Τρίτη, 23 Ιανουαρίου 2018

Case of victims of modern imaging technology: Increased information noise concealing the diagnosis.

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Case of victims of modern imaging technology: Increased information noise concealing the diagnosis.

World J Radiol. 2017 Dec 28;9(12):454-458

Authors: Mahajan A, Santhoshkumar GV, Kawthalkar AS, Vaish R, Sable N, Arya S, Desai S

Abstract
We present a case of tubercular arthritis who underwent numerous unnecessary investigations what is known as "victims of modern imaging technology" or VOMIT. Today there is an exponential rise in the volume of the medical imaging, part of which is contributed by unnecessary and unjustified indications. We discuss about the untoward effects of the uninhibited and careless use of modern imaging modalities and possible ways to avoid. Skeletal manifestation of the tuberculosis is still common in the endemic countries like India. Although the final diagnosis of the skeletal tuberculosis like tubercular arthritis is made by bacteriological and histological studies, few demographic, clinical and radiological features might help making early diagnosis.

PMID: 29354211 [PubMed]



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Aggressive blood pressure treatment of hypertensive intracerebral hemorrhage may lead to global cerebral hypoperfusion: Case report and imaging perspective.

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Aggressive blood pressure treatment of hypertensive intracerebral hemorrhage may lead to global cerebral hypoperfusion: Case report and imaging perspective.

World J Radiol. 2017 Dec 28;9(12):448-453

Authors: Gavito-Higuera J, Khatri R, Qureshi IA, Maud A, Rodriguez GJ

Abstract
Hypoperfusion injury related to blood pressure decrease in acute hypertensive intracerebral hemorrhage continues to be a controversial topic. Aggressive treatment is provided with the intent to stop the ongoing bleeding. However, there may be additional factors, including autoregulation and increased intracranial pressure, that may limit this approach. We present here a case of acute hypertensive intracerebral hemorrhage, in which aggressive blood pressure management to levels within the normal range led to global cerebral ischemia within multiple border zones. Global cerebral ischemia may be of concern in the management of hypertensive hemorrhage in the presence of premorbid poorly controlled blood pressure and increased intracranial pressure.

PMID: 29354210 [PubMed]



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Imaging features of intrathoracic complications of lung transplantation: What the radiologists need to know.

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Imaging features of intrathoracic complications of lung transplantation: What the radiologists need to know.

World J Radiol. 2017 Dec 28;9(12):438-447

Authors: Chia E, Babawale SN

Abstract
Lung transplantation has been a method for treating end stage lung disease for decades. Despite improvements in the preoperative assessment of recipients and donors as well as improved surgical techniques, lung transplant recipients are still at a high risk of developing post-operative complications which tend to impact negatively the patients' outcome if not recognised early. The recognised complications post lung transplantation can be broadly categorised into acute and chronic complications. Recognising the radiological features of these complications has a significant positive impact on patients' survival post transplantation. This manuscript provides a comprehensive review of the radiological features of post lung transplantations complications over a time continuum.

PMID: 29354209 [PubMed]



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Endovascular treatment of pulmonary embolism: Selective review of available techniques.

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Endovascular treatment of pulmonary embolism: Selective review of available techniques.

World J Radiol. 2017 Dec 28;9(12):426-437

Authors: Nosher JL, Patel A, Jagpal S, Gribbin C, Gendel V

Abstract
Acute pulmonary embolism (PE) is the third most common cause of death in hospitalized patients. The development of sophisticated diagnostic and therapeutic modalities for PE, including endovascular therapy, affords a certain level of complexity to the treatment of patients with this important clinical entity. Furthermore, the lack of level I evidence for the safety and effectiveness of catheter directed therapy brings controversy to a promising treatment approach. In this review paper, we discuss the pathophysiology and clinical presentation of PE, review the medical and surgical treatment of the condition, and describe in detail the tools that are available for the endovascular therapy of PE, including mechanical thrombectomy, suction thrombectomy, and fibrinolytic therapy. We also review the literature available to date on these methods, and describe the function of the Pulmonary Embolism Response Team.

PMID: 29354208 [PubMed]



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Dynamic contrast-enhanced magnetic resonance imaging of prostate cancer: A review of current methods and applications.

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Dynamic contrast-enhanced magnetic resonance imaging of prostate cancer: A review of current methods and applications.

World J Radiol. 2017 Dec 28;9(12):416-425

Authors: Mazaheri Y, Akin O, Hricak H

Abstract
In many areas of oncology, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has proven to be a clinically useful, non-invasive functional imaging technique to quantify tumor vasculature and tumor perfusion characteristics. Tumor angiogenesis is an essential process for tumor growth, proliferation, and metastasis. Malignant lesions demonstrate rapid extravasation of contrast from the intravascular space to the capillary bed due to leaky capillaries associated with tumor neovascularity. DCE-MRI has the potential to provide information regarding blood flow, areas of hypoperfusion, and variations in endothelial permeability and microvessel density to aid treatment selection, enable frequent monitoring during treatment and assess response to targeted therapy following treatment. This review will discuss the current status of DCE-MRI in cancer imaging, with a focus on its use in imaging prostate malignancies as well as weaknesses that limit its widespread clinical use. The latest techniques for quantification of DCE-MRI parameters will be reviewed and compared.

PMID: 29354207 [PubMed]



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Kit-basierte Markierung von PSMA-Liganden



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Various Cranial and Orbital Imaging Findings in Pediatric Abusive and Non-abusive Head trauma, and Relation to Outcomes

Abstract

Background and Purpose

Differentiating Abusive Head Trauma (AHT) from Non-abusive Head trauma (NAHT) has profound clinical prognostic and legal implications, as certain imaging findings can individually be more suggestive of NAHT, while others are more suggestive of AHT. This study was set out to evaluate for an association between the various imaging findings in AHT with outcome.

Material and Methods

Over 7-years, 55 children (age 0-4 years') with head trauma and magnetic resonance imaging (MRI) were included as either: abusive (n = 16), non-abusive (n = 35), or indeterminate (n = 4). Two pediatric neuroradiologists jointly reviewed the imaging. The frequency of imaging findings and their association with ≥6 months' outcome were calculated.

Results

Comparing abusive versus non-abusive head trauma, complex subdural hematoma was present in 81% (n = 13/16) and 29% (n = 10/35), hypoxic-ischemic injury in 44% (n = 7/16) and 6% (n = 2/35), and diffuse axonal injury in 12% (n = 2/16) and 26% (n = 9/35), respectively. Susceptibility-weighted imaging (SWI) retinal hemorrhages were absent in non-abusive trauma (0/35), but present in 44% (n = 7/16) of the abusive group. In abuse, simple subdural hematomas were absent. Significant associations were found between the presence of abusive trauma with both hypoxic ischemic insult (OR = 12.83, p = 0.0024) and complex subdural hematoma (OR = 10.83, p = 0.0007). The presence of hypoxic ischemic injury (HII) did correlate significantly with clinical outcome (p = 0.017), while retinal hemorrhages on SWI and complex subdural hematoma did not (p = 0.1696-p = 0.2496).

Conclusion

Neuroimaging findings can be helpful in discriminating these two conditions on presentation, as well as in helping solidify the suspicion of AHT. Regarding eventual outcome in AHT, the most important predictor is clearly HII.



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Prognostic Value of Metabolic and Volumetric Parameters of FDG PET in Pediatric Osteosarcoma: A Hypothesis-generating Study.

Prognostic Value of Metabolic and Volumetric Parameters of FDG PET in Pediatric Osteosarcoma: A Hypothesis-generating Study.

Radiology. 2018 Jan 19;:162758

Authors: Im HJ, Zhang Y, Wu H, Wu J, Daw NC, Navid F, Shulkin BL, Cho SY

Abstract
Purpose To preliminarily assess the potential prognostic value of various fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) parameters before, during, and after neoadjuvant chemotherapy (NCT). Materials and Methods Thirty-four patients with osteosarcoma were enrolled prospectively from 2008 to 2012 and underwent FDG PET/computed tomography (CT) imaging before (baseline scan), during (interim scan) and after NCT (posttherapy scan). The study was approved by the institutional review board and informed consent was received from patients. Maximum and peak standardized uptake value (SUVmax and SUVpeak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured. Predictive value of FDG PET parameters for event-free survival (EFS) and overall survival (OS) were evaluated. Multivariable Cox regression analysis for EFS and OS was performed by using histologic response and initial presence of metastasis as covariates. Results At baseline scan, SUVpeak, MTV, and TLG were predictive of EFS (P = .006-.03) and OS (P = .001-.03) but not associated with histologic response. At interim and posttherapy scan, SUVmax, SUVpeak, MTV, and TLG were associated with histologic response (P = .0002-.04) and predictive of EFS (P = .004-.02) and OS (P = .001-.03). Multivariable Cox regression analysis revealed that the FDG PET parameters either at baseline, interim, or posttherapy were independently predictive of EFS and OS. In particular, baseline MTV was an independent predictor of EFS (hazard ratio, 5.0 [95% confidence interval {CI}: 1.5, 16.8]) and OS (hazard ratio, 29.4 [95% CI: 2.2, 392.2]). Conclusion SUVpeak, MTV, and TLG either at baseline, interim, or posttherapy were predictive of EFS and OS and may be useful prognostic biomarkers for osteosarcoma. © RSNA, 2018 Online supplemental material is available for this article.

PMID: 29357275 [PubMed - as supplied by publisher]



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Glioblastoma: Vascular Habitats Detected at Preoperative Dynamic Susceptibility-weighted Contrast-enhanced Perfusion MR Imaging Predict Survival.

Glioblastoma: Vascular Habitats Detected at Preoperative Dynamic Susceptibility-weighted Contrast-enhanced Perfusion MR Imaging Predict Survival.

