Immunity, Inflammation and Disease, EarlyView.
Δευτέρα 7 Μαΐου 2018
A clinical follow‐up of omalizumab in routine treatment of allergic asthma monitored by CD‐sens
Effects of long-term fertilization practices on heavy metal cadmium accumulation in the surface soil and rice plants of double-cropping rice system in Southern China
Abstract
Fertilizer regime is playing an important role in heavy metal cadmium (Cd) accumulation in paddy soils and crop plant. It is necessary to assess the Cd accumulation in soils and rice (Oryza sativa L.) plants under long-term fertilization managements, and the results which help to assess the environmental and food risk in Southern China. However, the effects of different organic manure and chemical fertilizers on Cd accumulation in soils and rice plant remain unclear under intensively cultivated rice conditions. Therefore, the objective was to explore Cd accumulation in paddy soils and rice plant at mature stage under different long-term fertilization managements in the double-cropping rice system. Cd accumulation in the surface soils (0–20 cm) and rice plant with chemical fertilizer alone (MF), rice straw residue and chemical fertilizer (RF), 30% organic matter and 70% chemical fertilizer (LOM), 60% organic matter and 40% chemical fertilizer (HOM), and without fertilizer input (CK) basis on 32 years long-term fertilization experiment were analyzed. The results showed that the soil total Cd content was increased by 0.296 and 0.351 mg kg−1 and 0.261 and 0.340 mg kg−1 under LOM and HOM treatments at early and late rice mature stages, respectively, compared with the CK treatment. And the soil available Cd content was increased by 0.073 and 0.137 mg kg−1 and 0.102 and 0.160 mg kg−1 under LOM and HOM treatments at early and late rice mature stages, respectively, compared with the CK treatment. The bioconcentration factor of Cd across different parts of rice plant was the highest in root, followed by stem and grain, and the lowest in leaves. At early and late rice mature stages, the root Cd concentration of rice plant was increased by 0.689 and 0.608 mg kg−1 with HOM treatment, the stem Cd concentration of rice plant was increased by 0.666 and 0.758 mg kg−1 with RF treatment, and the leaf and grain Cd concentration of rice plant was increased 0.094 and 0.082 mg kg−1 and 0.086 and 0.083 mg kg−1 with LOM treatment, respectively, compared with the CK treatment. The soil Cd single-factor contaminant index (PCd) under different fertilization treatments was as the following HOM > LOM > RF > MF > CK. Meanwhile, the PCd with LOM and HOM treatments was higher than that of the MF, RF, and CK treatments, but there is no significant difference between that of MF and RF treatments. Therefore, long-term application of rice straw residue and chemical fertilizer had no obvious effect on the accumulation of Cd in paddy soils and grain, and soil Cd accumulation was increased as application of organic fertilizer.
Application of a coupled model of photosynthesis and stomatal conductance for estimating plant physiological response to pollution by fine particulate matter (PM 2.5 )
Abstract
Fine particulate matter (PM2.5) is a current environmental issue that has an impact on the global ecology. Vegetation is a known sink for PM2.5 deposition but the effects of these particles on plant growth, and specifically on plant photosynthesis by changing their leaf water potential, are still not well understood. This study aimed to determine and characterize possible relationships between PM2.5 and plant photosynthesis under different PM2.5 concentrations. Both indoor and outdoor measurements were carried out to evaluate the variation dynamics of net photosynthetic rate and stomatal conductance of four plant species with different leaf characteristics under different PM2.5 levels. A calibrated coupled model of photosynthesis and stomatal conductance was developed to estimate the relationship between plant photosynthesis and PM2.5 reliably. Net photosynthetic rate and stomatal conductance declined over time at elevated PM2.5, with large variations with PM2.5 concentrations. Using a calibrated model of photosynthesis coupled to stomatal conductance, we show that PM2.5 can influence plant photosynthesis that primarily occurs through the stomata on leaves. Although the effect of particles on plant photosynthesis was not as high as that of photosynthetically active radiation, temperature, and CO2 concentration around the leaf, the effect from PM2.5 can be significant, in particular, in highly polluted atmospheres.
Organic solvent removal by pervaporation membrane technology: experimental and simulation
Abstract
This work presents purification of cyclohexane using polydimethylsiloxane (PDMS) membranes in pervaporation (PV) process. The PDMS is a rubbery polymer and appropriate as membrane material for purification of cyclohexane. PV which is a low-energy separation process was chosen for purification of cyclohexane due to its superior advantages compared to other processes. Effect of feed concentration on separation factor was investigated in order to optimize the process. It was indicated that dehydration of 80 wt% cyclohexane mixture at a temperature of 300 K and a vacuum pressure of 10 mmHg could be effectively achieved and high separation factor of 2500 was obtained. Furthermore, a two-dimensional mechanistic model was proposed for predicting mass transfer of cyclohexane in the process. The mechanistic model accounts for mass transfer of cyclohexane across the membrane, and concentration distribution of cyclohexane was determined. It was revealed that the most mass transfer flux of cyclohexane occur at the region near the inlet of feed channel, while the flux at the upper side of the module reaches zero value due to the effect of velocity distribution on the convective mass transfer of cyclohexane.
Leachate phytotoxicity of flue gas desulfurization residues from coal-fired power plant
Abstract
Flue gas desulfurization residues (FGDR) are the main solid wastes produced in coal-fired power plants that can be reused as alternative materials for civil and agricultural applications. However, the pollutants contained in the FGDR might contaminate the local environment, hindering their material reuse. In this study, the physical-chemical characteristics, leaching, and phytotoxicity (Triticum aestivum) of the material were investigated. The FGDR samples were obtained from three pulverized coal-fired power plants in China. Multivariate statistical analyses were used to consider the contributions of the leaching components to the germination index of wheat seeds in the FGDR leachates. The FGDR contained a high percentage of amorphous mass. The ranges of selected metals and micronutrients in the FGDR are As (31.5–63.0 mg/kg), B (574–3090 mg/kg), Ba (2799–3073 mg/kg), Cr (up to 4.73 mg/kg), Cu (0.29–1.38 mg/kg), Mn (136–370 mg/kg), Ni (9.93–22.9 mg/kg), Pb (1.29–7.29 mg/kg), Sr (886–1706 mg/kg), and Zn (335–458 mg/kg). The leaching toxicity of the FGDR leachates was lower than the regulatory limit of the identification standards for hazardous waste, indicating that the FGDR are non-hazardous materials. Metals, especially Ba, Cu, Fe, and Pb, as well as As and B, in the leachate had inhibitory effects on seed germination than the other constituents. The results in this study showed that the leachate phytotoxicity resulting from FGDR could be evaluated before the utilization of FGDR, giving crucial information for the adaptation of these alternative materials.
Association between oral mucosal lesions and crack and cocaine addiction in men: a cross-sectional study
Abstract
The aim of this cross-sectional study was to evaluate the prevalence of oral mucosal lesions (OMLs) and their association with crack/cocaine addiction in men. Clinical oral examination was performed in 161 adult male patients at the School of Dentistry of the Federal University of Bahia, Brazil. Crack/cocaine addiction was determined from the medical records, and all drug-addicted individuals used both crack and cocaine. All participants (40 crack/cocaine-addicted men and 121 non-addicted men) underwent a systematic evaluation of the lips, labial mucosa, commissures, buccal mucosa and sulcus, gingiva and alveolar ridge, tongue, floor of the mouth, and soft and hard palate by a single examiner. Bivariate and regression analyses were conducted to assess for the presence of OMLs and the association of OMLs with crack/cocaine addiction. OMLs were found in 22 participants with a significantly greater prevalence in the crack/cocaine-addicted group (25 vs. 9.9%; p = 0.01). The most prevalent types of lesions in the addicted group were traumatic ulcer and actinic cheilitis (7.5% for each) followed by fistulae associated with a retained dental root (5%). After adjusting for covariates, crack/cocaine addiction was significantly associated with OMLs (OR = 2.87; 95% CI = 1.08–7.67; p = 0.03). The prevalence of OMLs was higher in crack/cocaine-addicted individuals, and crack/cocaine addiction was significantly associated with OMLs. A public health program aimed at the early diagnosis and treatment of OMLs is vital to improving the oral health status of individuals addicted to crack/cocaine.
In-depth molecular characterization and biodegradability of water-extractable organic nitrogen in Erhai Lake sediment
Abstract
Dissolved organic nitrogen (DON) constitutes a significant fraction of the total dissolved nitrogen content of most aquatic systems and is thus a major nitrogen source for bacteria and phytoplankton. The present work applied Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR MS) to a compound-level analysis of the depth-dependent molecular composition of water-extractable organic nitrogen (WEON) in lake sediment. The study focused on Erhai Lake, China. It was found that a large portion (from 16.33 ± 7.87 to 39.54 ± 5.77%) of the WEON in the lake sediment was reactive under cultivation by algal or bacteria. The WEON in the mid-region of Erhai sediment particularly exhibited a lower bioavailability, having been less affected by the basin environment. The FT-ICR MS results revealed the presence of thousands of compounds in the Erhai Lake sediment samples collected at different depths, with the N-containing compounds accounting for 28.3–34.4% of all the compounds. The WEON molecular weight was also observed to increase with increasing sediment depth. A van Krevelen diagram showed that the lignin-type components were dominant (~ 56.2%) in the sediment WEON, contributing to its stabilization and reducing the risk of sediment nutrient release. The FT-ICR MS results further revealed 204 overlapping formulas of WEON for each core sediment sample, attributable to the presence of refractory components. It was observed that 78.4% of the formulas were within the lignin-like region, suggesting unique allochthonous DON sources. The aliphatic component proportion of all the unique formulas was also found to increase with increasing sediment depth. This indicates that, with the development and evolution of the Erhai Basin, the more labile WEON components were transformed into more stable lignin-like substrates, with a positive effect on the Lake Erhai ecosystem.
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Advanced oxidation processes on doxycycline degradation: monitoring of antimicrobial activity and toxicity
Abstract
Advanced oxidation processes (AOPs) have been highly efficient in degrading contaminants of emerging concern (CEC). This study investigated the efficiency of photolysis, peroxidation, photoperoxidation, and ozonation at different pH values to degrade doxycycline (DC) in three aqueous matrices: fountain, tap, and ultrapure water. More than 99.6% of DC degradation resulted from the UV/H2O2 and ozonation processes. Also, to evaluate the toxicity of the original solution and throughout the degradation time, antimicrobial activity tests were conducted using Gram-positive (Bacillus subtilis) and Gram-negative (Escherichia coli) bacteria, and acute toxicity test using the bioluminescent marine bacterium (Vibrio fischeri). Antimicrobial activity reduced as the drug degradation increased in UV/H2O2 and ozonation processes, wherein the first process only 6 min was required to reduce 100% of both bacteria activity. In ozonation, 27.7 mg L−1 of ozone was responsible for reducing 100% of the antimicrobial activity. When applied the photoperoxidation process, an increase in the toxicity occurred as the high levels of degradation were achieved; it means that toxic intermediates were formed. The ozonated solutions did not present toxicity.
