14% for the plane acceptance check.

Objective: This review comprehensively examines the fabrication methods and device designs (2D/3D configuration) and their advantages and disadvantages, focusing on updated μPADs applications for motif identification.

Methods: The evolution of paper-based devices, starting from the traditional devices of dipstick and lateral flow assay (LFA) with μPADs, has been described. Patterned structure fabrication of each technique has been compared among the equipment used, benefits, and drawbacks. Microfluidic device designs, including 2D and 3D configurations, have been introduced as well as their modifications. Various designs of μPADs have been integrated with many powerful detection methods such as colorimetry, electrochemistry, fluorescence, chemiluminescence, electrochemiluminescence, and SER-based sensors for medicinal diagnosis applications.

Conclusion: The μPADs potential to deal with commercialization in terms of the state-of-the-art of μPADs in medicinal diagnosis has been discussed. A great prototype, which is currently in a reallife application breakthrough, has been updated.

Objective: The current study aims to address the effects of dapagliflozin on the expression of fractalkine (FKN), known as CX3CL1, and its receptors CX3CR1, Nuclear factor-kappa B(NF-κB) p65 activity, Reactive oxygen species (ROS), and inflammation in LPS-treated H9c2 cell line.

Methods: H9c2 cells were cultured with lipopolysaccharide (LPS) to establish a model of LPS-induced damage, and then, subsequently were treated with dapagliflozin for 72 h. Our work included measurement of cell viability (MTT), Malondialdehyde (MDA), intracellular ROS, tumor necrosis factor-α (TNF-α), NF-κB activity, and expression of CX3CL1/CX3CR1.

Results: The results showed that LPS-induced reduction of cell viability was successfully rescued by dapagliflozin treatment. The cellular levels of MDA, ROS, and TNF-α, as an indication of cellular oxidative stress and inflammation, were significantly elevated in H9c2 cells compared to the control group. Furthermore, dapagliflozin ameliorated inflammation and oxidative stress through the modulation of the levels of MDA, TNF-α, and ROS. Correspondingly, dapagliflozin reduced the expression of CX3CL1/CX3CR1, NF-κB p65 DNA binding activity, and it also attenuated nuclear acetylated NF-κB p65 in LPS-induced injury in H9c2 cells compared to untreated cells.

Conclusion: These findings shed light on the novel pharmacological potential of dapagliflozin in the alleviation of LPS-induced CX3CL1/CX3CR1-mediated injury in inflammatory conditions such as sepsis-induced cardiomyopathy.

Methods: We constructed an ensemble model composed of three high-performance DILI prediction models to utilize the unique advantage of each machine learning algorithm.

Results: The ensemble model exhibited high predictive performance, with an area under the curve of 0.88, sensitivity of 0.83, specificity of 0.77, F1-score of 0.82, and accuracy of 0.80. When a test dataset collected from the literature was used to compare the performance of our model with publicly available DILI prediction models, our model achieved an accuracy of 0.77, sensitivity of 0.82, specificity of 0.72, and F1-score of 0.79, which were higher than those of the other DILI prediction models. As many published DILI prediction models are not available for public access, which hinders in silico drug discovery, we made our DILI prediction model publicly accessible (http://ssbio.cau.ac.kr/software/dili/).

Conclusion: We expect that our ensemble model may facilitate advancements in drug discovery by providing a highly predictive model and reducing the drug withdrawal rate.