Πέμπτη, 30 Νοεμβρίου 2017

Lymphographic-Like Technique for the Treatment of Microcystic Lymphatic Malformation Components of <3 mm [HEAD & NECK]

BACKGROUND AND PURPOSE:

The treatment of microcystic lymphatic malformations remains challenging. Our aim was to describe the lymphographic-like technique, a new technique of slow bleomycin infusion for the treatment of microcyst components of <3 mm, performed at our institution.

MATERIALS AND METHODS:

A retrospective analysis of a prospectively collected lymphatic malformation data base was performed. Patients with at least 1 microcystic lymphatic malformation component demonstrated on MR imaging treated by lymphographic-like technique bleomycin infusion were included in the study. Patient interviews and MR imaging were performed to assess subjective and objective (microcystic lymphatic malformation size decrease of >30%) clinical improvement, respectively. Patients were reviewed 3 months after each sclerotherapy session. Lymphographic-like technique safety and efficacy were assessed.

RESULTS:

Between January 2012 and July 2016, sixteen patients (5 males, 11 females; mean age, 15 years; range, 1–47 years) underwent the bleomycin lymphographic-like technique for microcystic lymphatic malformations. Sixty sclerotherapy sessions were performed, with a mean of 4 sessions per patient (range, 1–8 sessions) and a mean follow-up of 26 months (range, 5–58 months). We observed no major and 3 minor complications: 1 eyelid infection, 1 case of severe postprocedural nausea and vomiting, and 1 case of skin discoloration. One patient was lost to follow-up. Overall MR imaging objective improvement was observed in 5/16 (31%) patients; overall improvement of clinical symptoms was obtained in 93% of treated patients.

CONCLUSIONS:

The bleomycin lymphographic-like technique for microcystic lymphatic malformations is safe and feasible with objective improvement in about one-third of patients. MR signal intensity changes after the lymphographic-like technique are associated with subjective improvement of the patient's symptoms.



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CT Attenuation Analysis of Carotid Intraplaque Hemorrhage [EXTRACRANIAL VASCULAR]

BACKGROUND AND PURPOSE:

Intraplaque hemorrhage is considered a leading parameter of carotid plaque vulnerability. Our purpose was to assess the CT characteristics of intraplaque hemorrhage with histopathologic correlation to identify features that allow for confirming or ruling out the intraplaque hemorrhage.

MATERIALS AND METHODS:

This retrospective study included 91 patients (67 men; median age, 65 ± 7 years; age range, 41–83 years) who underwent CT angiography and carotid endarterectomy from March 2010 to May 2013. Histopathologic analysis was performed for the tissue characterization and identification of intraplaque hemorrhage. Two observers assessed the plaque's attenuation values by using an ROI (≥ 1 and ≤2 mm2). Receiver operating characteristic curve, Mann-Whitney, and Wilcoxon analyses were performed.

RESULTS:

A total of 169 slices were assessed (59 intraplaque hemorrhage, 63 lipid-rich necrotic core, and 47 fibrous); the average values of the intraplaque hemorrhage, lipid-rich necrotic core, and fibrous tissue were 17.475 Hounsfield units (HU) and 18.407 HU, 39.476 HU and 48.048 HU, and 91.66 HU and 93.128 HU, respectively, before and after the administration of contrast medium. The Mann-Whitney test showed a statistically significant difference of HU values both in basal and after the administration of contrast material phase. Receiver operating characteristic analysis showed a statistical association between intraplaque hemorrhage and low HU values, and a threshold of 25 HU demonstrated the presence of intraplaque hemorrhage with a sensitivity and specificity of 93.22% and 92.73%, respectively. The Wilcoxon test showed that the attenuation of the plaque before and after administration of contrast material is different (intraplaque hemorrhage, lipid-rich necrotic core, and fibrous tissue had P values of .006, .0001, and .018, respectively).

CONCLUSIONS:

The results of this preliminary study suggest that CT can be used to identify the presence of intraplaque hemorrhage according to the attenuation. A threshold of 25 HU in the volume acquired after the administration of contrast medium is associated with an optimal sensitivity and specificity. Special care should be given to the correct identification of the ROI.



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John Nash and the Organization of Stroke Care [PRACTICE PERSPECTIVES]

SUMMARY:

The concept of Nash equilibrium, developed by John Forbes Nash Jr, states that an equilibrium in noncooperative games is reached when each player takes the best action for himself or herself, taking into account the actions of the other players. We apply this concept to the provision of endovascular thrombectomy in the treatment of acute ischemic stroke and suggest that collaboration among hospitals in a health care jurisdiction could result in practices such as shared call pools for neurointervention teams, leading to better patient care through streamlined systems.



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Influences for Gender Disparity in Academic Neuroradiology [ACADEMIC PERSPECTIVES]

BACKGROUND AND PURPOSE:

There has been extensive interest in promoting gender equality within radiology, a predominately male field. In this study, our aim was to quantify gender representation in neuroradiology faculty rankings and determine any related factors that may contribute to any such disparity.

MATERIALS AND METHODS:

We evaluated the academic and administrative faculty members of neuroradiology divisions for all on-line listed programs in the US and Canada. After excluding programs that did not fulfill our selection criteria, we generated a short list of 85 US and 8 Canadian programs. We found 465 faculty members who met the inclusion criteria for our study. We used Elsevier's SCOPUS for gathering the data pertaining to the publications, H-index, citations, and tenure of the productivity of each faculty member.

RESULTS:

Gender disparity was insignificant when analyzing academic ranks. There are more men working in neuroimaging relative to women (2 = 0.46; P = .79). However, gender disparity was highly significant for leadership positions in neuroradiology (2 = 6.76; P = .009). The median H-index was higher among male faculty members (17.5) versus female faculty members (9). Female faculty members have odds of 0.84 compared with male faculty members of having a higher H-index, adjusting for publications, citations, academic ranks, leadership ranks, and interaction between gender and publications and gender and citations (9).

CONCLUSIONS:

Neuroradiology faculty members follow the same male predominance seen in many other specialties of medicine. In this study, issues such as mentoring, role models, opportunities to engage in leadership/research activities, funding opportunities, and mindfulness regarding research productivity are explored.



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Reproducibility of Deep Gray Matter Atrophy Rate Measurement in a Large Multicenter Dataset [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Precise in vivo measurement of deep GM volume change is a highly demanded prerequisite for an adequate evaluation of disease progression and new treatments. However, quantitative data on the reproducibility of deep GM structure volumetry are not yet available. In this paper we aim to investigate this reproducibility using a large multicenter dataset.

MATERIALS AND METHODS:

We have assessed the reproducibility of 2 automated segmentation software packages (FreeSurfer and the FMRIB Integrated Registration and Segmentation Tool) by quantifying the volume changes of deep GM structures by using back-to-back MR imaging scans from the Alzheimer Disease Neuroimaging Initiative's multicenter dataset. Five hundred sixty-two subjects with scans at baseline and 1 year were included. Reproducibility was investigated in the bilateral caudate nucleus, putamen, amygdala, globus pallidus, and thalamus by carrying out descriptives as well as multilevel and variance component analysis.

RESULTS:

Median absolute back-to-back differences varied between GM structures, ranging from 59.6–156.4 μL for volume change, and 1.26%–8.63% for percentage volume change. FreeSurfer had a better performance for the outcome of longitudinal volume change for the bilateral amygdala, putamen, left caudate nucleus (P < .005), and right thalamus (P < .001). For longitudinal percentage volume change, Freesurfer performed better for the left amygdala, bilateral caudate nucleus, and left putamen (P < .001). Smaller limits of agreement were found for FreeSurfer for both outcomes for all GM structures except the globus pallidus. Our results showed that back-to-back differences in 1-year percentage volume change were approximately 1.5–3.5 times larger than the mean measured 1-year volume change of those structures.

CONCLUSIONS:

Longitudinal deep GM atrophy measures should be interpreted with caution. Furthermore, deep GM atrophy measurement techniques require substantially improved reproducibility, specifically when aiming for personalized medicine.



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Alphabet Soup: Sagittal Balance Correction Osteotomies of the Spine--What Radiologists Should Know [REVIEW ARTICLE]

SUMMARY:

Global sagittal malalignment has been demonstrated to have correlation with clinical symptoms and is a key component to be restored in adult spinal deformity. In this article, various types of sagittal balance-correction osteotomies are reviewed primarily on the basis of the 3 most commonly used procedures: Smith-Petersen osteotomy, pedicle subtraction osteotomy, and vertebral column resection. Familiarity with the expected imaging appearance and commonly encountered complications seen on postoperative imaging studies following correction osteotomies is crucial for accurate image interpretation.



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Time for a Time Window Extension: Insights from Late Presenters in the ESCAPE Trial [INTERVENTIONAL]

BACKGROUND AND PURPOSE:

The safety and efficacy of endovascular therapy for large-artery stroke in the extended time window is not yet well-established. We performed a subgroup analysis on subjects enrolled within an extended time window in the Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke (ESCAPE) trial.

MATERIALS AND METHODS:

Fifty-nine of 315 subjects (33 in the intervention group and 26 in the control group) were randomized in the ESCAPE trial between 5.5 and 12 hours after last seen healthy (likely to have groin puncture administered 6 hours after that). Treatment effect sizes for all relevant outcomes (90-day mRS shift, mRS 0–2, mRS 0–1, and 24-hour NIHSS scores and intracerebral hemorrhage) were reported using unadjusted and adjusted analyses.

RESULTS:

There was no evidence of treatment heterogeneity between subjects in the early and late windows. Treatment effect favoring intervention was seen across all clinical outcomes in the extended time window (absolute risk difference of 19.3% for mRS 0–2 at 90 days). There were more asymptomatic intracerebral hemorrhage events within the intervention arm (48.5% versus 11.5%, P = .004) but no difference in symptomatic intracerebral hemorrhage.