Efficiency analysis of the electrocoagulation and electroflotation treatment of poultry slaughterhouse wastewater using aluminum and graphite anodes
Abstract
The application of electrocoagulation (EC) and electroflotation (EF) was investigated for the treatment of poultry slaughterhouse wastewater in a bench scale unit cell electrolyzer with different EC-to-EF ratios at current densities of 3, 9, and 15 mA cm−2. The EC-to-EF ratio was controlled by current reversal using aluminum and graphite electrodes. The electrochemical treatment showed satisfactory removal efficiencies for Al coagulant loads greater than 51.8 mg L−1. The 4/5 EC to EF ratio (69.1 mg L−1 Al and 32.2 NmL L−1 additional EF gas) and 3/5 (51.8 mg L−1 Al/64 NmL L−1 additional EF gas) presented the best results for the removal of COD (76–85%), color (93–99%), and turbidity (95–99%), with the additional benefit of reducing the electrode consumption and sludge disposal costs proportionally to the EC-to-EF ratio. The effects of the EC-to-EF ratio and the current density on efficiency of the electrochemical treatment for the removal of COD, apparent color, turbidity, TSS, TSD, and NH3-N were discussed in the light of the physicochemical and electrochemical processes underlying the removal mechanism for each parameter. In particular, the blow-off mechanism seems to play an important role in the NH3-N removal, whereas indirect electrooxidation mechanism accounts for a fraction of the soluble COD removal for the electrodes configuration used in the treatment.
Play in the Information Age
Abstract
This article is an inquiry on the role of play in shaping the cultures of the Information Age. By applying concepts from Postphenomenology and the Philosophy of Information, this paper argues that play and computation share a capacity to shape human experience. I will apply the concept of re-ontologization to describe the effect that computation has had in shaping the world. I will apply the concept of relational strategies to argue that play is a way of interfacing with the computational world. This paper argues that play is a particularly relevant form of shaping the human experience of the re-ontologized infosphere because play, like computation, can create worlds. The goal of this article is to propose a research program that situates play as a relevant perspective to analyze the culture of the Information Age.
Evolution of human health risk based on EPA modeling for adults and children and pollution level of potentially toxic metals in Rafsanjan road dust: a case study in a semi-arid region, Iran
Abstract
Humans can be directly exposed to potentially toxic metals in the urban environment via inhalation, ingestion, or dermal contact of dust particles. This paper focuses on human health risk assessment of urban dust contaminated with potentially toxic metals. The levels, sources, and human health risks of nine potentially toxic metals (i.e., As, Cd, Cu, Cr, Ni, Pb, Co, Mn, and Zn) in 200 road dust samples from Rafsanjan area were investigated. Pollution level was assessed using the pollution index (PI) and geoaccumulation index (Igeo), and the health risk assessment was performed following the methodology described by the US Environmental Protection Agency. The mean concentrations of As, Cu, Pb, Cd, Cr, Ni, Zn, Co, and Mn in road dust were 105.3 ± 5.7, 791.4 ± 29.8, 123.1 ± 9.7, 28.4 ± 3.3, 3.1 ± 0.6, 18.4 ± 1.6, 252.6 ± 8.3, 16.5 ± 1.4, and 525.9 ± 21.0 mg kg−1, respectively. Thus, the concentrations of potentially toxic metals in road dust were higher than their corresponding natural background values, indicating that all studied potentially toxic metals were impacted by anthropogenic activities. The results of the current study are comparable to other studies conducted on road dust in other cities worldwide. Both of Igeo and PI decreased following order Cu > Mn > Pb > As > Zn > Cd > Ni > Cr > Co. Health risk assessment indicated that both of children and adults could be exposed to a potential increased risk of developing cancer over a lifetime from exposure to arsenic through ingestion of the dust samples. However, Pb ingestion can increase cancer risk in children.
MCDM analysis of wind energy in Turkey: decision making based on environmental impact
Abstract
Development of new wind energy projects require complex planning process involving many social, technical, economic, environmental, political concerns, and different agents such as investors, utilities, governmental agencies, or social groups. The aim of this study is to develop a tool combining Geographic Information System (GIS) and Multi-Criteria Decision-Making (MCDM) methodologies, and its application for Turkey as a case study. A variety of constraints and criteria were identified based on a literature review and regulations gathered from variety of agencies, use of which resulted in determination of infeasible sites. Then, pairwise comparisons were carried out using analytic hierarchy process as the MCDM method to estimate relative importance of the criteria, and to visualize a suitability map with three classes. As the final stage, decision making was carried out based on environmental impact where 45.5% of the Turkish territory was found as infeasible area. Sixty percent of the remaining area are covered by the moderate suitability class, followed by the highly suitable area (20.3%) and low suitable area (19.8%). The output of this study can be used by energy planners to estimate the extent that wind energy can be developed based on public perception, administrative, and environmental aspects.
A scientometric review of emerging trends and new developments in agricultural ecological compensation
Abstract
Agricultural ecological compensation has drawn an increasingly broad range of interest since early 1990s. In recent years, the volume of the literature grows rapidly. As a result, a systematic review of the diverse research field and its current trends becomes essential. This paper surveys the literature of agricultural ecological compensation between 1990 and 2016. Specifically, by employing CiteSpace information visualization software, we firstly identified the research hotspots and evolution path and then illustrated the frontier and developing trend of the domain in core and broader perspectives. It is found that the focus of the academic community has always been researches on the theoretical policy and application of the payment for agro-ecosystem services, agricultural ecological compensation based on contingent valuation method, and ecological compensation of farmland landscape and organic food production as well as willingness to accept/pay for land use and ecological protection. Meanwhile, we also found that, in recent years, qualitative research has received more and more attention in the field of agricultural ecological compensation, since global warming, agricultural carbon emissions, and other emerging environmental issues have aroused widespread concern of the people around the world. Moreover, we believed that more and more scholars will employ case study methodology to analyze agricultural ecological compensation in specific systems, regions, or circumstances in the future.
The acclimatization strategies of kidney vetch ( Anthyllis vulneraria L.) to Pb toxicity
Abstract
Kidney vetch (Anthyllis vulneraria L.) is a well-known Zn hyperaccumulator. Zn often occurs with Pb in one ore; thus, plants inhabiting waste dumps are exposed not only to Zn but also to Pb toxicity. While the response of kidney vetch to Zn toxicity is relatively well known, the Pb survival strategy of Anthyllis vulneraria has not been the subject of investigations. The aim of presented research was to determine the survival strategy of kidney vetch exposed to high lead concentrations. Shoot explants of a calamine kidney vetch ecotype were placed on agar media containing 0.0, 0.5, 1.0, and 1.5 mM Pb. Morphological, physiological, and biochemical responses, in particular photosynthetic apparatus of plantlets, were examined. The most pronounced changes were observed in plants grown on media supplemented with 1.5 mM Pb after 8 weeks of culture. Increased dry weight and high lead accumulation were observed in roots. Similarly, in shoots, increased dry weight and a decreased number of newly formed shoots were recorded. The accumulation of lead was many times lower in shoots than in roots. In leaf cells' ultra-structure, looser arrangement of chloroplast thylakoid grana was observed. Despite the decrease in chlorophyll a and carotenoid content, the photosynthetic apparatus remained efficient due to the lack of photoinhibition and increased electron transport rate beyond photosystem II (PSII). For the first time, an acclimatization mechanism based on maintaining the high efficiency of photosynthetic apparatus resulting from increasing of electron transport rate was described.