Radiology. 2018 Jan 19;:170845

Authors: Juan-Albarracín J, Fuster-Garcia E, Pérez-Girbés A, Aparici-Robles F, Alberich-Bayarri Á, Revert-Ventura A, Martí-Bonmatí L, García-Gómez JM

Abstract
Purpose To determine if preoperative vascular heterogeneity of glioblastoma is predictive of overall survival of patients undergoing standard-of-care treatment by using an unsupervised multiparametric perfusion-based habitat-discovery algorithm. Materials and Methods Preoperative magnetic resonance (MR) imaging including dynamic susceptibility-weighted contrast material-enhanced perfusion studies in 50 consecutive patients with glioblastoma were retrieved. Perfusion parameters of glioblastoma were analyzed and used to automatically draw four reproducible habitats that describe the tumor vascular heterogeneity: high-angiogenic and low-angiogenic regions of the enhancing tumor, potentially tumor-infiltrated peripheral edema, and vasogenic edema. Kaplan-Meier and Cox proportional hazard analyses were conducted to assess the prognostic potential of the hemodynamic tissue signature to predict patient survival. Results Cox regression analysis yielded a significant correlation between patients' survival and maximum relative cerebral blood volume (rCBVmax) and maximum relative cerebral blood flow (rCBFmax) in high-angiogenic and low-angiogenic habitats (P < .01, false discovery rate-corrected P < .05). Moreover, rCBFmax in the potentially tumor-infiltrated peripheral edema habitat was also significantly correlated (P < .05, false discovery rate-corrected P < .05). Kaplan-Meier analysis demonstrated significant differences between the observed survival of populations divided according to the median of the rCBVmax or rCBFmax at the high-angiogenic and low-angiogenic habitats (log-rank test P < .05, false discovery rate-corrected P < .05), with an average survival increase of 230 days. Conclusion Preoperative perfusion heterogeneity contains relevant information about overall survival in patients who undergo standard-of-care treatment. The hemodynamic tissue signature method automatically describes this heterogeneity, providing a set of vascular habitats with high prognostic capabilities. © RSNA, 2018.

PMID: 29357274 [PubMed - as supplied by publisher]



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Progressive Reduction in Gray Matter in Patients with Schizophrenia Assessed with MR Imaging by Using Causal Network Analysis.

Progressive Reduction in Gray Matter in Patients with Schizophrenia Assessed with MR Imaging by Using Causal Network Analysis.

Radiology. 2018 Jan 19;:171832

Authors: Jiang Y, Luo C, Li X, Duan M, He H, Chen X, Yang H, Gong J, Chang X, Woelfer M, Biswal BB, Yao D

Abstract
Purpose To investigate the temporal and causal relationships of structural changes in the brain in patients with schizophrenia. Materials and Methods T1-weighted magnetic resonance (MR) images of 97 patients with schizophrenia (29 women; mean ± standard deviation age, 41 years ± 11.5; range, 16-66 years; illness duration, 16.3 years ± 10.9; range, 0-50 years) and 126 age- and sex-matched (38 years ± 14.9; range, 18-68 years; 42 women) healthy control subjects were evaluated. The causal network of structural covariance was used to assess the causal relationships of structural changes in patients with schizophrenia. This was accomplished by applying Granger causality analysis to the morphometric T1-weighted images ranked according to duration of disease. Results With greater disease duration, reduction in gray matter volume began in the thalamus and progressed to the frontal lobe, and then to the temporal and occipital cortices as well and the cerebellum (P < .00001, false discovery rate corrected). The thalamus was shown to be the primary hub of the directional network and exhibited positive causal effects on the frontal, temporal, and occipital regions as well as on the cerebellum (P < .05, false discovery rate corrected). The frontal regions, which were identified to be transitional points, projected causal effects to the occipital lobe, temporal regions, and the cerebellum and received causal effects from the thalamus (P < .05, false discovery rate corrected). Conclusion Schizophrenia shows progression of gray matter abnormalities over time, with the thalamus as the primary hub and the frontal regions as prominent nodes. © RSNA, 2018 Online supplemental material is available for this article.

PMID: 29357273 [PubMed - as supplied by publisher]



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Characterization of Degree of Intestinal Fibrosis in Patients with Crohn Disease by Using Magnetization Transfer MR Imaging.

Characterization of Degree of Intestinal Fibrosis in Patients with Crohn Disease by Using Magnetization Transfer MR Imaging.

Radiology. 2018 Jan 19;:171221

Authors: Li XH, Mao R, Huang SY, Sun CH, Cao QH, Fang ZN, Zhang ZW, Huang L, Lin JJ, Chen YJ, Rimola J, Rieder F, Chen MH, Feng ST, Li ZP

Abstract
Purpose To evaluate the role of magnetization transfer (MT) magnetic resonance (MR) imaging for the characterization of intestinal fibrosis compared with contrast material-enhanced and diffusion-weighted MR imaging and its capability for differentiating fibrotic from inflammatory strictures in humans with Crohn disease (CD) by using surgical histopathologic analysis as the reference standard. Materials and Methods Institutional review board approval and informed consent were obtained for this prospective study. Abdominal MT imaging, contrast-enhanced imaging, and diffusion-weighted imaging of 31 consecutive patients with CD were analyzed before elective surgery. The bowel wall MT ratio normalized to skeletal muscle, the apparent diffusion coefficient (ADC), and the percentage of enhancement gain were calculated; region-by-region correlations with the surgical specimen were performed to determine the histologic degree of fibrosis and inflammation. The performance of MT imaging was validated in five new patients. One-way analysis of variance test, Spearman rank correlation, and receiver operating characteristic curve were used for statistical analysis. Results Normalized MT ratios strongly correlated with fibrosis scores (r = 0.769; P = .000) but did not correlate with inflammation scores (r = -0.034; P = .740). Significant differences (F = 49.002; P = .000) in normalized MT ratios were found among nonfibrotic, mildly, moderately, and severely fibrotic walls. The normalized MT ratios of mixed fibrotic and inflammatory bowel walls were significantly higher than those of bowel walls with only inflammation present (t = -8.52; P = .000). A high accuracy of normalized MT ratios was shown with an area under the receiver operating characteristic curve (AUC) of 0.919 (P = .000) for differentiating moderately to severely fibrotic bowel walls from nonfibrotic and mildly fibrotic bowel walls, followed by ADC (AUC, 0.747; P = .001) and the percentage of enhancement gain (AUC, 0.592; P = .209). The sensitivity, specificity, and AUC of MT imaging for diagnosing moderate to severe fibrosis in the validation data set were 80% (12 of 15), 100% (three of three), and 0.9 (P = .033), respectively. Conclusion MT imaging outperforms ADC and contrast-enhanced imaging in detecting and distinguishing varying degrees of bowel fibrosis with or without coexisting inflammation. MT imaging could potentially be used as a method to differentiate fibrotic from inflammatory intestinal strictures in patients with CD. © RSNA, 2018 Online supplemental material is available for this article.

PMID: 29357272 [PubMed - as supplied by publisher]



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Case 250: Alpers-Huttenlocher Syndrome.

Case 250: Alpers-Huttenlocher Syndrome.

Radiology. 2018 Feb;286(2):720-725

Authors: Wu J, Yang C, Collins J, Ginat DT

Abstract
History A 10-year-old girl with global developmental delay and attention deficit hyperactivity disorder was transferred from an outside hospital because of confusion and multiple episodes of left face and arm jerking. Physical examination revealed normal muscle bulk, strength, and tone in the bilateral upper and lower extremities but insuppressible left arm and jaw twitching Lumbar puncture revealed no white or red blood cells, a normal glucose level of 55 mg/dL (3.0 mmol/L) (normal range, 50-80 mg/dL [2.8-4.4 mmol/L]), and an elevated protein level of 81.6 mg/dL (normal range, 15-60 mg/100 dL). A comprehensive metabolic panel revealed lactic acidosis. The patient was initially started on levetiracetam, phenobarbital, phenytoin, and topiramate for status epilepticus. Hepatic dysfunction was not present at initial admission but developed 2 months later, with an alanine aminotransferase level of 90-406 U/L (1.5-6.8 μkat/L) (normal range, 8-37 U/L [0.13-0.62 μkat/L]) and aspartate aminotransferase in the range of 75-187 U/L (1.2-3.1 μkat/L) (normal range, 8-35 U/L [0.13-0.58 μkat/L]). Electroencephalography revealed right parietal and occipital spike-and-wave discharges, with bursts of up to 20 seconds, which were indicative of subclinical status epilepticus. The family history was remarkable for a sister with head lag, developmental delay, seizure disorder, and liver failure.

PMID: 29356648 [PubMed - in process]



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Science to Practice: Will Gadolinium Chelates Be Replaced by Iron Chelates in MR Imaging?

Science to Practice: Will Gadolinium Chelates Be Replaced by Iron Chelates in MR Imaging?

Radiology. 2018 Feb;286(2):409-411

Authors: Tweedle MF

Abstract
Boehm-Sturm et al ( 1 ) pose a possible paradigm shift in magnetic resonance (MR) imaging: the substitution of iron chelates for gadolinium chelates as paramagnetic contrast agents. The advent of nephrogenic systemic fibrosis challenges the wide-spread perception that gadolinium is benign, and that all gadolinium-based contrast agents (GBCAs) are identical. Long-term gadolinium retention in patients with normal renal function is now a disturbing fact. Unlike gadolinium, iron is an endogenous metal with a tightly regulated transport and storage mechanism. The question the article raises is therefore a compelling one.

PMID: 29356647 [PubMed - in process]



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Science to Practice: Decrypting the Enigma of Ablation-induced Off-Target Effects-Is Network Pathway Analysis the Final Piece of the Puzzle?

Science to Practice: Decrypting the Enigma of Ablation-induced Off-Target Effects-Is Network Pathway Analysis the Final Piece of the Puzzle?

Radiology. 2018 Feb;286(2):405-408

Authors: Murali N, Laage-Gaupp FM, Chapiro J, Geschwind JF

Abstract
As part of the ongoing effort to better understand and mitigate pro-oncogenic off-target effects of imaging-guided radiofrequency ablation (RFA), Kumar et al ( 1 ) used gene expression and network pathway analysis to examine the gene activation profiles in the peri-ablational zone after RFA in a breast adenocarcinoma liver metastasis animal model. Their analysis identified STAT3 (signal transducer and activator of transcription 3) as a key transcription factor upregulated in many signaling pathways in the peri-ablational zone after RFA. Consequently, the authors successfully used two STAT3 inhibitors to reduce distant tumor growth after treatment with RFA. By demonstrating that judicious and appropriate adjuvant therapy helped contain distant tumor growth caused by ablation, Kumar et al have managed to pave the road ahead for the definitive success of ablation.

