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Δευτέρα 3 Σεπτεμβρίου 2018

The Sjögren's syndrome‐associated autoantigen Ro52/TRIM21 modulates follicular B cell homeostasis and immunoglobulin production

Clinical &Experimental Immunology, Volume 0, Issue ja, -Not available-.


Melanoma and mastocytosis: is really only a coincidence?

Clinical and Experimental Dermatology, EarlyView.


Use of vismodegib for the treatment of multiple basal cell carcinomas in a patient with xeroderma pigmentosum

Pediatric Dermatology, EarlyView.


Yellowish‐orange plaques and slack skin in a Chinese boy

Australasian Journal of Dermatology, EarlyView.


Allergic contact dermatitis caused by propolis‐enriched honey: A case of severe penile oedema

Australasian Journal of Dermatology, EarlyView.


Multimodal therapy: Holistic approach

TM Srinivasan

International Journal of Yoga 2018 11(3):175-176



Yoga as an integrative approach for prevention and treatment of oral cancer

Akshay Anand, Atul Kumar Goyal, Jaimanti Bakshi, Kaushal Sharma, Dharam Vir, Anita Didi

International Journal of Yoga 2018 11(3):177-185

Despite tremendous advancements in medicine, the number of oral cancer cases continues to increase, and the need for integrating alternate medicine or adopting an integrative approach has become a compelling cost-effective requirement for the management and treatment of diseases. Conventional treatment of oral cancer involves surgery followed by radiotherapy with or without chemotherapy which causes several complications including poor quality of life and high chances of recurrence of cancer. Oral cancer is often linked with obesity which is major risk factors in other cancers. Apart from obesity, oral cancer is thought to have an inverse relation with neurodegenerative disorders presumably because cell death decreases in the former case and increases in the latter. Ancient mind–body techniques such as yoga have not been adequately tested as a tool to synergize the cellular equilibrium pertaining to the treatment of oral cancer. Nerve growth factor (NGF), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) are among the early experimental cellular biomarkers that may be used to probe the modulation of oral cancer, obesity, and neurodegenerative disorders. Yoga has been reported to influence these molecules in healthy individuals but whether their expression can be altered in patients of oral cancer by yoga intervention is the subject of this research being discussed in this review article. Therefore, the present article not only reviews the current status of research studies in oral cancer, obesity, and neurodegenerative disorders but also how these are linked to each other and why the investigations of the putative NGF pathway, involving TNF-α and IL-6, could provide useful clues to understand the molecular effects brought about by yoga intervention in such patients.

Effect of yoga-nidra on adolescents well-being: A mixed method study

Bhalendu S Vaishnav, Smruti B Vaishnav, Vibha S Vaishnav, Jagdish R Varma

International Journal of Yoga 2018 11(3):245-248

Context: Adolescent well-being is a priority area for health-care interventions in the 21st century. Yoga-nidra is an ancient Indian method of enabling individuals to attain a positive state of deep physical, mental, and emotional relaxation. The practice produces a state of simultaneous relaxation and detachment resulting in inner awareness and release of stress on all planes of one's being. Aim: This mixed method study was carried out in adolescent students aged 13–15 years with an aim to assess effects of Yoga-nidra on various dimensions of well-being. Materials and Methods: Thirty-six students received Yoga-nidra sessions 30 min daily for 3 days in a week for 1 month. Primary outcome measures were happiness, perceived stress, overall quality of life, and psychological general well-being. These and other experiential dimensions of well-being comprising of enthusiasm, alertness, quietude, clarity of thought, control over anger, self-confidence, and self-awareness were evaluated before and after intervention. Qualitative observations were recorded from participants, their teachers, and parents. Results of quantitative and qualitative methods were analyzed and compared. Results: Yoga-nidra intervention resulted in significant improvement in all primary outcome measures. Participants reported significant improvement in the feelings of happiness, enthusiasm, quietude, being more inspired and alert, active, having clarity of thought, control over anger, and self-confidence at the end of the study period. Mixed method design of the study provided cross-validation and convergence of results obtained from quantitative and qualitative assessment tools. Conclusion: Yoga-nidra is beneficial in improving multiple dimensions of adolescent well-being.

Implication of asana, pranayama and meditation on telomere stability

Mrithunjay Rathore, Jessy Abraham

International Journal of Yoga 2018 11(3):186-193

Telomeres, the repetitive sequences that protect the ends of chromosomes, help to maintain genomic integrity and are of key importance to human health. Telomeres progressively shorten throughout life and a number of studies have shown shorter telomere length to be associated with lifestyle disorders. Previous studies also indicate that yoga and lifestyle-based intervention have significant role on oxidative DNA damage and cellular aging. However, very few publications investigate telomere stability and its implication from the point of view of asana, pranayama, and meditation. In this context, a review was conducted to systematically assess the available data on the effectiveness of asana, pranayama, and meditation in maintaining telomere and telomerase. Literature search was performed using the following electronic databases: Cochrane Library, NCBI, PubMed, Google Scholar, EMBASE, and Web of Science. We explored the possible mechanisms of how asana, pranayama, and meditation might be affecting telomere length and telomerase. Moreover, results showed that asana and pranayama increase the oxygen flow to the cells and meditation reduces the stress level by modulating the hypothalamic–pituitary–adrenal axis. Summing up the result, it can be concluded that practice of asana, pranayama, and meditation can help to maintain genomic integrity and are of key importance to human health and lifestyle disorders.

Effect of yoga-based ocular exercises in lowering of intraocular pressure in glaucoma patients: An affirmative proposition

Sankalp , Tanuj Dada, Raj Kumar Yadav, Muneeb Ahmad Faiq

International Journal of Yoga 2018 11(3):239-241

Glaucoma is the most common cause of irreversible blindness worldwide, with >65 million sufferers. It is incurable and the only therapeutic approach accepted till now is the lowering of intraocular pressure (IOP) medically and/or surgically. These known interventions might have many side effects and complications. Yoga-based interventions are now well accepted as alternative therapy in many chronic diseases. The effects of yoga in glaucoma, however, have not been studied adequately. Accommodation (the process of adjustment of optical power to maintain clear vision) of eyes leads to instant lowering of IOP. Therefore, we hypothesize that one of the yoga-based interventions, Tratak kriya, which includes ocular exercises might lead to lowering of IOP in glaucoma patients. The proposed Tratak kriya leads to contraction and relaxation of ciliary muscles which might increase outflow of aqueous humor. In addition, this yoga-based intervention might decrease stress and improve quality of life in glaucoma patients.

Oxygen consumption during viniyoga practice in adults

Gurjeet S Birdee, Sujata Ghosh Ayala, Regina Tyree, Maciej Buchowski

International Journal of Yoga 2018 11(3):194-200

Context: The purpose of this study was to measure the oxygen consumption (V̇O2) during Viniyoga yoga movements (asanas) and to compare V̇O2walking among adults. Methods: Yoga practitioners (n = 10) were recruited to measure V̇O2while at rest (30 min), practicing yoga (16 movements with different variations), and treadmill walking at 2 mph (10 min) and 3 mph (10 min). V̇O2was measured using a whole-room indirect calorimetry. Each yoga movement was categorized by body orientation as standing, lying, and sitting. The differences in V̇O2between yoga and walking were examined using Pearson's correlations. Differences in V̇O2between poses (standing, sitting, and lying) were examined using linear regression models. V̇O2. Results: Mean yoga-V̇O2for the entire yoga session was 3.7 (standard deviation [SD] 0.43, range: 4.4–8.9) ml/kg/min. Yoga-V̇O2varied by body orientation: standing = 7.5 (SD = 1.5) ml/kg/min, lying = 5.3 (SD = 1.0) ml/kg/min, and sitting = 5.4 (SD = 1.1) ml/kg/min. After adjusting for body mass, frequency of yoga practice, and resting energy expenditure, female gender was negatively associated with mean yoga V̇O2for standing (B = −112.19, P < 0.05), lying (B = −141.87, P < 0.05), and sitting (B = −129.96, P < 0.05). Mean V̇O2for walking 2 mph was comparable with sitting (r = 0.836, P < 0.05) and lying (r = 0.735, P < 0.05) whereas walking at 3 mph was comparable with standing (r = 0.718, P < 0.05) and sitting (r = 0.760, P < 0.05). Conclusion: We conclude that V̇O2during yoga practice is comparable to V̇O2during slow treadmill walking and may vary based on gender and body orientation.

Effect of a structured yoga program on fatigue, depression, cardiorespiratory fitness, and quality of life in a postmenopausal breast cancer survivor

Ashwini A Dangi, Sheetal K Aurangabadkar, Medha V Deo

International Journal of Yoga 2018 11(3):255-257

A 52-year-old postmenopausal female diagnosed with duct carcinoma of the left breast underwent modified radical mastectomy 2 years ago. She had completed six cycles of chemotherapy postsurgery and complained of significant fatigue and depression. Her fatigue score on Piper Fatigue Scale was 4.1 and depression score on Beck's Depression Inventory was 22. She had a poor 6-min walking distance and a reduced quality of life. She was given a structured yoga program for 40 min five times a week for 4 weeks. Results showed a marked reduction in fatigue and depression scores and improvement in cardiorespiratory fitness. Her quality of life also showed improvement after the structured yoga therapy. This case report highlights the benefits of yoga for reducing fatigue, depression, and improving the cardiorespiratory fitness and overall quality of life in a breast cancer survivor.

Musculoskeletal modeling and analysis of trikonasana

Arun Kumar, Rohith C Kapse, Navneet Paul, Anil M Vanjare, SN Omkar

International Journal of Yoga 2018 11(3):201-207

Context: Yoga has origins speculated to date back to pre-Vedic Indian period and is practiced as a common exercise, both in India as well as all around the world. Although the yoga practices are ages old, there is not much research literature available. Moreover, with the advancement in technology, the modern analysis tools are not used up to their full potential. Aims: This research focuses on developing a framework for analyzing trikonasana, using the optical motion capture system, and validating the noninvasive method for analyzing muscle activity in prominent muscles while performing trikonasana. Subjects and Methods: We have adopted the noninvasive analysis method using optical motion capture system OptiTrack™ for recording the human motion and musculoskeletal modeling software LifeMod™ to analyze the muscle activity while performing trikonasana. Surface electromyography (sEMG) studies were performed using Trigno™ (Delsys Inc.) wireless sEMG sensors to validate the LifeMod simulation results pertaining muscle activation. Results: It was observed that the characteristics of the sEMG match to that of the estimated muscle tension from the architecture used in this study. The muscle groups such as external right obliques muscles, rectus abdominis of the front leg, and gluteus maximus and gluteus medius of the rear leg were observed to undergo major activation during an isometric contraction while performing trikonasana. The magnitudes of the muscle tension during the left bend depict a close resemblance to the muscle tension magnitudes during the right bend. Conclusions: The optical motion capture system and musculoskeletal modeling software can be used to analyze muscle activity in any yoga exercise noninvasively. Since the yoga exercises majorly require the practitioner to maintain a certain posture for a considerable duration, our approach can be used to find the important muscles involved and their corresponding muscle tension when they undergo isometric contraction.