Chronic Hematic Cyst of the Right Maxillary Sinus and Orbit Presenting as Proptosis
A 28-year-old man presented to the emergency room complaining of right proptosis. He also manifested eye pain and facial fullness and redness in this side. Seven years ago, he had right hemifacial gunshot trauma treated with surgical reconstruction. The CT scan showed expansion of the right maxillary sinus due to a hypodense nonenhancing lesion extending to the nasal cavity, masticatory space, and extraconal space of the orbit. MRI was performed showing high signal intensity of the lesion on T2-weighted images indicating a cystic nature. T1-weighted images also demonstrated high signal intensity of the lesion suggesting hemorrhage. At endoscopic maxillary antrostomy, the diagnosis of a chronic hematic cyst was confirmed. Chronic hematic cysts of the orbit should be included in the differential diagnosis of proptosis, especially if there is clinical history of past trauma. Due to the fact that physical examination is nonspecific, radiologic evaluation is useful to confirm the diagnosis and for presurgical planning.In Vivo Effects of Retrobulbar Bimatoprost Injection on Orbital Fat
Purpose: Recent publications have reported the adverse effects of prostaglandin analogues on the periocular tissues. These medications may cause periorbital lipodystrophy, enophthalmos, and deepening of the superior sulcus deformity. While these effects may have adverse consequences for some patients, the atrophy of the periorbital fat may have a useful role in diseases that lead to orbital and periorbital fat hypertrophy such as thyroid eye disease. In this pilot study, the authors investigated the effects of retrobulbar bimatoprost injection on the intraocular pressure and orbital fat in a rat animal model. Methods: Three rats were sedated and intraocular pressure was measured. A 0.1 ml aliquot of bimatoprost was injected into the right orbit of all rats. In the left orbit, 0.1 ml of phosphate-buffered saline was injected as a control. Three weeks later, all rats were sedated and intraocular pressure was measured before euthanizing. Routine histologic staining was performed and thin sections through the intraconal orbital fat were obtained. Density of intraconal adipocytes was measured and adipocyte heterogeneity was determined using a computer image analysis algorithm. Results: The specimens injected with bimatoprost demonstrated atrophy of orbital fat with significantly increased adipocyte density (p = 0.009) and heterogeneity (p = 0.008) when compared with control. Intraocular pressure was not significantly decreased at 3 weeks after injection of retrobulbar bimatoprost. Conclusions: In this pilot study, orbital injection of bimatoprost demonstrated atrophy of intraconal adipocytes when compared with control orbits injected with saline. The orbits injected with bimatoprost were noted to have smaller, more heterogeneous adipocytes that were densely packed in the intraconal space. The study limitations include the small sample size, which limited the ability for us to make conclusions about the effect on intraocular pressure. Nevertheless, the findings presented suggest that retrobulbar bimatoprost may present a nonsurgical alternative to induce atrophy of the orbital fat without inducing inflammation or hypotony.Intravenous Steroids With Antibiotics on Admission for Children With Orbital Cellulitis
Purpose: To compare the outcomes of children with orbital cellulitis treated with intravenous (IV) dexamethasone and antibiotics on admission to patients treated with antibiotics alone. Methods: Prospective comparative interventional study. Forty-three children admitted to a tertiary institution with orbital cellulitis were enrolled. On admission, all patients were started on broad spectrum IV antibiotics and parents were offered IV dexamethasone (0.3 mg/kg/d every 6 hours for 3 days). Patients whose parents refused steroid treatment served as the control group. Results: Twenty-eight (65%) patients received IV steroids and antibiotics on admission while 15 (35%) received IV antibiotics alone. Children who received IV steroids had significantly shorter hospital stays than those who did not receive steroids (3.8 ± 0.2 days vs. 6.7 ± 0.3 days; pOrbital Hobnail Hemangioma
A 64-year-old woman presented with a 1 year history of progressive left proptosis and "blurry vision." Imaging studies revealed a left superior orbital mass distorting the optic nerve and superior rectus muscle. Excisional biopsy established the diagnosis of hobnail hemangioma. This report describes the first case of an orbital hobnail hemangioma, a lesion that more commonly presents in the dermis.Volumization of the Brow at the Time of Blepharoplasty: Treating the Eyebrow Fat Pad as an Independent Unit
Purpose: Loss of volume in the sub-brow fat pad with associated descent of the eyebrow is a common anatomical finding resulting in both functional and aesthetic consequences. A variety of techniques have been described to address brow position at the time of blepharoplasty. To our knowledge, none of these techniques treat the sub-brow fat pad as an isolated unit. Doing so enables the surgeon to stabilize and volumize the brow without resultant tension on the blepharoplasty wound. The authors describe a technique for addressing volume loss in the eyebrow with associated brow descent that treats the sub-brow fat pad as an isolated unit. Methods: A retrospective review of all patients undergoing brow ptosis repair by a single surgeon (J.W.S.) over an 11-month period was performed. Results: Eighteen patients and 33 brows underwent the technique described. Patients were followed for an average of 11 weeks (range: 4 weeks to 20 weeks). All patients preoperatively displayed both visually significant dermatochalasis and brow descent below the orbital rim. Evaluation of pre- and postoperative photos demonstrates successful volumization of the brow with skin redraping without focal dimpling or undue tension on the eyelid wound. Conclusions: Performing a dissection that allows the sub-brow fat pad to be elevated in isolation from the overlying orbicularis and underlying periosteum allows for volumization and of the brow without compromising closure. This technique is a safe and effective means of volumizing the brow and treating secondary brow descent.Anomalous Sphenoid Diploe Vein: Case Report Highlighting the Value of Careful CT Evaluation Prior to Decompression Surgery
Lateral bony decompression may offer several biomechanical advantages and has become a commonly used surgical approach. Preoperative imaging plays a key role in surgical planning by providing information about the locoregional anatomy. The marrow space of the greater wing of the sphenoid is a focal point of the decompression surgery based on the volume that it occupies. Several vessels pass through the sphenoid bone, but most are small caliber vessels. The authors describe a case of an uncommon anatomical variant of the cranial diploic venous system in which the anterior transverse diploic vessel traverses the marrow space of the sphenoid. The vessel was identified on preoperative CT evaluation. Despite anticipation of potential bleeding, lateral decompression was abandoned due to difficulties in maintaining hemostasis which compromised the view for safe surgical progress.Endoscopic Corneal Neurotization: Cadaver Feasibility Study
Purpose: The authors describe a cadaver feasibility study investigating a minimally invasive technique for corneal neurotization with the supraorbital nerve harvested endoscopically. Methods: A cadaver study was performed to investigate the technical feasibility of corneal neurotization via endoscopic supraorbital nerve transfer to the corneoscleral limbus. Results: Endoscopic corneal neurotization was successfully performed on each cadaveric hemiface. Conclusion: The use of an endoscope allows for a minimally invasive approach to corneal neurotization with the supraorbital nerve.Fibrous Histiocytoma of the Lacrimal Sac in an 11-Year-Old Male
Fibrous histiocytoma is a soft tissue tumor with cells resembling both fibroblasts and histiocytes. Occasionally in the orbit, they rarely arise in the lacrimal sac. Similar to prior cases described, the patient presented with symptoms of epiphora and a slowly enlarging mass inferior to the right medial canthus. Imaging demonstrated a circumscribed 1.2 cm × 1.1 cm × 1.1 cm mass within the lacrimal sac without surrounding bony destruction. Grossly, the tumor appeared homogenous and rubbery. Pathologic study results from the case demonstrated zones of hypercellularity and hypocellularity with a fibrous appearance, admixed with spindle cells and collections of foamy histiocytes. A diagnosis of benign fibrous histiocytoma was rendered, with the patient experiencing a complete resolution of symptoms at subsequent follow up. To the authors' knowledge, this is the first reported solitary case report of a fibrous histiocytoma of the lacrimal sac in a pediatric patient.Visual Outcomes and Local Control After Fractionated Stereotactic Radiotherapy for Optic Nerve Sheath Meningioma
Purpose: To review the outcomes of patients with optic nerve sheath meningiomas (ONSM) treated with fractionated stereotactic radiotherapy. Methods: Patient characteristics, treatment, and outcomes were analyzed for all patients with primary and secondary ONSM treated from 2001 to 2012. Clinically significant visual acuity change was defined as a 2-line change on the Snellen eye chart from pre-fractionated stereotactic radiotherapy. Results: Forty-one patients were treated: 23 patients with primary ONSM and 18 patients with secondary ONSM. The median age at diagnosis was 56 years. The median visual follow up was 3.8 years and the median radiologic follow up was 4.4 years. At diagnosis, 36% had normal vision (20/20–20/40), 10% had mild impairment (
Differences in Wait Times for Cosmetic Blepharoplasty by ASOPRS Members
Purpose: Adequate access to subspecialty care is of concern to patients and physicians alike. One measure of availability is the wait time for cosmetic procedures. The authors investigated geographical differences in wait times for cosmetic upper eyelid blepharoplasty of American Society of Ophthalmic Plastic and Reconstructive Surgery members across the country. Methods: This study surveyed all 533 American Society of Ophthalmic Plastic and Reconstructive Surgery members' practices in the United States based on the publically available contact information (www.asoprs.org). Scripted telephone calls were made requesting self-referred cosmetic upper eyelid blepharoplasty. Wait times until the first available appointment and time until the first available surgery date were collected. Results: Of the membership, 387 (72.6% response rate) respondents offered appointments for cosmetic upper eyelid blepharoplasty. Overall, 84.2% of respondents were male. Practice breakdown was 83.4% in private practice and 16.5% in academic practice. Median wait time until the next available appointment was 14 days (mean 21.2 days, 0–205 days; p = 0.145). Private practice wait time was shorter than academic (median 14 vs. 18 days, mean 19.7 vs. 28.9 days; p =0.004). However, there was wide variability based on region. Conclusions: Patients seeking cosmetic upper eyelid blepharoplasty have good access to care by American Society of Ophthalmic Plastic and Reconstructive Surgery members. There are variabilities based on academic versus private practice. Further study can evaluate whether similar findings exist for medically necessary functional procedures. This information may help assess the need for additional practitioners.Inflammatory Mediators in Xanthelasma Palpebrarum: Histopathologic and Immunohistochemical Study
Purpose: To evaluate the expression of inflammatory mediators in xanthelasma palpebrarum. Methods: In this retrospective histopathologic case–control study, xanthelasma specimens obtained from the private practice and pathology archives of 1 author (R.Z.S.) were analyzed and compared with the blepharoplasty tissues from age- and sex-matched controls. Paraffin-embedded tissue sections were stained with hematoxylin–eosin and CD3, CD20, CD163, cyclooxygenase-1, inducible nitric oxide synthase, matrix metallopeptidase-9, and myeloperoxidase antibodies. Immunostaining was quantified by light microscopy and with a computerized image analysis system of scanned images. Results: Hematoxylin–eosin-stained preparations of xanthelasma specimens demonstrated significantly more intense chronic lymphocytic infiltrate when compared with the control blepharoplasty tissues (pMesenchymal Chondrosarcoma of the Lacrimal Gland
A 23-year-old woman presented with right-sided painless proptosis that developed in 12 months. MRI studies demonstrated a well-delineated tumorous enlargement of the right lacrimal gland with homogenous signal intensity and compressing the globe. The tumor was removed totally and in 1 piece with the tentative diagnosis of a pleomorphic adenoma. Pathologic examination revealed biphasic neoplastic elements, which were composed of the cartilaginous matrix and small round cell component. Immunohistopathological examination showed positive CD99 staining and negative reaction to S100, panCK, and CD15. The patient then received a total of 64 Gy orbital radiotherapy in 32 fractionations. There has been no recurrence or metastasis during 14 months of follow up. This case showed that mesenchymal chondrosarcoma may arise from the lacrimal gland and must be considered in the differential diagnosis of lacrimal gland tumors in young adults.Scleral Contact Lenses in an Academic Oculoplastics Clinic: Epidemiology and Emerging Considerations
Purpose: To describe the role and efficacy of scleral contact lenses (SCLs) in the treatment of progressive keratopathy in patients who have undergone periocular surgical procedures, to investigate the financial impact of these surgical interventions, and to demonstrate the role of oculoplastic surgery in improving scleral contact lens fit. Methods: A retrospective medical record review was performed to identify patients who both received SCLs and were examined by the oculoplastics service at the University of Iowa between January 1990 and December 2015. Inclusion criteria also required a minimum of 12 months of patient follow up after being fit with a SCL. The indication for SCL use, as well as clinical outcomes and cumulative relative value units (RVUs) of prior oculoplastic treatments and SCL therapy were recorded for each patient. Results: Six hundred and fifty-nine patients were fitted with SCLs at the authors' institution during the 25-year study period, 43 of whom were examined by the oculoplastics service for reasons related to their SCL. Patients who were fitted for SCLs before (27 patients) or after (16 patients) evaluation in the oculoplastics clinic presented with a variety of corneal and periocular pathology. Corneal indications for SCLs in patients seen secondarily in the oculoplastics clinic included decreased corneal sensation (from CN V palsy or neurotrophic keratopathy), decreased corneal healing from limbal stem cell deficiency, exposure keratopathy, and keratoconjunctivitis sicca secondary to Sjogren's syndrome or orbital radiation. Indications for oculoplastic clinic evaluation in current scleral lens patients included lagophthalmos, trichiasis, epiphora, cicatricial changes in the eyelids or fornices, and eyelid or eyebrow malposition affecting SCL centration. In all 27 patients, surgical intervention resulted in improved SCL centration. Sixteen patients (5 with CN VII palsy, 4 with CN V and CN VII palsy, 4 with neurotrophic keratitis, and 3 with cicatricial entropion) had progressive corneal decompensation despite primary oculoplastics procedures to protect the cornea and ultimately benefitted from SCL treatment secondarily. Fourteen of these 16 patients demonstrated an improved visual acuity of 1 line or more using SCLs. Procedures performed before referral for SCLs included tarsorrhaphies, gold weights, ectropion repair with lateral tarsal strip, retraction repair with spacer grafts, full-thickness skin grafts, cheek lifts, and punctal occlusion. The total RVUs of these procedures performed per patient were tabulated. The RVU range was 10.47–33.96 with an average of 19.5 RVUs (standard deviation = 9.4 RVUs) per patient. Conclusions: Scleral contact lenses may offer a useful alternative to stabilize the ocular surface, improve vision, and minimize the financial impact and morbidity of multiple periocular procedures in select patients with progressive keratopathy of varying etiologies. The therapeutic indications and utilization of SCLs are likely to increase in oculoplastic practices with optometric support, particularly in academic settings. Surgical correction of eyelid and eyebrow malposition, as well as epiphora, may also be useful adjunctive procedures to optimize SCL fit.Biopsy-Proven Metastatic Merkel Cell Carcinoma to the Orbit: Case Report and Review of Literature
Merkel cell carcinoma is a rare neuroendocrine tumor of subspecialized dermal mechanoreceptors, associated with immunosuppression. The usual ophthalmic presentation is an eyelid lesion. The authors present a case of biopsy-proven orbital metastatic Merkel cell carcinoma in the absence of any eyelid lesion, in an immunosuppressed patient with a history of multiple cancers. There are to the authors' knowledge only 2 other case reports of presumed metastatic Merkel cell carcinoma to the orbit, though neither were biopsied. Despite its rarity, metastatic Merkel cell carcinoma should be included in the differential of a metastatic orbital lesion, in the patient with a known or suspected cutaneous primary. The patient has had an excellent response to combined radiotherapy and programmed death-1 inhibitor pembrolizumab, and this case highlights the potential benefit of an exciting new biologic therapy.Blepharoplasty Effect on a Described Algorithmic Approach to External Ptosis Repair: Is It Time for Unbundling?
