Intravenous Steroids With Antibiotics on Admission for Children With Orbital Cellulitis

Purpose: To compare the outcomes of children with orbital cellulitis treated with intravenous (IV) dexamethasone and antibiotics on admission to patients treated with antibiotics alone. Methods: Prospective comparative interventional study. Forty-three children admitted to a tertiary institution with orbital cellulitis were enrolled. On admission, all patients were started on broad spectrum IV antibiotics and parents were offered IV dexamethasone (0.3 mg/kg/d every 6 hours for 3 days). Patients whose parents refused steroid treatment served as the control group. Results: Twenty-eight (65%) patients received IV steroids and antibiotics on admission while 15 (35%) received IV antibiotics alone. Children who received IV steroids had significantly shorter hospital stays than those who did not receive steroids (3.8 ± 0.2 days vs. 6.7 ± 0.3 days; p

Orbital Hobnail Hemangioma

A 64-year-old woman presented with a 1 year history of progressive left proptosis and "blurry vision." Imaging studies revealed a left superior orbital mass distorting the optic nerve and superior rectus muscle. Excisional biopsy established the diagnosis of hobnail hemangioma. This report describes the first case of an orbital hobnail hemangioma, a lesion that more commonly presents in the dermis.

Volumization of the Brow at the Time of Blepharoplasty: Treating the Eyebrow Fat Pad as an Independent Unit

Purpose: Loss of volume in the sub-brow fat pad with associated descent of the eyebrow is a common anatomical finding resulting in both functional and aesthetic consequences. A variety of techniques have been described to address brow position at the time of blepharoplasty. To our knowledge, none of these techniques treat the sub-brow fat pad as an isolated unit. Doing so enables the surgeon to stabilize and volumize the brow without resultant tension on the blepharoplasty wound. The authors describe a technique for addressing volume loss in the eyebrow with associated brow descent that treats the sub-brow fat pad as an isolated unit. Methods: A retrospective review of all patients undergoing brow ptosis repair by a single surgeon (J.W.S.) over an 11-month period was performed. Results: Eighteen patients and 33 brows underwent the technique described. Patients were followed for an average of 11 weeks (range: 4 weeks to 20 weeks). All patients preoperatively displayed both visually significant dermatochalasis and brow descent below the orbital rim. Evaluation of pre- and postoperative photos demonstrates successful volumization of the brow with skin redraping without focal dimpling or undue tension on the eyelid wound. Conclusions: Performing a dissection that allows the sub-brow fat pad to be elevated in isolation from the overlying orbicularis and underlying periosteum allows for volumization and of the brow without compromising closure. This technique is a safe and effective means of volumizing the brow and treating secondary brow descent.

Anomalous Sphenoid Diploe Vein: Case Report Highlighting the Value of Careful CT Evaluation Prior to Decompression Surgery

Lateral bony decompression may offer several biomechanical advantages and has become a commonly used surgical approach. Preoperative imaging plays a key role in surgical planning by providing information about the locoregional anatomy. The marrow space of the greater wing of the sphenoid is a focal point of the decompression surgery based on the volume that it occupies. Several vessels pass through the sphenoid bone, but most are small caliber vessels. The authors describe a case of an uncommon anatomical variant of the cranial diploic venous system in which the anterior transverse diploic vessel traverses the marrow space of the sphenoid. The vessel was identified on preoperative CT evaluation. Despite anticipation of potential bleeding, lateral decompression was abandoned due to difficulties in maintaining hemostasis which compromised the view for safe surgical progress.

Endoscopic Corneal Neurotization: Cadaver Feasibility Study

Purpose: The authors describe a cadaver feasibility study investigating a minimally invasive technique for corneal neurotization with the supraorbital nerve harvested endoscopically. Methods: A cadaver study was performed to investigate the technical feasibility of corneal neurotization via endoscopic supraorbital nerve transfer to the corneoscleral limbus. Results: Endoscopic corneal neurotization was successfully performed on each cadaveric hemiface. Conclusion: The use of an endoscope allows for a minimally invasive approach to corneal neurotization with the supraorbital nerve.