PMID: 29356646 [PubMed - in process]



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Beyond BI-RADS Density: A Call for Quantification in the Breast Imaging Clinic.

Beyond BI-RADS Density: A Call for Quantification in the Breast Imaging Clinic.

Radiology. 2018 Feb;286(2):401-404

Authors: Conant EF, Sprague BL, Kontos D

PMID: 29356645 [PubMed - in process]



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Absence of Cortical Vein Opacification is Associated with Lack of Intra-arterial Therapy Benefit in Stroke.

Absence of Cortical Vein Opacification is Associated with Lack of Intra-arterial Therapy Benefit in Stroke.

Radiology. 2018 Feb;286(2):731

Authors: Jansen IGH, van Vuuren AB, van Zwam WH, van den Wijngaard IR, Berkhemer OA, Lingsma HF, Slump CH, van Oostenbrugge RJ, Treurniet KM, Dippel DWJ, van Walderveen MAA, van der Lugt A, Roos YBWEM, Marquering HA, Majoie CBLM, van den Berg R, MR CLEAN Trial Investigators

PMID: 29356644 [PubMed - in process]



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Seymour H. Levitt, MD.

Seymour H. Levitt, MD.

Radiology. 2018 Feb;286(2):732

Authors: Lo SS, Song CW, Dusenbery KE

PMID: 29356643 [PubMed - in process]



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Choosing the Safest Gadolinium-based Contrast Medium for MR Imaging: Not So Simple after All.

Choosing the Safest Gadolinium-based Contrast Medium for MR Imaging: Not So Simple after All.

Radiology. 2018 Feb;286(2):483-485

Authors: Davenport MS

PMID: 29356642 [PubMed - in process]



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Shoulder Injuries in the Overhead-Throwing Athlete: Epidemiology, Mechanisms of Injury, and Imaging Findings.

Shoulder Injuries in the Overhead-Throwing Athlete: Epidemiology, Mechanisms of Injury, and Imaging Findings.

Radiology. 2018 Feb;286(2):370-387

Authors: Lin DJ, Wong TT, Kazam JK

Abstract
The unparalleled velocity achieved by overhead throwers subjects the shoulder to extreme forces, resulting in both adaptive changes and pathologic findings that can be detected at imaging. A key biomechanical principle of throwing is achieving maximum external rotation, which initially leads to adaptive changes that may result in a pathologic cascade of injuries. In addition to the well-established concepts of glenohumeral internal rotation deficit and internal impingement, osseous and soft-tissue injuries of the shoulder unique to overhead athletes are illustrated. The epidemiology and biomechanics of throwing injuries are reviewed, and examples from the authors' institutional experience with competitive, collegiate, and professional baseball players are provided to demonstrate the constellation of unique imaging findings seen in overhead throwing athletes. Given the widespread popularity of baseball, and other sports relying on overhead throwing motions at all playing levels from recreational to professional, it is important for radiologists in various practice settings to be familiar with the special mechanisms, locations, and types of shoulder injuries seen in the overhead throwing population. © RSNA, 2018.

PMID: 29356641 [PubMed - in process]



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Is Noise in the MR Imager a Significant Risk Factor for Hearing Loss?

Is Noise in the MR Imager a Significant Risk Factor for Hearing Loss?

Radiology. 2018 Feb;286(2):609-610

Authors: Salvi R, Sheppard A

PMID: 29356640 [PubMed - in process]



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Diagnostic Ability with Abbreviated Biparametric and Full Multiparametric Prostate MR Imaging: Is the Use of PI-RADS Version 2 Appropriate for Comparison?

Diagnostic Ability with Abbreviated Biparametric and Full Multiparametric Prostate MR Imaging: Is the Use of PI-RADS Version 2 Appropriate for Comparison?

Radiology. 2018 Feb;286(2):726-727

Authors: Kaji Y, Inamura K

PMID: 29356639 [PubMed - in process]



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Quantitative MR Imaging Is Increasingly Important in Liver Disease.

Quantitative MR Imaging Is Increasingly Important in Liver Disease.

Radiology. 2018 Feb;286(2):557-559

Authors: Boesch C

PMID: 29356638 [PubMed - in process]



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Contribution of Bone Calcium to Bone Mineral Density.

Contribution of Bone Calcium to Bone Mineral Density.

Radiology. 2018 Feb;286(2):727-728

Authors: Chen X, Ding X

PMID: 29356637 [PubMed - in process]



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Recall Rate Benchmark for Screening Breast MR Imaging in Community Practice.

Recall Rate Benchmark for Screening Breast MR Imaging in Community Practice.

Radiology. 2018 Feb;286(2):728-729

Authors: Seidenwurm D, Breslau J

PMID: 29356636 [PubMed - in process]



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Clinical Applicability of Deep Learning System in Detecting Tuberculosis with Chest Radiography.

Clinical Applicability of Deep Learning System in Detecting Tuberculosis with Chest Radiography.

Radiology. 2018 Feb;286(2):729-731

Authors: Ting DSW, Yi PH, Hui F

PMID: 29356635 [PubMed - in process]



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Radiotheranostics in Cancer Diagnosis and Management.

Radiotheranostics in Cancer Diagnosis and Management.

Radiology. 2018 Feb;286(2):388-400

Authors: Jadvar H, Chen X, Cai W, Mahmood U

Abstract
The fundamental foundation for precision medicine is accurate and specific targeting of cancer cells. Advances in the understanding of cancer biology, developments in diagnostic technologies, and expansion of therapeutic options have all contributed to the concept of personalized cancer care. Theranostics is the systematic integration of targeted diagnostics and therapeutics. The theranostic platform includes an imaging component that "sees" the lesions followed by administration of the companion therapy agent that "treats" the same lesions. This strategy leads to enhanced therapy efficacy, manageable adverse events, improved patient outcome, and lower overall costs. Radiotheranostics refers to the use of radionuclides for the paired imaging and therapy agents. Radioiodine is the classic radiotheranostic agent that has been used clinically in management of thyroid diseases for nearly 75 years. More recently there have been major exciting strides in radiotheranostics for neuroendocrine tumors and prostate cancer, among other conditions. Regulatory approval of a number of radiotheranostic pairs is anticipated in the near future. Continued support will be needed in research and development to keep pace with the current momentum in radiotheranostics innovations. Moreover, regulatory and reimbursement agencies need to streamline their requirements for seamless transfer of the radiotheranostic agents from the bench to the bedside. In this review, the concept, history, recent developments, current challenges, and outlook for radiotheranostics in the treatment of patients with cancer will be discussed. © RSNA, 2018.

PMID: 29356634 [PubMed - in process]



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Case 254.

Case 254.

Radiology. 2018 Feb;286(2):715-719

Authors: Molière S, Kremer S, Bierry G

PMID: 29356633 [PubMed - in process]



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The pineapple technique for excision of large plexiform neurofibromas

Abstract

Plexiform neurofibromas (PNF) occur in up to 30% of patients with neurofibromatosis type 1 (NF1). To date, management of this tumors remains medically challenging. Surgical approach represents the only viable treatment option of progressive growing plexiform neurofibromas but surgical complications may be relatively common. Intraoperative tumor bleeding was found to occur as one of the most frequent complications. We report the case of a 28-year-old male patient presented with a large back-pack shaped plexiform neurofibroma. The tumor was successfully excised using the pineapple technique, with minimal intraoperative blood loss. To our opinion, this is the first reported case of excision of a plexiform neurofibroma combined with multi-layered hemostatic suture technique. This novel application proves the efficacy and the potential of the technique, extending its feasibility to the excision of any type of vascular tumor or extensive cancerous masses.

Level of Evidence: Level V, therapeutic study



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Distal sensory to distal motor nerve anastomosis can protect lower extremity muscle atrophy in a murine model

Abstract

Background

Delayed reinnervation of denervated motor neuron has irreversible consequences. We introduced distal motor to distal sensory anastomosis (DDSA) as a practical, time-saving method to protect injured motor neurons and its target tissues.

Methods

Two experimental groups of Wistar rats were studied. In DDSA group, the distal end of the tibial sensory nerve of the left leg was anastomosed to the distal common peroneal nerve. The same nerves were dissected without anastomosis in the control group. Four months later, visual functional assessment of sciatic nerves was performed, and histological structures of the nerves and muscles and ultra-structure of nerves were evaluated.

Results

Significant enhancement was seen in intermediate toe spread factor in DDSA group (P < 0.05), but toe spread factor and subsequently sciatic statistic index demonstrated no significant improvement. The surgical procedures resulted in an ipsilateral rehabilitation in DDSA group with statistically significant (P < 0.05) improvement in muscle weight and myelinated axon count. Light and electron microscopy evaluations of the histological specimen showed obvious prevention of nerve and muscle tissues degeneration following anastomosis.

Conclusions

Overall, DDSA showed a peripheral nerve could repair, survive, and protect target tissues from degeneration without connection to their cell bodies and central nervous system. Some possible explanations for these positive results could be the restorative role of electrochemical signaling directly from the skin sensory nerve receptors and stimulation of Schwann cell to convert to its regenerative phenotype.

Level of Evidence: Not ratable.



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Breast augmentation combined with a transposed glandular flap for prevention and correction of lower pole deformities

Abstract

Background

Lower pole deformities constitute the most complex problem encountered during and after breast augmentation. If the procedure is not accurately planned, the choice of techniques to correct lower pole deformity intraoperatively can be limited, leading to the possibility of additional scarring or the necessity of a second surgery.

Methods

Volume deficiencies of the lower pole after implant placement, such as flatness and double bubble, are indications for the proposed technique. A glandular flap is created by bisecting the lower pole of the gland and is transposed inwards and downwards to fill the deficient area. It is not necessary to fix the flap in place.

Results

Between January 2011 and December 2014, 30 patients underwent breast augmentation or augmentation-mastopexy combined with a transposed glandular flap. A desired lower pole was achieved in all the cases. No major complications were observed.

Conclusions

The transposed glandular flap herein described was proven to be useful to correct volume deficiencies of the lower pole after implant placement in cases of primary and secondary cases of breast augmentation.