CONCLUSIONS:

Patients with an extended time window could potentially benefit from endovascular treatment. Ongoing randomized controlled trials using imaging to identify late presenters with favorable brain physiology will help cement the paradigm of using time windows to select the population for acute imaging and imaging to select individual patients for therapy.



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MR Imaging Characteristics Associate with Tumor-Associated Macrophages in Glioblastoma and Provide an Improved Signature for Survival Prognostication [ADULT BRAIN]

BACKGROUND AND PURPOSE:

In glioblastoma, tumor-associated macrophages have tumor-promoting properties. This study determined whether routine MR imaging features could predict molecular subtypes of glioblastoma that differ in the content of tumor-associated macrophages.

MATERIALS AND METHODS:

Seven internally derived MR imaging features were assessed in 180 patients, and 25 features from the Visually AcceSAble Rembrandt Images feature set were assessed in 164 patients. Glioblastomas were divided into subtypes based on the telomere maintenance mechanism: alternative lengthening of telomeres positive (ALT+) and negative (ALT–) and the content of tumor-associated macrophages (with [M+] or without [M–] a high content of macrophages). The 3 most frequent subtypes (ALT+/M–, ALT–/M+, and ALT–/M–) were correlated with MR imaging features and clinical parameters. The fourth group (ALT+/M+) did not have enough cases for correlation with MR imaging features.

RESULTS:

Tumors with a regular margin and those lacking a fungating margin, an expansive T1/FLAIR ratio, and reduced ependymal extension were more frequent in the subgroup of ALT+/M– (P < .05). Radiologic necrosis, lack of cystic component (by both criteria), and extensive peritumoral edema were more frequent in ALT–/M+ tumors (P < .05). Multivariate testing with a Cox regression analysis found the cystic imaging feature was additive to tumor subtype, and O6-methylguanine methyltransferase (MGMT) status to predict improved patient survival (P < .05).

CONCLUSIONS:

Glioblastomas with tumor-associated macrophages are associated with routine MR imaging features consistent with these tumors being more aggressive. Inclusion of cystic change with molecular subtypes and MGMT status provided a better estimate of survival.



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Scientific abstracts from the 2017 ACOMS and CAOMS Joint Scientific Conference and Exhibition

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Publication date: Available online 21 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): ACOMS




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Table of Contents

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Publication date: December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 6





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Letter to the editor: Comments in relation to the CPC case entitled: “Submucosal nodule in buccal mucosa” Oral Surg Oral Med Oral Pathol Oral Radiol 2016;122:660-665.1

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Publication date: Available online 16 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Ciro Dantas Soares, Román Carlos




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Predictors of obturator functioning and satisfaction in turkish maxillectomy patients using an obturator prosthesis

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Publication date: Available online 22 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Meltem Ozdemir-Karatas, Ali Balik, Gulumser Evlioglu, Ömer Uysal, Kadriye Peker
ObjectiveTo determine the socio-demographic, behavioral and clinical factors affecting obturator function and satisfaction using the Obturator Functioning Scale (OFS) in maxillectomy patients rehabilitated with obturator prostheses.Material and methodsStudy sample consisted 41 maxillectomy patients. The OFS was translated and adapted into Turkish for assessing obturator functioning and patient satisfaction. Data were collected from patients' medical records and self-completed questionnaires, including the Turkish version of the OFS, socio-demographic and behavioral characteristics. Descriptive statistics, Mann Whitney U test, Spearman's correlation coefficient, and backward stepwise multiple linear regression were used for data analysis.ResultsInternal consistency (Cronbach's Alpha = 0.85) and test-retest reliability (Intraclass correlation coefficient = 0.86) were acceptable for the OFS. The most frequently reported problem was "difficulty in chewing". Bivariate analysis revealed significant differences in total OFS scores in terms of surgery type, defect size, and education level, except for the other clinical and socio-demographic characteristics and behavioral factors. Education level and surgery type were found to be the most important predictors of patient satisfaction and obturator functioning.ConclusionThe Turkish version of the OFS might be a useful tool for clinicans to identify the patients who are at risk for poor obturator functioning and satisfaction as well as their unmet needs.



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Prevalence of temporomandibular disorders discovered incidentally during routine dental examination using the research diagnostic criteria for temporomandibular disorders

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Publication date: Available online 21 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Wael M. Talaat, Omar I. Adel, Saad Al Bayatti
ObjectivesTo assess the prevalence of temporomandibular disorders (TMD) discovered incidentally during routine dental examination, identify disease patterns, and evaluate patients' attitude toward accepting treatment.Study designA total of 3009 subjects were examined at the University Dental Hospital Sharjah. Research Diagnostic Criteria for TMD (RDC/TMD) Axes I and II were used for assessment. Subjects with acute/serious dysfunction symptoms underwent cone-beam computed tomography (CBCT) examination. MRI was used to confirm the diagnosis of disc displacement.ResultsNon-self-reported TMD prevalence was 10.8% (n=325). Among TMD patients, the disorders were diagnosed more in women (65.85%) (p<0.05), and between the ages of 25 and 45 (65.54%) (p<0.05). Axis I assessment revealed disc displacement with reduction (group IIa) was the most common (40.92%). Axis II chronic pain grade (CPG) showed 32.62% of TMD patients experienced chronic pain, whereas 66.77% had mild disability. Interest to pursue treatment was indicated by 92.31% of patients. CBCT and MRI assessment changed the primary diagnosis in 26.08% and 18.47% of cases, respectively.ConclusionsTMD screening during routine dental examination led to the diagnosis of non-self-reported TMD, most commonly related to disc displacement with reduction. Radiographic assessment was important to confirm TMD diagnosis. Patients diagnosed with TMD during dental screening expressed interest in pursuing treatment.



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Editorial Board

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Publication date: December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 6





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Khat and synthetic cathinones: emerging drugs of abuse with dental implications

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Publication date: Available online 22 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Worku Abebe
The rising global availability of the stimulant and euphoric substances, khat and synthetic cathinones, has become a cause for concern in many countries, including the US. Both substances are illegal in US, although this has not deterred the use. Besides central nervous system effects, these drugs also cause sympathomimetic and oro-dental adverse effects, similar to those of amphetamine. While synthetic cathinones are more stronger than khat in most cases, the latter additionally contains tannins, which have astringent effects on tissues components, including in the oral cavity. Recognizing the use prevalence and reported oro-dental adverse effects of khat and synthetic cathinones, dental practitioners should be more familiar with these substances in order to optimally treat and educate their patients abusing them. This paper reviews the pharmacology and adverse effects of khat and synthetic cathinones, along with the extent of their use in US, with particular emphasis on dental implications.



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Reply to the letter to the editor

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Publication date: Available online 21 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Jesca Silva, Priscila Andrade, Bruno Sotto-Maior, Neuza Assis, Karina Lopes Devito




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Acknowledgement of reviewers 2017

Publication date: Available online 20 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology





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Inflammatory reaction of the anterior dorsal tongue presumably to sodium lauryl sulfate within toothpastes: a triple case report.

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Publication date: Available online 22 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Ronald S. Brown, Langston Smith, Alison L. Glascoe
BackgroundSodium lauryl sulfate (SLS) is a popular surface active agent ingredient within toothpastes, known for its foaming action. Surface active agents increase the effectiveness of toothpastes with respect to dental plaque removal. SLS is a known irritant and also has allergenic potential. The authors report three patients with oral pain secondary to inflammation of the dorsal anterior tongue. These patients were all using toothpastes with SLS as an ingredient.ResultsThe dorsal tongue lesions and oral pain resolved upon switching to toothpastes without SLS as an ingredient.ConclusionsClinicians should be aware of the potential of SLS within toothpastes to cause oral mucosal inflammatory reactions of the anterior dorsal tongue. To our knowledge, these are the first case reports of oral mucosal inflammatory reactions of the anterior dorsal tongue associated with SLS containing toothpastes.



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DNA methylation polymerase chain reaction (PCR) array of apoptosis-related genes in pleomorphic adenomas of the salivary glands

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Publication date: December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 6
Author(s): Núbia Braga Pereira, Ana Carolina de Melo do Carmo, Kelma Campos, Sara Ferreira dos Santos Costa, Marina Gonçalves Diniz, Ricardo Santiago Gomez, Carolina Cavalieri Gomes
ObjectiveThe aim of this study was to evaluate the DNA methylation profile in 22 apoptosis-related genes in pleomorphic adenomas (PAs) of the salivary glands, in comparison with normal salivary glands (NSGs), and to address the differences in methylation patterns between smaller and larger tumors. Additionally, we investigated if the hypermethylation of differentially methylated genes between NSGs and PAs impacted the messenger RNA (mRNA) transcription.DesignTwenty-three fresh PA samples and 12 NSG samples were included. The PA samples were divided into 2 groups: PAs with clinical size larger than 2 cm (n = 12) and PAs with clinical size 2 cm or smaller (n = 11). DNA methylation at the promoter region of a panel of 22 genes involved in apoptosis was profiled by using a human apoptosis DNA methylation polymerase chain reaction array, and the transcriptional levels of genes showing differential methylation profiles between PAs and NSGs were assessed.ResultsTNFRSF25 and BCL2 L11 were highly methylated in PAs, in comparison with NSGs, irrespective of tumor size. However, no difference could be observed in the mRNA transcription between PAs and NSGs.ConclusionsHypermethylation of the proapoptotic genes BCL2 L11 and TNFRSF25 is observed in PA. However, this phenomenon did not impact mRNA transcription.