Fibrous Histiocytoma of the Lacrimal Sac in an 11-Year-Old Male

Fibrous histiocytoma is a soft tissue tumor with cells resembling both fibroblasts and histiocytes. Occasionally in the orbit, they rarely arise in the lacrimal sac. Similar to prior cases described, the patient presented with symptoms of epiphora and a slowly enlarging mass inferior to the right medial canthus. Imaging demonstrated a circumscribed 1.2 cm × 1.1 cm × 1.1 cm mass within the lacrimal sac without surrounding bony destruction. Grossly, the tumor appeared homogenous and rubbery. Pathologic study results from the case demonstrated zones of hypercellularity and hypocellularity with a fibrous appearance, admixed with spindle cells and collections of foamy histiocytes. A diagnosis of benign fibrous histiocytoma was rendered, with the patient experiencing a complete resolution of symptoms at subsequent follow up. To the authors' knowledge, this is the first reported solitary case report of a fibrous histiocytoma of the lacrimal sac in a pediatric patient.

Visual Outcomes and Local Control After Fractionated Stereotactic Radiotherapy for Optic Nerve Sheath Meningioma

Purpose: To review the outcomes of patients with optic nerve sheath meningiomas (ONSM) treated with fractionated stereotactic radiotherapy. Methods: Patient characteristics, treatment, and outcomes were analyzed for all patients with primary and secondary ONSM treated from 2001 to 2012. Clinically significant visual acuity change was defined as a 2-line change on the Snellen eye chart from pre-fractionated stereotactic radiotherapy. Results: Forty-one patients were treated: 23 patients with primary ONSM and 18 patients with secondary ONSM. The median age at diagnosis was 56 years. The median visual follow up was 3.8 years and the median radiologic follow up was 4.4 years. At diagnosis, 36% had normal vision (20/20–20/40), 10% had mild impairment (

Transitional Cell Carcinoma of Lacrimal Sac

No abstract available

Differences in Wait Times for Cosmetic Blepharoplasty by ASOPRS Members

Purpose: Adequate access to subspecialty care is of concern to patients and physicians alike. One measure of availability is the wait time for cosmetic procedures. The authors investigated geographical differences in wait times for cosmetic upper eyelid blepharoplasty of American Society of Ophthalmic Plastic and Reconstructive Surgery members across the country. Methods: This study surveyed all 533 American Society of Ophthalmic Plastic and Reconstructive Surgery members' practices in the United States based on the publically available contact information (www.asoprs.org). Scripted telephone calls were made requesting self-referred cosmetic upper eyelid blepharoplasty. Wait times until the first available appointment and time until the first available surgery date were collected. Results: Of the membership, 387 (72.6% response rate) respondents offered appointments for cosmetic upper eyelid blepharoplasty. Overall, 84.2% of respondents were male. Practice breakdown was 83.4% in private practice and 16.5% in academic practice. Median wait time until the next available appointment was 14 days (mean 21.2 days, 0–205 days; p = 0.145). Private practice wait time was shorter than academic (median 14 vs. 18 days, mean 19.7 vs. 28.9 days; p =0.004). However, there was wide variability based on region. Conclusions: Patients seeking cosmetic upper eyelid blepharoplasty have good access to care by American Society of Ophthalmic Plastic and Reconstructive Surgery members. There are variabilities based on academic versus private practice. Further study can evaluate whether similar findings exist for medically necessary functional procedures. This information may help assess the need for additional practitioners.

Oculoplastics Abstracts

No abstract available

Inflammatory Mediators in Xanthelasma Palpebrarum: Histopathologic and Immunohistochemical Study

Purpose: To evaluate the expression of inflammatory mediators in xanthelasma palpebrarum. Methods: In this retrospective histopathologic case–control study, xanthelasma specimens obtained from the private practice and pathology archives of 1 author (R.Z.S.) were analyzed and compared with the blepharoplasty tissues from age- and sex-matched controls. Paraffin-embedded tissue sections were stained with hematoxylin–eosin and CD3, CD20, CD163, cyclooxygenase-1, inducible nitric oxide synthase, matrix metallopeptidase-9, and myeloperoxidase antibodies. Immunostaining was quantified by light microscopy and with a computerized image analysis system of scanned images. Results: Hematoxylin–eosin-stained preparations of xanthelasma specimens demonstrated significantly more intense chronic lymphocytic infiltrate when compared with the control blepharoplasty tissues (p

Mesenchymal Chondrosarcoma of the Lacrimal Gland

A 23-year-old woman presented with right-sided painless proptosis that developed in 12 months. MRI studies demonstrated a well-delineated tumorous enlargement of the right lacrimal gland with homogenous signal intensity and compressing the globe. The tumor was removed totally and in 1 piece with the tentative diagnosis of a pleomorphic adenoma. Pathologic examination revealed biphasic neoplastic elements, which were composed of the cartilaginous matrix and small round cell component. Immunohistopathological examination showed positive CD99 staining and negative reaction to S100, panCK, and CD15. The patient then received a total of 64 Gy orbital radiotherapy in 32 fractionations. There has been no recurrence or metastasis during 14 months of follow up. This case showed that mesenchymal chondrosarcoma may arise from the lacrimal gland and must be considered in the differential diagnosis of lacrimal gland tumors in young adults.