Purpose: To investigate the effects of performing a previously described algorithmic levator resection for involutional ptosis with a blepharoplasty instead of through a small incision. Methods: Eyelids with involutional ptosis and normal levator function were included in the study. An upper blepharoplasty was performed first. An external levator resection was then performed based on a described technique involving 2 mm resection of aponeurosis for 1 mm of desired lift, consistent tension on the aponeurosis between surgical cases, and standardized suture placement. Results: Forty-one eyelids of 25 patients were included. Mean postoperative margin to reflex distance 1 (MRD1) was 2.98 mm, which was significantly higher than preoperative MRD1 (0.67 mm), but lower than the predetermined goal MRD1 (3.35 mm). Eight eyelids did not meet primary outcome of MRD1 within 1 mm of goal MRD1, with 5 undercorrections. There was no difference between the postoperative MRD1 compared with the same ptosis technique performed through a small incision only, but there were more intraoperative suture adjustments and fewer eyelids meeting the primary outcome when a concurrent blepharoplasty was performed. Conclusions: The addition of blepharoplasty with a previously described algorithmic approach external levator resection has an 80% success rate in achieving the primary outcome. When compared with a small-incision ptosis repair, concurrent blepharoplasty results in a less predictable outcome and an increased need for intraoperative adjustment. Performing an algorithmic technique for external levator resection with a blepharoplasty has less predictable outcomes, which raises the question of separating the procedures to improve patient care.Nasal Glioma: A Rare Cause of Congenital Inner Canthal Swelling
Nasal glioma, encephalocele, and ectopic brain are rare congenital anomalies. The terminology applied to these entities has been historically confusing. In many cases, the terms overlap and may be employed synonymously although some authors emphasize their differences. The authors describe herein a child with an inner canthal mass of brain-like tissue that they interpret as nasal glioma, a variety of encephalocele that has lost its connection to the intracranial contents. This research was conducted in conformity with the Helsinki Declaration and Health Insurance Portability and Accountability Act regulations.Utility of PROSE Device in the Management of Complex Oculoplastic Pathology
Purpose: To describe the use of Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) device in the management of complex oculoplastic pathology. Methods: The authors retrospectively reviewed the records of individuals over 18 years of age who were referred and successfully fit with the PROSE scleral device between January 1995 and June 2015. Results: Nine cases were identified that had complex oculoplastic disease and severe corneal surface disease. All patients with ptosis had improvement in marginal reflex distance-1 following PROSE and 5 of 7 patients with ptosis were spared further surgical intervention. Two underwent surgical repair with successful corneal stabilization with PROSE. Those with eyelid malposition including ectropion, entropion, or trichiasis experienced improvement in their corneal surface and deferred further surgical intervention. Conclusions: These cases highlight the use of the PROSE device to elevate the upper eyelid in patients with lagophthalmos and ptosis, stabilize the corneal surface to allow for additional eyelid surgery to be performed safely, and protect the corneal surface in patients with intractable trichiasis and entropion. Prosthetic Replacement of the Ocular Surface Ecosystem should be considered in patients with complex oculoplastic pathology to improve visual function, corneal surface disease, and eyelid position.Basic Photographic Standards for Abdominal Contouring Procedures and Abdominoplasty/Lipectomy
Abstract
Standardized reliable medical photographic documentation should be made by every plastic surgeon for valid comparisons of preoperative and post-operative illustrations. However, photographic documentation in aesthetic surgery has also an important medico-legal impact as if not performed accurately it can result in severe legal ramifications. Therefore, we evaluated and redefined the existing photographic standards for abdominal contouring procedures and abdominoplasty/lipectomy further, to achieve consistent detailed photographs without any corresponding distortion or distraction. The results of the modification in standardized photographic documentation in aesthetic abdominoplasty and lipectomy are based on the basic principles of photography in plastic and aesthetic surgery and are presented in this article.
Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Influence of Flap Thickness on Nipple Projection After Nipple Reconstruction Using a Modified Star Flap
Abstract
Background
In nipple reconstruction, the width, length, and thickness of modified star flaps are concerns for long-term reconstructed nipple projection. However, the flap's projection has not been analyzed, based on its thickness. The aim of the present study was to investigate how flap thickness in a modified star flap influences the resulting reconstructed nipple and achieves an appropriate flap width in design.
Methods
Sixty-three patients who underwent nipple reconstruction using a modified star flap following implant-based breast reconstruction between August 2014 and July 2016 were included in this case-controlled study. The length of laterally diverging flaps was 1.5 times their width. The thickness of each flap was measured using ultrasonography, and the average thickness was defined as the flap thickness. We investigated the correlation between the resulting reconstructed nipple and flap thickness, and the difference of the change in the reconstructed nipple projection after using a thin or thick flap.
Results
The average flap thickness was 3.8 ± 1.7 (range 2.5–6.0) mm. There was a significant, linear correlation between the flap thickness and resulting reconstructed nipple projection (β = 0.853, p < 0.01). Furthermore, the difference between the thin and thick flaps in the resulting reconstructed nipple projection was significant (p < 0.01).
Conclusion
Measuring the flap thickness preoperatively may allow surgeons to achieve an appropriate flap width; otherwise, alternative methods for higher projection might be used.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Reply To: “The impact of a career night information session on medical students' perceptions of the scope of practice of plastic surgeons.”
Publication date: Available online 7 May 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Tyler Safran, Benjamin Beland, Alex Viezel-Mathieu, James Lee
Protective effects of conventional and colon-targeted lycopene and linalool on ulcerative colitis induced by acetic acid in rats
Abstract
Objective
To compare the potential protective effects of conventional and colon-targeted lycopene (TLC) and linalool (TLN) on acetic acid (AA)-induced ulcerative colitis (UC) in rats.
Methods
Conventional and colon-targeted LC (10 mg/kg) and LN (200 mg/kg) were administered in vivo orally for 7 days and sulfasalazine (100 mg/kg) was also used as reference drug. Then, 4% AA was administered intrarectally to induce UC. Subsequently, the colon tissues were taken as samples for biochemical and histopathological analysis.
Results
Malondialdehyde (MDA), interleukin 1β (IL-1β), IL-6, cyclooxygenase-2 (COX-2) and nuclear factor kappa B (NF-κB) levels were decreased (p < 0.05) in the targeted groups compared to the AA group, whereas nuclear factor-erythroid 2-related factor 2 (Nrf-2) level was increased (p < 0.05). Tumor necrosis factor α (TNF-α) level was also decreased (p < 0.05) and catalase activity (CAT) was increased (p < 0.05) in the TLC group compared to the AA group. IL-1β and IL-6 levels were lower in the TLC group compared to the conventional LC and sulfasalazine groups (p < 0.05). COX-2 and NF-κB levels were lower, while the Nrf-2 level was higher in the targeted groups compared to the conventional groups (p < 0.05). Furthermore, COX-2 level was lower and Nrf-2 level was higher in the targeted groups compared to the sulfasalazine group (p < 0.05).
Conclusion
As expected, sulfasalazine was effective on all parameters analyzed, but the colon-targeted pretreatments were more effective from sulfasalazine on some parameters. Therefore, colon-targeted plant-derived therapies might be alternative approaches to provide protection against UC, which deserves to be investigated further.
Osthole ameliorates neurogenic and inflammatory hyperalgesia by modulation of iNOS, COX-2, and inflammatory cytokines in mice
Abstract
Background
Osthole is a bioactive component reported in medicinal plants such as Angelica pubescens and Cnidium monnieri, known for analgesic activity. However, the toxicity, median effective dose (ED50), and dual modulation of nitric oxide and cyclooxygenase pathways along with inflammatory cytokines of osthole are yet to be determined.
Methods
The animals (mice) were assessed for general behaviour and mortality in varying doses (50, 300, and 2000 mg kg−1) of osthole for acute toxicity over 14 days. The analgesic activity was investigated using acetic acid and formalin-induced hyperalgesia, and anti-inflammatory activity was explored in carrageenan-induced paw oedema. ED50 of osthole was calculated using Design Expert software. Involvement of nitric oxide and cyclooxygenase pathways was investigated by agonist challenges with l-arginine and substance P, respectively. The expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) was determined in spinal sections by immunohistochemical analysis. Lipopolysaccharide (LPS) challenge was used to assess in vivo effect on inflammatory cytokines (TNFα and IL-6).