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Multifocal occurrence of intraoral isolated MS in a patient without leukemic presentation: a case report and literature review

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Publication date: Available online 22 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Yanxin Shen, Lei Zhao, Yafei Wu, Ping Huang
Myeloid sarcoma (MS), also referred to as chloroma or granulocytic sarcoma, is a rare extramedullary malignant tumor composed of immature myeloid cells. MS usually occurs with acute myelocytic leukemia (AML), myeloproliferative neoplasm, or myelodysplastic syndrome, or as a recurrence of AML; however, MS may occasionally present isolated, without current or previous peripheral blood or bone marrow involvement. The oral and maxillofacial MS, especially isolated, is extremely rare, and the clinical manifestations are diverse and usually non-specific. Here we report a rare case of isolated nonleukemic MS involving the gingivae, mucosa of the left maxillary edentulate region and the adjacent hard palate. The pertinent literature was also reviewed to provide additional clarification on the clinicopathologic characteristics, differential diagnosis, treatment regimens and prognosis of oral and maxillofacial isolated MS.



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Evaluation of clinical and radiographic indices as predictors of osteoporotic fractures: a 10-year longitudinal study

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Publication date: Available online 21 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Grethe Jonasson, Valter Sundh, Magnus Hakeberg, Margareta Ahlqwist, Lauren Lissner, Dominique Hange
ObjectivesTo evaluate two radiographic and three clinical indices as predictors of future osteoporotic fractures.Study designIn a prospective, longitudinal study with a 10-year fracture follow-up, the two radiographic indices, mandibular cortical erosion (normal, mild/moderate erosion, and severe erosion of the inferior cortex) and cortex thickness, were assessed using panoramic radiographs of 411 women, aged 62-78 years. The clinical indices were the fracture assessment tool, FRAX(R), the osteoporosis index of risk, OSIRIS, and the osteoporosis self-assessment tool, OST.ResultsThe relative risks (RR) for future fracture were significant for FRAX(R)>15%, 4.1 (95% CI: 2.4-7.2), and for severely eroded cortices, 1.7 (95% CI: 1.1-2.8). Cortical thickness <3mm, OSIRIS, and OST were not significant fracture predictors (RR 1.1, 1.4, and 1.5 respectively). For the five tested fracture predictors, Fisher's exact test gave the following p-values for differences between fractured and non-fractured groups: FRAX( R) <0.001, cortical erosion 0.023, OST 0.078, OSIRIS 0.206, and cortical thickness 0.678. The area under the curve (AUC) was 0.69 for FRAX(R)>15%, 0.58 for cortical erosion, and 0.52 for cortical thickness. Adding OSIRIS and OST did not change AUC significantly.ConclusionFRAX(R) and severely eroded cortices predicted fracture but cortical thickness, OSIRIS, and OST did not.



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It is not about lip retraction

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Publication date: Available online 21 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Sze Lok Lau




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Assessment of alveolar bone marrow fat content using 15T MRI

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Publication date: Available online 21 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Arthur Rodriguez Gonzalez Cortes, Ouri Cohen, Ming Zhao, Eduardo Massaharu Aoki, Rodrigo Alves Ribeiro, Lina Abu Nada, Claudio Costa, Emiko Saito Arita, Faleh Tamimi, Jerome L. Ackerman
ObjectivesBone marrow fat is inversely correlated with bone mineral density. The aim of this study is to present a method to quantify alveolar bone marrow fat content using a 15T MRI scanner.Study DesignA 15T MRI scanner with a 13-mm ID loop-gap radiofrequency coil was used to scan seven 3 mm diameter alveolar bone biopsy specimens. A 3D gradient-echo (GRE) T1-weighted pulse sequence was chosen to obtain images. All images were obtained with a voxel size (58 µm3) sufficient to resolve trabecular spaces. Automated volume of the bone marrow fat content and derived bone volume fraction (BV/TV) were calculated. Results were compared with actual BV/TV obtained from micro-CT scans.ResultsMean fat tissue volume was 20.1 ± 11%. There was a significantly strong inverse correlation between fat tissue volume and BV/TV (r = –0.68, p = 0.045). Furthermore, there was a strong agreement between BV/TV derived from MRI and obtained with Micro-CT (ICC = 0.92, p = 0.001).ConclusionBone marrow fat of small alveolar bone biopsy specimens can be quantified with sufficient spatial resolution using an ultra-high-field MRI scanner and a T1-weighted pulse sequence.



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Accuracy of biomarkers obtained from cone beam computed tomography in assessing the internal trabecular structure of the mandibular condyle

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Publication date: December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 6
Author(s): Fouad H. Ebrahim, Antonio C.O. Ruellas, Beatriz Paniagua, Erika Benavides, Karl Jepsen, Larry Wolford, Joao Roberto Goncalves, Lucia H.S. Cevidanes
ObjectiveThe aim of this study was to validate the ability of cone beam computed tomography (CBCT) to measure condylar internal trabecular bone structure and bone texture parameters accurately.Study DesignSixteen resected condyles of individuals undergoing temporomandibular joint replacement were collected and used as samples. These condyles were then radiographically imaged by using clinically oriented dental CBCT and research oriented micro–computed tomography (micro-CT). The CBCT scans were then compared with the gold standard micro-CT scans in terms of 21 bone imaging parameters. Descriptive histologic investigation of the specimens was also performed.ResultsSignificant correlations were found for several imaging parameters between the CBCT and micro-CT images, including trabecular thickness (r = 0.92), trabecular separation (r = 0.78), bone volume (r = 0.90), bone surface area (r = 0.79), and degree of anisotropy measurements (r = 0.77).ConclusionsMeasurements of trabecular thickness, trabecular separation, bone volume, bone surface area, and degree of anisotropy obtained from high-resolution dental CBCT images may be suitable bone imaging biomarkers that can be utilized clinically and in future research.



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Reply to the Letter to the Editor: Comments in relation to the CPC case entitled:

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Publication date: Available online 20 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Natália Batista Daroit, Bruna Jalfim Maraschin, Vinícius Coelho Carrard, Pantelis Varvaki Rados, Fernanda Visioli




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A symptomatic swelling of the upper lip

Publication date: Available online 17 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Ana Carolina Uchoa Vasconcelos, Adriano Mota Loyola, Ana Paula Neutzling Gomes, Vera Cavalcanti de Araújo, Sandra Beatriz Chaves Tarquínio, Felipe Martins Silveira, Maria Cássia Ferreira de Aguiar




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Announcement

Publication date: December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 6





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Anticoagulants are dental friendly

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Publication date: Available online 16 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Michael J. Wahl, Craig S. Miller, Nelson L. Rhodus, Peer Kämmerer, Atanaska Dinkova, Rajesh V. Lalla, Branislav V. Bajkin




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Extreme widening of asymmetric giant cystic Virchow-Robin spaces



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Concerns about a New Preterm MR Imaging Scoring System.

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Concerns about a New Preterm MR Imaging Scoring System.

AJNR Am J Neuroradiol. 2017 Nov 23;:

Authors: de Vries LS, Cowan FM

PMID: 29170275 [PubMed - as supplied by publisher]



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Reply.

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Reply.

AJNR Am J Neuroradiol. 2017 Nov 23;:

Authors: George JM, Fiori S, Fripp J, Pannek K, Bursle J, Moldrich RX, Guzzetta A, Coulthard A, Ware RS, Rose SE, Colditz PB, Boyd RN

PMID: 29170274 [PubMed - as supplied by publisher]



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Optimization of Quantitative Dynamic Postgadolinium MRI Technique Using Normalized Ratios for the Evaluation of Temporomandibular Joint Synovitis in Patients with Juvenile Idiopathic Arthritis.

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Optimization of Quantitative Dynamic Postgadolinium MRI Technique Using Normalized Ratios for the Evaluation of Temporomandibular Joint Synovitis in Patients with Juvenile Idiopathic Arthritis.

AJNR Am J Neuroradiol. 2017 Nov 23;:

Authors: Caruso P, Buch K, Rincon S, Hakimelahi R, Peacock ZS, Resnick CM, Foster C, Guidoboni L, Donahue T, Macdonald R, Rothermel H, Curtin HD, Kaban LB

Abstract
BACKGROUND AND PURPOSE: MR imaging has been shown to be useful in the diagnosis of juvenile idiopathic arthritis of the temporomandibular joint. Prior MR imaging approaches have relied mainly on the subjective interpretation of synovial enhancement as a marker for synovial inflammation. Although, more recently, several attempts have been made to quantify synovial enhancement, these methods have not taken into account the dynamic enhancement characteristics of the temporomandibular joint and the effect of sampling time. Our aim was to develop a clinically feasible, reproducible, dynamic, contrast-enhanced MR imaging technique for the quantitative assessment of temporomandibular joint synovitis in patients with juvenile idiopathic arthritis and to study the effect of sampling time on the evaluation of synovitis.
MATERIALS AND METHODS: This was a retrospective study of all patients who had dynamic, contrast-enhanced coronal T1 3T MR imaging through the temporomandibular joint at our institution between January 1, 2015, and July 8, 2016. Patients in this cohort included those with a history of juvenile idiopathic arthritis and control patients who underwent MR imaging for other routine, clinical purposes. Synovial enhancement was calculated for each temporomandibular joint using 3 different types of equations termed normalization ratios. The enhancement profiles generated by each equation were studied to determine which provided the best discrimination between affected and unaffected joints, was the least susceptible to sampling errors, and was the most clinically feasible.
RESULTS: A ratio of synovial enhancement (defined as the difference between the postgadolinium and the pregadolinium T1 signal of the synovium) to the postgadolinium signal of the longus capitis provided the best discrimination between affected and unaffected joints, the least susceptibility to sampling error, and was thought to be the most clinically feasible method of quantification of synovial inflammation. Additional synovial enhancement ratios studied did not provide the same level rates of discrimination between the affected and unaffected joints and were thought to be too temporally variable to provide reliable clinical use.
CONCLUSIONS: We provide a robust, reproducible, dynamic gadolinium-enhanced MR imaging technique for the quantitative assessment of temporomandibular joint synovitis in patients with juvenile idiopathic arthritis.

PMID: 29170273 [PubMed - as supplied by publisher]



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Vertebroplasty and Kyphoplasty for Osteoporotic Vertebral Fractures: What Are the Latest Data?