Scleral Contact Lenses in an Academic Oculoplastics Clinic: Epidemiology and Emerging Considerations

Purpose: To describe the role and efficacy of scleral contact lenses (SCLs) in the treatment of progressive keratopathy in patients who have undergone periocular surgical procedures, to investigate the financial impact of these surgical interventions, and to demonstrate the role of oculoplastic surgery in improving scleral contact lens fit. Methods: A retrospective medical record review was performed to identify patients who both received SCLs and were examined by the oculoplastics service at the University of Iowa between January 1990 and December 2015. Inclusion criteria also required a minimum of 12 months of patient follow up after being fit with a SCL. The indication for SCL use, as well as clinical outcomes and cumulative relative value units (RVUs) of prior oculoplastic treatments and SCL therapy were recorded for each patient. Results: Six hundred and fifty-nine patients were fitted with SCLs at the authors' institution during the 25-year study period, 43 of whom were examined by the oculoplastics service for reasons related to their SCL. Patients who were fitted for SCLs before (27 patients) or after (16 patients) evaluation in the oculoplastics clinic presented with a variety of corneal and periocular pathology. Corneal indications for SCLs in patients seen secondarily in the oculoplastics clinic included decreased corneal sensation (from CN V palsy or neurotrophic keratopathy), decreased corneal healing from limbal stem cell deficiency, exposure keratopathy, and keratoconjunctivitis sicca secondary to Sjogren's syndrome or orbital radiation. Indications for oculoplastic clinic evaluation in current scleral lens patients included lagophthalmos, trichiasis, epiphora, cicatricial changes in the eyelids or fornices, and eyelid or eyebrow malposition affecting SCL centration. In all 27 patients, surgical intervention resulted in improved SCL centration. Sixteen patients (5 with CN VII palsy, 4 with CN V and CN VII palsy, 4 with neurotrophic keratitis, and 3 with cicatricial entropion) had progressive corneal decompensation despite primary oculoplastics procedures to protect the cornea and ultimately benefitted from SCL treatment secondarily. Fourteen of these 16 patients demonstrated an improved visual acuity of 1 line or more using SCLs. Procedures performed before referral for SCLs included tarsorrhaphies, gold weights, ectropion repair with lateral tarsal strip, retraction repair with spacer grafts, full-thickness skin grafts, cheek lifts, and punctal occlusion. The total RVUs of these procedures performed per patient were tabulated. The RVU range was 10.47–33.96 with an average of 19.5 RVUs (standard deviation = 9.4 RVUs) per patient. Conclusions: Scleral contact lenses may offer a useful alternative to stabilize the ocular surface, improve vision, and minimize the financial impact and morbidity of multiple periocular procedures in select patients with progressive keratopathy of varying etiologies. The therapeutic indications and utilization of SCLs are likely to increase in oculoplastic practices with optometric support, particularly in academic settings. Surgical correction of eyelid and eyebrow malposition, as well as epiphora, may also be useful adjunctive procedures to optimize SCL fit.

Biopsy-Proven Metastatic Merkel Cell Carcinoma to the Orbit: Case Report and Review of Literature

Merkel cell carcinoma is a rare neuroendocrine tumor of subspecialized dermal mechanoreceptors, associated with immunosuppression. The usual ophthalmic presentation is an eyelid lesion. The authors present a case of biopsy-proven orbital metastatic Merkel cell carcinoma in the absence of any eyelid lesion, in an immunosuppressed patient with a history of multiple cancers. There are to the authors' knowledge only 2 other case reports of presumed metastatic Merkel cell carcinoma to the orbit, though neither were biopsied. Despite its rarity, metastatic Merkel cell carcinoma should be included in the differential of a metastatic orbital lesion, in the patient with a known or suspected cutaneous primary. The patient has had an excellent response to combined radiotherapy and programmed death-1 inhibitor pembrolizumab, and this case highlights the potential benefit of an exciting new biologic therapy.