Level of Evidence: Level IV, therapeutic study



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Osteonecrosis of the jaw (ONJ) in patients who receive Bone Targeting Agents (BTAs): the power of e-learning

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A Study of Mechanical Property of Artificial Frozen Clay under Dynamic Load

To determine the mechanical properties of artificial frozen clay under dynamic load, 81 triaxial shear tests were carried out for artificial frozen clay at different temperatures, amplitudes, frequencies, and precompressions and three kinds of testing conditions. The change laws of the dynamic modulus of elasticity, maximum dynamic shear modulus, dynamic damping ratio, and strain rate were determined. These results can guide future research on the mechanical mechanisms of frozen soil, providing both theoretical and practical significance.

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Influence of Manufacturing Methods of Implant-Supported Crowns on External and Internal Marginal Fit: A Micro-CT Analysis

Aim. To evaluate the influence of different manufacturing methods of single implant-supported metallic crowns on the internal and external marginal fit through computed microtomography. Methods. Forty external hexagon implants were divided into 4 groups , according to the manufacturing method: GC, conventional casting; GI, induction casting; GP, plasma casting; and GCAD, CAD/CAM machining. The crowns were attached to the implants with insertion torque of 30 N·cm. The external (vertical and horizontal) marginal fit and internal fit were assessed through computed microtomography. Internal and external marginal fit data (μm) were submitted to a one-way ANOVA and Tukey’s test . Qualitative evaluation of the images was conducted by using micro-CT. Results. The statistical analysis revealed no significant difference between the groups for vertical misfit . There was no significant difference for the internal and horizontal marginal misfit in the groups GC, GI, and GP, but it was found for the group GCAD . Qualitative analysis revealed that most of the samples of cast groups exhibited crowns underextension while the group GCAD showed overextension. Conclusions. The manufacturing method of the crowns influenced the accuracy of marginal fit between the prosthesis and implant. The best results were found for the crowns fabricated through CAD/CAM machining.

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High-Energy Impact Behaviors of Hybrid Composite Plates Strengthened with 3D-UHMWPE Composites

This study deals with drop-impact effects of new hybrid concrete plates strengthened with an ultrahigh molecular weight polyethylene (UHMWPE). The proposed 3D-UHMWPE results in excellent mechanical properties such as high abrasion resistance, impact strength, and low coefficient of friction. These special properties allow the product to be used in several high-performance applications. In this study, we used two kinds of high-performance materials for the impact reinforcement of a structure made of conventional materials such as a concrete. In particular, the impact mechanism of a fiber-concrete hybrid structure was studied using various parameters. The parametric studies are focused on the various effects of drop-impact on the structural performance. The combined effects of using different fiber-reinforced materials on the impact behavers are also investigated.

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A Mathematical Bridge between Discretized Gauge Theories in Quantum Physics and Approximate Reasoning in Pairwise Comparisons

We describe a mathematical link between aspects of information theory, called pairwise comparisons, and discretized gauge theories. The link is made by the notion of holonomy along the edges of a simplex. This correspondence leads to open questions in both fields.

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Hybridized Symbiotic Organism Search Algorithm for the Optimal Operation of Directional Overcurrent Relays

This paper presents the solution of directional overcurrent relay (DOCR) problems using Simulated Annealing based Symbiotic Organism Search (SASOS). The objective function of the problem is to minimize the sum of the operating times of all primary relays. The DOCR problem is nonlinear and highly constrained with two types of decision variables, namely, the time dial settings (TDS) and plug setting (PS). In this paper, three models of the problem are considered, the IEEE 3-bus, 4-bus, and 6-bus, respectively. We have applied SASOS to solve the problem and the obtained results are compared with other algorithms available in the literature.

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Parking Management Efficiency Analysis through Various Charge Schemes for Day-Long Commuting considering Elastic Travel Demand

In this paper, we investigate the travel pattern of the day-long commuting in a bisection bottleneck network and the efficiency of pricing schemes with elastic travel demand. We extend the Vickrey model to morning and evening commutes and allow commuters to arrive at workplace late and depart from workplace early. The parking searching time is considered in the morning commute. Next, we derive the independent morning and evening commuting travel patterns without road toll and parking fee. Then, we propose three pricing regimes: duration dependent parking fees; optimal time-varying road tolls; optimal time-varying road tolls with duration dependent parking fees. We compare the efficiency of the four schemes with elastic demand. Theoretical analysis and the numerical examples show that optimal time-varying road toll is the most efficient pricing scheme. Charging a duration dependent fee neither improves nor deteriorates the scheme of time-varying road toll, if the toll rates are appropriately set. The regime of duration dependent parking fee only is less efficient than the regime of independent morning and evening commuting travel patterns without road toll and parking fee. In the regime of duration dependent parking fee, the social surplus decreases with the increase of duration dependent parking fee rate.

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Analgesic and Anti-Inflammatory Activities of Diethyl Ether and n-Hexane Extract of Polyalthia suberosa Leaves

In folk medicine, Polyalthia suberosa is used as abortifacient, laxative, febrifuge analgesic, filler of tooth cavities, and anti-HIV drug and for rheumatism and various skin infections. The present study was directed to evaluate the analgesic and anti-inflammatory activities of diethyl ether and n-hexane extracts of Polyalthia suberosa leaves (PSDE and PSNH). A variety of tests including formalin-induced paw licking test, acetic acid induced writhing test, and tail immersion test were used to assess the analgesic activity. In addition, xylene-induced ear edema test was used to evaluate anti-inflammatory activity of PSDE and PSNH. PSDE and PSNH at 200 and 400 mg/kg doses expressed analgesic as well as anti-inflammatory activities in mice. In formalin-induced paw licking test, acetic acid induced writhing test, and xylene-induced ear edema test, the extracts exhibited significant inhibition ( versus control) of pain and inflammation. Alternatively, in tail immersion test, PSDE 400 mg/kg showed significant ( versus control) latency at 30 min but another tested sample had no significant latency. From this study, it could be shown that Polyalthia suberosa leaves may contain analgesic and anti-inflammatory agents which support its use in traditional medicine.

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Prediction of Microvascular Invasion in Hepatocellular Carcinoma: Preoperative Gd-EOB-DTPA-Dynamic Enhanced MRI and Histopathological Correlation

Objective. To investigate the imaging features observed in preoperative Gd-EOB-DTPA-dynamic enhanced MRI and correlated with the presence of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients. Methods. 66 HCCs in 60 patients with preoperative Gd-EOB-DTPA-dynamic enhanced MRI were retrospectively analyzed. Features including tumor size, signal homogeneity, tumor capsule, tumor margin, peritumor enhancement during mid-arterial phase, peritumor hypointensity during hepatobiliary phase, signal intensity ratio on DWI and apparent diffusion coefficients (ADC), T1 relaxation times, and the reduction rate between pre- and postcontrast enhancement images were assessed. Correlation between these features and histopathological presence of MVI was analyzed to establish a prediction model. Results. Histopathology confirmed that MVI were observed in 17 of 66 HCCs. Univariate analysis showed tumor size (), margin (), peritumor enhancement (), and hypointensity during hepatobiliary phase () were associated with MVI. A multiple logistic regression model was established, which showed tumor size, margin, and peritumor enhancement were combined predictors for the presence of MVI (). of this prediction model was 0.353, and the sensitivity and specificity were 52.9% and 93.0%, respectively. Conclusion. Large tumor size, irregular tumor margin, and peritumor enhancement in preoperative Gd-EOB-DTPA-dynamic enhanced MRI can predict the presence of MVI in HCC.

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Low IL-6, IL-10, and TNF-α and High IL-13 Cytokine Levels Are Associated with Severe Hepatic Fibrosis in Schistosoma mansoni Chronically Exposed Individuals

Several studies have attributed the etiopathogenesis of chronic Schistosoma mansoni related hepatic fibrosis to unregulated immune responses against trapped parasite ova in the host. However, there is limited data on immune profiles associated with varying degrees of the disease in a population under chronic exposure to the parasite. We therefore investigated the role of selected T-helper (Th)1, Th2, and Th17 cytokines in relation to hepatic fibrosis severity among individuals resident in a hyper-Schistosoma mansoni endemic region of Western Zambia. Two hundred and forty-four S. mansoni infected individuals with and without fibrosis were analysed for cytokine profiles. Based on hepatic fibrosis stage as determined by ultrasound, participants were categorized into Group 0, Group I, Group II, and Group III. Cytokines were measured in S. mansoni egg stimulated whole blood culture supernatants using the BD Cytometric Bead Array kits. Compared to the nonfibrotic group, participants in the severe hepatic fibrotic group produced less interleukin- (IL-) 6, IL-10, and tumour necrosis factor-alpha (TNF-α). On the other hand, IL-13 was significantly elevated in this group compared to the nonfibrotic group (). Our results suggest that low IL-6, IL-10, and TNF-α and high IL-13 levels may influence S. mansoni disease progression.

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Higher-Order Stationary Dispersive Equations on Bounded Intervals

A boundary value problem for a stationary nonlinear dispersive equation of order on an interval was considered. The existence, uniqueness, and continuous dependence of a regular solution have been established.

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Impact of Various Acids and Bases on the Voltammetric Response of Platinum Group Metal Oxides

The voltammetric response of platinum metal oxides is discussed with respect to novel pH sensors combining both miniaturization and stability. For practical applications in solutions of any kind, for example, in tap water and in domestic sewage, various interferences must be considered, such as chloride and reducing agents. This work clarifies the voltammetric behavior of RuO2 electrodes in solutions of different pH values and ionic strengths.

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Respiratory Motion Correction for Compressively Sampled Free Breathing Cardiac MRI Using Smooth -Norm Approximation

Transformed domain sparsity of Magnetic Resonance Imaging (MRI) has recently been used to reduce the acquisition time in conjunction with compressed sensing (CS) theory. Respiratory motion during MR scan results in strong blurring and ghosting artifacts in recovered MR images. To improve the quality of the recovered images, motion needs to be estimated and corrected. In this article, a two-step approach is proposed for the recovery of cardiac MR images in the presence of free breathing motion. In the first step, compressively sampled MR images are recovered by solving an optimization problem using gradient descent algorithm. The -norm based regularizer, used in optimization problem, is approximated by a hyperbolic tangent function. In the second step, a block matching algorithm, known as Adaptive Rood Pattern Search (ARPS), is exploited to estimate and correct respiratory motion among the recovered images. The framework is tested for free breathing simulated and in vivo 2D cardiac cine MRI data. Simulation results show improved structural similarity index (SSIM), peak signal-to-noise ratio (PSNR), and mean square error (MSE) with different acceleration factors for the proposed method. Experimental results also provide a comparison between k-t FOCUSS with MEMC and the proposed method.