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Vertebroplasty and Kyphoplasty for Osteoporotic Vertebral Fractures: What Are the Latest Data?

AJNR Am J Neuroradiol. 2017 Nov 23;:

Authors: Chandra RV, Maingard J, Asadi H, Slater LA, Mazwi TL, Marcia S, Barr J, Hirsch JA

Abstract
Osteoporotic vertebral compression fractures frequently result in significant morbidity and health care resource use. For patients with severe and disabling pain, vertebral augmentation (vertebroplasty and kyphoplasty) is often considered. Although vertebroplasty was introduced >30 years ago, there are conflicting opinions regarding the role of these procedures in the treatment of osteoporotic vertebral compression fractures. This review article updates clinicians on the published prospective randomized controlled data, including the most recent positive trials that followed initial negative trials in 2009. Analysis of multiple national claim datasets has also provided further insight into the utility of these procedures. Finally, we considered the recent recommendations of national organizations and medical societies that advise on the use of vertebral augmentation procedures for osteoporotic vertebral compression fractures.

PMID: 29170272 [PubMed - as supplied by publisher]



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Temporal Lobe Malformations in Achondroplasia: Expanding the Brain Imaging Phenotype Associated with FGFR3-Related Skeletal Dysplasias.

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Temporal Lobe Malformations in Achondroplasia: Expanding the Brain Imaging Phenotype Associated with FGFR3-Related Skeletal Dysplasias.

AJNR Am J Neuroradiol. 2017 Nov 23;:

Authors: Manikkam SA, Chetcuti K, Howell KB, Savarirayan R, Fink AM, Mandelstam SA

Abstract
Thanatophoric dysplasia, achondroplasia, and hypochondroplasia belong to the fibroblast growth factor receptor 3 (FGFR3) group of genetic skeletal disorders. Temporal lobe abnormalities have been documented in thanatophoric dysplasia and hypochondroplasia, and in 1 case of achondroplasia. We retrospectively identified 13 children with achondroplasia who underwent MR imaging of the brain between 2002 and 2015. All children demonstrated a deep transverse temporal sulcus on MR imaging. Further common neuroimaging findings were incomplete hippocampal rotation (12 children), oversulcation of the mesial temporal lobe (11 children), loss of gray-white matter differentiation of the mesial temporal lobe (5 children), and a triangular shape of the temporal horn (6 children). These appearances are very similar to those described in hypochondroplasia, strengthening the association of temporal lobe malformations in FGFR3-associated skeletal dysplasias.

PMID: 29170271 [PubMed - as supplied by publisher]



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The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents.

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The Role of Hemodynamics in Intracranial Bifurcation Arteries after Aneurysm Treatment with Flow-Diverter Stents.

AJNR Am J Neuroradiol. 2017 Nov 23;:

Authors: Narata AP, de Moura FS, Larrabide I, Perrault CM, Patat F, Bibi R, Velasco S, Januel AC, Cognard C, Chapot R, Bouakaz A, Sennoga CA, Marzo A

Abstract
BACKGROUND AND PURPOSE: Treatment of intracranial bifurcation aneurysms with flow-diverter stents can lead to caliber changes of the distal vessels in a subacute phase. This study aims to evaluate whether local anatomy and flow disruption induced by flow-diverter stents are associated with vessel caliber changes in intracranial bifurcations.
MATERIALS AND METHODS: Radiologic images and demographic data were acquired for 25 patients with bifurcation aneurysms treated with flow-diverter stents. Whisker plots and Mann-Whitney rank sum tests were used to evaluate if anatomic data and caliber changes could be linked. Symmetry/asymmetry were defined as diameter ratio 1 = symmetric and diameter ratio <1 = asymmetric. Computational fluid dynamics was performed on idealized and patient-specific anatomies to evaluate flow changes induced by flow-diverter stents in the jailed vessel.
RESULTS: Statistical analysis identified a marked correspondence between asymmetric bifurcation and caliber change. Symmetry ratios were lower for cases showing narrowing or subacute occlusion (medium daughter vessel diameter ratio = 0.59) compared with cases with posttreatment caliber conservation (medium daughter vessel diameter ratio = 0.95). Computational fluid dynamics analysis in idealized and patient-specific anatomies showed that wall shear stress in the jailed vessel was more affected when flow-diverter stents were deployed in asymmetric bifurcations (diameter ratio <0.65) and less affected when deployed in symmetric anatomies (diameter ratio ∼1.00).
CONCLUSIONS: Anatomic data analysis showed statistically significant correspondence between caliber changes and bifurcation asymmetry characterized by diameter ratio <0.7 (P < .001). Similarly, computational fluid dynamics results showed the highest impact on hemodynamics when flow-diverter stents are deployed in asymmetric bifurcations (diameter ratio <0.65) with noticeable changes on wall sheer stress fields. Further research and clinical validation are necessary to identify all elements involved in vessel caliber changes after flow-diverter stent procedures.

PMID: 29170270 [PubMed - as supplied by publisher]



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Feasibility of Brain Atrophy Measurement in Clinical Routine without Prior Standardization of the MRI Protocol: Results from MS-MRIUS, a Longitudinal Observational, Multicenter Real-World Outcome Study in Patients with Relapsing-Remitting MS.

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Feasibility of Brain Atrophy Measurement in Clinical Routine without Prior Standardization of the MRI Protocol: Results from MS-MRIUS, a Longitudinal Observational, Multicenter Real-World Outcome Study in Patients with Relapsing-Remitting MS.

AJNR Am J Neuroradiol. 2017 Nov 23;:

Authors: Zivadinov R, Bergsland N, Korn JR, Dwyer MG, Khan N, Medin J, Price JC, Weinstock-Guttman B, Silva D, MS-MRIUS Study Group

Abstract
BACKGROUND AND PURPOSE: Feasibility of brain atrophy measurement in patients with MS in clinical routine, without prior standardization of the MRI protocol, is unknown. Our aim was to investigate the feasibility of brain atrophy measurement in patients with MS in clinical routine.
MATERIALS AND METHODS: Multiple Sclerosis and Clinical Outcome and MR Imaging in the United States (MS-MRIUS) is a multicenter (33 sites), retrospective study that included patients with relapsing-remitting MS who began treatment with fingolimod. Brain MR imaging examinations previously acquired at the baseline and follow-up periods on 1.5T or 3T scanners with no prior standardization were used, to resemble a real-world situation. Brain atrophy outcomes included the percentage brain volume change measured by structural image evaluation with normalization of atrophy on 2D-T1-weighted imaging and 3D-T1WI and the percentage lateral ventricle volume change, measured by VIENA on 2D-T1WI and 3D-T1WI and NeuroSTREAM on T2-fluid-attenuated inversion recovery examinations.
RESULTS: A total of 590 patients, followed for 16 months, were included. There were 585 (99.2%) T2-FLAIR, 425 (72%) 2D-T1WI, and 166 (28.2%) 3D-T1WI longitudinal pairs of examinations available. Excluding MR imaging examinations with scanner changes, the analyses were available on 388 (65.8%) patients on T2-FLAIR for the percentage lateral ventricle volume change, 259 and 257 (43.9% and 43.6%, respectively) on 2D-T1WI for the percentage brain volume change and the percentage lateral ventricle volume change, and 110 (18.6%) on 3D-T1WI for the percentage brain volume change and percentage lateral ventricle volume change. The median annualized percentage brain volume change was -0.31% on 2D-T1WI and -0.38% on 3D-T1WI. The median annualized percentage lateral ventricle volume change was 0.95% on 2D-T1WI, 1.47% on 3D-T1WI, and 0.90% on T2-FLAIR.
CONCLUSIONS: Brain atrophy was more readily assessed by estimating the percentage lateral ventricle volume change on T2-FLAIR compared with the percentage brain volume change or percentage lateral ventricle volume change using 2D- or 3D-T1WI in this observational retrospective study. Although measurement of the percentage brain volume change on 3D-T1WI remains the criterion standard and should be encouraged in future prospective studies, T2-FLAIR-derived percentage lateral ventricle volume change may be a more feasible surrogate when historical or other practical constraints limit the availability of percentage brain volume change on 3D-T1WI.

PMID: 29170269 [PubMed - as supplied by publisher]



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Leukoaraiosis Attenuates Diagnostic Accuracy of Large-Vessel Occlusion Scales.

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Leukoaraiosis Attenuates Diagnostic Accuracy of Large-Vessel Occlusion Scales.

AJNR Am J Neuroradiol. 2017 Nov 23;:

Authors: Mayasi Y, Goddeau RP, Moonis M, Silver B, Jun-O'Connell AH, Puri AS, Henninger N

Abstract
BACKGROUND AND PURPOSE: Prehospital stroke scales may help identify patients likely to have large-vessel occlusion to facilitate rapid triage to thrombectomy-capable stroke centers. Scale misclassification may result in inaccurate decisions and possible harm. Pre-existing leukoaraiosis has been shown to attenuate the association between deficit type and stroke severity. We sought to determine whether leukoaraiosis affects the predictive ability of 5 commonly used large-vessel occlusion scales.
MATERIALS AND METHODS: We retrospectively analyzed 274 consecutive patients with stroke with available brain MR imaging and vessel imaging. We used the following large-vessel occlusion scales: the 3-Item Stroke Scale; Field Assessment Stroke Triage for Emergency Destination; Rapid Arterial Occlusion Evaluation; Vision, Aphasia, Neglect score; and Cincinnati Prehospital Stroke Severity Scale. For diagnostic scale accuracy, we assessed sensitivity, specificity, positive predictive value, negative predictive value, and κ. Multivariable logistic regression was used to determine the predictive ability of the scales after adjustment for leukoaraiosis and potential confounders.
RESULTS: In unadjusted analyses, all scales predicted the presence of large-vessel occlusion (n = 46, P < .01 each), though diagnostic accuracy was attenuated among patients with moderate-to-severe leukoaraiosis. After adjustment, the Field Assessment Stroke Triage for Emergency Destination (OR = 3.2; 95% CI, 1.1-9.5; P = .033) and Rapid Arterial Occlusion Evaluation (OR = 3.7; 95% CI, 1.3-10.8; P = .015), but not the 3-Item Stroke Scale (OR = 5.4; 95% CI, 0.86-33.9; P = .073), Vision, Aphasia, Neglect score (OR = 2.5; 95% CI, 0.8-7.2), and Cincinnati Prehospital Stroke Severity Scale (OR = 2.8; 95% CI, 1.0-8.0), predicted large-vessel occlusion.
CONCLUSIONS: The diagnostic accuracy of the tested large-vessel occlusion scales was attenuated in the presence of moderate-to-severe leukoaraiosis. This information that may aid the design of future studies that require large-vessel occlusion scale screening of patients who are likely to have concomitant leukoaraiosis.