Blepharoplasty Effect on a Described Algorithmic Approach to External Ptosis Repair: Is It Time for Unbundling?

Purpose: To investigate the effects of performing a previously described algorithmic levator resection for involutional ptosis with a blepharoplasty instead of through a small incision. Methods: Eyelids with involutional ptosis and normal levator function were included in the study. An upper blepharoplasty was performed first. An external levator resection was then performed based on a described technique involving 2 mm resection of aponeurosis for 1 mm of desired lift, consistent tension on the aponeurosis between surgical cases, and standardized suture placement. Results: Forty-one eyelids of 25 patients were included. Mean postoperative margin to reflex distance 1 (MRD1) was 2.98 mm, which was significantly higher than preoperative MRD1 (0.67 mm), but lower than the predetermined goal MRD1 (3.35 mm). Eight eyelids did not meet primary outcome of MRD1 within 1 mm of goal MRD1, with 5 undercorrections. There was no difference between the postoperative MRD1 compared with the same ptosis technique performed through a small incision only, but there were more intraoperative suture adjustments and fewer eyelids meeting the primary outcome when a concurrent blepharoplasty was performed. Conclusions: The addition of blepharoplasty with a previously described algorithmic approach external levator resection has an 80% success rate in achieving the primary outcome. When compared with a small-incision ptosis repair, concurrent blepharoplasty results in a less predictable outcome and an increased need for intraoperative adjustment. Performing an algorithmic technique for external levator resection with a blepharoplasty has less predictable outcomes, which raises the question of separating the procedures to improve patient care.

Nasal Glioma: A Rare Cause of Congenital Inner Canthal Swelling

Nasal glioma, encephalocele, and ectopic brain are rare congenital anomalies. The terminology applied to these entities has been historically confusing. In many cases, the terms overlap and may be employed synonymously although some authors emphasize their differences. The authors describe herein a child with an inner canthal mass of brain-like tissue that they interpret as nasal glioma, a variety of encephalocele that has lost its connection to the intracranial contents. This research was conducted in conformity with the Helsinki Declaration and Health Insurance Portability and Accountability Act regulations.

Utility of PROSE Device in the Management of Complex Oculoplastic Pathology

Purpose: To describe the use of Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) device in the management of complex oculoplastic pathology. Methods: The authors retrospectively reviewed the records of individuals over 18 years of age who were referred and successfully fit with the PROSE scleral device between January 1995 and June 2015. Results: Nine cases were identified that had complex oculoplastic disease and severe corneal surface disease. All patients with ptosis had improvement in marginal reflex distance-1 following PROSE and 5 of 7 patients with ptosis were spared further surgical intervention. Two underwent surgical repair with successful corneal stabilization with PROSE. Those with eyelid malposition including ectropion, entropion, or trichiasis experienced improvement in their corneal surface and deferred further surgical intervention. Conclusions: These cases highlight the use of the PROSE device to elevate the upper eyelid in patients with lagophthalmos and ptosis, stabilize the corneal surface to allow for additional eyelid surgery to be performed safely, and protect the corneal surface in patients with intractable trichiasis and entropion. Prosthetic Replacement of the Ocular Surface Ecosystem should be considered in patients with complex oculoplastic pathology to improve visual function, corneal surface disease, and eyelid position.

Basic Photographic Standards for Abdominal Contouring Procedures and Abdominoplasty/Lipectomy

Abstract

Standardized reliable medical photographic documentation should be made by every plastic surgeon for valid comparisons of preoperative and post-operative illustrations. However, photographic documentation in aesthetic surgery has also an important medico-legal impact as if not performed accurately it can result in severe legal ramifications. Therefore, we evaluated and redefined the existing photographic standards for abdominal contouring procedures and abdominoplasty/lipectomy further, to achieve consistent detailed photographs without any corresponding distortion or distraction. The results of the modification in standardized photographic documentation in aesthetic abdominoplasty and lipectomy are based on the basic principles of photography in plastic and aesthetic surgery and are presented in this article.

Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Influence of Flap Thickness on Nipple Projection After Nipple Reconstruction Using a Modified Star Flap

Abstract

Background

In nipple reconstruction, the width, length, and thickness of modified star flaps are concerns for long-term reconstructed nipple projection. However, the flap's projection has not been analyzed, based on its thickness. The aim of the present study was to investigate how flap thickness in a modified star flap influences the resulting reconstructed nipple and achieves an appropriate flap width in design.