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A Coupled One-Dimensional Numerical Simulation of the Land Subsidence Process in a Multilayer Aquifer System due to Hydraulic Head Variation in the Pumped Layer

After exploitation of groundwater had been reduced and the groundwater level of the confined aquifer had risen, land subsidence was observed to continue rather than cease for several years according to the layer-wise mark monitoring data in Xi’an. To analyze the phenomena, a numerical model of a coupled one-dimensional multilayer aquifer system is developed to represent land subsidence due to hydraulic head variation in the pumped layer. The numerical simulation results show that the pressure head in other layers does not rise immediately when the hydraulic head in the pumped layer starts to recover after pumping ceases. In addition, after the pumping is stopped, a dividing point can be found in aquitards next to the pumped layer, with the aquitards being divided into two parts: a compressed part and a rebounding part. The dividing points move toward the side and away from the pumped layer with the transferring of pore pressure in the aquitard. The results of the simulation also show that there is a transition period between land subsidence and rebound. In this transition period, land could continue to subside even though the hydraulic head in the pumped layer begins to recover.

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Antilliaanse pro justitia gerapporteerde adolescenten. Een onderzoek naar psychiatrische stoornissen, verstandelijke beperkingen, toerekeningsvatbaarheid en behandeladvies

Onderzoek naar psychiatrische stoornissen, verstandelijke beperkingen, toerekeningsvatbaarheid en behandeladvies van Antilliaanse jongeren die tussen 2000 en 2006 middels rapportages pro justitia zijn vastgesteld. Antilliaanse jongeren hadden vaker een gedragsstoornis en vaker een zwakbegaafd functieniveau, maar minder vaak adhd en minder vaak een ontwikkelingsstoornis dan Nederlandse jongeren. Ook vergeleken met andere migrantenjongeren werd vaker de diagnose zwakbegaafdheid gesteld. Antillianen kregen vaker een pij-maatregel opgelegd en minder vaak ambulante behandeling dan Nederlandse jongeren. Oorzaken zouden kunnen worden gevonden in de samenstelling van de groep Antillianen die de afgelopen jaren naar Nederland is gekomen, evenals taalproblemen en cultuurgebondenheid van vragenlijsten, en het mogelijke verschil in interpretatie van gedrag tussen Antilliaanse en Nederlandse jongeren door gedragsdeskundigen.

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‚O gütige Maria‘. Übersetzung des lateinischen Lieds G 9 – O Maria pia aus dem Korpus Mönch von Salzburg



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Možnosti aplikace counterfactual impact evaluation v České republice

Impact Evaluation of the Structural Funds is a growing area. There had been conducted several counterfactual impact evaluations of the EU funds. Such studies have not been often implemented yet in the Czech Republic. For this reason, the paper focuses on operational programmes and support areas that can be considered for counterfactual impact evaluation in the Czech Republic. We have tested the possibility in all operational programmes in the Czech Republic. For the selection of appropriate programmes, there had been used the core criterias required to conduct out this type of evaluation. The result is a selection of several support areas in various operational programmes that provide an opportunity for the realization of such an evaluation.

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Feeding amount significantly alters overt tumor onset rate in a zebrafish melanoma model [RESEARCH ARTICLE]

Vadim Grigura, Megan Barbier, Anna P. Zarov, and Charles K. Kaufman

The manner in which zebrafish are fed may have important impacts on the behavior of disease models. We examined the effect of different feeding regimens on the rate of overt melanoma tumor onset in a p53/BRAF-dependent model, a commonly used read-out in this and many other cancer models. We demonstrate that increased feeding leads to more rapid melanoma onset. The ability to modulate overt tumor onset rates with this regimen indicates additional flexibility to ‘tune’ the system to more quickly generate tumors for study and to begin to address questions related to cancer metabolism using the zebrafish model.



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Compensation for chronic oxidative stress in ALADIN null mice [RESEARCH ARTICLE]

Ramona Jühlen, Mirko Peitzsch, Sebastian Gärtner, Dana Landgraf, Graeme Eisenhofer, Angela Huebner, and Katrin Koehler

Mutations in the AAAS gene coding for the nuclear pore complex protein ALADIN lead to the autosomal recessive disorder triple A syndrome. Triple A patients present with a characteristic phenotype including alacrima, achalasia and adrenal insufficiency. Patient fibroblasts show increased levels of oxidative stress, and several in vitro studies have demonstrated that the nucleoporin ALADIN is involved in both the cellular oxidative stress response and adrenal steroidogenesis. It is known that ALADIN knock-out mice lack a phenotype resembling human triple A syndrome. The objective of this study was to determine whether the application of chronic oxidative stress by ingestion of paraquat would generate a triple A-like phenotype in ALADIN null mice. Adult male mice were fed either a paraquat (0.25 g/kg diet) or control diet for 11 days. After application of chronic oxidative stress, ALADIN knock-out mice presented with an unexpected compensated glutathione metabolism, but lacked a phenotype resembling human triple A syndrome. We did not observe increased levels of oxidative stress and alterations in adrenal steroidogenesis in mice depleted for ALADIN. This study stresses the species-specific role of the nucleoporin ALADIN, which in mice involves a novel compensatory mechanism for regulating the cellular glutathione redox response.



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QTL mapping for microtuber dormancy and GA3 content in a diploid potato population [RESEARCH ARTICLE]

Raja Mohib Muazzam Naz, Mengtai Li, Safia Ramzan, Gege Li, Jun Liu, Xingkui Cai, and Conghua Xie

The genetic control of dormancy is poorly understood in most plant species, but dormancy is a prominent feature for the potato industry. We used the microtuber system, in which tubers were produced in vitro and stored at 20°C, to perform quantitative trait locus (QTL) analysis for dormancy and gibberellic acid (GA3) content in an F1 population consisting of 178 genotypes derived from an interspecific cross between Solanum chacoense acc. PI 320285 (long dormancy) and Solanum phureja acc. DM1-3 516 R44 (short dormancy). In this analysis, 163 markers were used to construct a genetic map with a total length of 591.8 cM. Through QTL analysis, we identified 22 markers closely linked to the timing of dormancy release and GA3 content. The male parent alleles were closely related with long dormancy, with the most significant effect on chromosome I, which accounted for 9.4% of phenotypic variation. The dormancy and GA3 QTLs localized to the same position in the genome, confirming that same genomic region controls GA3 content at different developmental stages or in dormant and sprouting tubers. The identified QTLs may be useful for future breeding strategies and studies of dormancy in potato.



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White matter integrity correlates with residual consciousness in patients with severe brain injury

Abstract

Previous studies have suggested that white matter disruption plays an important role in disorders of consciousness (DOC) after severe brain injury. Nevertheless, the integrity of white matter architecture supporting consciousness and its relations with clinical severity in patients with DOC remain to be established. In this study, diffusion tensor imaging (DTI) data was collected from 14 DOC patients and 15 healthy control subjects. We combined tract-based spatial statistics (TBSS) with region of interest (ROI) analysis to examine differences of DTI metrics on white matter skeletons between DOC patients and healthy controls, and the association between white matter integrity and patients’ residual consciousness assessed by Coma Recovery Scale-Revised (CRS-R). We found that: (1) patients with DOC had widespread white matter integrity disruptions, especially in the fornix; (2) the alteration of white matter microstructure was mainly attributed to the increase in radial diffusivity, possibly reflecting demyelination; (3) the behavioral CRS-R assessment score was positively correlated with white matter integrity in the fornix, uncinate fasciculus, pontine crossing tract, and posterior limb of internal capsule. Our results suggest that despite the widespread abnormalities of white matter following severe brain injury, the impairment of consciousness is likely to result from disruptions of key pathways that link brain regions in distributed networks.



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Reduced spontaneous low frequency oscillations as measured with functional near-infrared spectroscopy in mild cognitive impairment

Abstract

Spontaneous low frequency oscillations (LFO) in functional imaging data have gained increased interest in the study of cognitive decline. Persons diagnosed with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) display alterations in their amount of LFO in various brain regions. This is commonly interpreted as disruptions in the autoregulation of the cerebral microvascular system. In the present study LFO (0,07–0,11 Hz) were measured with 52-channel near-infrared spectroscopy (NIRS) in 61 healthy elderly persons (70–76 years), 54 MCI subjects (70–76 years) and 25 healthy young controls (21–48 years) during rest over the frontal and the parietal cortex. Both MCI and healthy elderly controls showed less LFO in the frontal cortex as compared to young subjects. For the parietal cortex a decrease in LFO could be observed for the MCI group in comparison to healthy elderly subjects. Correlations of more LFO with worse performance in neuropsychological tests point to compensatory processes. LFO measured with NIRS might be especially suited for longitudinal studies aiming at predicting cognitive decline.



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IJERPH, Vol. 15, Pages 179: System-Wide and Group-Specific Health Service Improvements: Cross-Sectional Survey of Outpatient Improvement Preferences and Associations with Demographic Characteristics

IJERPH, Vol. 15, Pages 179: System-Wide and Group-Specific Health Service Improvements: Cross-Sectional Survey of Outpatient Improvement Preferences and Associations with Demographic Characteristics

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15020179

Authors: Elizabeth Fradgley Christine Paul Jamie Bryant Alison Zucca Christopher Oldmeadow

Efficient patient-centred quality improvement requires an understanding of the system-wide areas of dissatisfaction along with evidence to identify the programs which can be strategically targeted according to specific patient characteristics and preferences. This cross-sectional study reports the proportion of chronic disease outpatients selecting 23 patient-centred improvement initiatives. Using univariate tests and multivariable logistic regressions, this multi-site study also identifies initiatives differentially selected by outpatients according to clinical and demographic characteristics. A total of 475 outpatients participated (49% response). Commonly selected initiatives included: reducing wait-times (22.3%); convenient appointment scheduling (16.0%); and receiving up-to-date treatment information (16.0%). Within univariate tests, preferences for information and service accessibility initiatives were not significantly associated with specific subgroups. However, seven initiatives were preferred according to age, gender, diagnosis status, and chronic disease type within multivariate models. For example, neurology outpatients were more likely to select assistance to manage psychological symptoms when compared to oncology outpatients (OR: 2.89). Study findings suggest that system-wide programs to enhance information provision are strategic approaches to improve experiences across patient characteristics. Furthermore, a few initiatives can be targeted to specific groups and emphasized the importance of detailed scoping analyses and tailored implementation plans when designing patient-centred quality improvement programs.