Results
Acute toxicity studies revealed no behavioural abnormality or mortality on osthole treatment and unremarkable histological findings. Osthole was found to significantly decrease acetic acid and formalin-induced hyperalgesia (ED50 = 5.43 mg kg−1) and carrageenan-induced paw oedema with no toxicity symptoms. Osthole produced a marked decrease in iNOS and COX-2 expression as well as TNFα and IL-6. The findings corroborate to modulation of iNOS and COX-2 and inflammatory cytokines by osthole. This study provides promising insights and prospects for application of osthole in pain management.
Is the pharmaceutical industry’s preoccupation with the monotherapy drug model stifling the development of effective new drug therapies?
Abstract
Drug discovery and development is heavily biased towards the development of monotherapies. Screening, testing, and evaluation of mono-entity drugs are generally much simpler than drug combinations, and are generally easier to get approval from the regulatory authorities for their clinical use. However, monotherapy drugs may not have optimal activity, may have associated toxicities, or may lose activity over time as their target develops resistance. Drug combinations, often developed from existing monotherapies, may have improved efficacy and/or be less toxic. Furthermore, the existing drugs which have lost efficacy due to the development of resistance can often be re-activated by combining them with other chemical entities. Thus, whilst the current climate for drug approval, registration, and clinical use drives the majority of drug development research towards the development of monotherapies, combinations are often a substantial improvement on the original drug. This commentary examines monotherapy and combinational therapy models and discusses the benefits and limitations of each model.
Microarray-based expression analysis of phytohormone-related genes in rice seedlings during cyanide metabolism
Abstract
Plants exhibit highly coordinated, dynamic reactions to various abiotic stressors. As cyanide is a non-essential element for plant growth, entry inside plants can exert toxicity at multiple levels. In plant, hormone plays a pivot role under stress conditions. The fluctuations of stress-responsive hormones help in altering cellular dynamics and hence play a central role in coordination and adaptation growth responses under stress. This study focusses on uptake of cyanide in Oryza sativa seedlings and its effect on physiological and on genetic level. Microarray approach has been focused on transcriptional profiling of genes which are involved in systemic acquired resistance for cyanide. Our study shows that the change in different hormonal contents maintained almost the same pattern in roots and shoots upon CN exposure, except for SA. However, the hormone-related gene expression pattern conducted by microarray analysis was inconsistent in both plant materials (root/shoots). Comparison of gene expression between root/shoots showed a total of 29 in roots and 16 DEGs, respectively, indicating that hormone-related genes in roots were more responsive than those in shoots during exogenous CN metabolism. These results showed a remarkable change at transcript level of plant hormone-related genes, including biosynthesis, degradation, induction, and signal transduction under cyanide stress.
Does nitrite and nitrate levels in drinking water impact the health of people in Dakahlia governorate, Egypt?
Abstract
A total of 1291 drinking water samples were examined for nitrite and nitrate during 6 months from December, 2015 to May, 2016 at 17 cities of Dakahlia governorate (Nile Delta, north of Egypt), and the results were utilized for assessment of health risk of the exposure from drinking water by calculating average daily intake (ADI), hazard quotient (HQ), and the hazard index (HI). The nitrite and nitrate in drinking water had a concentration range of 0.030–0.113 and 2.41–8.70 mg L−1, with mean values of 0.059 ± 0.014 and 5.25 ± 1.61 mg L−1, respectively. Nitrite and nitrate levels in rural areas and ground water samples were significantly higher than that in the urban ones. None of the analyzed samples exceeded WHO guideline values that set out to prevent methemoglobinemia. The values of HQ and HI for all age groups do not exceed unity indicating a low risk of methaemoglobinaemia for the population in this area. Results of the present study indicate that there is no health risk of residents from nitrite and nitrate through drinking water in the studied area. However, the other sources of exposure to nitrite and nitrate should be investigated in further studies.
Effects of compost and technosol amendments on metal concentrations in a mine soil planted with Brassica juncea L.
Abstract
Mining activities often cause important impacts on soil and water quality. The main objective of this study was to evaluate the effect of amendments (compost and technosol made from waste) on metal concentrations in a mine soil planted with Brassica juncea. A greenhouse experiment with cylinder pots was carried out during 11 months. The mine soil was collected from the settling pond of the depleted copper mine of Touro (Galicia, Northwest Spain). A series of characteristics were analysed including soil pseudototal metal concentrations, soil CaCl2-extractable (phytoavailable) metal concentrations and metal concentrations in soil pore water. The results showed that at depth 0–15 cm SCP (mine soil + compost, grown with B. juncea) had a significantly lower CaCl2-extractable Cu, Pb, Ni and Zn concentration than STP (mine soil + technosol, grown with B. juncea) over the time (P < 0.05). At depths 15, 30 and 45 cm, STP and SCP had lower Cu pore water concentration than S over the time. The highest translocation factor (TF) values for all metals (Cu, Pb, Ni and Zn) were observed at time 1 (3 months) in the settling pond soils treated with technosol and B. juncea L. The conclusions of this experiment revealed that SCP compared to STP caused a higher reduction on Cu, Pb, Ni and Zn phytoavailable concentrations in the first depths.
Cyclooxygenase and lipoxygenase gene expression in the inflammogenesis of breast cancer
Abstract
We examined the expression of major inflammatory genes, cyclooxygenase-1 and 2 (COX1, COX2) and arachidonate 5-lipoxygenase (ALOX5) in 1090 tumor samples of invasive breast cancer from The Cancer Genome Atlas (TCGA). Mean cyclooxygenase expression (COX1 + COX2) ranked in the upper 99th percentile of all 20,531 genes and surprisingly, the mean expression of COX1 was more than tenfold higher than COX2. Highly significant correlations were observed between COX2 with eight tumor-promoting genes (EGR2, IL6, RGS2, B3GNT5, SGK1, SLC2A3, SFRP1 and ETS2) and between ALOX5 and ten tumor promoter genes (CD33, MYOF1, NLRP1, GAB3, CD4, IFR8, CYTH4, BTK, FGR, CD37). Expression of CYP19A1 (aromatase) was significantly correlated with COX2, but only in tumors positive for ER, PR and HER2. Tumor-promoting genes correlated with the expression of COX1, COX2, and ALOX5 are known to effectively increase mitogenesis, mutagenesis, angiogenesis, cell survival, immunosuppression and metastasis in the pathogenesis of breast cancer.
Hierarchical protein export mechanism of the bacterial flagellar type III protein export apparatus
Abstract
The bacterial flagellum is supramolecular motility machinery consisting of the basal body, the hook and the filament. Flagellar proteins are translocated across the cytoplasmic membrane via a type III protein export apparatus, diffuse down the central channel of the growing structure and assemble at the distal end. Flagellar assembly begins with the basal body, followed by the hook and finally the filament. The completion of hook assembly is the most important morphological checkpoint of the sequential flagellar assembly process. When the hook reaches its mature length of about 55 nm in Salmonella enterica, the type III protein export apparatus switches export specificity from proteins required for the structure and assembly of the hook to those responsible for filament assembly, thereby terminating hook assembly and initiating filament assembly. Three flagellar proteins, namely FliK, FlhB and FlhA, are responsible for this substrate specificity switching. Upon completion of the switching event, interactions among FlhA, the cytoplasmic ATPase complex and flagellar type III export chaperones establish the assembly order of the filament at the hook tip. Here, we describe our current understanding of a hierarchical protein export mechanism used in flagellar type III protein export.Infection risk in gyms during physical exercise
Abstract
This study aimed to analyze the risk of infection (influenza and tuberculosis) for individuals participating in physical exercise. This was achieved by assessment of carbon dioxide (CO2) concentrations, and examination of the physical characteristics of a number of gyms to determine whether there was a relationship to CO2 levels. This study was performed in three different gyms ventilated with either split system or central system air conditioners. The risk of airborne infection (percent of susceptible persons infected) was estimated for each gym using the Wells-Riley model. The risk of infection increased during periods of peak occupancy where the ventilation required by occupants was greater. In each gym, the highest risk of infection occurred during the evening where occupancy and CO2 levels were high. The infection risk for influenza was high in all situations due to the high quantum generation rate for this agent. This study suggests that inefficient ventilation in gyms is a significant problem, with high CO2 concentrations resulting in impaired air quality and high health risks to users, including increased risk of infections such as influenza and tuberculosis.
Characterization, preparation, and uses of nanomagnetic Fe 3 O 4 impregnated onto fish scale as more efficient adsorbent for Cu 2+ ion adsorption
Abstract
In this research, the Cu2+ ion adsorption from aqueous solution was investigated by fish scale (FS) and nanomagnetic (Fe3O4) loaded fish scale (MFS) from fishery biomass. We characterized the structure and morphology of synthesized magnetic adsorbent by Fourier transform infrared spectroscopy (FTIR), FESEM, and XRD. The FTIR and XRD tests confirmed the collagen fibers, apatite crystals, and nanomagnetite particles presence in the MFS structure. The isotherm models of Langmuir, Freundlich, and Dubinin-Radushkevich were exerted to the empirical equilibrium data, by which was found that the Langmuir equation have the best fit to the experimental data in comparison to the other isotherm equations. The maximum capacities of monolayer coverage of FS and MFS for adsorption of Cu2+ ions were achieved, respectively, 61.73 and 103.1 mg g−1 based on Langmuir isotherm at 45 °C. It was also discovered that the Cu2+ ion adsorption onto MFS was totally a physisorption-controlled process. It was perceived that the model of pseudo-second order rate kinetics also could be applied for predicting of studied adsorption processes. Here, the adsorption was a spontaneous and endothermic process because of the negative and the positive values of ∆G0 and ∆H0, respectively. The reusability potential of the used adsorbents was studied, so that the results showed an efficiency of 76.5 and 83.92% for FS and MFS, respectively, after four adsorption-desorption cycles.
Development of bark-based magnetic iron oxide particle (BMIOP), a bio-adsorbent for removal of arsenic (III) from water
Abstract
Novel low-cost bark-based magnetic iron oxide particles (BMIOPs) were synthesized and investigated for the removal of As(III) in drinking water. The synthesized BMIOP had a saturation magnetization value of 38.62 emug−1 which was found to be enough for the magnetic separation of exhausted BMIOP after As(III) adsorption. Parameters like agitation speed, adsorbent dosage, contact time, pH, temperature, and initial concentration were thoroughly investigated. Langmuir, Freundlich, and Dubinin–Radushkevich isotherms were used for the modeling of experiments and observed a maximum adsorption (19.61 mg g−1) of As(III) by Langmuir isotherm. Kinetics of As(III) sorption were well correlated with the coefficients in pseudo-first-order than the pseudo-second-order rate equation. Thermodynamic parameter investigation revealed that As(III) sorption process is endothermic, feasible, and spontaneous. BMIOP emerged as less expensive adsorbent for the abatement of arsenic ion from the drinking water. BMIOP showed 13.58 mg g−1 adsorption capacity when As(V) alone is present, while it is 9.43 and 7.04 mg g−1 for As(V) and As(III), respectively, when present together in the water.