PMID: 29170268 [PubMed - as supplied by publisher]



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Perivascular Spaces in Old Age: Assessment, Distribution, and Correlation with White Matter Hyperintensities.

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Perivascular Spaces in Old Age: Assessment, Distribution, and Correlation with White Matter Hyperintensities.

AJNR Am J Neuroradiol. 2017 Nov 23;:

Authors: Laveskog A, Wang R, Bronge L, Wahlund LO, Qiu C

Abstract
BACKGROUND AND PURPOSE: The visual rating scales for perivascular spaces vary considerably. We sought to develop a new scale for visual assessment of perivascular spaces and to further describe their distribution and association with white matter hyperintensities in old age.
MATERIALS AND METHODS: This population-based study included 530 individuals who did not have dementia and were not institutionalized (age, ≥60 years or older; mean age, 70.7 years; 58.9% women) who were living in central Stockholm, Sweden. A semiquantitative visual rating scale was developed to score the number and size of visible perivascular spaces in 7 brain regions in each hemisphere. A modified Scheltens visual rating scale was used to assess white matter hyperintensities.
RESULTS: The global scores for perivascular spaces ranged from 4-32 for number, 3-22 for size, and 7-54 for the combination of number and size. The weighted κ statistics for the intra- and interrater reliability both were 0.77. The global score for the number of perivascular spaces increased with advancing age (P < .001). The scores for the number of perivascular spaces in the basal ganglia and subinsular regions were significantly correlated with the load of white matter hyperintensities, especially in lobar and deep white matter regions (partial correlation coefficients, >0.223; P < .01).
CONCLUSIONS: The new visual rating scale for perivascular spaces shows excellent intra- and interrater reliability. The number of perivascular spaces globally and, especially, in the basal ganglia, is correlated with the load of lobar and deep white matter hyperintensities, supporting the view that perivascular spaces are a marker for cerebral small-vessel disease.

PMID: 29170267 [PubMed - as supplied by publisher]



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Posttreatment Infarct Volumes when Compared with 24-Hour and 90-Day Clinical Outcomes: Insights from the REVASCAT Randomized Controlled Trial.

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Posttreatment Infarct Volumes when Compared with 24-Hour and 90-Day Clinical Outcomes: Insights from the REVASCAT Randomized Controlled Trial.

AJNR Am J Neuroradiol. 2017 Nov 23;:

Authors: Al-Ajlan FS, Al Sultan AS, Minhas P, Assis Z, de Miquel MA, Millán M, San Román L, Tomassello A, Demchuk AM, Jovin TG, Cuadras P, Dávalos A, Goyal M, Menon BK, REVASCAT Investigators

Abstract
BACKGROUND AND PURPOSE: Endovascular therapy has become the standard of care for patients with disabling anterior circulation ischemic stroke due to proximal intracranial thrombi. Our aim was to determine whether the beneficial effect of endovascular treatment on functional outcome could be explained by a reduction in posttreatment infarct volume in the Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours (REVASCAT) trial.
MATERIALS AND METHODS: The REVASCAT trial was a multicenter randomized open-label trial with blinded outcome evaluation. Among 206 enrolled subjects (endovascular treatment, n = 103; control, n = 103), posttreatment infarct volume was measured in 204 subjects. Posttreatment infarct volumes were compared with treatment assignment and recanalization status. Appropriate statistical models were used to assess the relationship among baseline clinical and imaging variables, posttreatment infarct volume, the 24-hour NIHSS score, and functional status with the 90-day modified Rankin Scale score.
RESULTS: The median posttreatment infarct volume in all subjects was 23.7 mL (interquartile range = 68.9 mL) and 16.3 mL (interquartile range = 50.2 mL) in the endovascular treatment arm and 38.6 mL (interquartile range = 74.9 mL) in the control arm (P = .02 for endovascular treatment versus control subjects). Baseline NIHSS (P < .01), site of occlusion (P < .03), baseline NCCT ASPECTS (P < .01), and recanalization status (P = .02) were independently associated with posttreatment infarct volume. Baseline NIHSS (P < .01), time from symptom onset to randomization (P = .02), treatment type (P = .04), and recanalization status (P < .01) were independently associated with the 24-hour NIHSS scores. The 24-hour NIHSS score strongly mediated the relationship between treatment type and 90-day mRS (P < .01 for indirect effect when adjusted for age), while posttreatment infarct volume did not (P = .26).
CONCLUSIONS: Endovascular treatment saves brain and improves 90-day clinical outcomes primarily through a beneficial effect on the 24-hour stroke severity.

PMID: 29170266 [PubMed - as supplied by publisher]



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A nationwide survey of French dentists' knowledge and implementation of current guidelines for antibiotic prophylaxis of infective endocarditis in patients with predisposing cardiac conditions.

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A nationwide survey of French dentists' knowledge and implementation of current guidelines for antibiotic prophylaxis of infective endocarditis in patients with predisposing cardiac conditions.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Oct 18;:

Authors: Cloitre A, Duval X, Hoen B, Alla F, Lesclous P

Abstract
OBJECTIVES: To prevent infective endocarditis in patients with predisposing cardiac conditions, antibiotic prophylaxis is recommended worldwide, except in the United Kingdom. To determine the relevance of this strategy, investigating how the current guidelines are applied is crucial. The first aim of this study was to assess dentists' implementation of the current guidelines. The secondary aims were to identify relevant areas to improve the training of dentists and to determine temporal trends in practitioners' attitudes by comparison with 2 previous surveys conducted in 1991 and 2001.
STUDY DESIGN: An electronic national survey was sent to the 12,000 member practitioners of the French Union for Oral Health.
RESULTS: Even though 58.9% of the respondents stated that their knowledge of current guidelines was good, a scoring system showed that only 34.5% had overall knowledge of these guidelines.
CONCLUSIONS: This study revealed relevant areas to improve the training of dentists, such as knowledge of some cardiac conditions, the potential side effects of the antibiotics used, and the pathogenesis of infective endocarditis. Consequently, dentists' knowledge should be improved before any conclusions can be drawn on the relevance of this antibiotic prophylaxis strategy and its influence on infective endocarditis incidence.

PMID: 29174663 [PubMed - as supplied by publisher]



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The reliability of different methods of manual volumetric segmentation of pharyngeal and sinonasal subregions.

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The reliability of different methods of manual volumetric segmentation of pharyngeal and sinonasal subregions.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Dec;124(6):577-587

Authors: Neelapu BC, Kharbanda OP, Sardana HK, Gupta A, Vasamsetti S, Balachandran R, Rana SS, Sardana V

Abstract
OBJECTIVES: The purpose of the study was to test the intra and interobserver reliability of manual volumetric segmentation of pharyngeal and sinonasal airway subregions.
STUDY DESIGN: Cone beam computed tomography data of 15 patients were collected from an orthodontic clinical database. Two experienced orthodontists independently performed manual segmentation of the airway subregions. Four performance measures were considered to test intra and interobserver reliability of manual segmentation: (1) volume correlation, (2) mean slice correlation, (3) percentage of volume difference, and (4) percentage of nonoverlapping voxels.
RESULTS: Intra and interobserver reliability was observed to be greater than 0.96 for the entire pharyngeal and sinonasal airway sinus subregions by both observers using the volume correlation method. Mean slice correlation was found to be greater than 0.84, showing the existence of nonoverlapping voxels. Therefore, the percentage of nonoverlapping voxels was used as a reliability measure and was found to be less than 20% for both intra and interobserver markings.
CONCLUSIONS: The mean slice correlation and percentage of nonoverlapping voxels were the most reliable performance measures of segmentation correctness. Volume correlation and the percentage of volume difference were observed to be the most reliable performance measures for volume correctness.

PMID: 29169513 [PubMed - in process]



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Radiation-related caries assessment through the International Caries Detection and Assessment System and the Post-Radiation Dental Index.

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Radiation-related caries assessment through the International Caries Detection and Assessment System and the Post-Radiation Dental Index.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Dec;124(6):542-547

Authors: Palmier NR, Ribeiro ACP, Fonsêca JM, Salvajoli JV, Vargas PA, Lopes MA, Brandão TB, Santos-Silva AR

Abstract
OBJECTIVE: Although radiation-related caries (RRC) are a well-known toxicity of head and neck radiotherapy, a clinical classification system for RRC has not yet been clinically validated. Therefore, the aim of this study was to assess whether the International Caries Detection and Assessment System (ICDAS) and the Post-Radiation Dental Index (PRDI) were viable methods for the assessment of RRC.
STUDY DESIGN: Clinicopathologic data and intraoral digital photographs of 60 patients (833 teeth) affected by RRC were assessed and classified according to the ICDAS and PRDI criteria.
RESULTS: A total of 814 (97.7%) teeth presented RRC lesions ranging from early stage to complete tooth destruction. Mean scores for the whole sample were 5 for ICDAS and 3 for PRDI, indicating that RRC were diagnosed predominately in late stages. ICDAS and PRDI criteria underestimate the clinical expressivity of RRC by not including the whole qualitative clinical spectrum of RRC, such as enamel cracks, delamination, dental crown amputation, surface color alterations, and atypical lesions topography (incisal/cuspal caries).
CONCLUSIONS: ICDAS and PRDI may not be considered viable for the assessment of RRC. The development of a specific clinical classification system is urgently needed to help clinicians recognize the peculiar patterns of RRC, particularly in incipient cases.