Development and validation of integrated yoga module for obesity in adolescents

Sunanada Surendra Rathi, Nagarathna Raghuaram, Padmini Tekur, Ruchira Rupesh Joshi, Nagendra Hongasandra Ramarao

International Journal of Yoga 2018 11(3):231-238

Background: Obesity is a growing global epidemic and cause of noncommunicable diseases. Yoga is one of the effective ways to reduce stress which is one of the causes of obesity. Nowadays, children in adolescent age are more prone to get obese due to lack of physical activity making them more sedentary. Aim: To identify the design and validation of Integrated Approach of Yoga Therapy Module (IAYTM) for obesity in adolescents. Materials and Methods: First phase – IAYTM for obesity was designed based on the literature review of classical texts and recently published research articles. Second phase – Designed IAYTM was validated by 16 subject matter (yoga) experts. Content-validity ratio (CVR) was analyzed using Lawshe's formula. Results: Yoga practices were designed for Integrated Yoga Module for Obesity in Adolescents. Yoga practices with CVR ≥0.5 and which were validated by 16 yoga experts and approved in faculty group discussion were included in final Integrated Yoga Therapy Module. Conclusion: The yoga practices were designed and validated for IAYTM for obesity in adolescents.

A randomized trial comparing effect of yoga and exercises on quality of life in among nursing population with chronic low back pain

Nitin J Patil, R Nagaratna, Padmini Tekur, PV Manohar, Hemant Bhargav, Dhanashri Patil

International Journal of Yoga 2018 11(3):208-214

Background: Chronic low back pain (CLBP) adversely affects quality of life (QOL) in nursing professionals. Integrated yoga has a positive impact on CLBP. Studies assessing the effects of yoga on CLBP in nursing population are lacking. Aim: This study was conducted to evaluate the effects of integrated yoga and physical exercises on QOL in nurses with CLBP. Methods: A total of 88 women nurses from a tertiary care hospital of South India were randomized into yoga group (n = 44; age – 31.45 ± 3.47 years) and physical exercise group (n = 44; age – 32.75 ± 3.71 years). Yoga group was intervened with integrated yoga therapy module practices, 1 h/day and 5 days a week for 6 weeks. Physical exercise group practiced a set of physical exercises for the same duration. All participants were assessed at baseline and after 6 weeks with the World Health Organization Quality of Life-brief (WHOQOL-BREF) questionnaire. Results: Data were analyzed by Paired-samples t-test and Independent-samples t-test for within- and between-group comparisons, respectively, using the Statistical Package for the Social Sciences (SPSS). Within-group analysis for QOL revealed a significant improvement in physical, psychological, and social domains (except environmental domain) in both groups. Between-group analysis showed a higher percentage of improvement in yoga as compared to exercise group except environmental domain. Conclusions: Integrated yoga was showed improvements in physical, psychological, and social health domains of QOL better than physical exercises among nursing professionals with CLBP. There is a need to incorporate yoga as lifestyle intervention for nursing professionals.

Add-on yoga therapy for social cognition in schizophrenia: A pilot study

Ramajayam Govindaraj, Shalini Naik, NK Manjunath, Urvakhsh Meherwan Mehta, BN Gangadhar, Shivarama Varambally

International Journal of Yoga 2018 11(3):242-244

Background: Yoga as a mind–body therapy is useful in lifestyle-related disorders including neuropsychiatric disorders. In schizophrenia patients, yoga has been shown to significantly improve negative symptoms, functioning, and plasma oxytocin level. Aim: The aim of the study was to study the effect of add-on yoga therapy on social cognition in schizophrenia patients. Materials and Methods: In a single pre-post, study design, 15 schizophrenia patients stabilized on antipsychotic medication for 6 weeks were assessed for social cognition (theory of mind, facial emotion recognition, and social perception [SP]) and clinical symptoms (negative and positive symptoms and social disability) before and after twenty sessions of add-on yoga therapy. Results: There was a significant improvement in the social cognition composite score after 20 sessions of yoga (t[13] = −5.37, P≤ 0.001). Clinical symptoms also reduced significantly after twenty sessions of yoga. Conclusion: Results are promising to integrate yoga in clinical practice, if proven in well-controlled clinical trials.

The impact of yoga Nidra and seated meditation on the mental health of college professors

Camila Ferreira-Vorkapic, Claudio Joaquim Borba-Pinheiro, Murilo Marchioro, Daniel Santana

International Journal of Yoga 2018 11(3):215-223

Background: World statistics for the prevalence of anxiety and mood disorders shows that a great number of individuals will experience some type of anxiety or mood disorder at some point in their lifetime. Mind–body interventions such as Hatha Yoga and seated meditation have been used as a form of self-help therapy and it is especially useful for challenging occupations such as teachers and professors. Aims: In this investigation, we aimed at observing the impact of Yoga Nidra and seated meditation on the anxiety and depression levels of college professors. Materials and Methods: Sixty college professors, men and women, aged between 30 and 55 years were randomly allocated in one of the three experimental groups: Yoga Nidra, seated meditation, and control group. Professors were evaluated two times throughout the 3-month study period. Psychological variables included anxiety, stress, and depression. Results: Data analysis showed that the relaxation group presented better intragroup results in the anxiety levels. Meditation group presented better intragroup results only in the anxiety variable (physical component). Intergroup analysis showed that, except for the depression levels, both intervention groups presented better results than the control group in all other variables. Conclusions: Prepost results indicate that both interventions represent an effective therapeutic approach in reducing anxiety and stress levels. However, there was a tendency toward a greater effectiveness of the Yoga Nidra intervention regarding anxiety, which might represent an effective tool in reducing both cognitive and physiological symptoms of anxiety.

Home-Based yoga program for the patients suffering from malignant lymphoma during chemotherapy: A feasibility study

Gurpreet Kaur, Gaurav Prakash, Pankaj Malhotra, Sandhya Ghai, Sukhpal Kaur, Mahender Singh, Kulbeer Kaur

International Journal of Yoga 2018 11(3):249-254

Background: Yoga is proven beneficial in improving quality of life among breast cancer survivors receiving chemotherapy, but its effectiveness in lymphoma patients needs to be explored. As chemotherapy-induced neutropenia is very common among lymphoma patients, they are much prone to infections from the environment. Furthermore, trained yoga instructors are not available in every setting, so there is a need to develop home-based yoga program modules for lymphoma patients receiving chemotherapy. Aim: The aim of the study was to explore the feasibility and safety of yogic exercises among lymphoma patients during chemotherapy. Subjects and Methods: An interventional, single-arm prepost design study was conducted at a tertiary health-care center. Patients suffering from malignant lymphoma (18–65 years) with Eastern Cooperative Oncology Group performance status from 0 to 2, planned to receive chemotherapy were administered a home-based yoga program over a period of 2 months from the start of chemotherapy. The primary outcome variables were retention rate, acceptance rate, safety, and adherence. Health-related quality of life (HRQOL), fatigue level, overall sleep quality, depression, anxiety level, and pain were also assessed. Statistical Analysis: Descriptive statistics was used to see the feasibility and adherence. The paired t-test was used to compare various pre and postintervention outcome measures. Results: Fourteen patients (median age: 36 years, range13–65 years) of malignant lymphoma were enrolled in the study. Male-to-female ratio was 9:5. Non-Hodgkin's lymphoma patients constituted 64%. The recruitment rate was 93%. Favorable retention (100%), acceptability (97%), adherence (78.6%), and no serious adverse events following yoga practice were reported. Improvement was also found in HRQOL, fatigue, sleep, depression, and anxiety. However, it needs further validation in a randomized study. Conclusion: Home-based yoga program is safe and feasible among the patients suffering from malignant lymphoma receiving chemotherapy.

Changes in reaction time after yoga bellows-type breathing in healthy female volunteers

Shirley Telles, Sushma Pal, Ram Kumar Gupta, Acharya Balkrishna

International Journal of Yoga 2018 11(3):224-230

Background: Previously, yoga bellows-type breathing (bhastrika pranayama) reduced reaction time (RT) or reduced anticipatory responses in male participants or a mixed group of male and female participants. Aims: The present study as a control trial aimed to assess the effects of yoga bellows-type breathing on RT in females exclusively. Methods: The sample consisted of 25 healthy females, aged between 19 and 32 years (group mean ± standard deviation, 22.8 ± 3.5 years). All of them had prior minimum experience of yoga including yoga bellows-type breathing of 12 months. The RT was assessed in each participant before and after three randomized sessions differed in the intervention given held on three separate days. The sessions were (i) YOGA bellows-type breathing or bhastrika pranayama(BHK), (ii) Breath awareness (BAW), and (iii) Sitting quietly (CTL) as a control session. The duration of the intervention was 18 min, and the participants were assessed for RT before and after the intervention. Results: Repeated measures ANOVA, post hoc tests with Bonferroni adjusted showed that the time taken to obtain a correct response reduced significantly after 18 min of BAW (P < 0.05) and CTL (P < 0.05). However, no changes were seen in the RT after BHK. Conclusions: The results suggest that different interventions may optimize performance in tasks requiring attention in females compared to males.

Model, methods, and perspectives in yoga

Ananda Balayogi Bhavanani

International Journal of Yoga 2018 11(3):258-260



Airborne foliar transfer of particular metals in Lactuca sativa L.: translocation, phytotoxicity, and bioaccessibility

Abstract

The uptake, translocation, and human bioaccessibility of metals originating from atmospheric fine particulate matters (PM) after foliar exposure is not well understood. Lettuce (Lactuca sativa L.) plants were exposed to micronic PbO, CuO, and CdO particulate matters (PMs) by the foliar pathway and mature plants (6 weeks old) were analyzed in terms of: (1) metal accumulation and localization on plant leaf surface, and metal translocation factor (TF) and global enrichment factor (GEF) in the plants; (2) shoot growth, plant dry weight (DW), net photosynthesis (Pn), stomatal conductance (Gs), and fatty acid ratio; (3) metal bioaccessibility in the plants and soil; and (4) the hazard quotient (HQ) associated with consumption of contaminated plants. Substantial levels of metals were observed in the directly exposed edible leaves and newly formed leaves of lettuce, highlighting both the possible metal transfers throughout the plant and the potential for human exposure after plant ingestion. No significant changes were observed in plant biomass after exposure to PbO, CuO, and CdO-PMs. The Gs and fatty acid ratio were increased in leaves after metal exposure. A dilution effect after foliar uptake was suggested which could alleviate metal phytotoxicity to some degree. However, plant shoot growth and Pn were inhibited when the plants are exposed to PbO, and necrosis enriched with Cd was observed on the leaf surface. Gastric bioaccessibility of plant leaves is ranked: Cd > Cu > Pb. Our results highlight a serious health risk of PbO, CuO, and CdO-PMs associated with consumption of vegetables exposed to these metals, even in newly formed leaves in the case of PbO and CdO exposure. Finally, the study highlights the fate and toxicity of metal rich-PMs, especially in the highly populated urban areas which are increasingly cultivated to promote local food.