Graphical Abstract
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Cluster Randomized Test-Negative Design (CR-TND) Trials: A Novel and Efficient Method to Assess the Efficacy of Community Level Dengue Interventions
Abstract
Cluster randomized trials are the gold standard for assessing efficacy of community-level interventions, such as vector control strategies against dengue. We describe a novel cluster randomized trial methodology with a test-negative design, which offers advantages over traditional approaches. It utilizes outcome-based sampling of patients presenting with a syndrome consistent with the disease of interest, who are subsequently classified as test-positive cases or test-negative controls on the basis of diagnostic testing. We use simulations of a cluster trial to demonstrate validity of efficacy estimates under the test-negative approach. This demonstrates that, provided study arms are balanced for both test-negative and test-positive illness at baseline and that other test-negative design assumptions are met, the efficacy estimates closely match true efficacy. We also briefly discuss analytical considerations for an odds ratio-based effect estimate arising from clustered data, and outline potential approaches to analysis. We conclude that application of the test-negative design to certain cluster randomized trials could increase their efficiency and ease of implementation.Tim‐3 exacerbates kidney ischaemia/reperfusion injury through the TLR‐4/NF‐κB signalling pathway and an NLR‐C4 inflammasome activation
Clinical &Experimental Immunology, EarlyView.
Correction to: Morphological characteristics of chronic total occlusion: predictors of different strategies for long-segment femoral arterial occlusions
Abstract
The original version of this article unfortunately contained mistakes. The legends to Figs. 2–4 were incorrectly interchanged. The correct versions are given below. The original article has been corrected.
Baseline neutrophil‐to‐lymphocyte ratio in patients with advanced melanoma treated with immune checkpoint inhibitors: reply from the authors
British Journal of Dermatology, EarlyView.
Reply to: Frequency of squamous cell carcinoma in situ (SCCIS) and SCC in re‐excisions of biopsy‐proven cutaneous SCCIS
British Journal of Dermatology, EarlyView.
Whole-body ultra-low dose CT using spectral shaping for detection of osteolytic lesion in multiple myeloma
Abstract
Objectives
The aim of this study was to investigate the radiation dose and image quality of a whole-body low-dose CT (WBLDCT) using spectral shaping at 100 kV (Sn 100 kV) for the assessment of osteolytic lesions in patients with multiple myeloma.
Methods
Thirty consecutive patients were retrospectively selected, who underwent a WBLDCT on a third-generation dual-source CT (DSCT) (Sn 100 kV, ref. mAs: 130). They were matched with patients, who were examined on a second-generation DSCT with a standard low-dose protocol (100 kV, ref. mAs: 111). Objective and subjective image quality, radiation exposure as well as the frequency of osteolytic lesions were evaluated.
Results
All scans were of diagnostic image quality. Subjective overall image quality was significantly higher in the study group (p = 0.0003). Objective image analysis revealed that signal intensities, signal-to-noise ratio and contrast-to-noise ratio of the bony structures were equal or significantly higher in the control group. There was no significant difference in the frequency of osteolytic lesions (p = 0.259). The median effective dose of the study protocol was significantly lower (1.45 mSv vs. 5.65 mSv; p < 0.0001).
Conclusion
WBLDCT with Sn 100 kV can obtain sufficient image quality for the depiction of osteolytic lesions while reducing the radiation dose by approximately 74%.
Key points
• Spectral shaping using tin filtration is beneficial for whole-body low-dose CT
• Sn 100 kV yields sufficient image quality for depiction of osteolytic lesions
• Whole-body low-dose CT can be performed with a median dose of 1.5 mSv
Use of the Kwak Thyroid Image Reporting and Data System (K-TIRADS) in differential diagnosis of thyroid nodules: systematic review and meta-analysis
Abstract
Purpose
The purpose of this systematic literature review was to assess the usefulness of the Thyroid Image Reporting and Data System (K-TIRADS) classification proposed by Kwak for differentiation of thyroid nodules.
Material and methods
Four literature databases were searched for relevant articles through early January 2017. A meta-analysis was performed to calculate pooled sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-) and diagnostic odds ratio (DOR). The area under the curve (AUC) from the pooled receiver operating characteristic (ROC) was used to assess the usefulness of this classification for differentiation of thyroid nodules. Meta-analysis was conducted by using meta-analysis software.
Results
We analysed six publications describing 10,926 nodules. Pooled sensitivity, specificity, LR+, LR-, DOR, and AUC for pooled ROC were 0.983 (95 % CI 0.976–0.989), 0.552 (95 % CI 0.542–0.562), 2.666 (95 % CI 1.692–4.198), 0.05 (95 % CI 0.035–0.072), 51.020 (95 % CI 15.241–170.79) and 0.938, respectively.
Conclusions
Kwak TIRADS has high sensitivity and low specificity. Thus, it is very useful to discard the benign cases and to reduce the number of biopsies.
Key Points
• Routine, adequate standardization of thyroid nodules ultrasound classification is mandatory.
• Kwak TIRADS parameters are accurate for differentiating focal thyroid lesions.
• Kwak TIRADS system is simple to apply.
• Kwak TIRADS system may become a useful diagnostic tool.
Significance of hyperechoic marks observed during high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules
Abstract
Objective
To examine the association between the appearance of hyperechoic marks (HEMs) during high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules and nodule shrinkage at 6 months.
Methods
One hundred and thirty-six patients who underwent HIFU for benign thyroid nodule were analysed. An independent person carefully examined the B-mode ultrasonography screen for the appearance of HEMs after each pulse. The proportion of HEMs (%) was calculated by: [(Number of pulses that resulted in HEMs) / (Total number of pulses given per treatment) × 100] while the nodule shrinkage was measured by volume reduction ratio (VRR) = [Baseline volume–volume at 6 months]/[Baseline volume] * 100. Treatment success was defined as VRR ≥ 50 %.
Results
Patients with HEMs (n=91) had significantly greater 6-month VRR than those without HEMs (n=45) (65.76 % vs. 36.76 %, p<0.001). By regression analysis, after adjusting for age and energy per pulse, smaller nodule volume at baseline (OR 1.143, 95 % CI 1.038–1.256, p=0.006) and appearance of HEMs (OR 275.44, 95 % CI 26.63–2848.98, p<0.001) were independent predictors for treatment success.
Conclusions
The appearance of HEMs during treatment was an independent determinant of treatment success following single-session HIFU ablation of benign thyroid nodule.
Key Points
• HIFU is a safe and effective treatment for benign thyroid nodules.
• Lower BMI and greater applied power increase likelihood of hyperechoic marks.
• The appearance of hyperechoic marks during HIFU affects subsequent treatment outcome.
Demystifying liver iron concentration measurements with MRI
Abstract
This Editorial comment refers to the article: Non-invasive measurement of liver iron concentration using 3-Tesla magnetic resonance imaging: validation against biopsy. D'Assignies G, et al. Eur Radiol Nov 2017.
Key Points
• MRI is a widely accepted reliable tool to determine liver iron concentration.
• MRI cannot measure iron directly, it needs calibration.
• Calibration curves for 3.0T are rare in the literature.
• The study by d'Assignies et al. provides valuable information on this topic.
• Evaluation of liver iron overload should no longer be restricted to experts.
Gallbladder wall oedema and ascites are independent predictors of progression to hepatic veno-occlusive disease for children with hematopoietic stem cell transplantation
Abstract
Objectives
To evaluate the predictive value of ultrasonography in children with clinically suspicious hepatic veno-occlusive disease (VOD) after hematopoietic stem cell transplantation (HSCT).
Methods
Among 216 children who underwent HSCT, 70 also underwent colour Doppler ultrasonography. Of these, 59 had only one sign/symptom, which did not fulfil the diagnostic criteria (clinical suspicion of VOD) at that time. VOD was confirmed in 20 patients (VOD group), while 39 had other conditions (non-VOD group). The following findings were reviewed and compared between groups: left portal vein (peak velocity, direction), left hepatic artery (peak-systolic/end-diastolic velocities, resistive index), middle hepatic vein (peak velocity, phasicity), hepatomegaly, splenomegaly, gallbladder wall thickness, and ascites.
Results
The VOD group showed significantly higher reversed flow in portal vein (P = 0.011), peak systolic velocity of left hepatic artery (P = 0.028), monophasicity of middle hepatic vein (P = 0.015), hepatomegaly (P = 0.001), gallbladder wall thickness (P < 0.001), and ascites (P < 0.001). Multivariate regression revealed that gallbladder wall thickness and ascites (odds ratio = 35.370, 56.393) were associated with VOD.
Conclusions
The presence of reversed flow in portal vein, increased peak systolic velocity of hepatic artery, monophasicity of hepatic vein, hepatomegaly, gallbladder wall thickness, and ascites were significantly associated with progression to VOD in children with clinically suspicious VOD after HSCT.
Key Points
• Ultrasonography with Doppler can help predict progression to VOD.
• Gallbladder wall oedema and ascites are the independent predictors of progression to VOD.
Impact of noncardiac findings in patients undergoing CT coronary angiography: a substudy of the Scottish computed tomography of the heart (SCOT-HEART) trial
Abstract
Objectives
Noncardiac findings are common on coronary computed tomography angiography (CCTA). We assessed the clinical impact of noncardiac findings, and potential changes to surveillance scans with the application of new lung nodule guidelines.
Methods
This substudy of the SCOT-HEART randomized controlled trial assessed noncardiac findings identified on CCTA. Clinically significant noncardiac findings were those causing symptoms or requiring further investigation, follow-up or treatment. Lung nodule follow-up was undertaken following the 2005 Fleischner guidelines. The potential impact of the 2015 British Thoracic Society (BTS) and the 2017 Fleischner guidelines was assessed.
Results
CCTA was performed in 1,778 patients and noncardiac findings were identified in 677 (38%). In 173 patients (10%) the abnormal findings were clinically significant and in 55 patients (3%) the findings were the cause of symptoms. Follow-up imaging was recommended in 136 patients (7.6%) and additional clinic consultations were organized in 46 patients (2.6%). Malignancy was diagnosed in 7 patients (0.4%). Application of the new lung nodule guidelines would have reduced the number of patients undergoing a follow-up CT scan: 68 fewer with the 2015 BTS guidelines and 78 fewer with the 2017 Fleischner guidelines; none of these patients subsequently developed malignancy.
Conclusions
Clinically significant noncardiac findings are identified in 10% of patients undergoing CCTA. Application of new lung nodule guidelines will reduce the cost of surveillance, without the risk of missing malignancy.