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IJERPH, Vol. 15, Pages 180: Groundwater Arsenic Contamination in the Ganga River Basin: A Future Health Danger

IJERPH, Vol. 15, Pages 180: Groundwater Arsenic Contamination in the Ganga River Basin: A Future Health Danger

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15020180

Authors: Dipankar Chakraborti Sushant Singh Mohammad Rahman Rathindra Dutta Subhas Mukherjee Shyamapada Pati Probir Kar

This study highlights the severity of arsenic contamination in the Ganga River basin (GRB), which encompasses significant geographic portions of India, Bangladesh, Nepal, and Tibet. The entire GRB experiences elevated levels of arsenic in the groundwater (up to 4730 µg/L), irrigation water (~1000 µg/L), and in food materials (up to 3947 µg/kg), all exceeding the World Health Organization’s standards for drinking water, the United Nations Food and Agricultural Organization’s standard for irrigation water (100 µg/L), and the Chinese Ministry of Health’s standard for food in South Asia (0.15 mg/kg), respectively. Several individuals demonstrated dermal, neurological, reproductive, cognitive, and cancerous effects; many children have been diagnosed with a range of arsenicosis symptoms, and numerous arsenic-induced deaths of youthful victims are reported in the GRB. Victims of arsenic exposure face critical social challenges in the form of social isolation and hatred by their respective communities. Reluctance to establish arsenic standards and unsustainable arsenic mitigation programs have aggravated the arsenic calamity in the GRB and put millions of lives in danger. This alarming situation resembles a ticking time bomb. We feel that after 29 years of arsenic research in the GRB, we have seen the tip of the iceberg with respect to the actual magnitude of the catastrophe; thus, a reduced arsenic standard for drinking water, testing all available drinking water sources, and sustainable and cost-effective arsenic mitigation programs that include the participation of the people are urgently needed.



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IJMS, Vol. 19, Pages 319: Comparative Genomics of the Balsaminaceae Sister Genera Hydrocera triflora and Impatiens pinfanensis

IJMS, Vol. 19, Pages 319: Comparative Genomics of the Balsaminaceae Sister Genera Hydrocera triflora and Impatiens pinfanensis

International Journal of Molecular Sciences doi: 10.3390/ijms19010319

Authors: Zhi-Zhong Li Josphat Saina Andrew Gichira Cornelius Kyalo Qing-Feng Wang Jin-Ming Chen

The family Balsaminaceae, which consists of the economically important genus Impatiens and the monotypic genus Hydrocera, lacks a reported or published complete chloroplast genome sequence. Therefore, chloroplast genome sequences of the two sister genera are significant to give insight into the phylogenetic position and understanding the evolution of the Balsaminaceae family among the Ericales. In this study, complete chloroplast (cp) genomes of Impatiens pinfanensis and Hydrocera triflora were characterized and assembled using a high-throughput sequencing method. The complete cp genomes were found to possess the typical quadripartite structure of land plants chloroplast genomes with double-stranded molecules of 154,189 bp (Impatiens pinfanensis) and 152,238 bp (Hydrocera triflora) in length. A total of 115 unique genes were identified in both genomes, of which 80 are protein-coding genes, 31 are distinct transfer RNA (tRNA) and four distinct ribosomal RNA (rRNA). Thirty codons, of which 29 had A/T ending codons, revealed relative synonymous codon usage values of &gt;1, whereas those with G/C ending codons displayed values of &lt;1. The simple sequence repeats comprise mostly the mononucleotide repeats A/T in all examined cp genomes. Phylogenetic analysis based on 51 common protein-coding genes indicated that the Balsaminaceae family formed a lineage with Ebenaceae together with all the other Ericales.



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IJMS, Vol. 19, Pages 288: Role of Disulfide Bonds in Activity and Stability of Tigerinin-1R

IJMS, Vol. 19, Pages 288: Role of Disulfide Bonds in Activity and Stability of Tigerinin-1R

International Journal of Molecular Sciences doi: 10.3390/ijms19020288

Authors: Xiaolong Chen Cuihua Hu Yibing Huang Yuxin Chen

Tigerinin-1R (Arg–Val–Cys–Ser–Ala–Ile–Pro–Leu–Pro–Ile–Cys–His–NH2), a cationic 12-mer peptide containing a disulfide bond extracted from frog skin secretions, lacks antibacterial activity, but has the ability to stimulate insulin release both in vitro and in vivo. To study the structure–function relationships of tigerinin-1R, we designed and synthesized five analogs, including tigerinin-cyclic, tigerinin-1R-L4, tigerinin-linear, [C3K]tigerinin-1R, and [C11K]tigerinin-1R. Tigerinin-1R promoted insulin secretion in a concentration-dependent manner in INS-1 cells without obvious cytotoxicity. At a concentration of 10−5 M, [C11K]tigerinin-1R exhibited the highest stimulation ability, suggesting that the positive charge at the C-terminus may contribute to the in vitro insulin-releasing activity of tigerinin-1R. Tigerinin-1R peptides stimulated insulin release in INS-1 cells through a universal mechanism that involves mobilization of intracellular calcium without disrupting the cell membrane. In vivo experiments showed that both tigerinin-1R and [C11K]tigerinin-1R improved glucose tolerance in overnight-fasted mice. Due to its structural stability, tigerinin-1R showed superior hypoglycemic activity to [C11K]tigerinin-1R, which suggested a critical role of the disulfide bonds. In addition, we also identified a protective effect of tigerinin-1R peptides in apoptosis induced by oxidative stress. These results further confirm the potential for the development of tigerinin-1R as an anti-diabetic therapeutic agent in clinical practice.



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Predictors of Persistent Milk Allergy in Children: A Retrospective Cohort Study

Background: Cow’s milk (CM) allergy is the second most common food allergy developed during infancy in Japan. To identify predictors of persistent CM allergy, we investigated the tolerance acquisition rate based on an oral food challenge in children under 6 years of age, diagnosed with immediate-type CM allergy. Methods: This retrospective cohort study included 131 children born in 2005 with a history of immediate allergic reaction to CM, of whom 39 were excluded because of ongoing oral immunotherapy (n = 18) or a lack of follow-up data (n = 21). The 92 remaining participants were followed for 6 years. Tolerance was defined as no adverse reaction to 200 mL of CM and regular intake of milk at home. Subjects were divided into 3 groups based on age at tolerance acquisition: group I (#x3c;3 years; n = 31), group II (3–6 years; n = 42), and group III (persistent allergic group; n = 19). Results: Tolerance acquisition rates by 3, 5, and 6 years of age were 32.6% (30/92), 64.1% (59/92), and 84.8% (70/92), respectively. Age at first hospital visit was significantly higher in groups II and III than in group I (p #x3c; 0.001). The incidence of anaphylaxis to other foods was also higher in group III than in group I (p = 0.04), as was CM-induced anaphylaxis (p = 0.03). Furthermore, milk and casein-specific immunoglobulin E (IgE) levels were significantly higher in group III than in group II after birth and remained high thereafter (p #x3c; 0.05). Conclusions: The history of anaphylaxis and high milk-specific IgE levels were associated with persistent CM allergy.
Int Arch Allergy Immunol

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Focus on the Involvement of the Nose and Paranasal Sinuses in Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome): Nasal Cytology Reveals Infiltration of Eosinophils as a Very Common Feature

Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is a necrotizing vasculitis that predominantly affects small- to medium-sized vessels. It is characterized by a wide spectrum of extrapulmonary symptoms, including sinonasal and paranasal sinus abnormalities. These are the most common features of this disease, constituting diagnostic criteria for EGPA. However, the actual clinical features, cellular mechanisms and impact on patients’ quality of life (QoL) are still a matter of study. Methods: Thirty-nine EGPA patients underwent multidimensional rhinological evaluations, including rhinofibroscopy, nasal cytology, and QoL questionnaires. This was coupled with respiratory and rheumatological assessments. Results: Twenty-eight patients were diagnosed with chronic rhinosinusitis (CRS). Of these, 18 had nasal polyposis (NP). Chronic rhinitis was diagnosed in 10 patients. Of these, 3 had allergic rhinitis (AR) and seven had non-AR (NAR). Overall, only 1 patient (2.6%) was normal. Nasal cytology showed that hypereosinophilia was present in 17/28 patients with CRS, 4/7 patients with NAR and all patients with AR. SNOT-22 and SF-36 showed a severe impact of nasal symptoms on QoL. No differences in asthma control or rheumatological patterns for EGPA were observed among patients with or without NP. Conclusions: Even when the rheumatological assessment scored EGPA “under control” according to the Birmingham Vasculitis Activity Score and Vasculitis Damage Index, sinonasal diseases and related nasal inflammatory processes were not controlled. Therefore, there is a need for clinical monitoring and targeted treatment to control the inflammatory processes and improve the QoL of EGPA patients.
Int Arch Allergy Immunol

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How breast cancer survivors can increase their reduced life expectancy

A USC study suggests regular exercise could add to the life expectancy of breast cancer survivors because it lowers their heightened risk of cardiovascular disease, Type 2 diabetes and possibly breast cancer recurrence. "Many people don't know the No. 1...

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FDA broadens afatinib indication to previously untreated, metastatic NSCLC with other non-resistant EGFR mutations

The Food and Drug Administration granted approval to afatinib for a broadened indication in first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumours have non-resistant epidermal growth factor receptor (EGFR)...

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Generic quality of life in persons with hearing loss: a systematic literature review

To the best of our knowledge, no empirically based consensus has been reached as to if, and to what extent, persons with hearing loss (HL) have reduced generic Quality of life (QoL). There seems to be limited ...