PMID: 29169512 [PubMed - in process]



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Longitudinal and cross-sectional assessment of quality of life in surgically treated advanced (T4) cancer of the buccal mucosa.

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Longitudinal and cross-sectional assessment of quality of life in surgically treated advanced (T4) cancer of the buccal mucosa.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Dec;124(6):529-536

Authors: Mair MD, Nair S, Nikam S, Nair D, Agarwal JP, Chaturvedi P

Abstract
OBJECTIVE: Quality of life (QOL) has become an important aspect of today's health care management. This study performed longitudinal assessment of QOL in patients with advanced cancers of the buccal mucosa (T4). We compared the QOL between patients who received adjuvant chemoradiation therapy (CTRT) and that of patients who received radiation therapy alone and assessed whether baseline QOL can predict disease recurrence.
STUDY DESIGN: This was a prospective study of 225 patients with T4 buccal mucosal cancer. Health-related QOL was assessed at baseline and at 3, 6, 9, and 12 months after completion of treatment by means of the European Organization for Research and Treatment of Cancer Core QOL Questionnaire and the HN35 questionnaire.
RESULTS: There was persistent improvement in global QOL and pain. Emotional functioning improved at 12 months. Most of the head and neck-specific symptoms deteriorated at 3 months, with subsequent improvement at 12 months except in swallowing, senses, speech, social eating, social contact, and sexuality. Patients who received adjuvant CTRT had poorer QOL. Poorer baseline global QOL (P = .049), dyspnea (P = .04), appetite loss (P = .015), and weight loss (P = .08) may predict recurrence.
CONCLUSIONS: Although there is an improvement in global QOL and pain, most of the head and neck-specific symptoms worsened in the immediate postoperative period. Adjuvant CTRT has a persistent effect on specific domains compared with adjuvant radiation therapy alone. Poor baseline QOL scores are associated with a higher risk of recurrence.

PMID: 29169511 [PubMed - in process]



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Relationships matter in oral cancer: will single-stain immunohistochemistry become irrelevant in the age of multispectral imaging?

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Relationships matter in oral cancer: will single-stain immunohistochemistry become irrelevant in the age of multispectral imaging?

Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Dec;124(6):517-518

Authors: Bell RB, Fox BA

PMID: 29169510 [PubMed - in process]



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Estimating the number of fractions by tumour site for European countries in 2012 and 2025: An ESTRO-HERO analysis

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Publication date: Available online 29 November 2017
Source:Radiotherapy and Oncology
Author(s): Josep M. Borras, Cai Grau, Julieta Corral, Karen Wong, Michael B. Barton, Jacques Ferlay, Freddie Bray, Yolande Lievens
Background and purposeThe optimal number of radiotherapy fractions is a relevant input for planning resource needs. An estimation of the total number of fractions by country and tumour site is assessed for 2012 and 2025.MethodsEuropean cancer incidence data by tumour site and country for 2012 and 2025 were extracted from the GLOBOCAN database. Incidence and stage data were introduced in the Australian Collaboration for Cancer Outcomes Research and Evaluation (CCORE) model, producing an evidence-based proportion of incident cases with an indication for radiotherapy and fractions by indication. An indication was defined as a clinical situation in which radiotherapy was the treatment of choice.ResultsThe total number of fractions if radiotherapy was given according to guidelines to all patients with an indication in Europe was estimated to be 30 million for 2012; with a forecasted increase of 16.1% by 2025, yet with differences by country and tumour. The average number of fractions per course was 17.6 with a small range of differences following stage at diagnosis. Among the treatments with radical intent the average was 24 fractions, while it decreased to 2.5 among palliative treatments.DiscussionAn increase in the total number of fractions is expected in many European countries in the coming years following the trends in cancer incidence. In planning radiotherapy resources, these increases should be balanced to the evolution towards hypofractionation, along with increased complexity and quality assurance.



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Needle use and dosimetric evaluation in cervical cancer brachytherapy using the Utrecht applicator

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Publication date: Available online 29 November 2017
Source:Radiotherapy and Oncology
Author(s): Milena Smolic, Chèrita Sombroek, Monique C.W.M. Bloemers, Baukelien van Triest, Marlies E. Nowee, Anton Mans
Background and purposeTo analyse the clinical use of needles and examine the feasibility to meet the planning criteria in three fractions of cervical cancer brachytherapy. Furthermore, to investigate whether the needles with the largest discrepancy between application and loading are essential to treatment planning.Materials and methodsFor 22 patients we analysed the applied and loaded needle patterns, and examined the dosimetric results for small (<30 cm3) and large (≥30 cm3) CTVHR. We removed from the clinical plans (CP) the needles applied most, but with the lowest loading frequency and intensity and re-optimized these plans (RP).ResultsOn average 5.8 needles were applied and 4.8 loaded per fraction, with average intensity 22% (17% for small, 29% for large CTVHR). Mid-lateral needles were applied and loaded most frequently and intensely. The average CTVHR D90% prescribed dose was 88.8 Gy (SD 4.2) EQD210, the average OAR D2cm3 limit was respected. Omitting the mid-ventral needles, minimal statistically significant differences were found in dose distributions between RP and CP.ConclusionsApplying on average 5.8 needles per fraction it was possible to meet the planning criteria for targets and OARs in three BT fractions for both small and large CTVHR. The mid-ventral needles were not essential in treatment planning, unless situated in the vicinity of the GTVres.



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Comparative analysis of gut bacterial communities of green turtles (Chelonia mydas) pre-hospitalization and post-rehabilitation by high-throughput sequencing of bacterial 16S rRNA gene

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Publication date: March 2018
Source:Microbiological Research, Volume 207
Author(s): Md. Shamim Ahasan, Thomas B. Waltzek, Roger Huerlimann, Ellen Ariel
Stranded green turtles (Chelonia mydas) are often cared for in rehabilitation centers until they recover. Although the specific causal agents of diseases in stranded turtles are difficult to diagnose, we know that gut microbiota of green turtles play a vital role in health as well as a wide range of diseases. The objective of this study was to characterize and compare the gut bacterial communities between pre-hospitalization (PH) and post-rehabilitation (PR) stranded green turtles using high-throughput sequencing analysis targeting V1–V3 regions of the bacterial 16S rRNA gene. A total of eight cloacal swab samples were collected from four green turtles undergoing rehabilitation. Proteobacteria dominating in both PH and PR samples without any significant difference. Firmicutes was the second and Bacteroidetes was the third most abundant phylum in PH samples, while Bacteroidetes prevailed in PR samples, followed by Firmicutes. The predominance of the genus Bacteroides in both PH and PR samples indicates the importance of this genus in turtle gut health. At a class level, Epsilonproteobacteria was significantly (P<0.05) associated with PH samples and Deltaproteobacteria predominated (P<0.05) in PR samples. The significant abundance of Campylobacter fetus, Escherichia coli, Clostridium botulinum and Vibrio parahaemolyticus in PH samples indicate pathogenic associations with stranded green turtles with zoonotic potential. The presence of Salmonella enterica in only PR samples suggest possible acquisition of this bacteria during rehabilitation. In this study, all post-rehabilitation green turtles exhibited similar bacterial communities, irrespective of their microbial compositions at pre-hospitalization. The marked differences in the gut bacterial communities of PH and PR turtles indicate the outcome of dietary, management and environmental shift during rehabilitation. Therefore, it is important to address the process of restoring normal gut microbiota of recovered turtles prior to release back to their natural habitat.



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Modulation in phenolic root exudate profile of Abelmoschus esculentus expressing activation of defense pathway

Publication date: March 2018
Source:Microbiological Research, Volume 207
Author(s): Shatrupa Ray, Sandhya Mishra, Kartikay Bisen, Surendra Singh, Birinchi Kumar Sarma, Harikesh Bahadur Singh
Phenolics play a key role in communication between plants and microbes in the rhizosphere. In this study, shikimic, gallic, fumaric, ferulic, vanillic acid and quercetin in root exudates of Abelmoschus esculentus act as chemoattractants of endophytic Alcaligenes faecalis strains, BHU 12, BHU 16 and BHU M7. In vitro chemotaxis assay showed that BHU 12 expressed highest chemotactic movement (CFU ∼50×1012) towards A.esculentus root exudates followed by BHU 16 and BHU M7 (CFU∼ 9×1012), thereby confirming their ability to colonize the host rhizoplane region. However, BHU 16 expressed highest biofilm formation ability followed by BHU 12 and BHU M7. Assessment of chemotactic and biofilm formation potential towards individual phenolic acids revealed BHU 12 to be maximally attracted towards 1μM shikimic acid (2×1015) while BHU 16 towards 1mM vanillic acid (6.5×1012) and BHU M7 towards 1mM ferulic acid (3.5×1012), thereby confirming the phenolic acid components responsible for particularly attracting the endophytic isolates. Upon colonization, the endophytic isolates modified the phenolic profiles of root exudates in planta in a manner so as to plausibly attract more of the beneficial rhizospheric microbiota as well as self-fortification against pathogenic microbes. This hypothesis was verified by monitoring the changes in phenolic components of A. esculentus root exudate owing to S. rolfsii infection, a disastrous soil-borne pathogen. Thus, on the whole, the work provides intricate details of plant-endophyte interactions for biotic stress management through careful manipulation of root exudates, thereby aiding in sustainable agriculture.