Zn(II), Pb(II), and Cd(II) adsorption from aqueous solution by magnetic silica gel: preparation, characterization, and adsorption

Abstract

A novel magnetic silica gel adsorbent (Fe3O4-Si-COOH) was successfully prepared by introducing carboxyl group in situ to improve the performance for Pb(II), Zn(II), and Cd(II) adsorption. Infrared spectroscopy (IR), scanning electron microscope (SEM), transmission electron microscope (TEM), thermo-gravimetric analyzer (TGA), the Brunauer-Emmett-Teller (BET) surface area, X-ray diffraction (XRD), and vibrating sample magnetometer (VSM) characterizations suggested that Fe3O4-Si-COOH has been successfully prepared. The adsorption performance was evaluated by batch experiments with different initial concentrations, ionic strength, contact time, and pH. The adsorption kinetics data followed pseudo-second-order model and exhibited a three-stage intraparticle diffusion mode. Isothermal adsorption equilibrium data were best fitted by the Freundlich model and the adsorption capacity were 155, 110, and 93 mg/g (initial concentration 210 mg/L) for Pb(II), Zn(II), and Cd(II), respectively. The result of X-ray photoelectron spectroscopy (XPS) survey spectrum suggested that the main adsorption mechanism is that the H+ of carboxyl groups exchanged with heavy metal ions in the adsorption processes. In addition, the adsorbed Fe3O4-Si-COOH could be regenerated and the adsorption capacity of reused Fe3O4-Si-COOH could maintain 80.3% after five cycles. Hence, the Fe3O4-Si-COOH could be a kind of potential material for removing Pb(II), Zn(II), and Cd(II) from wastewater.

Graphical abstract


Cadmium accumulation and subcellular distribution in populations of Hylotelephium spectabile (Boreau) H. Ohba

Abstract

A pot experiment was conducted among six populations of Hylotelephium spectabile (Boreau) H. Ohba: four from Jiangsu province, one from Shandong province, and one from Shanxi province, China, to investigate the variation of Cd accumulation and subcellular distribution of this species (a newly reported Cd high accumulator). Under five different real Cd-contaminated soils (Cd: 0.93–97.97 mg/kg), results showed considerable differences in Cd concentration in (a) leaf (1.09–50.7 mg/kg), (b) stem (0.61–13.0 mg/kg), and (c) root (1.55–24.5 mg/kg) among the populations. Analysis of subcellular Cd distribution indicated that Cd accumulated in the leaves of H. spectabile was mainly in the cellular debris (44.1 to 53.5%), followed by heat-stable protein (HSP, 20.9 to 29.0%), Cd-rich granules (MRG, 9.9 to 19.5%), heat-denatured protein (6.0 to 8.5%), and organelle fractions (3.1 to 7.4%). The populations of H. spectabile with more Cd partitioned to cellular debris and biological detoxified metal (HSP + MRG) fractions have greater capacity to accumulate Cd, indicating the probable intrinsic mechanism to accumulate Cd. Therefore, H. spectabile has the considerable potential of phytoremediation for Cd-contaminated soils, but screening suitable populations according to soil Cd concentrations is necessary before used for phytoremediation of Cd-contaminated soils.



Plant uptake and translocation of perfluoroalkyl acids in a wheat–soil system

Abstract

Application of per- and polyfluoroalkyl substances (PFASs) is shifting to short-chain analogs (C ≤ 6) that raises concerns for their potential ecotoxicological risks. In the present study, pot experiments were carried out to study the effects of perfluoroalkyl acids (PFAAs), including perfluoroalkyl carboxylic acids (PFCAs) and perfluoroalkyl sulfonic acids (PFSAs), with different carbon chain lengths (C4, C6, and C8) on the growth of wheat seedlings and their plant uptake and transfer at two spiking levels (200 and 2000 μg/kg soil). Exposure to C4 PFAAs slightly inhibited chlorophyll activity, whereas exposure to C8 PFAAs showed enhancement. The bioaccumulation factors (BAFs) for C4 PFAAs in wheat were over 10, while BAFs for C8 PFAAs were all below 1. Rhizospheric and root to shoot transfer factors for PFAAs were both negatively correlated with their log Kow (p < 0.05). PFCAs exhibited both higher rhizospheric mobility and accumulation potentials than PFSAs of the same chain lengths. Hence, perfluoroalkyl chain governs the mobility of PFAAs in a soil–plant system besides interactions of their head groups, and the substitution with shorter chain PFASs raises concerns for their higher plant accumulation potential that brings higher ecotoxicological and human exposure risks via food chains.



The concentration of heavy metals in noodle samples from Iran’s market: probabilistic health risk assessment

Abstract

In the current study, the concentration of heavy metals including lead (Pb), chromium (Cr), cadmium (Cd), and aluminum (Al) in commonly instant noodles consumed in Iran (either imported from other countries or produced in Iran) was investigated by acid digestion method followed by an inductively coupled plasma optical emission spectrometry system (ICP-OES). Also, the associated non-carcinogenic risk due to ingestion of heavy metals for adults and children was estimated by calculating percentile 95% target hazard quotient (THQ) in the Monte Carlo simulation (MCS) method. The average concentrations of Pb, Cr, Cd, and Al in Iranian instant noodle samples were measured as 1.21 ± 0.81, 0.08 ± 0.10, 0.03 ± 0.06, and 9.15 ± 4.82 (mg/kg) and in imported instant noodle samples were 1.00 ± 0.61, 0.07 ± 0.07, 0.04 ± 0.03, and 15.90 ± 0.93 (mg/kg), respectively. A significant difference (p value < 0.05) in the mean concentration of Pb, Cr, Cd, and Al of Iranian instant noodle and imported instant noodle samples was observed. Also, the concentration of Pb, Cr, Cd, and Al in all brands of instant noodle (0.025 mg/kg, 0.050 mg/kg, 0.003 mg/kg, and 0.237 mg/kg, respectively) surpassed the WHO-permitted limits for Pb, Cr, Cd, and Al. Percentile 95% of THQ of Pb, Cr, Cd, and Al for the adult consumers was calculated as 0.012, 0.000007, 0.010, and 1.789; while in the case of children, percentile 95% of THQ of Pb, Cr, Cd, and Al was defined as 0.044, 0.00023, 0.035, and 6.167, respectively. Health risk assessment indicated that both adults and children are at considerable non-carcinogenic health risk for Al (THQ > 1). Therefore, approaching the required strategies in order to reduce the concentration of heavy metals particularly Al in the instant noodle is recommended.



Efficacy of breast reconstruction with fat grafting: A systematic review and meta-analysis

Breast reconstruction with fat grafting is a new alternative to prosthetic implants and flaps for women with breast cancer. In this study, we investigate the efficacy of fat grafting for breast reconstruction in a meta-analysis.

Cartilage sparing surgery for melanoma of the external ear

The excision of melanoma of the external ear poses a challenge to surgeons, who must achieve adequate oncological control while minimising impact on form and function. Cartilage preserving surgery is an attractive option as it leaves behind a scaffold for immediate reconstruction with a variety of techniques including full thickness skin grafts (FTSGs) and local flaps. This manuscript will review the literature comparing cartilage sparing surgery with composite excision of skin and cartilage for the treatment of auricular melanoma.

Readability and quality of breast reduction on-line resources

Many patients are now using the Internet as a resource for health-related information. It is recommended that the readability of patient education materials should be equal to or less than an 11-13-year-old reading level.The aim of this study was to evaluate the readability and quality of websites related to breast reduction.The largest internet search engine was queried for 'breast reduction'. 112 articles from the ten most popular websites were downloaded for analysis. Results from the private cosmetic industry were excluded.

Comparison of piezosurgery, percutaneous and endonasal continuous osteotomy techniques on a caprine skull model

Osteotomy is a crucial step in rhinoplasty which can have a significant impact on the outcome. In addition to previous percutaneous (external perforating) and endonasal (internal) approaches, piezosurgery has been used in rhinoplasty practice since 2007. This experimental model was planned to compare the three osteotomy techniques.

Utilization of Installation Wound Vacuum Device for Breast Implant Salvage: Approach and Results

Negative pressure wound therapy allow for an increase in fibroblast migration, a decrease in cell death and stimulation of angiogenesis, all to allow for more rapid wound healing. With irrigating vacs, wounds can be continually washed without painful dressing changes, while concurrently providing the benefit of intermittent negative pressure.

Shear wave elastography in the diagnosis of the ulnar tunnel syndrome.

An interesting alternative to traditional diagnostic techniques of the upper extremity nerve entrapments might be provided by an ultrasound elastography that started to gain attention in recent research. The aim of this preliminary study was to verify if quantitative analysis of ulnar nerve stiffness with shear-wave elastography can be used to diagnose the ulnar tunnel syndrome, an ulnar nerve neuropathy at the Guyon's canal. The study included 46 patients (39 women) and 39 healthy controls (34 women).

A SIMPLE METHOD FOR LYMPHEDEMA SELF-MEASUREMENT USING THE ZOZOSUIT BODYSUIT

Dear Editor,

Allergic contact dermatitis in a child caused by isothiazolinones in a “noise putty”

Contact Dermatitis, EarlyView.


Survival, disease progression and prognostic factors in elderly patients with mycosis fungoides and Sézary syndrome: a retrospective analysis of 174 patients

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


Management of patients with hereditary angioedema in Germany: comparison to other countries in the Icatibant Outcome Survey

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


Secukinumab survival and long‐term efficacy in patients with plaque psoriasis: real‐life data from a tertiary hospital in Greece

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


Comparison of clinical and ultrasound scores in patients with hidradenitis suppurativa: results from an Italian ultrasound working group

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


Hidradenitis suppurativa/acne inversa: A practical framework for treatment optimization – systematic review and recommendations from the HS ALLIANCE working group

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


Probabilistic risk assessment (Monte Carlo simulation method) of Pb and Cd in the onion bulb (Allium cepa) and soil of Iran

Abstract

Recently, the exposure to heavy metals through the consumption of vegetables has become a global concern. In this regard, the current study was aimed to measure the concentrations of lead (Pb) and cadmium (Cd) in the collected onion bulb samples as well as the surrounded soil using a flame atomic absorption spectrometer (FAAS). Additionally, the target hazard quotient (THQ) for males and females in all age groups of consumers were estimated by using Monte Carlo Simulation (MCS) method. Furthermore, the soil threshold values (STVs) were evaluated to investigate the heavy metal contents in the soil based on the established standard limits. In this context, 45 onion bulbs (HashtBandi region, 25 and Ravang region, 20) and 41 soil (HashtBandi region, 21 and Ravang region, 20) samples were collected (March–May of 2016). The average concentrations of Pb in the onions from HashtBandi and Ravang regions were determined as 0.0052 ± 0.0011 and 0.0061 ± 0.0022 mg/kg, and for Cd were 0.0095 ± 0.0024 and 0.0011 ± 0.0035 mg/kg, respectively. The average concentration of Pb in the soil from HashtBandi and Ravang regions were measured as 3.99 ± 3.77 and 2.03 ± 0.69 mg/kg, and for Cd, the corresponding values were determined as 2.21 ± 3.17 and 2.22 ± 0.92 mg/kg, respectively. The average concentration of Pb and Cd in both investigated onion bulb and soil were lower than Iranian national (onion bulb: Pb = 0.1 mg/kg, Cd = 0.05 mg/kg) and FAO/WHO (onion bulb: Pb = 0.3 mg/kg, Cd = 0.1 mg/kg; soil: Pb = 50 mg/kg, Cd = 0.3 mg/kg) standard limits. Moreover, the THQ and total target hazard quotient (TTHQ) for males and females in all age groups were less than 1 value. Therefore, no risk of the exposure to Pb and Cd as result of onion bulb consumption was reported. STVs for Pb and Cd in the HashtBandi region were calculated as 3.99 and 2.21 mg/kg, and Ravang as 2.03 and 2.22 mg/kg, respectively. Due to the higher calculated STVs for Cd while compared with the established standard limit for the soil, the further revisions regarding the heavy metal standard limits in the soil were recommended.