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Glucagon-Like Peptide-1 Mediates the Protective Effect of the Dipeptidyl Peptidase IV Inhibitor on Renal Fibrosis via Reducing the Phenotypic Conversion of Renal Microvascular Cells in Monocrotaline-Treated Rats

Chronic kidney diseases are characterized by renal fibrosis with excessive matrix deposition, leading to a progressive loss of functional renal parenchyma and, eventually, renal failure. Renal microcirculation lesions, including the phenotypic conversion of vascular cells, contribute to renal fibrosis. Here, renal microcirculation lesions were established with monocrotaline (MCT, 60 mg/kg). Sitagliptin (40 mg/kg/d), a classical dipeptidyl peptidase-4 (DPP-4) inhibitor, attenuated the renal microcirculation lesions by inhibiting glomerular tuft hypertrophy, glomerular mesangial expansion, and microvascular thrombosis. These effects of sitagliptin were mediated by glucagon-like peptide-1 receptor (GLP-1R), since they were blocked by the GLP-1R antagonist exendin-3 (Ex-3, 40 ug/kg/d). The GLP-1R agonist liraglutide showed a similar renal protective effect in a dose-independent manner. In addition, sitagliptin, as well as liraglutide, alleviated the MCT-induced apoptosis of renal cells by increasing the expression of survival factor glucose-regulated protein 78 (GRP78), which was abolished by the GLP-1R antagonist Ex-3. Sitagliptin and liraglutide also effectively ameliorated the conversion of vascular smooth muscle cells (SMCs) from a synthetic phenotype to contractile phenotype. Moreover, sitagliptin and liraglutide inhibited endothelial-mesenchymal transition (EndMT) via downregulating transforming growth factor-β1 (TGF-β1). Collectively, these findings suggest that DPP-4 inhibition can reduce microcirculation lesion-induced renal fibrosis in a GLP-1-dependent manner.

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A Rare Cause of a Fluctuating Cystic Lesion in the External Auditory Canal

Temporomandibular joint (TMJ) ganglionic cyst is an uncommon entity and only a few have been reported in the literature. TMJ ganglion within the external auditory canal presenting clinically as a fluctuating cystic lesion has never been reported. Here, we present a unique case of such a lesion together with otoscopic and radiological images as well as provide a descriptive review of TMJ ganglionic cysts.

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Severe Drug-Induced Agranulocytosis Successfully Treated with Recombinant Human Granulocyte Colony-Stimulating Factor

When elderly patients are prescribed many different medications, the risk for developing serious adverse events should be kept in mind. One of these adverse events is agranulocytosis, which, although rare, can be life-threatening if left untreated. The majority of agranulocytosis cases are caused by drugs, including antibiotics. Here, we report a case of severe agranulocytosis in a 96-year-old woman following antibiotic therapy which was successfully managed using recombinant human granulocyte colony-stimulating factor (rhG-CSF) and the appropriate choice of antibiotics to treat her concomitant infection.

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The Assessment of Systemic Risk in the Kenyan Banking Sector

The present paper aims to assess the systemic risk of the Kenyan banking system. We propose a theoretical framework to reveal the time evolution of the systemic risk using sequences of financial data and use the framework to assess the systemic risk of the Kenyan banking system that is regarded as the largest in the East and Central African region. Firstly, we estimate the bilateral exposures matrix using aggregate financial data on loans and deposits from annual reports and analyze the interconnectedness in the market using network centrality measures. Next, we extend the Eisenberg–Noe method to a multiperiod setting to the systemic risk of the Kenyan banking system, in which the multiperiod includes the dynamic evolutions of the Kenyan banking system of every bank and the structure of the interbank network system. We apply this framework to assess dynamically the systemic risk of the Kenyan banking system between 2009 and 2015. The main findings are the following. The theoretical network analysis using network centrality measures showed several banks displaying characteristics of systematically important banks (SIBs). The theoretical default analysis showed that a bank suffering a basic default will trigger a contagious default that caused several other banks in the sector to go bankrupt. Further stress test proved that the KCB bank theoretically caused a few contagious defaults due to an unusually high interconnectedness. This methodology can contribute by being part of monitoring system of the Central Bank of Kenya (regulatory body) as well as the implementation of policies (such as bank-internal stress tests) that assist in preventing default contagion.

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Site-Directed Spin Labeling EPR for Studying Membrane Proteins

Site-directed spin labeling (SDSL) in combination with electron paramagnetic resonance (EPR) spectroscopy is a rapidly expanding powerful biophysical technique to study the structural and dynamic properties of membrane proteins in a native environment. Membrane proteins are responsible for performing important functions in a wide variety of complicated biological systems that are responsible for the survival of living organisms. In this review, a brief introduction of the most popular SDSL EPR techniques and illustrations of recent applications for studying pertinent structural and dynamic properties on membrane proteins will be discussed.

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The Influence of Errors in Visualization Systems on the Level of Safety Threat in Air Traffic

Air traffic management is carried out by air traffic controllers assisted by complex technical systems that provide them with visualization of the traffic situation. In practice, visualization systems errors sometimes occur. The purpose of this paper is to determine the impact of errors of different types on the safety of the air traffic. The assessment of the threat level is influenced by subjective factors and cannot be expressed precisely. Therefore, the fuzzy reasoning theory has been used. The developed fuzzy model has been used to obtain a tool for simulation of the impact of various factors on traffic safety assessment. The results obtained indicate that the most important determinants of safety are the time when the air traffic controller remains unaware of the breakdown and the total time he/she does not have full knowledge of the traffic situation. It has been found that the key role for the proper operation of the air traffic visualization system and the restoration of full situational awareness is played by self-diagnostic systems that can restore the system’s correct functioning without even the controller being aware of the error occurrence. Their role in ensuring safety might be even greater than redundancy which is commonly used.

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UGT1A1 Genetic Variations and a Haplotype Associated with Neonatal Hyperbilirubinemia in Indonesian Population

Neonatal hyperbilirubinemia (NH) is a common finding in newborn babies in Indonesia. Common and rare variants of UGT1A1 have been known to contribute to NH etiology. This study aims to identify UGT1A1 genetic variation and haplotype associated with NH in Indonesian population. DNA was isolated from 116 cases and 115 controls and a targeted-deep sequencing approach was performed on the promoter, UTRs, and exonic regions of UGT1A1. Determining association of common variants and haplotype analysis were performed using PLINK and Haploview. Ten and 4 rare variants were identified in cases and controls, respectively. The UGT1A1 rare variants frequency in cases (5.17%) was higher than that in controls (1.7%). Four of those rare variants in cases (p.Ala61Thr, p.His300Arg, p.Lys407Asn, and p.Tyr514Asn) and three in controls (p.Tyr79X, p.Ala346Val, and p.Thr412Ser) are novel variants. The frequencies of p.Gly71Arg, p.Pro229Gln, and TA7 common variants were not significantly different between cases and controls. A haplotype, consisting of 3 major alleles of 3′ UTRs common variants (rs8330C>G, rs10929303C>T, and rs1042640C>G), was associated with NH incidence () in this population. Using targeted-deep sequencing and haplotype analysis, we identified novel UGT1A1 rare variants and disease-associated haplotype in NH in Indonesian population.

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Upper Extremity Compartment Syndrome in a Patient with Acute Gout Attack but without Trauma or Other Typical Causes

We report the case of a 30-year-old Polynesian male with a severe gout flare of multiple joints and simultaneous acute compartment syndrome (ACS) of his right forearm and hand without trauma or other typical causes. He had a long history of gout flares, but none were known to be associated with compartment syndrome. He also had concurrent infections in his right elbow joint and olecranon bursa. A few days prior to this episode of ACS, high pain and swelling occurred in his right upper extremity after a minimal workout with light weights. A similar episode occurred seven months prior and was attributed to a gout flare. Unlike past flares that resolved with colchicine and/or anti-inflammatory medications, his current upper extremity pain/swelling worsened and became severe. Hand and forearm fasciotomies were performed. Workup included general medicine, rheumatology and infectious disease consultations, myriad blood tests, and imaging studies including Doppler ultrasound and CT angiography. Additional clinical history suggested that he had previously unrecognized recurrent exertional compartment syndrome that led to the episode of ACS reported here. Chronic exertional compartment syndrome (CECS) presents a difficult diagnosis when presented with multiple symptoms concurrently. This case provides an example of one such diagnosis.

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Chronic Myelomonocytic Leukemia following Multicentric Castleman Disease

Multicentric Castleman disease (MCD) is a rare nonmalignant lymphoproliferative disorder presenting systemic symptoms such as fever, night sweats, fatigue, anemia, effusions, and multifocal lymphadenopathy. The etiology of MCD has not been clarified to date. The coexistence of MCD with chronic myelomonocytic leukemia (CMML) has been rarely reported. Although the pathogenesis remains unclear, this association probably reflects an incidental and fortuitous finding rather than the alteration of a common pluripotent stem cell precursor. Herein, we report on one case of MCD coexisting with CMML and elucidate the underlying mechanism of pathology in some aspects.

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Inexact SA Method for Constrained Stochastic Convex SDP and Application in Chinese Stock Market

We propose stochastic convex semidefinite programs (SCSDPs) to handle uncertain data in applications. For these models, we design an efficient inexact stochastic approximation (SA) method and prove the convergence, complexity, and robust treatment of the algorithm. We apply the inexact method for solving SCSDPs where the subproblem in each iteration is only solved approximately and show that it enjoys the similar iteration complexity as the exact counterpart if the subproblems are progressively solved to sufficient accuracy. Numerical experiments show that the method we proposed was effective for uncertain problem.

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Pulmonary Sarcoidosis following Etanercept Treatment for Ankylosing Spondylitis: A Case Report and Review of the Literature

Antitumor necrosis factor therapies have revolutionized the treatment of some inflammatory diseases. However, the use of these agents is associated with the development of many paradoxical autoimmune diseases. Less well-recognized is the association with sarcoidosis. We report a 55-year-old female with long-standing ankylosing spondylitis who developed persistent dry cough and dyspnea while receiving etanercept therapy. High-resolution computed tomography scanning showed mediastinal lymphadenopathy and multiple nodules in both lung fields developed two months after the administration of etanercept. Lymph node biopsy was not practicable. Histopathological examination of minor salivary gland biopsy revealed noncaseating granulomata, and the serum angiotensin-converting enzyme was very elevated. All infectious studies were negative. Etanercept was discontinued plus a course of corticosteroids with a clinical improvement, and a follow-up high-resolution computed tomography scanning 4 months later showed evident regression of mediastinal lymph nodes and pulmonary nodules. Potential pathogenic mechanisms of this paradoxical effect of tumor necrosis factor-alpha blocking agents are discussed.