Key Points
• Clinically significant noncardiac findings occur in 10% of patients undergoing CCTA.
• Noncardiac findings may be an important treatable cause of chest pain
• Further imaging investigations for noncardiac findings were recommended in 8% of patients after CCTA.
• New lung nodule follow-up guidelines will result in cost savings.
Apparent diffusion coefficient mapping using diffusion-weighted MRI: impact of background parenchymal enhancement, amount of fibroglandular tissue and menopausal status on breast cancer diagnosis
Abstract
Objectives
To investigate the impact of background parenchymal enhancement (BPE), amount of fibroglandular tissue (FGT) and menopausal status on apparent diffusion coefficient (ADC) values in differentiation between malignant and benign lesions.
Methods
In this HIPAA-compliant study, mean ADC values of 218 malignant and 130 benign lesions from 288 patients were retrospectively evaluated. The differences in mean ADC values between benign and malignant lesions were calculated within groups stratified by BPE level (high/low), amount of FGT (dense/non-dense) and menopausal status (premenopausal/postmenopausal). Sensitivities and specificities for distinguishing malignant from benign lesions within different groups were compared for statistical significance.
Results
The mean ADC value for malignant lesions was significantly lower compared to that for benign lesions (1.07±0.21 x 10−3 mm2/s vs. 1.53±0.26 x 10−3 mm2/s) (p<0.0001). Using the optimal cut-off point of 1.30 x 10−3 mm2/s, an area under the curve of 0.918 was obtained, with sensitivity and specificity both of 87 %. There was no statistically significant difference in sensitivities and specificities of ADC values between different groups stratified by BPE level, amount of FGT or menopausal status.
Conclusions
Differentiation between benign and malignant lesions on ADC values is not significantly affected by BPE level, amount of FGT or menopausal status.
Key Points
• ADC allows differentiation between benign and malignant lesions.
• ADC is useful for breast cancer diagnosis despite different patient characteristics.
• BPE, FGT or menopause do not significantly affect sensitivity and specificity.
Prospective study aiming to compare 2D mammography and tomosynthesis + synthesized mammography in terms of cancer detection and recall. From double reading of 2D mammography to single reading of tomosynthesis
Abstract
Objectives
To evaluate tomosynthesis compared with 2D-mammography in cancer detection and recalls in a screening-programme, and assess performing synthesized instead of 2D, and compare double reading of 2D with single reading of tomosynthesis.
Methods
Women (age 50–69 years) participating in the screening-programme were included. 2D-mammography and tomosynthesis were performed. There were four reading models: 2D-mammography (first); 2D-mammography (second); tomosynthesis + synthesized (third); tomosynthesis + synthesized + 2D (fourth reading). Paired double reading of 2D (first+second) and tomosynthesis (third+fourth) were analysed.
Results
In 16,067 participants, there were 98 cancers and 1,196 recalls. Comparing double reading of 2D with single reading of tomosynthesis, there was an increase of 12.6 % in cancer detection with the third reading (p= 0.043) and 6.9 % with the fourth reading (p=0.210), and a decrease in recalls of 40.5 % (p<0.001) and 44.4 % (p<0.001), respectively. With double reading of both techniques, there was an increase in cancer detection of 17.4 % (p = 0.004) and a decrease in recalls of 12.5 % (p = 0.001) with tomosynthesis.
Conclusion
Single reading of tomosynthesis plus synthesized increased cancer detection and decreased recalls compared with double reading 2D. 2D did not improve results when added to tomosynthesis.
Key Points
• Tomosynthesis increases cancer detection and decreases recall rates versus 2D mammography.
• Synthesized-mammography avoids performing 2D, showing higher cancer detection.
• Single reading of tomosynthesis + synthesized is feasible as a new practice.
Correction to: Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting
Abstract
The article Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting, written by [§§§ AuthorNames §§§]
Fat necrosis after abdominal surgery: A pitfall in interpretation of FDG-PET/CT
Abstract
Objective
We describe FDG-PET/CT findings of postoperative fat necrosis in patients following abdominal surgery, and evaluate their changes in size and FDG uptake over time.
Methods
FDG-PET/CT scans from January 2007–January 2016 containing the term 'fat necrosis' were reviewed. Lesions meeting radiological criteria of fat necrosis in patients with prior abdominal surgery were included.
Results
Forty-four patients, 30 males, mean age 68.4 ± 11.0 years. Surgeries: laparotomy (n=37; 84.1 %), laparoscopy (n=3; 6.8 %), unknown (n=4; 9.1 %). CTs of all lesions included hyperdense well-defined rims surrounding a heterogeneous fatty core. Sites: peritoneum (n=34; 77 %), omental fat (n=19; 43 %), subcutaneous fat (n=8; 18 %), retroperitoneum (n=2; 5 %). Mean lesion long axis: 33.6±24.9 mm (range: 13.0–140.0). Mean SUVmax: 2.6±1.1 (range: 0.6–5.1). On serial CTs (n=34), lesions decreased in size (p=0.022). Serial FDG-PET/CT (n=24) showed no significant change in FDG-avidity (p=0.110). Mean SUVmax did not correlate with time from surgery (p=0.558) or lesion size (p=0.259).
Conclusion
Postsurgical fat necrosis demonstrated characteristic CT features and may demonstrate increased FDG uptake. However, follow-up of subsequent imaging scans showed no increases in size or FDG-avidity. Awareness of this entity is important to avoid misinterpretation of findings as recurrent cancer.
Key Points
• Postsurgical fat necrosis may mimic cancer in FDG-PET/CT.
• Follow-up of fat necrosis showed no increase in FDG intensity.
• CT follow-up showed a decrease in lesion size.
• FDG uptake did not correlate with time lapsed from surgery.
Can histogram analysis of MR images predict aggressiveness in pancreatic neuroendocrine tumors?
Abstract
Objectives
To evaluate MRI derived whole-tumour histogram analysis parameters in predicting pancreatic neuroendocrine neoplasm (panNEN) grade and aggressiveness.
Methods
Pre-operative MR of 42 consecutive patients with panNEN >1 cm were retrospectively analysed. T1-/T2-weighted images and ADC maps were analysed. Histogram-derived parameters were compared to histopathological features using the Mann-Whitney U test. Diagnostic accuracy was assessed by ROC-AUC analysis; sensitivity and specificity were assessed for each histogram parameter.
Results
ADCentropy was significantly higher in G2-3 tumours with ROC-AUC 0.757; sensitivity and specificity were 83.3 % (95 % CI: 61.2–94.5) and 61.1 % (95 % CI: 36.1–81.7). ADCkurtosis was higher in panNENs with vascular involvement, nodal and hepatic metastases (p= .008, .021 and .008; ROC-AUC= 0.820, 0.709 and 0.820); sensitivity and specificity were: 85.7/74.3 % (95 % CI: 42–99.2 /56.4–86.9), 36.8/96.5 % (95 % CI: 17.2–61.4 /76–99.8) and 100/62.8 % (95 % CI: 56.1–100/44.9–78.1). No significant differences between groups were found for other histogram-derived parameters (p >.05).
Conclusions
Whole-tumour histogram analysis of ADC maps may be helpful in predicting tumour grade, vascular involvement, nodal and liver metastases in panNENs. ADCentropy and ADCkurtosis are the most accurate parameters for identification of panNENs with malignant behaviour.
Key Points
• Whole-tumour ADC histogram analysis can predict aggressiveness in pancreatic neuroendocrine neoplasms.
• ADC entropy and kurtosis are higher in aggressive tumours.
• ADC histogram analysis can quantify tumour diffusion heterogeneity.
• Non-invasive quantification of tumour heterogeneity can provide adjunctive information for prognostication.
Myocardial perfusion in patients with suspected coronary artery disease: comparison between 320-MDCT and rubidium-82 PET
Abstract
Objectives
Despite advances in non-invasive myocardial perfusion imaging (MPI) evaluation, computed tomography (CT) multiphase MPI protocols have not yet been compared with the highly accurate rubidium-82 positron emission tomography (82RbPET) MPI. Thus, this study aimed to evaluate agreement between 82RbPET and 320-detector row CT (320-CT) MPI using a multiphase protocol in suspected CAD patients.
Methods
Forty-four patients referred for MPI evaluation were prospectively enrolled and underwent dipyridamole stress 82RbPET and multiphase 320-CT MPI (five consecutive volumetric acquisitions during stress). Statistical analyses were performed using the R software.
Results
There was high agreement for recognizing summed stress scores ≥ 4 (kappa 0.77, 95% CI 0.55–0.98, p < 0.001) and moderate for detecting SDS ≥ 2 (kappa 0.51, 95% CI 0.23–0.80, p < 0.001). In a per segment analysis, agreement was high for the presence of perfusion defects during stress and rest (kappa 0.75 and 0.82, respectively) and was moderate for impairment severity (kappa 0.58 and 0.65, respectively). The 320-CT protocol was safe, with low radiation burden (9.3 ± 2.4 mSv).
Conclusions
There was a significant agreement between dipyridamole stress 320-CT MPI and 82RbPET MPI in the evaluation of suspected CAD patients of intermediate risk. The multiphase 320-CT MPI protocol was feasible, diagnostic and with relatively low radiation exposure.
Key Points
• Rubidium-82 PET and 320-MDCT can perform MPI studies for CAD investigation.
• There is high agreement between rubidium-82 PET and 320-MDCT for MPI assessment.
• Multiphase CT perfusion protocols are feasible and with low radiation.
• Multiphase CT perfusion protocols can identify image artefacts.
A simple method for bone age assessment: the capitohamate planimetry
Abstract
Objectives
To determine if the capitohamate (CH) planimetry could be a reliable indicator of bone age, and to compare it with Greulich-Pyle (GP) method.
Methods
This retrospective study included 391 children (age, 1–180 months). Two reviewers manually measured the areas of the capitate and hamate on plain radiographs. CH planimetry was defined as the measurement of the sum of areas of the capitate and hamate. Two reviewers independently applied the CH planimetry and GP methods in 109 children whose heights were at the 50th percentile of the growth chart.
Results
There was a strong positive correlation between chronological age and CH planimetry measurement (right, r = 0.9702; left, r = 0.9709). There was no significant difference in accuracy between CH planimetry (84.39–84.46 %) and the GP method (85.15–87.66 %) (p ≥ 0.0867). The interobserver reproducibility of CH planimetry (precision, 4.42 %; 95 % limits of agreement [LOA], −10.5 to 13.4 months) was greater than that of the GP method (precision, 8.45 %; LOA, −29.5 to 21.1 months).
Conclusions
CH planimetry may be a reliable method for bone age assessment.
Key Points
• Bone age assessment is important in the work-up of paediatric endocrine disorders.
• Radiography of the left hand is widely used to estimate bone age.