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The special existences: nanoRNA and nanoRNase

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Publication date: Available online 29 November 2017
Source:Microbiological Research
Author(s): Hebin Liao, Mafeng Liu, Xiaolan Guo
To adapt to a wide range of nutritional and environmental changes, cells must adjust their gene expression profiles. This process is completed by the frequent transcription and rapid degradation of mRNA. mRNA decay is initiated by a series of endo- and exoribonucleases. These enzymes leave behind 2- to 5-nt-long oligoribonucleotides termed “nanoRNAs” that are degraded by specific nanoRNases; the degradation of nanoRNA is essential because nanoRNA can mediate the priming of transcription initiation that is harmful for the cell via an unknown mechanism. Identified nanoRNases include Orn in E. coli, NrnA and NrnB in B. subtilis, and NrnC in Bartonella. Even though these nanoRNases can degrade nanoRNA specifically into mononucleotides, the biochemical features, structural features and functional mechanisms of these enzymes are different. Sequence analysis has identified homologs of these nanoRNases in different bacteria, including Gammaproteobacteria, Betaproteobacteria, Alphaproteobacteria, Firmicutes and Cyanobacteria. However, there are several bacteria, such as those belonging to the class Thermolithobacteria, that do not have homologs of these nanoRNases. In this paper, the source of nanoRNA, the features of different kinds of nanoRNases and the distribution of these enzymes in prokaryotes are described in detail.



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Epitope structure of the carbohydrate recognition domain of asialoglycoprotein receptor to a monoclonal antibody revealed by high resolution proteolytic excision mass spectrometry

Recent studies suggest that the H1 subunit of the carbohydrate recognition domain (H1CRD) of the asialoglycoprotein receptor is used as an entry site into hepatocytes by hepatitis A and B viruses and Marburg virus. Thus, molecules binding specifically to the CRD might exert inhibition towards these diseases by blocking the virus entry site. We report here the identification of the epitope structure of H1CRD to a monoclonal antibody by proteolytic epitope excision of the immune complex and high-resolution MALDI-FTICR mass spectrometry. As a prerequisite of the epitope determination, the primary structure of the H1CRD antigen was characterised by ESI-FTICR-MS of the intact protein and by LC-MS/MS of tryptic digest mixtures. Molecular mass determination and proteolytic fragments provided the identification of two intramolecular disulfide bridges (seven Cys residues), and a Cys-mercaptoethanol adduct formed by treatment with β-mercaptoethanol during protein extraction. The H1CRD antigen binds to the monoclonal antibody in both native and Cys-alkylated form. For identification of the epitope, the antibody was immobilized on N-hydroxysuccinimide (NHS)-activated Sepharose. Epitope excision and epitope extraction with trypsin and FTICR-MS of affinity-bound peptides provided the identification of two specific epitope peptides (5–16) and (17–23) that showed high affinity to the antibody. Affinity studies of the synthetic epitope peptides revealed independent binding of each peptide to the antibody.

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Secreted enzymatic activities of ectomycorrhizal fungi as a case study of functional diversity and functional redundancy

Introduction Many studies deal with taxonomic diversity (TD) or estimation of functional traits of ectomycorrhizal communities. However, to our knowledge, none of them has ever tried to calculate the functional diversity (FD) of those communities, which is of critical importance for the diversity and reliability of nutrient supply to the tree. Objectives Here, we propose to evaluate the functional diversity of ECM communities in their potential ability to mobilise nutrients from organic matter, in two different forest stands. Results Results show that in both forest stands: TD is strongly correlated with FD. ECM species are functionally redundant within the communities for their abilities to secrete organic matter degrading enzymes. The functional traits (enzymatic activities) of the studied ectomycorrhizal communities are not related within genera, nor within families or phylogenetically related groups of taxa. Some species show a wide phenotypic plasticity for their enzymatic profiles. Conclusion This study provides the first evidence of functional redundancy in ectomycorrhizal communities. More studies are now needed to evaluate the robustness of these results at wider ecosystem scales and using other relevant functional traits.

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Developmental trajectories of intentional self regulation in adolescence: the role of parenting and implications for positive and problematic outcomes among diverse youth

This study assessed 1574 Grades 5 to 11 youth (63.6% female) from the 4-H Study of Positive Youth Development (PYD), a longitudinal study involving U.S. adolescents, to assess if patterns of intentional self regulation (ISR) existed; whether these trajectories differed in relation to several Grade 5 parenting characteristics; and whether ISR trajectories were linked to positive and negative developmental outcomes at Grade 11. Growth mixture modeling identified a four-group solution of ISR trajectories: Steady Decline, Elevated, Late Onset, and Pronounced Decline. Most adolescents reported an incremental decrease in ISR from Grades 5 to 11 (Steady Decline). Lower levels of parental warmth, monitoring, and school involvement at Grade 5 predicted Late-Onset ISR development while Pronounced Decline adolescents reported lower levels of PYD and Contribution at Grade 11. We discuss the finding that youth at initially similar levels of ISR diverged over adolescence, while youth at initially disparate levels converged.

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Non-turbulent fluxes of carbon dioxide and sensible heat - A comparison of three forested sites

The advection initiative ADVEX within CarboEurope-IP conducted advection experiments at three European coniferous sites in 2005 and 2006. All experiments shared the same geometry and instrumentation. Data of the ADVEX experiments were used to calculate advective fluxes of carbon dioxide and sensible heat using exactly the same method. However, the advective flux of sensible heat can be assessed more easily than the carbon dioxide flux with its associated complex measurements of gas concentrations. We explored the possibility to use advective fluxes of sensible heat as a proxy for the corresponding flux of carbon dioxide despite somewhat differing sinks and sources. On average, advective fluxes of sensible heat were of opposite sign in relation to the advective fluxes of carbon dioxide for the three investigated sites, especially during nighttime. Therefore, the respective gradients were of opposite sign, on average, for vertical and (to a lesser extent) horizontal direction. This is not as obvious for horizontal direction as for the vertical direction. A scheme is presented to explain the correlation of the respective gradients for different conditions. Based on the gained insights and regression statistics, two simple empirical models were tested to derive advective fluxes of carbon dioxide from advective fluxes of sensible heat. Our results suggest that the advective flux of sensible heat could be taken as an indicator concerning the presence and sign of carbon dioxide advection. However, the suitability of advective fluxes of sensible heat as a quantitative proxy for advective fluxes of carbon dioxide is more problematic because the representativeness including the magnitude of advection derived from advection measurements is not yet clarified. An inspection of the budget of sensible heat and carbon dioxide revealed considerable changes by advection. The results indicate that the budget of carbon dioxide might be generally more affected by the investigated non-turbulent advective fluxes than the budget of sensible heat.

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The psychology and rationality of decisions from experience

Most investigations into how people make risky choices have employed a simple drosophila: monetary gambles involving stated outcomes and probabilities. People are asked to make decisions from description.When people decide whether to back up their computer hard drive, cross a busy street, or go out on a date, however, they do not enjoy the convenience of stated outcomes and probabilities. People make such decisions either in the void of ignorance or in the twilight of their own often limited experience of such real-world options. In the latter case, they make decisions from experience. Recent research has consistently documented that decisions from description and decisions from experience can lead to substantially different choices. Key in this description–experience gap is people’s treatment of rare events. In this paper, I briefly review studies that have documented the description–experience gap, offer several explanations for this gap, and discuss to what exten

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Loss of mTORC1 signaling alters pancreatic α cell mass and impairs glucagon secretion.

Glucagon plays a major role in the regulation of glucose homeostasis during fed and fasting states. However, the mechanisms responsible for the regulation of pancreatic α cell mass and function are not completely understood. In the current study, we identified mTOR complex 1 (mTORC1) as a major regulator of α cell mass and glucagon secretion. Using mice with tissue-specific deletion of the mTORC1 regulator Raptor in α cells (αRaptorKO), we showed that mTORC1 signaling is dispensable for α cell development, but essential for α cell maturation during the transition from a milk-based diet to a chow-based diet after weaning. Moreover, inhibition of mTORC1 signaling in αRaptorKO mice and in WT animals exposed to chronic rapamycin administration decreased glucagon content and glucagon secretion. In αRaptorKO mice, impaired glucagon secretion occurred in response to different secretagogues and was mediated by alterations in KATP channel subunit expression and activity. Additionally, our data identify the mTORC1/FoxA2 axis as a link between mTORC1 and transcriptional regulation of key genes responsible for α cell function. Thus, our results reveal a potential function of mTORC1 in nutrient-dependent regulation of glucagon secretion and identify a role for mTORC1 in controlling α cell-mass maintenance.

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Role of bundle helices in a regulatory crosstalk in the trimeric betaine transporter BetP

The Na(+)-coupled betaine symporter BetP regulates transport activity in response to hyperosmotic stress only in its trimeric state, suggesting a regulatory crosstalk between individual protomers. BetP shares the overall fold of two inverted structurally related five-transmembrane (TM) helix repeats with the sequence-unrelated Na(+)-coupled symporters LeuT, vSGLT, and Mhp1, which are neither trimeric nor regulated in transport activity. Conformational changes characteristic for this transporter fold involve the two first helices of each repeat, which form a four-TM-helix bundle. Here, we identify two ionic networks in BetP located on both sides of the membrane that might be responsible for BetP's unique regulatory behavior by restricting the conformational flexibility of the four-TM-helix bundle. The cytoplasmic ionic interaction network links both first helices of each repeat in one protomer to the osmosensing C-terminal domain of the adjacent protomer. Moreover, the periplasmic ionic interaction network conformationally locks the four-TM-helix bundle between the same neighbor protomers. By a combination of site-directed mutagenesis, cross-linking, and betaine uptake measurements, we demonstrate how conformational changes in individual bundle helices are transduced to the entire bundle by specific inter-helical interactions. We suggest that one purpose of bundle networking is to assist crosstalk between protomers during transport regulation by specifically modulating the transition from outward-facing to inward-facing state.