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Ileocecal Fistula Caused by Multiple Foreign Magnetic Bodies Ingestion

The incidence of accidental foreign body (FBs) ingestion is 100,000 cases/year in the US, with over than 80% of cases occurring in children below 5 years of age. Although a single FB may pass spontaneously and uneventfully through the digestive tract, the ingestion of multiple magnetics can cause serious morbidity due to proximate attraction through the intestinal wall. Morbidity and mortality depend on a prompt and correct diagnosis which is often difficult and delayed due to the patient's age and because the accidental ingestion may go unnoticed. We report our experience in the treatment of an 11-year-old child who presented to the emergency department with increasing abdominal pain, vomiting, diarrhea, and fever. Surgery evidenced an ileocecal fistula secondary to multiple magnetic FB ingestion with attraction by both sides of the intestinal wall. A 5-centimeter ileal resection was performed, and the cecal fistula was closed with a longitudinal manual suture. The child was discharged at postoperative day 8. After one year, the patient’s clinical condition was good.

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Can Sadurní (Begues, Baix Llobregat), de la captación de recursos abióticos al inicio de la minería de aluminofosfatos (10500-4000 cal ANE) en el macizo de Garraf



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Áreas de aprovisionamiento, territorios de subsistencia y producciones técnicas en el Neolítico antiguo de La Draga



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Chasing the traces of the diffusion of agriculture during the Early Neolithic in the Western Mediterranean: open questions and future perspectives



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Darreres troballes de prehistòria recent a l’Alt Empordà. Dos assentaments a l’aire lliure: la Serra del Mas Bonet (Vilafant) i els Banys de la Mercè (Capmany)



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Poblamiento, explotación y entorno natural de los estadios alpinos y subalpinos del Pirineo Central durante la primera mitad del Holoceno

This paper presents the results of the studies undergo at the Cova del Sardo and Abric de l’Estany de la Coveta I, two archaeological sites placed in the National Park of Aigüestortes and Estany de Sant Maurici. Both sites have been object of multiproxy analyses inside a long‐term research program in archaeology that promotes surface surveys and excavations in the head of Noguera Pallaresa and Noguera Ribagorçana basins, in the Central Southern Pyrenees. The studies shown different variables that suggest an anthropogenic impact on the vegetation during the first half of the Neolithic occupation at Cova del Sardo, that took place during the Holocene Climatic Optimum. The presence of cereals seeds in two Neolithic phases suggests the possibility of some kind of local agriculture, although this hasn’t been confirmed by pollen studies. Probably livestock it was the main economic activity in this site. In latter Neolithic phases at Cova del Sardo a recovery of a closed forest can be seen, while there is a climatic deterioration. Paradoxically, at this moment the occupation and exploitation pattern turns to a major emphasis towards the alpine pastures, with little camps around the lakes and glacial cirques just at the beginning of secondary basins. The palaeoecological study of archaeological contexts is very helpful to understand the local phenomena of environmental impact because of economic activities. [ES] Se presentan los resultados del estudio interdisciplinar realizado en Cova del Sardo y Abric de l’Estany de la Coveta I, ambos yacimientos en el entorno del Parque Nacional d’Aigüestortes i Estany de Sant Maurici. Estos se enmarcan en un amplio proyecto de prospección y excavación arqueológica entre las cabeceras de los valles de la Noguera Pallaresa y la Noguera Ribagorçana, en el Pirineo Central. Los estudios cubren la primera mitad del Holoceno y permiten documentar un impacto ambiental a nivel local durante la primera fase de ocupación neolítica, coincidente con el último Óptimo Climático. La presencia de cereales en el registro plantea la posibilidad de una agricultura local, no confirmada por los estudios polínicos. La ganadera fue probablemente la actividad principal. En las fases sucesivas se observa la recuperación del bosque cerrado, a la vez que se produce un deterioro climático y el patrón de ocupación y gestión del territorio cambia hacia una explotación de los pastos de alta montaña y los lagos, y bases de circos de las cabeceras de las cuencas secundarias. El estudio paleoecológico de contextos arqueológicos ha resultado de gran ayuda para la comprensión de fenómenos locales de impacto sobre el entorno como resultado de actividades económicas.

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Some unlikely intersections beyond André-Oort

According to the André–Oort conjecture, an algebraic curve in Y (1)n that is not equal to a special subvariety contains only finitely many points which correspond to ann-tuple of elliptic curves with complex multiplication. Pink’s conjecture generalizes the André–Oort conjecture to the extent that if the curve is not contained in a special subvariety of positive codimension, then it is expected to meet the union of all special subvarieties of codimension two in only finitely many points. We prove this for a large class of curves in Y (1)n. When restricting to special subvarieties of codimension two that are not strongly special we obtain finiteness for all curves defined over Q. Finally, we formulate and prove a variant of the Mordell–Lang conjecture for subvarieties of Y (1)n.

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Experimental archaeology as a resource for approaching formation processes of seed assemblages. First results and future perspectives

El propòsit d’aquest article és obtenir una primera aproximació a certs processos de formació del registre arqueobotànic. Per a aquest experiment s’ha treballat amb dues species: Triticum aestivum s. l. (5130 restes) i Lens culinaris (1478 restes). El primer objectiu és avaluar com la combustió afecta les diverses propietats de les granes quan conjunts de restes són exposats a les mateixes condicions controlades. El segon és comparar dos contextos deposicionals: un en el qual les restes quedin exposades a les condicions atmosfèriques i un altre en el qual s’enterri les restes en fosses. Finalment, es pretenen analitzar els efectes produïts en les granes per l’ús de diferents tècniques de recuperació: excavant amb un paletí o amb un tornavís; i tractant el sòl per flotació o mitjançant el rentat per columna de garbells. S’ha utilitzat un sistema de caracterització resta-per-resta per tal de descriure tots els canvis en les propietats de les granes després de cada fase de l’experiment. La carbonització de conjunts de diferent quantitat mostra algunes diferències que haurien de ser tingudes en compte quan s’interpreta el registre arqueològic.

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Persistent Asymptomatic Papules on the Chest

No abstract available

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Indeterminate Dendritic Cell Sarcoma in a Patient With Myelodysplastic Syndrome

No abstract available

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Sclerotic Ulcerated Plaque on the Back

No abstract available

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An Unusual Vesiculopustular Eruption: Challenge

No abstract available

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Superficial Acral Fibromyxoma With Cartilaginous Metaplasia

No abstract available

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Clinical characteristics and outcomes of cancer patients requiring intensive care unit admission: a prospective study

Abstract

Purpose

The study was aimed to describe the characteristics of cancer patients admitted to the oncological ICU and to identify clinical features associated with outcomes.

Methods

This is a prospective study (January 2014 to December 2015) of 522 cancer patients consecutively admitted to the oncological ICU. Patients with a length of oncological ICU stay ≤ 1 day were excluded. Demographic and clinical variables were obtained at oncological ICU admission. The primary outcome of interest was hospital mortality. Logistic regression analysis was performed to identify independent risk factors for hospital mortality.

Results

The study cohort consisted of 492 (94.3%) patients with solid tumours and 30 patients (5.7%) with haematological malignancies. Advanced cancer was observed in 53.3%. Unplanned admission accounted for 25.3%. Hospital mortality rate was 13.0% (n = 68), and it was higher for patients with unplanned admission than those for electively admitted patients (35.6% vs. 5.4; p < 0.0001). Stage IV of cancer (OR 5.28; 95% CI 2.71–10.28; p < 0.0001), patients from the emergency department (OR 3.33; 95% CI 1.68–6.61; p = 0.001), unplanned admission (OR 7.99; 95% CI 4.45–14.33; p < 0.0001), non-malignancy-related admission (OR 5.80; 95% CI 3.26–10.32; p < 0.0001), sepsis (OR 4.81; 95% CI 2.28–10.16; p < 0.0001), chemotherapy-induced adverse event (OR 5.64; 95% CI 2.33–13.66; p < 0.0001), and invasive mechanical ventilation (OR 18.70; 95% CI 9.93–35.21; p < 0.0001) were independently associated with increased hospital mortality in multivariate logistic regression analysis.

Conclusions

ICU admission of cancer patients should be based on potential chance of recovering from the acute problem. Clinical predictor for mortality could support this purpose (UIN: researchregistry3484).



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Transforming growth factor beta 1 (TGFβ1) polymorphisms and haplotype structures have dual roles in breast cancer pathogenesis

Abstract

Purpose

Despite the documented dual role of TGFβ1 in breast cancer (BC) pathogenesis, the subtype-specific influences of its polymorphisms remain undocumented. The present study investigated the effects of the TGFB1 promoter region (rs1800468 or G-800A and rs1800469 or C-509T) and signal peptide (rs1800470 or C29T and rs1800471 or G74C) single nucleotide polymorphisms (SNPs) and their haplotype structures on the susceptibility and clinicopathological presentation of BC subtypes.

Methods

TGFB1 genotypes were assessed by PCR-RFLP and haplotype structures were inferred for 323 BC patients and 405 neoplasia-free women, and case–control analyses were performed by logistic regression adjusted by age. Clinicopathological parameters (age at diagnosis, tumor size, histopathological grade, lymph node metastasis, proliferation index and disease stage) were tested for correlation with TGFB1 variants. All statistical analyses were two-tailed with an alpha level of 0.05.

Results

Variants related to increased TGFβ1 production (C-509T SNP and GTCG haplotype) were associated with increased susceptibility to HER2+ tumors and correlated with worse prognostic parameters in HER2+ and triple-negative (TN) BCs, but correlated negatively to Ki67 in ER/PR+HER2 tumors. Conversely, low TGFβ1 production variants (C29T SNP and GCTG haplotype) were protective against HER2+ tumors and correlated negatively with prognostic parameters in HER2+ and TN BCs, while indicating higher proliferation rates in ER/PR+HER2 tumors. Furthermore, the GCCG haplotype was associated with decreased susceptibility to ER/PR+HER2 tumors, but correlated positively with Ki67 in this subgroup.

Conclusion

The present study indicates that TGFB1 variants have subtype-specific roles in BC and may switch from tumor suppressor to promoter during tumor development, consistent with TGFβ1 dual role in BC pathogenesis.



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