Impact of cluster headache on employment status and job burden: a prospective cross-sectional multicenter study

Cluster headaches (CH) are recurrent severe headaches, which impose a major burden on the life of patients. We investigated the impact of CH on employment status and job burden.

The effect of ICT, financial development, growth, and trade openness on CO 2 emissions: an empirical analysis

Abstract

This study investigates the impact of Internet use, financial development, economic growth, and trade openness on carbon dioxide (CO2) emissions in selected European Union (EU) countries. To this end, pooled mean group (PMG) estimator is utilized for panel data from 2001 to 2014. Empirical findings suggest that Internet use has long-run relationship with CO2 emissions and lowering the environmental quality in EU countries. Also, the electricity consumption has a positive and significant effect on CO2 emissions. Moreover, interestingly, economic growth and financial development have a diminishing negative impact on CO2 emission. Heterogeneous panel Granger causality results suggest unidirectional causality running from Internet use to CO2 emissions. The finding implies that the European Union countries did not achieve the level of green information and telecommunication (ICTs) consumption. Overall, the innovative findings indicate that Internet use is raising the threat to the sustainable development. Thus, to curb and mitigate CO2 emissions from Internet use and electricity consumption is the need of time to maintain the sustainable development in EU countries.



Effects of Microcystis aeruginosa on the life history traits and SOD activity of Daphnia similoides sinensis

Abstract

With water eutrophication and global warming, cyanobacteria blooms have occurred frequently, and the interaction between M. aeruginosa and Daphnia has been widely paid attention by researchers. However, the effects of toxic M. aeruginosa on the SOD activity of Daphnia are poorly known. Six D. similoides sinensis clones collected from Lake Junshan and the offspring of two clones were employed. The effects of toxic M. aeruginosa on the life history traits and SOD activities of D. similoides sinensis in the mother and their offspring were studied. Toxic M. aeruginosa could significantly inhibit the life history traits (e.g., body lengths, offspring numbers at first reproduction, cumulative offspring numbers, and the intrinsic rate of population) and induce higher SOD activities of D. similoides sinensis. Compared with the mother, the effects of toxic M. aeruginosa on the life history traits and SOD activities of D. similoides sinensis in the offspring showed obvious differences. Moreover, the adaptability of the offspring to M. aeruginosa indicated also the differences between two clones. Our results suggested that the mother exposed to toxic M. aeruginosa could enhance the fitness of their offspring to Microcystis by maternal effect and was also affected by the D. similoides sinensis genotypes.



Rarasaponin-bentonite-activated biochar from durian shells composite for removal of crystal violet and Cr(VI) from aqueous solution

Abstract

This paper presents the preparation of composite material and its application for the adsorption of crystal violet and Cr(VI) from aqueous solution onto acid-activated bentonite (AAB) and rarasaponin–bentonite-activated biochar from durian shells composite (RBAB). The influence of initial pH of the solution and the temperature of adsorption on the adsorbents adsorption performance was also studied. Langmuir and Freundlich models could represent the adsorption equilibria equally well. Thermodynamic parameters such as ∆G°, ∆H°, and ∆S° were evaluated based on the adsorption isotherms. The values of ∆G°, ∆H°, and ∆S° for crystal violet adsorption system demonstrate behavior contrary to the Cr(VI) adsorption system. Where crystal violet adsorption is preferred at high temperatures with qmax, value is 518.64 mg/L; while adsorption Cr(VI) is better at low temperature with qmax, value is 106.30 mg/L. Pseudo-first-order and pseudo-second-order kinetic models could represent the kinetic data well.



Estimation and Validation of Flour Exposure in Bakeries in Alberta, Canada

Abstract
Objectives
In epidemiological studies of work-related ill-health only current exposures can, at best, be measured. Previous exposures may be estimated using contemporaneous hygiene records or published data. This study aimed to create a job exposure matrix for exposure in bakers for use in an ongoing cohort study.
Methods
A systematic review was conducted of English language publications on exposures in bakeries. All publications that appeared to contain quantitative measures of exposure to flour dust, wheat allergen, or fungal α-amylase were read independently by two investigators and relevant data extracted. A third investigator reviewed these data and publications were retained that reported full-shift exposures to inhalable dust, wheat allergen, or α-amylase, and for which geometric means (GMs) were given or could be estimated. For each study, the number of sampling results contributing to each GM was recorded together with information on task, bakery size, product, filter type, sampling head, the country in which the study was conducted, and the estimated year of sampling. Multivariable models were elaborated for each exposure using a linear mixed effects approach. The predictive capacity of the model for inhaled particles was tested against samples collected in eight Alberta bakeries. The capacity of exposure intensity, estimated from each of the three models, to predict sensitization was tested against skin prick testing (SPT) for bakery allergens in bakers currently employed in Alberta.
Results
One thousand three hundred and ninety-seven publications were identified through the systematic search, of which 27 had data used to create one or more of the predictive models. Weighted GMs were used as outcome variables. For inhalable dust, task, bakery size, type of sampling head, and year of sampling contributed to the final model. For wheat allergen and α-amylase, task, bakery size, sampling head, and year of sampling again contributed. Product (bread rather than confectionary or mixed products) was also important in these two latter measures. The model for inhalable dust was used to predict the concentration in 33 samples from Alberta bakeries. Overall, 91% of observed samples had 95% confidence intervals (CIs) overlapping the 95% CIs of the predicted values. A model including the Alberta samples found no effect attributable to Alberta provenance. Using this model for inhalable dust and the models developed solely from the literature for wheat allergen and α-amylase, a positive SPT for bakery allergens in 57 bakers recruited for this study was significantly related to log cumulative exposure for each of the three outcome variables and to log exposure intensity for wheat allergen and α-amylase.
Conclusions
The exposure models developed from the literature provide useful estimates of exposure. Calibration of the models against locally collected samples may be useful for countries poorly represented in the modeling dataset.

A global consensus statement on ashy dermatosis, erythema dyschromicum perstans, lichen planus pigmentosus, idiopathic eruptive macular pigmentation, and Riehl's melanosis

International Journal of Dermatology, EarlyView.


Highlights from the Literature



Forthcoming Meetings

Edited by Albert H. Kim and Jennie W. Taylor

Health insurance and the ongoing debate of quality and quantity

See the article by Brown et al. pp. 1374-1382.

First results on the DCVax phase III trial: raising more questions than providing answers

Recently, the long-awaited report on efficacy data of the DCVax trial has appeared in the Journal of Translational Medicine.1 Patients and physicians alike are eager to critically evaluate the first results of this important trial, which is one of the earliest major attempts to improve outcome in patients with glioblastoma using immunotherapy based on an autologous tumor lysate-pulsed dendritic cell vaccine (DCVax). It is not only one of the first randomized phase III trials of its kind, but in light of recent successes with cancer immunotherapies outside neuro-oncology, there is a huge interest in any form of immune treatment for glioma patients. Any report is highly relevant, not in the least as the treatment is offered commercially to patients, at high cost, and without the effectiveness of the treatment being known to date. In the interplay between concept-based hopes and urgent need for effective treatments, it is of the utmost importance that outcome data are shared with the community.

Four compartment method as an efficacious and simplified technique for autologous non‐cultured epidermal cell suspension preparation in vitiligo surgery: A randomized, active‐controlled study

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


Role of cytochrome c in modulating chromium-induced oxidative stress in Oryza sativa

Abstract

Cytochrome c (CYTc) is one of the redox-active molecules responsible for electron transport in plant mitochondria. It is important in the interaction of metal ions with mitochondrial proteome, it is also essential for insights into electron transport during oxidative stress. This study focused on the clarification of interactions of CYTc with metal accumulation and associated modulation of CYTc with reactive oxygen species (ROS) generation in rice seedlings exposed to chromium either hexavalent Cr(VI) or trivalent Cr(III). The result indicates that exposures to both Cr species resulted in significant accumulation of Cr in rice tissues. ROS-dependent growth inhibition of rice seedlings was also evident from both Cr treatments. Changes of CYTc content in roots and shoots maintained almost the same pattern after both Cr exposures. However, dynamically transcriptional levels of rice CYTc genes conducted by real-time quantitative RT-PCR were inconsistent in rice tissues. The results presented here demonstrate that oxidative stresses induced by ROS accumulation do not equally and/or detrimentally influence the perturbations of CYTc content and expression patterns of CYTc genes in rice tissues after Cr exposure, suggesting that the decrease of CYTc levels in roots did not originate ROS accumulation, it may be due to metal-binding properties, while enhancement of CYTc content in shoots was probably a signal of severe growth inhibition owing to ROS accumulation.



Towards a semantics for metanormative constructivism

Abstract

The status of constructivism as a metaethical or metanormative theory is unclear partly due to the lack of a clear semantics for central normative terms such as 'reason' and 'ought'. In a series of recent papers, Sharon Street has attempted to clarify the central commitments of constructivism by focusing on the idea of a practical point of view and what follows from it. We improve upon the informal understanding provided by Street and attempt to provide a semantics for 'ought'. Our semantics respects the core intuition of the constructivist that normative claims are made true because of our practical commitments as agents and also reflects the constructivist's commitment to the centrality of practical deliberation to normative truth. On our view, a normative claim of the form ⌜S ought to ϕ⌝ is true if ϕ is entailed from S's set of evaluative attitudes. We argue that a virtue of our definition is that it allows us to see precisely what is distinctive about constructivism as opposed to realism and expressivism.



Skin type differences in solar simulated radiation‐induced oxidative stress

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


MR Imaging of Patients with Cardiac Implantable Electronic Devices (CIEDs): Implementing a Program and Optimizing CMR

Abstract

Purpose of review

How to implement a program for MRI in patients with conditional and non-conditional ("legacy") CIED. How to optimize safety and image quality in CMR? What the radiologists need to know: device programming, pre- and post-MRI CIED parameters.

Recent findings

New Center for Medicare and Medicaid Services (CMS) guidelines have opened MRI to many patients with nonconditional devices. Newer pulse sequences for cardiac MRI (CMR) in device patients, including modified cine, late gadolinium enhancement and T1 mapping sequences, have resulted in improved image quality in device patients. We present several cases of CMR in device patients, including imaging of leadless pacemakers subcutaneous ICDs. Imaging pitfalls/artifacts in CMR interpretation are also presented.

Summary

An organized institutional workflow with an established protocol involving proper patient screening, device programming, scan monitoring, and pre- and post-ICD interrogation minimizes risk in patients with conditional and non-conditional CIEDs. Although rare, significant changes in lead performance, power-on/reset, inappropriate pacing or ICD discharges and battery voltage depletion should be documented. High-quality scans with accurate scar characterization in CIED patients require the use of wideband sequences. CMS has recently acknowledged MRI as a reasonable test necessary for the diagnosis and treatment of beneficiaries with implanted CIEDs, improving the financial prospects and encouraging future developments.



Quality and Safety in Emergency Radiology

Abstract

Purpose of Review

To review and outline problems and challenges in regard to patient safety along with solutions to overcome them.

Recent Findings

Errors and discrepancies in radiology practice are disappointingly common. The estimated rate of errors is more than 5% in many targeted studies. This requires a detailed review of different types of errors in radiology and potential strategies to prevent them.