Methods

Sixty-three patients who underwent nipple reconstruction using a modified star flap following implant-based breast reconstruction between August 2014 and July 2016 were included in this case-controlled study. The length of laterally diverging flaps was 1.5 times their width. The thickness of each flap was measured using ultrasonography, and the average thickness was defined as the flap thickness. We investigated the correlation between the resulting reconstructed nipple and flap thickness, and the difference of the change in the reconstructed nipple projection after using a thin or thick flap.

Results

The average flap thickness was 3.8 ± 1.7 (range 2.5–6.0) mm. There was a significant, linear correlation between the flap thickness and resulting reconstructed nipple projection (β = 0.853, p < 0.01). Furthermore, the difference between the thin and thick flaps in the resulting reconstructed nipple projection was significant (p < 0.01).

Conclusion

Measuring the flap thickness preoperatively may allow surgeons to achieve an appropriate flap width; otherwise, alternative methods for higher projection might be used.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Reply To: “The impact of a career night information session on medical students' perceptions of the scope of practice of plastic surgeons.”

Publication date: Available online 7 May 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Tyler Safran, Benjamin Beland, Alex Viezel-Mathieu, James Lee

Protective effects of conventional and colon-targeted lycopene and linalool on ulcerative colitis induced by acetic acid in rats

Abstract

Objective

To compare the potential protective effects of conventional and colon-targeted lycopene (TLC) and linalool (TLN) on acetic acid (AA)-induced ulcerative colitis (UC) in rats.

Methods

Conventional and colon-targeted LC (10 mg/kg) and LN (200 mg/kg) were administered in vivo orally for 7 days and sulfasalazine (100 mg/kg) was also used as reference drug. Then, 4% AA was administered intrarectally to induce UC. Subsequently, the colon tissues were taken as samples for biochemical and histopathological analysis.

Results

Malondialdehyde (MDA), interleukin 1β (IL-1β), IL-6, cyclooxygenase-2 (COX-2) and nuclear factor kappa B (NF-κB) levels were decreased (p < 0.05) in the targeted groups compared to the AA group, whereas nuclear factor-erythroid 2-related factor 2 (Nrf-2) level was increased (p < 0.05). Tumor necrosis factor α (TNF-α) level was also decreased (p < 0.05) and catalase activity (CAT) was increased (p < 0.05) in the TLC group compared to the AA group. IL-1β and IL-6 levels were lower in the TLC group compared to the conventional LC and sulfasalazine groups (p < 0.05). COX-2 and NF-κB levels were lower, while the Nrf-2 level was higher in the targeted groups compared to the conventional groups (p < 0.05). Furthermore, COX-2 level was lower and Nrf-2 level was higher in the targeted groups compared to the sulfasalazine group (p < 0.05).

Conclusion

As expected, sulfasalazine was effective on all parameters analyzed, but the colon-targeted pretreatments were more effective from sulfasalazine on some parameters. Therefore, colon-targeted plant-derived therapies might be alternative approaches to provide protection against UC, which deserves to be investigated further.

Osthole ameliorates neurogenic and inflammatory hyperalgesia by modulation of iNOS, COX-2, and inflammatory cytokines in mice

Abstract

Background

Osthole is a bioactive component reported in medicinal plants such as Angelica pubescens and Cnidium monnieri, known for analgesic activity. However, the toxicity, median effective dose (ED₅₀), and dual modulation of nitric oxide and cyclooxygenase pathways along with inflammatory cytokines of osthole are yet to be determined.

Methods

The animals (mice) were assessed for general behaviour and mortality in varying doses (50, 300, and 2000 mg kg⁻¹) of osthole for acute toxicity over 14 days. The analgesic activity was investigated using acetic acid and formalin-induced hyperalgesia, and anti-inflammatory activity was explored in carrageenan-induced paw oedema. ED₅₀ of osthole was calculated using Design Expert software. Involvement of nitric oxide and cyclooxygenase pathways was investigated by agonist challenges with l-arginine and substance P, respectively. The expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) was determined in spinal sections by immunohistochemical analysis. Lipopolysaccharide (LPS) challenge was used to assess in vivo effect on inflammatory cytokines (TNFα and IL-6).