• Capitatohamate planimetry is a reliable and reproducible method for assessing bone age.
Computed tomography findings in ABO-incompatible living donor liver transplantation recipients with biliary strictures
Abstract
Objectives
To evaluate CT findings of biliary strictures in ABO-incompatible living donor liver transplantation (LDLT) recipients, with emphasis on associated 1-month post-transplantation CT findings, and evaluate clinical outcomes.
Methods
Of 351 ABO-incompatible recipients, we retrospectively evaluated CT scans in 65 recipients with biliary stricture. The biliary strictures on CT scans were classified as type A (perihilar) and type B (diffuse). Precedent CT abnormality patterns and the presence of a periportal halo sign at 1-month post-transplantation were evaluated. For each patient, clinical outcomes were evaluated.
Results
Of 65 ABO-incompatible recipients with biliary strictures, 36.9% had type B strictures. Compared with biliary strictures at diagnosis, similar CT abnormality patterns were observed for 84.4% in type A and 86.4% in type B strictures at 1-month post-transplantation. Complex periportal halo signs on the 1-month post-transplantation CT were more frequently noted for type B than type A strictures (86.4% vs. 3.1%, P < 0.001). Progressive clinical outcomes were more frequently observed for type B than type A strictures (79.2% vs. 26.8%, P < 0.001), with a significantly shorter graft survival time (46.4 months vs. 90.8 months, P < 0.001).
Conclusion
CT abnormality patterns and complex periportal halo signs on 1-month post-transplantation CT may be clinically useful for managing biliary strictures in ABO-incompatible LDLT recipients.
Key Points
• Of ABO-incompatible LDLT recipients, type B biliary stricture incidence was 6.8%.
• Of type B strictures, 86.4% exhibited similar CT abnormality patterns at 1-month post-transplantation.
• Complex periportal halo at 1 month was significantly associated with type B strictures.
• Progressive clinical outcomes were more frequently observed in type B strictures.
Spectral multi-energy CT texture analysis with machine learning for tissue classification: an investigation using classification of benign parotid tumours as a testing paradigm
ABSTRACT
Objective
There is a rich amount of quantitative information in spectral datasets generated from dual-energy CT (DECT). In this study, we compare the performance of texture analysis performed on multi-energy datasets to that of virtual monochromatic images (VMIs) at 65 keV only, using classification of the two most common benign parotid neoplasms as a testing paradigm.
Methods
Forty-two patients with pathologically proven Warthin tumour (n = 25) or pleomorphic adenoma (n = 17) were evaluated. Texture analysis was performed on VMIs ranging from 40 to 140 keV in 5-keV increments (multi-energy analysis) or 65-keV VMIs only, which is typically considered equivalent to single-energy CT. Random forest (RF) models were constructed for outcome prediction using separate randomly selected training and testing sets or the entire patient set.
Results
Using multi-energy texture analysis, tumour classification in the independent testing set had accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 92%, 86%, 100%, 100%, and 83%, compared to 75%, 57%, 100%, 100%, and 63%, respectively, for single-energy analysis.
Conclusions
Multi-energy texture analysis demonstrates superior performance compared to single-energy texture analysis of VMIs at 65 keV for classification of benign parotid tumours.
Key Points
• We present and validate a paradigm for texture analysis of DECT scans.
• Multi-energy dataset texture analysis is superior to single-energy dataset texture analysis.
• DECT texture analysis has high accura\cy for diagnosis of benign parotid tumours.
• DECT texture analysis with machine learning can enhance non-invasive diagnostic tumour evaluation.
To share or not to share? Expected pros and cons of data sharing in radiological research
Abstract
The aims of this paper are to illustrate the trend towards data sharing, i.e. the regulated availability of the original patient-level data obtained during a study, and to discuss the expected advantages (pros) and disadvantages (cons) of data sharing in radiological research. Expected pros include the potential for verification of original results with alternative or supplementary analyses (including estimation of reproducibility), advancement of knowledge by providing new results by testing new hypotheses (not explored by the original authors) on pre-existing databases, larger scale analyses based on individual-patient data, enhanced multidisciplinary cooperation, reduced publication of false studies, improved clinical practice, and reduced cost and time for clinical research. Expected cons are outlined as the risk that the original authors could not exploit the entire potential of the data they obtained, possible failures in patients' privacy protection, technical barriers such as the lack of standard formats, and possible data misinterpretation. Finally, open issues regarding data ownership, the role of individual patients, advocacy groups and funding institutions in decision making about sharing of data and images are discussed.
Key Points
• Regulated availability of patient-level data of published clinical studies (data-sharing) is expected.
• Expected benefits include verification/advancement of knowledge, reduced cost/time of research, clinical improvement.
• Potential drawbacks include faults in patients' identity protection and data misinterpretation.
Feasibility study of MR-guided transgluteal targeted in-bore biopsy for suspicious lesions of the prostate at 3 Tesla using a freehand approach
Abstract
Objective
The aim of our study was (1) to establish an in-bore targeted biopsy of suspicious prostate lesions, avoiding bowel penetration using a transgluteal approach and (2) to assess operator setup, patient comfort and safety aspects in the clinical setting for freehand real-time MR-guidance established for percutaneous procedures in an open MR-scanner.
Material and methods
30 patients with suspect prostate lesions were biopsied in a cylindrical 3T-MRI system using a transgluteal approach in freehand technique. One to three biopsies were sampled using continuous dynamic imaging. Size, location and visibility of the lesion, intervention time, needle artefact size, interventional complications and histopathological diagnosis were recorded.
Results
All biopsies were technically successful. Nineteen patients showed evidence of prostate carcinoma. Cancer detection rate was 50 % in patients with previously negative TRUS-biopsy. The average intervention time was 26 min including a learning curve as the time was 13 min by the end of the study. No antibiotic prophylaxis was performed as none of the patients showed signs of infection.
Conclusions
MR-guided targeted freehand biopsies of prostate lesions using a transgluteal approach are both technically feasible and time efficient in a standard closed-bore 3T-MR scanner as well as safe for the individual patient.
Key Points
• Open-bore freehand interventional principles were adapted to closed-bore systems.
• Prostate MR-guided freehand biopsies were feasible in a clinical setting.
• A transgluteal approach provides a short and simplified work flow.
• An inoculation of the prostate with bowel flora is avoided.
• The intervention time is comparable to the stereotactic approach.
The myth of the myth of supervenience
Abstract
Supervenience is necessary co-variation between two sets of entities (properties, facts, objects, etc.). In the good old days, supervenience was considered a useful philosophical tool with a wide range of applications in the philosophy of mind, metaethics, epistemology, and elsewhere. In recent years, however, supervenience has fallen out of favor, giving place to grounding, realization, and other, more metaphysically "meaty", notions. The emerging consensus is that there are principled reasons for which explanatory theses cannot be captured in terms of supervenience, or as the slogan goes: "Supervenience Is Nonexplanatory" (SIN). While SIN is widely endorsed, it is far from clear what it amounts to and why we should believe it. In this paper, I will distinguish various theses that could be meant by it, and will argue that none of them is both interesting and plausible: on some interpretations of 'explanatory', we have no reason to believe that supervenience is unexplanatory, while on other interpretations, supervenience is indeed unexplanatory, but widely accepted textbook cases of explanatory relations come out as unexplanatory, too. This result raises doubts as to whether there is any interesting sense in which SIN is true, and suggests that the contemporary consensus about supervenience is mistaken.
Emission and combustion profile study of unmodified research engine propelled with neat biofuels
Abstract
The current work focuses on the experimental investigation to analyze the combustion and emission characteristics of a direct injection diesel engine fueled with neat biodiesel (BD100) and different proportions of cyclohexanol blends as a fuel additive in various volume fractions. Cyclohexanol is dispersed into a neat biodiesel in a volume fraction of 10, 20, and 30 vol%. The biodiesel is produced from neem oil by the conventional transesterification process. The experimental results revealed that with the increased cyclohexanol fraction, the combustion was found smooth. The addition of cyclohexanol has a positive influence on various physical and chemical properties of neat biodiesel. The in-cylinder pressure is comparatively low for diesel followed by cyclohexanol and biodiesel blends when compared with neat biodiesel. This is due to shorter ignition delay period. The heat-release rate of neat biodiesel is the highest among all fuels. The overall HC emission of BD70COH30 is 12.19% lower than BD100 and 16.34% lower than diesel. The overall CO2 emission of BD70COH30 is 13.91% higher than BD100 and 19.5% higher than diesel. The overall NOx emission of BD70COH30 is 5.31% lower than BD100 at all load engine operations. The presence of 10, 20, and 30% of cyclohexanol in biodiesel decreased smoke emissions as compared with neat biodiesel and diesel. The overall smoke emission of BD70COH30 is 19.23% lower than BD100 and 25.51% lower than diesel. The overall CO emission of cyclohexanol blended with biodiesel by 30 vol% (BD70COH30) is 17% lower than neat biodiesel and 21.8% lower than diesel. Based on the outcome of this study, neem oil biodiesel and cyclohexanol blends can be employed as a potential alternative fuel for existing unmodified diesel engines owing to its lesser emission characteristics.
Therapeutic effect of the alkaloid extract of the cyanobacterium Spirulina platensis on the lipid profile of hypercholesterolemic male rabbits
Abstract
The authors' objectives are to investigate the therapeutic effect of alkaloid extract of cyanobacteria Spirulina platensis on the lipid profile of hypercholesterolemic male rabbits and to identify the active compounds in the alkaloid extract. Male rabbits were divided into four groups of six animals. The intact rabbits in the first group served as a negative control. The second group served as a positive control (hypercholesterolemic rabbits). Over a 4-week period, hypercholesterolemic rabbits in the third group received a low dose of alkaloid extract (33 mg/kg), and the hypercholesterolemic rabbits in the fourth group received a high dose (66 mg/kg). The results revealed that both doses of alkaloid extract significantly decreased levels of cholesterol, triglycerides, low-density lipoproteins (LDL), and very low-density lipoproteins (VLDL) when compared to the control group, whereas the high-density lipoproteins (HDL) increased significantly compared to the control group. The active compounds in the alkaloid extract were identified using GC-mass. The most abundant compounds found in the extract were 1-(+)-ascorbic acid 2,6-dihexadecanoate, 9,12-octadecadienoic acid (Z, Z)-, hexadecanoic acid, 2-hydroxy-1- (hydroxymethyl) ethyl ester, and gamolenic acid.
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Does CBD Oil Lower Blood Pressure? This article was originally published at SundayScaries." Madeline Taylor POSTED ON January 13, 20...
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Publication date: Available online 28 September 2017 Source: Actas Dermo-Sifiliográficas Author(s): F.J. Navarro-Triviño