Summary

An effective health care delivery system relies heavily on high degrees of skill in professionalism and communication. Strategies to prevent errors and improve communication with physicians in the Emergency Department are helpful in providing quality patient care, thus also decreasing the chances of conflicts and litigation.



Imaging and its role in tendinopathy: current evidence and the need for guidelines



Cadmium-accumulator straw application alleviates cadmium stress of lettuce ( Lactuca sativa ) by promoting photosynthetic activity and antioxidative enzyme activities

Abstract

The effects of application of straw derived from cadmium (Cd) accumulator plants (Siegesbeckia orientalis, Conyza canadensis, Eclipta prostrata, and Solanum photeinocarpum) on growth and Cd accumulation of lettuce plants grown under Cd exposure were studied. Treatment with straw of the four Cd-accumulator species promoted growth, photosynthesis, and soluble protein contents and enhanced the activities of peroxidase in leaves of lettuce seedlings. The biomass of shoot of lettuce from high to low in turn is the treatment of C. canadensis straw > S. photeinocarpum straw > S. orientalis > E. prostrata > Control. The Cd content in edible parts (shoots) of the lettuce plants was significantly decreased in the presence of straw from the Cd-accumulator species, except the presence of the straw of E. prostrata. And, the greatest reduction in Cd content in shoots was 27.09% in the S. photeinocarpum straw treatment compared with that of the control. Therefore, application of straw of S. orientalis, C. canadensis, and S. photeinocarpum can promote the growth of lettuce seedlings, and decrease their Cd accumulation, when grown in Cd-contaminated soil, which is beneficial for production of lettuce safe for human consumption.



Impact of marine and continental sources on aerosol characteristics using an on-board SPAMS over southeast sea, China

Abstract

The chemical composition of atmospheric aerosols was characterized using an on-board single particle aerosol mass spectrometer (SPAMS) over the Southeast China Sea. High-time-resolution observation of marine aerosols was carried out to clarify the source of aerosols and the interaction of marine and continental aerosols. Atmospheric aerosols were determined by the interaction of continental and marine sources over coastal area. Aerosols from continental sources flux into sea surfaces through deposition or diffusion, which results in the rapid decrease of continental aerosols. Five main subtypes of carbonaceous particles are identified as C_Al-Si, C_V-Ni, C_S, C_K, and C_secondary to clarify the impact of marine and continental sources on atmospheric aerosols. High fraction of C_Al-Si and C_secondary is present over XA (Xiamen anchorage), accounting for 23.8% and 18.6% of total carbonaceous particles. Contrarily, the relative percentage of C_S increases as the distance from land to sea increases. The influence of continental aerosols declines, while the contribution of marine aerosols increases as the distance from land to sea increases. Air masses in XA, LSA (land to sea area), SLA (sea to land area), and SA (sea area) were all from ocean during the observation period, resulting in low relative fraction of continental aerosols in SLA, SA, and LSA. High-time-resolution measurement is useful to understand aerosol source types and the impact of marine and continental sources on marine atmosphere aerosols.



Behçet's disease diagnosed by lower extremity ulcers

International Wound Journal, EarlyView.


The role of nutrition in inflammatory pilosebaceous disorders: Implication of the skin‐gut axis

Australasian Journal of Dermatology, EarlyView.


Setting sun pattern in dermoscopy of a scalp nodule

Australasian Journal of Dermatology, EarlyView.


Analysis, characterization of coenzyme B12 biosynthetic gene clusters and improvement of B12 biosynthesis in Pseudomonas denitrificans ATCC 13867

Abstract
Coenzyme B12 is an essential cofactor for many enzymes such as glycerol dehydratase, methionine synthase and methylmalonyl-CoA mutase. Herein, we revisited the B12 biosynthetic gene clusters (I and II) in Pseudomonas denitrificans, a well-known industrial producer of the coenzyme B12, to understand the regulation of gene expression and improve the production of coenzyme B12. There existed eight operons, seven in the cluster I and one in the cluster II, and four operons were regulated by B12–responsive riboswitches with a switch-off concentration at ∼5 nM coenzyme B12. DNA sequences of the four riboswitches were partially removed, individually or in combination, to destroy the structures of riboswitches, but no improvement was observed. However, when whole length of riboswitches in the cluster I were completely removed and promoters regulated by the riboswitches were replaced with strong constitutive ones, B12 biosynthesis was improved up to two-fold. Interestingly, modification of the promoter region for cluster II, where many (>10) late genes of B12 biosynthesis belong, always resulted in a significant, more than six-fold reduction of B12 biosynthesis.

The two-component regulatory system CpxA/R is required for the pathogenesis of Aeromonas hydrophila

Abstract
Aeromonas hydrophila is a causative pathogen of many infectious diseases in fish and human. The two-component regulatory system enables bacteria to response to a wide range of stimuli, growth conditions and environments. The two-component system CpxA/R is prevalent in microorganisms and involved in the pathogenesis of a number of pathogens. In this study, we generated a ΔcpxA/R mutant of A. hydrophila ZYAH72 to explore the biological functions mediated by the CpxA/R in this organism. Compared to the wild type strain, the knockout mutant strain ΔcpxA/R exhibited a significant impairment in adherence to human epithelial cells Caco-2 and resistance against host killing in fish blood. However, the mutant strain and the wild type strain showed no difference in the cytotoxicity assay revealed that the absent of CpxA/R did not influence the cytopathic effect of this pathogen in vitro. Furthermore, the virulence of ΔcpxA/R was attenuated in zebrafish (Danio rerio) and grass carp (Ctenopharyngodon idella) infections, with reduced mortality or delayed death time. These findings suggest that CpxA/R is required for the virulence of A. hydrophila.

Enhancing acid tolerance of the probiotic bacterium Lactobacillus acidophilus NCFM with trehalose

Abstract
Enhancing the acid tolerance of the probiotic bacterial strain Lactobacillus acidophilus NCFM (L. acidophilus NCFM) is critical for improving its viability during transiting through gastrointestinal tract, which is the basis of eliciting beneficial effects as an intestinal probiotic. In this study, the role of trehalose and the glutamateγ-aminobutyric acid antiporter gene gadC in enhancing the acid tolerance of L. acidophilus NCFM was investigated. Trehalose at a concentration of 0.5% (w/v) was sufficient to significantly increase bacterial viability at pH 2.0, and trehalose of 2.0% can preserve more than 80% of bacterial viability both at pH 2.0 and 3.0. The inactivation of gadC gene in L. acidophilus NCFM significantly reduced bacterial viability at pH 2.0, and diminished the protective effect of trehalose against acid stress. In conclusion, exogeneous trehalose conferred L. acidophilus NCFM enhanced viability at extreme low pH values, an effect that appeared to depend on its endogenous glutamate-depenent acid resistance system.

Chlorothalonil Biotransformation by Cytochrome P450 Monooxygenases in Sclerotinia homoeocarpa

Abstract
Cytochrome P450s have been shown to play a vital role in the xenobiotic detoxification system of Sclerotinia homoeocarpa, the causal agent of the turfgrass disease dollar spot. A previous study indicated that three CYP450s were validated to play a functional role in resistance against different fungicide classes including propiconazole and plant growth regulator, flurprimidol. In this study, we present these CYP450s possess the capability to modify the multi-site mode of action fungicide chlorothalonil. Chlorothalonil is an extensively used contact fungicide and has been shown to persist in soils. High Performance Liquid Chromatography (HPLC) indicated faster rates of chlorothalonil biotransformation by CYP561 and CYP65 overexpression strains when compared to the wild-type and CYP68 overexpression strain. Our GC-MS results show that the primary transformation intermediate found in soils, 4-hydroxy-2,5,6 trichloro-isophthalonitrile is produced by CYP450s' metabolism. These findings suggest fungal CYP450s can biotransform chlorothalonil for biodegradation or detoxification.

Recent advances in the microbial hydroxylation and reduction of soy isoflavones

Abstract
Soy isoflavones are naturally occurring phytochemicals, which are biotransformed into functional derivatives through oxidative and reductive metabolic pathways of diverse microorganisms. Such representative derivatives, ortho-dihydroxyisoflavones (ODIs) and equols, have attracted great attention for their versatile health benefits since they were found from soybean fermented foods and human intestinal fluids. Recently, scientists in food technology, nutrition, and microbiology began to understand their correct biosynthetic pathways and nutraceutical values, and have attempted to produce the valuable bioactive compounds using microbial fermentation and whole-cell/enzyme-based biotransformation. Furthermore, artificial design of microbial catalysts and/or protein engineering of oxidoreductases were also conducted to enhance production efficiency and regioselectivity of products. This minireview summarizes and introduces the past year's studies and recent advances in notable production of ODIs and equols, and provides information on available microbial species and their catalytic performance with perspectives on industrial application.

Myo-inositol as an adjuvant to florfenicol against Aeromonas hydrophila infection in common carp Cyprinus carpio

Abstract
Florfenicol, a synthetic drug with chemical structure and spectrum of antibacterial activity similar to chloramphenicol, has been shown to be effective against a number of bacterial pathogens. However, there are increasing signs of florfenicol-resistant bacteria due to the misuse and overuse of florfenicol in aquaculture. In the present study, florfenicol had a higher bactericidal efficacy in the presence of myo-inositol, may be due to the ability of myo-inositol to increase susceptibility of Aeromonas hydrophila to florfenicol. Furthermore, in two different infected models, co-administration myo-inositol and florfenicol significantly reduced the bacterial load in the liver, kidney and spleen tissues of A. hydrophila-infected Cyprinus carpio, and greatly increased the survival rate of infected fish. Finally, it was also found that myo-inositol exhibited synergistic action with other antibiotic drugs including neomycin sulfate, ceftriaxone and enrofloxacin. The results obtained in this study suggest that myo-inositol as a efficient adjuvant to antibiotic drugs, could be useful in increasing the antimicrobial activity of antibiotic drugs against A. hydrophila infection, also be useful to help decrease the occurrence of antibiotic overuse in aquaculture.

Severe contact dermatitis caused by urushiol in Japanese lacquer

Contact Dermatitis, EarlyView.


Subtraction CT angiography improves evaluation of significant coronary artery disease in patients with severe calcifications or stents—the C-Sub 320 multicenter trial

Abstract

Objectives

Diagnostic accuracy of conventional coronary CT angiography (CCTAconv) may be compromised by blooming artifacts from calcifications or stents. Blooming artifacts may be reduced by subtraction coronary CT angiography (CCTAsub) in which non-contrast and contrast CT data sets are subtracted digitally. We tested whether CCTAsub in patients with severe coronary calcification or stents reduces the number of false-positive stenosis evaluations compared with CCTAconv.

Methods

In this study, 180 symptomatic patients scheduled for invasive coronary angiography (ICA) were prospectively enrolled and CT scanned (2013-2016) at three international centers. CCTAconv, and CCTAsub data sets were reconstructed. Target segments were defined as motion-free coronary segments with a suspected stenosis (> 50% of lumen) potentially due to blooming of either calcium or stents. Target segments were evaluated with respect to misregistration artifacts from the CCTAsub reconstruction process, in which case evaluation was omitted. CCTAsub and CCTAconv were compared with ICA. Primary outcome measure was the frequency of false positives by CCTAconv versus CCTAsub to identify > 50% coronary stenosis by ICA on a per-segment level.