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Combined MLST and AFLP typing of Bartonella henselae isolated from cats reveals new sequence types and suggests clonal evolution

Bartonella species are Gram-negative, fastidious bacteria. Bartonella henselae is found in cats and transmitted to humans via cat scratches or bites causing cat-scratch disease, characterized by clinical symptoms with varying severity. The prevalence of bartonellosis among humans in Germany appears to be high, and severe clinical cases have been described. However, epidemiological data of B. henselae in cats are rare. In this study we determined the detection rates of Bartonella ssp. in cats by culture and real-time PCR. Furthermore, B. henselae isolates were genetically characterized by highly discriminatory amplified fragment length polymorphism (AFLP) and multilocus sequence typing (MLST). Bartonella spp. were isolated by culture from 11 (2.2%) of 507 blood samples. Out of 169 blood samples additionally analyzed by PCR, 28 (16.6%) were found positive for Bartonella spp., illustrating the advantage of PCR in Bartonella spp. detection. PCR-REA identified B. henselae in 27 cats and Bartonella clarridgeiae in one cat. B. henselae isolates from different geographical regions in Germany were genetically characterized by AFLP and MLST. Both methods confirmed genetic diversity of B. henselae on the strain level. MLST identified 11 new sequence types, all of them assigned to three clonal complexes as determined by eBURST. AFLP typing revealed genetic relation among the B. henselae isolates from the same geographical region. Combining AFLP typing and MLST/eBURST analyses revealed that B. henselae of the same AFLP subcluster belonged to the same clonal complex. Altogether these results indicate that B. henselae may evolve clonally.

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Impacts of Shewanella putrefaciens strain CN-32 cells and extracellular polymeric substances on the sorption of As(V) and As(III) on Fe(III)-(Hydr)oxides

We investigated the effects of Shewanella putrefaciens cells and extracellular polymeric substances on the sorption of As(III) and As(V) to goethite, ferrihydrite, and hematite at pH 7.0. Adsorption of As(III) and As(V) at solution concentrations between 0.001 and 20 μM decreased by 10 to 45% in the presence of 0.3 g L−1 EPS, with As(III) being affected more strongly than As(V). Also, inactivated Shewanella cells induced desorption of As(V) from the Fe(III)-(hydr)oxide mineral surfaces. ATR-FTIR studies of ternary As(V)-Shewanella−hematite systems indicated As(V) desorption concurrent with attachment of bacterial cells at the hematite surface, and showed evidence of inner-sphere coordination of bacterial phosphate and carboxylate groups at hematite surface sites. Competition between As(V) and bacterial phosphate and carboxylate groups for Fe(III)-(oxyhydr)oxide surface sites is proposed as an important factor leading to increased solubility of As(V). The results from this study have implications for the solubility of As(V) in the soil rhizosphere and in geochemical systems undergoing microbially mediated reduction and indicate that the presence of sorbed oxyanions may affect Fe-reduction and biofilm development at mineral surfaces.

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Influence of arsenate adsorption to ferrihydrite, goethite, and boehmite on the kinetics of arsenate reduction by Shewanella putrefaciens strain CN-32

The kinetics of As(V) reduction by Shewanella putrefaciens strain CN-32 was investigated in suspensions of 0.2, 2, or 20 g L–1 ferrihydrite, goethite, or boehmite at low As (10 μM) and lactate (25 μM) concentrations. Experimental data were compared with model predictions based on independently determined sorption isotherms and rates of As(V) desorption, As(III) adsorption, and microbial reduction of dissolved As(V), respectively. The low lactate concentration was chosen to prevent significant Fe(III) reduction, but still allowing complete As(V) reduction. Reduction of dissolved As(V) followed first-order kinetics with a 3 h half-life of As(V). Addition of mineral sorbents resulted in pronounced decreases in reduction rates (32–1540 h As(V) half-life). The magnitude of this effect increased with increasing sorbent concentration and sorption capacity (goethite < boehmite < ferrihydrite). The model consistently underestimated the concentrations of dissolved As(V) and the rates of microbial As(V) reduction after addition of S. putrefaciens (∼5 × 109 cells mL–1), suggesting that attachment of S. putrefaciens cells to oxide mineral surfaces promoted As(V) desorption and thereby facilitated As(V) reduction. The interplay between As(V) sorption to mineral surfaces and bacterially induced desorption may thus be critical in controlling the kinetics of As reduction and release in reducing soils and sediments.

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Age and motivation predict gaze behavior for facial expressions

This study investigated age-related differences between younger (M = 25.52 years) and older (M = 70.51 years) adults in avoidance motivation and the influence of avoidance motivation on gaze preferences for happy, neutral, and angry faces. In line with the hypothesis of reduced negativity effect later in life, older adults avoided angry faces and (to a lesser degree) preferred happy faces more than younger adults did. This effect cannot be explained by age-related changes in dispositional motivation. Irrespective of age, avoidance motivation predicted gaze behavior towards emotional faces. The study demonstrates the importance of interindividual differences beyond young adulthood.

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Substrate specificity and ion coupling in the Na+/betaine symporter BetP

BetP is an Na(+)-coupled betaine-specific transporter of the betaine-choline-carnitine (BCC) transporter family involved in the response to hyperosmotic stress. The crystal structure of BetP revealed an overall fold of two inverted structurally related repeats (LeuT-fold) that BetP shares with other sequence-unrelated Na(+)-coupled symporters. Numerous structures of LeuT-fold transporters in distinct conformational states have contributed substantially to our understanding of the alternating access mechanism of transport. Nevertheless, coupling of substrate and co-transported ion fluxes has not been structurally corroborated to the same extent. We converted BetP by a single-point mutation--glycine to aspartate--into an H(+)-coupled choline-specific transporter and solved the crystal structure of this mutant in complex with choline. The structure of BetP-G153D demonstrates a new inward-facing open conformation for BetP. Choline binding to a location close to the second, low-affinity sodium-binding site (Na2) of LeuT-fold transporters is facilitated by the introduced aspartate. Our data confirm the importance of a cation-binding site in BetP, playing a key role in a proposed molecular mechanism of Na(+) and H(+) coupling in BCC transporters.

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The role of trimerization in the osmoregulated betaine transporter BetP

The osmoregulated betaine transporter BetP is a stable trimer. Structural studies have shown that individual protomers can adopt distinct transport conformations, implying a functional role for the trimeric state in transport, although the role of trimerization in regulation is not yet understood. We designed putative monomeric mutants by molecular-dynamics simulations and in silico alanine-scanning mutagenesis. Several mutants including BetP-W101A/T351A were monomeric in detergent as well as in the membrane, as shown by blue native gel electrophoresis, crosslinking and electron microscopy. This monomeric form retains the ability to accumulate betaine, but is no longer regulated by hyperosmotic shock.

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Quantification of mRNA and protein and integration with protein turnover in a bacterium

Biological function and cellular responses to environmental perturbations are regulated by a complex interplay of DNA, RNA, proteins and metabolites inside cells. To understand these central processes in living systems at the molecular level, we integrated experimentally determined abundance data for mRNA, proteins, as well as individual protein half-lives from the genome-reduced bacterium Mycoplasma pneumoniae. We provide a fine-grained, quantitative analysis of basic intracellular processes under various external conditions. Proteome composition changes in response to cellular perturbations reveal specific stress response strategies. The regulation of gene expression is largely decoupled from protein dynamics and translation efficiency has a higher regulatory impact on protein abundance than protein turnover. Stochastic simulations using in vivo data show how low translation efficiency and long protein half-lives effectively reduce biological noise in gene expression. Protein abundances are regulated in functional units, such as complexes or pathways, and reflect cellular lifestyles. Our study provides a detailed integrative analysis of average cellular protein abundances and the dynamic interplay of mRNA and proteins, the central biomolecules of a cell.

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Functional specificity of local synaptic connections in neocortical networks

Neuronal connectivity is fundamental to information processing in the brain. Therefore, understanding the mechanisms of sensory processing requires uncovering how connection patterns between neurons relate to their function. On a coarse scale, long-range projections can preferentially link cortical regions with similar responses to sensory stimuli. But on the local scale, where dendrites and axons overlap substantially, the functional specificity of connections remains unknown. Here we determine synaptic connectivity between nearby layer 2/3 pyramidal neurons in vitro, the response properties of which were first characterized in mouse visual cortex in vivo. We found that connection probability was related to the similarity of visually driven neuronal activity. Neurons with the same preference for oriented stimuli connected at twice the rate of neurons with orthogonal orientation preferences. Neurons responding similarly to naturalistic stimuli formed connections at much higher rates than those with uncorrelated responses. Bidirectional synaptic connections were found more frequently between neuronal pairs with strongly correlated visual responses. Our results reveal the degree of functional specificity of local synaptic connections in the visual cortex, and point to the existence of fine-scale subnetworks dedicated to processing related sensory information.

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Risk factors revealed: keratinocyte carcinoma following transplant



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A promising combination: electrical impedance spectroscopy added at baseline visit to short-term sequential digital dermoscopy



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Dapsone is a potentially useful adjuvant therapy for bullous pemphigoid



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Plain language summaries



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Image Gallery: Cutaneous signs of acute pancreatitis



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Editor's Choice



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Dapsone: a forgotten and underestimated treatment option for bullous pemphigoid?



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Rituximab and short-course prednisone as the new gold standard for new-onset pemphigus vulgaris and pemphigus foliaceus



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Psoriasis Gene to Clinic, 8th International Congress. The Queen Elizabeth II Conference Centre, London, U.K., 30th November – 2nd December 2017



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Regulatory pathways implicated in male androgenetic alopecia pathogenesis



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Needling warts: are we any further forward?



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Going paperless: a new era for patient-reported outcome measures in dermatology



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Image Gallery: Generalized circinate cutaneous lesions simulating circinate balanitis



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Participating in trials can inform better clinical practice



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