Results

After exclusion of 76 patients, 104 (14% females) with mean age 67 years and median Agatston score 852 were included. There were 136 target segments with misregistration and 121 target segments without. Accuracy calculations in target segments without misregistration showed a reduction of the false positives from 72% [95% confidence interval (CI): 63-80%] in CCTAconv to 33% (CI:25-42%) in CCTAsub, at the expense of 7% (CI:3-14%) false negatives in CCTAsub.

Conclusions

In severely calcified coronary arteries or stents, CCTAsub reduces the false-positive rate in well-aligned, calcified or stent segments suspected of significant stenosis on CCTAconv. Nevertheless, misregistration artifacts are frequent in CCTAsub.

Key Points

• A high calcium-score reduces the diagnostic accuracy in patients scanned with cardiac CT.

• These patients would normally need an invasive angiogram for diagnosis.

• In this prospective, multicenter study, subtraction CT, when evaluable, reduces false-positive stenosis evaluations.

• Subtraction coronary CT angiography may, when evaluable, reduce excessive downstream testing.



Correction to: Magnetic resonance with diffusion-weighted imaging improves assessment of focal liver lesions in patients with potentially resectable pancreatic cancer on CT

The original version of this article, published on 19 January 2018, unfortunately contained a mistake.



Scapholunate instability: improved detection with semi-automated kinematic CT analysis during stress maneuvers

Abstract

Objectives

To evaluate the diagnostic performance of radioulnar deviation (RUD) and clenching fist (CF) maneuvers for the evaluation of scapholunate dissociation (SLD) using quantitative kinematic CT.

Methods

Thirty-seven patients with suspected scapholunate instability were prospectively evaluated with kinematic CT. Two radiologists independently evaluated the SLD during RUD and CF maneuvers. Various dynamic parameters describing SLD were compared (maximal value, variation coefficient and range) in patients with and without scapholunate ligament ruptures confirmed by CT arthrography.

Results

SLD in CF varied from 3.17 ± 0.38 to 3.24 ± 0.80 mm in controls and from 4.11 ± 0.77 and 4.01 ± 0.85 mm in patients with scapholunate ligament ruptures for reader 1 and 2 (p < 0.009). SLD in RUD varied from 3.35 ± 0.51 and 3.01 ± 0.78 mm in controls and from 4.51 ± 1.26 to 4.42 ± 1.75 mm in patients with scapholunate ligament ruptures for reader 1 and 2 (p varied from 0.001 to 0.002). The inter-observer variability was better for RUD (ICC = 0.85 versus 0.6 for RUD and CF respectively).

Conclusion

Analysis of SLD using kinematic CT has shown significant measurement differences between the groups with or without scapholunate instability with good diagnostic performance.

Key Points

• Kinematic CT can quantitatively assess scapholunate dissociation.

• SLD analysis on kinematic CT has excellent reproducibility with radioulnar deviation maneuver.

• Scapholunate dissociation was significantly different in patients with and without instability.

• Diagnostic performance for scapholunate instability identification was better with radioulnar deviation.



Correction to: Anatomy of the retro-oesophageal major aortopulmonary collateral arteries in patients with pulmonary atresia with ventricular septal defect: results from preoperative CTA

The original version of this article, originally published online ahead of printing on January 05, 2018, unfortunately contained mistakes.



Optic radiations are thinner and show signs of iron deposition in patients with long-standing remitting-relapsing multiple sclerosis: an enhanced T 2 * -weighted angiography imaging study

Abstract

Objective

This study aimed to investigate iron deposition and thickness and signal changes in optic radiation (OR) by enhanced T2*-weighted angiography imaging (ESWAN) in patients with relapsing-remitting multiple sclerosis (RRMS) with unilateral and bilateral lesions or no lesions.

Methods

Fifty-one RRMS patients (42 patients with a disease duration [DD] ≥ 2 years [group Mor], nine patients with a DD < 2 years [group Les]) and 51 healthy controls (group Con) underwent conventional magnetic resonance imaging (MRI) and ESWAN at 3.0 T. The mean phase value (MPV) of the OR was measured on the phase image, and thickness and signal changes of the OR were observed on the magnitude image.

Results

The average MPVs for the OR were 1,981.55 ± 7.75 in group Mor, 1,998.45 ± 2.01 in group Les, and 2,000.48 ± 5.53 in group Con. In group Mor, 28 patients with bilateral OR lesions showed bilateral OR thinning with a heterogeneous signal, and 14 patients with unilateral OR lesions showed ipsilateral OR thinning with a heterogeneous signal. In the remaining nine patients without OR lesions and in group Con, the bilateral OR had a normal appearance. In the patients, a negative correlation was found between DD and OR thickness and a positive correlation was found between MPV and OR thickness.

Conclusions

We confirmed iron deposition in the OR in the RRMS patients, and the OR thickness was lower in the patients than in the controls.

Key Points

• Enhanced T 2 * -weighted magnetic resonance angiography (ESWAN) provides new insights into multiple sclerosis (MS).

• Focal destruction of the optic radiation (OR) is detectable by ESWAN.

• Iron deposition in OR can be measured on ESWAN phase image in MS patients.

• OR thickness was lower in the patients than in the controls.

• Iron deposition and thickness changes of the OR are associated with disease duration.



The inhibitory effect of gadoxetate disodium on hepatic transporters: a study using indocyanine green

Abstract

Objectives

To assess the inhibitory effect of gadoxetate disodium on the transporter system using indocyanine green (ICG).

Materials and Methods

Groups of six female B6 Albino mice were injected with the test agent (0.62 mmol/kg gadoxetate disodium) or phosphate-buffered saline (control) 10 min before injection of ICG. Identical fluorescence images were subsequently obtained to create time-efficiency curves of liver parenchymal uptake. The study was performed on hypothermic and normothermic mice. The logarithms of the absorption rate constants (logKa values) and of the elimination rate constants (logKe values) were calculated for each experimental condition, and between-group differences were compared using Student's t-test.

Results

The logKe values of the test group were lower than those of the control group at both temperatures (-6.52 vs. -5.87 under hypothermic conditions and -4.54 vs. -4.14 under normothermic conditions), and both differences were statistically significant (p = 0.037, 0.015 respectively). In terms of the logKa values, although the difference did not reach statistical significance (p = 0.052), the test group had lower values than the control group under hypothermic conditions (-0.771 vs. -0.376). In normothermic mice, the logKa values for the test and control groups were 0.037 and 0.277 respectively, thus not significantly different (p = 0.404).

Conclusions

Gadoxetate disodium inhibited ICG excretion. Thus, gadoxetate disodium inhibited the ATP-binding cassette sub-family C member 2 transporter.

Key Points

• Gadoxetate disodium inhibited ICG excretion.

• Gadoxetate disodium tended to inhibit hepatic ICG uptake.

• Drug-drug interactions of gadoxetate disodium need further investigation.



Arterial spin-labeling is useful for the diagnosis of residual or recurrent meningiomas

Abstract

Objectives

ASL is useful in evaluating tumour blood flow and in detecting hypervascular tumours. The purpose of this study was to assess the additive value of ASL to non-contrast and contrast-enhanced (NC/CE)-T1WI for diagnosing residual or recurrent meningiomas.

Methods

This retrospective study included 25 postoperative patients (20 women, 5 men; median age, 65 [32–85] years) with and 25 gender- and age-matched postoperative patients without residual or recurrent meningiomas. ASL was performed using a pseudocontinuous method. Seven independent observers (two radiology residents, two general radiologists and three neuroradiologists) participated in two reading sessions consisting of only NC/CE-T1WI (first session) or NC/CE-T1WI with ASL (second session). We evaluated the sensitivity and diagnostic performance for the detection of residual or recurrent meningiomas. The diagnostic performance was assessed using a figure of merit (FOM) calculated via jackknife free-response receiver-operating characteristics. Statistical analysis was performed with paired t tests, with a significance level of p < .05.

Results

The sensitivities were as follows (NC/CE-T1WI vs. NC/CE-T1WI with ASL): residents (62.1% vs. 70.7%), general radiologists (75.9% vs. 87.9%), neuroradiologists (97.7% vs. 100%) and all observers (81.3% vs. 88.2%). The FOMs were as follows (NC/CE-T1WI vs. NC/CE-T1WI with ASL): residents (0.76 vs. 0.83), general radiologists (0.83 vs. 0.93), neuroradiologists (0.95 vs. 0.99) and all observers (0.86 vs. 0.93). The addition of ASL significantly improved the diagnostic parameters for all observers except neuroradiologists (p <. 05).

Conclusions

ASL improved the detection rate of residual or recurrent meningiomas on NC/CE-T1WI among both radiology residents and general radiologists.

Key Points

• ASL improved diagnostic performance for residual/recurrent meningioma compare to NC/CE-T1WI alone.

• Diagnostic sensitivity was increased after adding ASL compared with NC/CE-T1WI.

• FOM was increased after adding ASL compared with NC/CE-T1WI.



Clinical impact of preoperative liver MRI in the evaluation of synchronous liver metastasis of colon cancer

Abstract

Objectives

To investigate whether additional MRI including gadoxetic acid enhancement is associated with survival rate (SR) in patients with synchronous liver metastasis of colon cancer (sCLM), compared with patients assessed only with CT.

Methods

Fifty-two patients underwent only CT (CT group) and 65 underwent additional MRI (CT+MRI group) for preoperative work-up of sCLM. In the CT+MRI group, the discrepancy between CT and MRI was analyzed. The 5-year SR was compared between the groups, and affecting factors were investigated. The inverse probability treatment weighting analysis (IPTW) adjusted by propensity scores was performed.

Results

In the CT+MRI group, 44 (67.7%) showed a discrepancy in the number of sCLMs between CT and MRI. MRI detected 39 additional sCLMs initially missed on CT in 26 patients. The number of detected sCLMs was better correlated with the pathologic findings in the CT+MRI group than in the CT group (p = 0.008). The estimated 5-year SR in the CT+MRI group was 70.8%, while that in the CT group was 48.1%. On adjusted multivariate analyses after the IPTW, the CT+MRI group showed a significantly lower risk of overall mortality than the CT group.

Conclusion

Additional preoperative evaluation by MRI allowed us to more precisely detect sCLM and was associated with a better SR.

Key Points

• CT+MRI group showed significantly higher 5-year survival rates than CT group.

• CT+MRI group was an independent prognostic factor of overall mortality.

• MRI facilitates more accurate detection and better lesion characterization.

• MRI selected better candidates for curative treatment.

• The benefits of MRI were reflected by better survival.



Correction to: Reference ranges of left ventricular structure and function assessed by contrast-enhanced cardiac MR and changes related to ageing and hypertension in a population-based study

The original version of this article, published on 14 March 2018, unfortunately contained a mistake.



Interobserver and intermodality agreement of standardized algorithms for non-invasive diagnosis of hepatocellular carcinoma in high-risk patients: CEUS-LI-RADS versus MRI-LI-RADS

Abstract

Objectives

We compared the interobserver agreement for the recently introduced contrast-enhanced ultrasound (CEUS)-based algorithm CEUS-LI-RADS (Liver Imaging Reporting and Data System) versus the well-established magnetic resonance imaging (MRI)-LI-RADS for non-invasive diagnosis of hepatocellular carcinoma (HCC) in high-risk patients.

Methods

Focal liver lesions in 50 high-risk patients (mean age 66.2 ± 11.8 years; 39 male) were assessed retrospectively with CEUS and MRI. Two independent observers reviewed CEUS and MRI examinations, separately, classifying observations according to CEUS-LI-RADSv.2016 and MRI-LI-RADSv.2014. Interobserver agreement was assessed with Cohen's kappa.

Results

Forty-three lesions were HCCs; two were intrahepatic cholangiocarcinomas; five were benign lesions. Arterial phase hyperenhancement was perceived less frequently with CEUS than with MRI (37/50 / 38/50 lesions = 74%/78% [CEUS; observer 1/observer 2] versus 46/50 / 44/50 lesions = 92%/88% [MRI; observer 1/observer 2]). Washout appearance was observed in 34/50 / 20/50 lesions = 68%/40% with CEUS and 31/50 / 31/50 lesions = 62%/62%) with MRI. Interobserver agreement was moderate for arterial hyperenhancement (ĸ = 0.511/0.565 [CEUS/MRI]) and "washout" (ĸ = 0.490/0.582 [CEUS/MRI]), fair for CEUS-LI-RADS category (ĸ = 0.309) and substantial for MRI-LI-RADS category (ĸ = 0.609). Intermodality agreement was fair for arterial hyperenhancement (ĸ = 0.329), slight to fair for "washout" (ĸ = 0.202) and LI-RADS category (ĸ = 0.218)

Conclusion

Interobserver agreement is substantial for MRI-LI-RADS and only fair for CEUS-LI-RADS. This is mostly because interobserver agreement in the perception of washout appearance is better in MRI than in CEUS. Further refinement of the LI-RADS algorithms and increasing education and practice may be necessary to improve the concordance between CEUS and MRI for the final LI-RADS categorization.

Key Points

• CEUS-LI-RADS and MRI-LIRADS enable standardized non-invasive diagnosis of HCC in high-risk patients.

• With CEUS, interobserver agreement is better for arterial hyperenhancement than for "washout".

• Interobserver agreement for major features is moderate for both CEUS and MRI.

• Interobserver agreement for LI-RADS category is substantial for MRI, and fair for CEUS.

• Interobserver-agreement for CEUS-LI-RADS will presumably improve with ongoing use of the algorithm.



Non-contrast-enhanced magnetic resonance angiography: a reliable clinical tool for evaluating transplant renal artery stenosis

Abstract

Purpose

To evaluate image quality of non-contrast-enhanced magnetic resonance angiography (MRA) and compare transplant renal artery stenosis (TRAS) seen by non-contrast-enhanced MRA with digital subtraction angiography (DSA) as the gold standard.

Materials and methods

330 patients receiving 369 non-contrast-enhanced MRA examinations from July 2014 to June 2017 were included. Thirty patients received at least two MRA examinations. Image quality was independently assessed by two radiologists. Inter-observer agreement was analyzed. Transplant renal artery anatomy and complications were evaluated and compared with DSA. If possible, accuracy was calculated on a per-artery basis.

Results

Good or excellent image quality was found in 95.4 % (352/369) of examinations with good inter-observer agreement (K=0.760). Twenty-two patients with DSA had 28 non-contrast-enhanced MRA examinations within a 2-month period. Of these, 19 patients had TRAS, two patients had pseudoaneurysms, and one patient had a normal transplant renal artery but an occluded external iliac artery. Non-contrast-enhanced MRA correctly detected 19 TRAS and nine normal arteries, giving 96.6 % accuracy on a per-artery basis.

Conclusions

Non-contrast-enhanced MRA demonstrates a good depiction of the transplanted renal artery and shows good correlation with DSA in cases where there was TRAS.

Key Points

• Good or excellent image quality was found in 95.4 % of examinations.

• Non-contrast-enhanced MRA can clearly map transplant renal artery anatomy.

• Non-contrast-enhanced MRA is a reliable tool to detect TRAS.



Improvement of radiology reporting in a clinical cancer network: impact of an optimised multidisciplinary workflow

Abstract

Purpose

To assess the effectiveness of implementing a quality improvement project in a clinical cancer network directed at the response assessment of oncology patients according to RECIST-criteria.

Methods

Requests and reports of computed tomography (CT) studies from before (n = 103) and after (n = 112) implementation of interventions were compared. The interventions consisted of: a multidisciplinary working agreement with a clearly described workflow; subspecialisation of radiologists; adaptation of the Picture Archiving and Communication System (PACS); structured reporting.

Results

The essential information included in the requests and the reports improved significantly after implementation of the interventions. In the requests, mentioning start date increased from 2% to 49%; date of baseline CT from 7% to 64%; nadir date from 1% to 41%. In the reports, structured layout increased from 14% to 86%; mentioning target lesions from 18% to 80% and non-target lesions from 11% to 80%; measurements stored in PACS increased from 76% to 97%; labelled key images from 38% to 95%; all p values < 0.001.

Conclusion

The combination of implementation of an optimised workflow, subspecialisation and structured reporting led to significantly better quality radiology reporting for oncology patients receiving chemotherapy. The applied multifactorial approach can be used within other radiology subspeciality areas as well.

Key points

Undeveloped subspecialisation makes adherence to RECIST guidelines difficult in general hospitals.

A clinical cancer network provides opportunities to improve healthcare.

Optimised workflow, subspecialisation and structured reporting substantially improve request and report quality.

Good interdisciplinary communication between oncologists, radiologists and others contributes to quality improvement.



Extracardiac findings at cardiac MR imaging: a single-centre retrospective study over 14 years

Abstract

Objectives

To determine the prevalence and significance of extracardiac findings (ECF) in a large set of cardiac magnetic resonance (MR) imaging examinations.

Methods

The institutional review board (IRB) of the Charité approved this retrospective, single-centre study. A total of 4376 cardiac MR imaging reports of 3553 patients (age 37.4 ± 20 years, 60.8 % male) examined from 2000 to 2014 were included. Findings with a recommendation for follow-up were considered "major ECF". To analyse the association of indication, age and gender with ECF, Poisson regression and computed incidence rate ratios (IRR) were evaluated.

Results

The overall prevalence of ECF was 34% (95% confidence interval [CI] 32.5–35.6%). Major ECF were present in 3.4% (95% CI 2.9–4.1%) while findings that changed patient management were found in 0.9% (95% CI 0.7–1.3%). In the cases of congenital heart disease, ECF prevalence was higher compared to myocarditis (IRR, 6.0; 95% CI 5.1–7.1%; p < 0.001), while the prevalence of major ECF was lower (IRR, 0.2; 95% CI 0.02–0.51%; p < 0.05). Older patient age was associated with more nonvascular ECF (p < 0.001). Female patients had the same probability of having an ECF as male patients (IRR, 1.04; 95% CI 0.95–1.1%; p = 0.43).

Conclusion

ECF in cardiac MR imaging are present in about every third patient while relevant ECF that change patient management can be found in about one out of 100 patients. Our data suggest that it is important to involve well-trained radiologists in reading cardiac MR images, which often reveal ECF if congenital heart disease is the clinical indication.

Key Points

Extracardiac findings are present in about every third patient.

Relevant ECF changing patient management are found in one out of 100 findings.

Chance of ECF is high in patients with CHD and vascular indications.



Surgery after FOLFIRINOX treatment for locally advanced and borderline resectable pancreatic cancer: increase in tumour attenuation on CT correlates with R0 resection

Abstract

Objectives

To assess factors associated with radical resection (R0) of pancreatic ductal adenocarcinoma (PDAC) after induction treatment with FOLFIRINOX.

Methods

Patients with either locally advanced (LA) and borderline resectable (BR) PDAC undergoing surgical exploration after FOLFIRINOX were retrospectively enrolled. Two pancreatic radiologists reviewed the CT blinded to the final outcome and assessed chemotherapy response and resectability. Patients were then divided into R0 resected (group A) and not resected/R1 resected (group B), which were compared.

Results

Of 59 patients included, 19 were defined as unresectable (32%), 33 borderline resectable (56%) and 7 resectable (12%) during the blind radiological evaluation after FOLFIRINOX. Once in a surgical setting, 27% were non-resectable, whereas 73% received surgical resection with a 70% R0 rate. Consequent sensitivity and specificity were 86% and 29%. At imaging review, significant decreases in longest tumour dimension were observed in both groups: from 32 mm (95% CI 15–55) to 21 (10–44) in group A and from 34 (18–70) to 26 (7–60) in group B, p < 0.05. However, a significant increase in tumour attenuation in all phases was only observed for R0 resected, from 52 HU (26–75) to 65 (35–92) in arterial phase (p < 0.001) and from 62 (36–96) to 78 (40–120) in the venous (p = 0.001).

Conclusion

After neoadjuvant FOLFIRINOX, CT predicted resectability with acceptable sensitivity but low specificity. The observation of increased tumour attenuation at CT scan after FOLFIRINOX treatment might represent a reliable predictor of R0 resection.

Key Points

• CT drives the assessment of PDAC resectability after FOLFIRINOX

• CT predicts resectability with acceptable sensitivity but low specificity

• Significant increase in tumour attenuation was only observed for R0 resected PDAC

• Tumour attenuation after FOLFIRINOX represents a reliable predictor of R0 resection



Cardiac implanted electronic devices and MRI safety in 2018—the state of play

Abstract

Traditionally, the presence of cardiac implanted electronic devices (CIEDs) was a contra-indication to magnetic resonance (MR) imaging. Professional groups from around the world are releasing updated guidelines for the imaging of MR-conditional and legacy CIEDs, reflecting increasing evidence that this can be performed safely when strict protocols are followed.

Key Points

The presence of a pacemaker or automatic implanted cardioverter defibrillator is no longer an absolute contraindication to magnetic resonance imaging.

Strict protocols enable diagnostic quality images to be obtained with minimal risk.

Close collaboration among radiologists, cardiologists and device manufacturer representatives is required.



Use of whole body CT to detect patterns of CPR-related injuries after sudden cardiac arrest

Abstract

Aims and objectives

We have recently implemented a dedicated sudden cardiac arrest (SCA) - whole-body computed tomography (WBCT) protocol to evaluate SCA patients with return of spontaneous circulation (ROSC) following cardiopulmonary resuscitation (CPR). The aim of this study is to evaluate the number and pattern of CPR-related injuries in ROSC patients with SCA-WBCT.

Methods and materials

Single-centre retrospective review of 39 patients (13 female; 20 male, mean age 51.8 years) with non-traumatic, out-of-hospital SCA and ROSC and evaluation with dedicated SCA-WBCT over a 10-month period.

Results

In-hospital mortality was 54%. CPR-related injuries were detected in 85% (33/39).

Chest injuries were most common on WBCT: 85% (33) subjects had rib fractures (mean of 8.5 fractures/subject); 31% (12) sternal fractures; 13% (5) mediastinal haematoma; 10% (4) pneumothorax; 8% (3) pneumomediastinum and 3% (1) haemothorax. Three subjects (8%) had abdominal injuries on WBCT, including one hepatic haematoma with active haemorrhage.

Conclusion

CPR-related injuries on WBCT after ROSC are common, with serial rib fractures detected most commonly. An unexpectedly high rate of abdominal injuries was detected on SCA-WBCT. Radiologists need to be attuned to the spectrum of CPR-related injuries in WBCT, including abdominal injuries and subtle rib fractures.

Key Points

CPR frequently causes injuries.

Radiologists should be aware of the spectrum of CPR related injuries.

Rib fractures are frequent and radiologic findings often subtle.

Clinically unexpected abdominal injuries may be present.



Magnetic resonance guided focused high frequency ultrasound ablation for focal therapy in prostate cancer – phase 1 trial

Abstract

Objectives

To evaluate the feasibility and safety of focal therapy for low–intermediate risk prostate cancer (PCa) with magnetic resonance-guided high frequency focused ultrasound (MRgFUS)

Methods

This IRB-approved phase 1 prospective study enrolled eight patients with prostate specific antigen (PSA) ≤ 10 ng/ml, ≤ cT2a and Gleason score ≤ 7 (4 + 3) disease following informed consent. Under MRI guidance, focused high frequency ultrasound energy was delivered to ablate the target tissue. Treatment-related adverse events were recorded. Oncologic outcomes were evaluated with multiparametric MRI, PSA and TRUS biopsy at 6 months following treatment.

Results

Ten target lesions [six Gleason 6 lesions, two Gleason 7 (3 + 4) and two Gleason 7 (4 + 3)] were treated in eight men (prostate volume range, 25–50 cc; mean MRI time, 248 min per patient; mean sonication duration, 65 min). Mean target volume was 2.7 cc and mean post-treatment non-perfused volume was 4.3 cc. Quality of life parameters were similar between baseline and 6 months in 6/8 patients. All treated regions were negative on MRI; 4/8 patients and 6/10 target lesions (60%) were clear of disease on biopsy. One patient with 2-mm Gleason 8 disease in one of five cores from treatment site (4 + 3 disease at baseline) subsequently underwent prostatectomy with negative surgical margins. Three patients with low volume (5–15%) Gleason 6 residual disease were offered active surveillance. Mean PSA decreased from 5.06 at baseline to 3.4 ng/ml at 6 months.

Conclusion

MRgFUS is a feasible and safe method of noninvasively ablating low–intermediate risk PCa with acceptable short-term oncologic outcomes.

Key Points

Focal therapy selectively ablates locally confined, clinically significant index lesion with a margin while sparing rest of gland and adjacent vital structures.

Magnetic resonance-guided focused high frequency ultrasound surgery (MRgFUS) combines MRI with HIFU.

MRgFUS provides ability to monitor treatments in real time and allows a targeted approach for focal ablation.

MRgFUS is a feasible, safe method of noninvasively ablating low–intermediate risk PCa.

MRgFUS provides acceptable oncologic outcomes at 6 months.



Experience of neuroprotective air injection during radiofrequency ablation (RFA) of spinal osteoid osteoma

Abstract

Purpose

To assess the usefulness of epidural air injection during the RFA treatment of spinal osteoid osteoma.

Methods

A retrospective review of 17 patients who underwent RFA for spinal osteoid osteoma between September 2006 and May 2017 was performed. All the procedures were performed by a single radiologist. We reviewed the perioperative CT studies to assess the distribution of air relative to the osteoid osteoma. The clinical outcome of each patient group was evaluated during routine follow-up.

Results

Seventeen patients were treated for spinal OO (male:female 13:4; mean age was 16, ranging from 4 to 42). The nidus size ranged from 5.8 to 17.2 mm (mean 11.2). In nine cases epidural air injection was performed. In three cases the neuroprotective air was deemed satisfactory with a clear layer of air between the osteoid osteoma and the dural sac being visualised. In six patients adherence between the cortical bone immediately adjacent to the osteoid osteoma and the dural sac in contact was observed.

In 15 patients the procedure was successful in terms of pain relief. No neural damage or other complication was reported in either group.

Conclusion

RFA is a safe treatment for spinal osteoid osteoma. Neuroprotective air injection does not appear to be necessary when performing the treatment in the spine.

Key Points

• Seventeen patients with spinal OO were treated with RFA, nine with air injection and eight without. Clinically successful treatment was achieved in 15 patients, with 2 subsequently undergoing surgery

• In 6/9 cases the injected air failed to achieve separation between the osteoid osteoma and the thecal sac because of inflammatory adhesion

• No complications were observed, regardless of whether neuroprotective air was instilled. Neuroprotective air injection appears unnecessary when treating spinal OO



Early osteosclerotic changes predict chemotherapy response in non-small-cell lung cancer patients with bone metastases

Abstract

Objectives

To explore the relationship between osteosclerotic changes and chemotherapy response in non-small-cell lung cancer (NSCLC) patients with bone metastases (BM).

Methods

Fifty-two NSCLC patients with BM were enrolled from 1 January 2010–31 June 2015 and divided into two groups based on their CT features: an osteosclerotic change (OC) group and a no-osteosclerotic change (NOC) group. The disease control rate (DCR) was evaluated, and progression-free survival (PFS) was analysed using Kaplan-Meier curves. Univariate and multivariate Cox regression analyses were performed to analyse the factors that could affect PFS.

Results

Osteosclerotic changes were observed in 35/52 patients. The median interval when osteosclerotic changes occurred was 2 months (range 1–3 months) after chemotherapy. The OC group had a significantly higher 3-month DCR than the NOC group (p < 0.001). The OC group had a higher 1-year PFS rate than the NOC group (1-year PFS: 74.9% vs. 30.2%, p < 0.001). Univariate Cox regression analysis indicated that pathological subtype (HR = 4.419; 95% CI = 1.635–11.941, p = 0.003) and osteosclerotic changes (HR = 0.199; 95% CI = 0.083–0.477, p < 0.001) were significant predictors of PFS.

Conclusion

Early osteosclerotic changes predict chemotherapy response in NSCLC patients with BM.

Key Points

Osteosclerotic changes were prevalent CT features after chemotherapy in NSCLC patients.

Osteosclerotic changes were positively related to increased 3-month DCR.

Osteosclerotic changes were positively related to increased 1-year PFS rate.



An investigator‐blinded, randomized, prospective, comparative study of efficacy of four anti‐inflammatory and barrier hand moisturizers in patients with chronic hand dermatitis

Dermatologic Therapy, EarlyView.


The use of etanercept for treatment of toxic epidermal necrolysis when toxic shock syndrome is in the differential

Dermatologic Therapy, EarlyView.


Values of body mass index (BMI) and body surface area (BSA) in patients with psoriatic arthritis treated with adalimumab: Preliminary report

Dermatologic Therapy, EarlyView.


“SENECA” Sinecatechins 10% ointment: A green tea extract for the treatment of actinic keratosis. Case series

Dermatologic Therapy, EarlyView.


Adipose tissue, fillers, and skin tightening

Dermatologic Therapy, EarlyView.


Parasitoids of the eucalyptus gall wasp Leptocybe spp.: a global review

Abstract

The genus Leptocybe Fisher & La Salle (Hymenoptera: Eulophidae) and its type species L. invasa were first described in 2004. Leptocybe spp. are global pests of eucalyptus plantations, and parasitoids play an important role in their control. In this review, we describe the species, distribution, biology, ecology and parasitism levels of Leptocybe spp. parasitoids and the problems associated with biological control programmes against Leptocybe spp. Additionally, prospects for the use of conservation or augmentative biological control programmes against Leptocybe spp. are discussed. Worldwide, approximately 23 species of parasitoids of Leptocybe spp. in 7 families and 10 genera have been found to date. Comparing the parasitism levels of the parasitoids showed that Quadrastichus mendeli, Selitrichodes neseri and several (approximately 4) native Megastigmus spp. could be exploited to manage Leptocybe spp. Available information on the Leptocybe spp. parasitoids is expected to improve our understanding related to ongoing studies of biological control programmes against Leptocybe spp.



Ultrashort time-to-echo quantitative magnetic resonance imaging of the triangular fibrocartilage: differences in position

Abstract

Purpose

To compare T2* values of the triangular fibrocartilage (TFC) obtained by ultrashort time-to-echo (UTE) techniques at the neutral position, ulnar flexion of the wrist, and pronation of the forearm.

Materials and methods

MR imaging was performed in ten healthy volunteers with a 3-T MR system by using an eight-channel knee coil. Coronal wrist T2* maps from three-dimensional cone UTE pulse sequences were obtained at the neutral, ulnar flexion, and pronation positions (TR: 19 ms, TE: 0.032 ms/4 ms/8 ms/12 ms, FOV: 18 cm, matrix: 430 × 430, section thickness: 1.5 mm, scan time: 8 min 31 s). UTE-T2* maps were calculated on a pixel-by-pixel basis for all structures of the wrist visualized in the coronal planes. The entire region of interest (ROI) for TFC was manually delineated, and the average T2* value was calculated for each ROI by three radiologists. The Kruskal-Wallis test, Wilcoxon signed-rank test, or intraclass correlation coefficients (ICC) were used for statistics.

Results

The difference in the average T2* value among the three groups according to the forearm/wrist position was significant (p < 0.001). The T2* value of the TFC at pronation (mean ± 2 SD: 7.92 ± 1.37 ms) was significantly lower than those at the neutral (10.08 ± 1.90 ms) and ulnar flexion positions (9.15 ± 1.03 ms) (p < 0.017). The ICC showed a substantial interobserver agreement in the T2* value measurements of the TFC (ICC = 0.986).

Conclusion

T2* relaxation time measurement of the TFC using UTE may be useful for assessing the loading effect by the forearm/wrist position.

Key Points

The T2* value of the TFC may reflect the biomechanics of the wrist joint.

Acute loading at pronation results in a decrease in the T2* value of the TFC.

Quantitative wrist UTE MRI was successfully performed in vivo.



Multiparametric ultrasomics of significant liver fibrosis: A machine learning-based analysis

Abstract

Objective

To assess significant liver fibrosis by multiparametric ultrasomics data using machine learning.

Materials and Methods

This prospective study consisted of 144 patients with chronic hepatitis B. Ultrasomics—high-throughput quantitative data from ultrasound imaging of liver fibrosis—were generated using conventional radiomics, original radiofrequency (ORF) and contrast-enhanced micro-flow (CEMF) features. Three categories of features were explored using pairwise correlation and hierarchical clustering. Features were selected using diagnostic tests for fibrosis, activity and steatosis stage, with the histopathological results as the reference. The fibrosis staging performance of ultrasomics models with combinations of the selected features was evaluated with machine-learning algorithms by calculating the area under the receiver-operator characteristic curve (AUC).

Results

ORF and CEMF features had better predictive power than conventional radiomics for liver fibrosis stage (both p < 0.01). CEMF features exhibited the highest diagnostic value for activity stage (both p < 0.05), and ORF had the best diagnostic value for steatosis stage (both p < 0.01). The machine-learning classifiers of adaptive boosting, random forest and support vector machine were found to be optimal algorithms with better (all mean AUCs = 0.85) and more stable performance (coefficient of variation = 0.01–0.02) for fibrosis staging than decision tree, logistic regression and neural network (mean AUC = 0.61–0.72, CV = 0.07–0.08). The multiparametric ultrasomics model achieved much better performance (mean AUC values of 0.78–0.85) than the features from a single modality in discriminating significant fibrosis (≥ F2).

Conclusion

Machine-learning-based analysis of multiparametric ultrasomics can help improve the discrimination of significant fibrosis compared with mono or dual modalities.

Key Points

• Multiparametric ultrasomics has achieved much better performance in the discrimination of significant fibrosis (≥ F2) than the single modality of conventional radiomics, original radiofrequency and contrast-enhanced micro-flow.

• Adaptive boosting, random forest and support vector machine are the optimal algorithms for machine learning.