Results

Acute toxicity studies revealed no behavioural abnormality or mortality on osthole treatment and unremarkable histological findings. Osthole was found to significantly decrease acetic acid and formalin-induced hyperalgesia (ED₅₀ = 5.43 mg kg⁻¹) and carrageenan-induced paw oedema with no toxicity symptoms. Osthole produced a marked decrease in iNOS and COX-2 expression as well as TNFα and IL-6. The findings corroborate to modulation of iNOS and COX-2 and inflammatory cytokines by osthole. This study provides promising insights and prospects for application of osthole in pain management.

Is the pharmaceutical industry’s preoccupation with the monotherapy drug model stifling the development of effective new drug therapies?

Abstract

Drug discovery and development is heavily biased towards the development of monotherapies. Screening, testing, and evaluation of mono-entity drugs are generally much simpler than drug combinations, and are generally easier to get approval from the regulatory authorities for their clinical use. However, monotherapy drugs may not have optimal activity, may have associated toxicities, or may lose activity over time as their target develops resistance. Drug combinations, often developed from existing monotherapies, may have improved efficacy and/or be less toxic. Furthermore, the existing drugs which have lost efficacy due to the development of resistance can often be re-activated by combining them with other chemical entities. Thus, whilst the current climate for drug approval, registration, and clinical use drives the majority of drug development research towards the development of monotherapies, combinations are often a substantial improvement on the original drug. This commentary examines monotherapy and combinational therapy models and discusses the benefits and limitations of each model.

Microarray-based expression analysis of phytohormone-related genes in rice seedlings during cyanide metabolism

Abstract

Plants exhibit highly coordinated, dynamic reactions to various abiotic stressors. As cyanide is a non-essential element for plant growth, entry inside plants can exert toxicity at multiple levels. In plant, hormone plays a pivot role under stress conditions. The fluctuations of stress-responsive hormones help in altering cellular dynamics and hence play a central role in coordination and adaptation growth responses under stress. This study focusses on uptake of cyanide in Oryza sativa seedlings and its effect on physiological and on genetic level. Microarray approach has been focused on transcriptional profiling of genes which are involved in systemic acquired resistance for cyanide. Our study shows that the change in different hormonal contents maintained almost the same pattern in roots and shoots upon CN exposure, except for SA. However, the hormone-related gene expression pattern conducted by microarray analysis was inconsistent in both plant materials (root/shoots). Comparison of gene expression between root/shoots showed a total of 29 in roots and 16 DEGs, respectively, indicating that hormone-related genes in roots were more responsive than those in shoots during exogenous CN metabolism. These results showed a remarkable change at transcript level of plant hormone-related genes, including biosynthesis, degradation, induction, and signal transduction under cyanide stress.

Does nitrite and nitrate levels in drinking water impact the health of people in Dakahlia governorate, Egypt?

Abstract

A total of 1291 drinking water samples were examined for nitrite and nitrate during 6 months from December, 2015 to May, 2016 at 17 cities of Dakahlia governorate (Nile Delta, north of Egypt), and the results were utilized for assessment of health risk of the exposure from drinking water by calculating average daily intake (ADI), hazard quotient (HQ), and the hazard index (HI). The nitrite and nitrate in drinking water had a concentration range of 0.030–0.113 and 2.41–8.70 mg L⁻¹, with mean values of 0.059 ± 0.014 and 5.25 ± 1.61 mg L⁻¹, respectively. Nitrite and nitrate levels in rural areas and ground water samples were significantly higher than that in the urban ones. None of the analyzed samples exceeded WHO guideline values that set out to prevent methemoglobinemia. The values of HQ and HI for all age groups do not exceed unity indicating a low risk of methaemoglobinaemia for the population in this area. Results of the present study indicate that there is no health risk of residents from nitrite and nitrate through drinking water in the studied area. However, the other sources of exposure to nitrite and nitrate should be investigated in further studies.

Effects of compost and technosol amendments on metal concentrations in a mine soil planted with Brassica juncea L.

Abstract

Mining activities often cause important impacts on soil and water quality. The main objective of this study was to evaluate the effect of amendments (compost and technosol made from waste) on metal concentrations in a mine soil planted with Brassica juncea. A greenhouse experiment with cylinder pots was carried out during 11 months. The mine soil was collected from the settling pond of the depleted copper mine of Touro (Galicia, Northwest Spain). A series of characteristics were analysed including soil pseudototal metal concentrations, soil CaCl₂-extractable (phytoavailable) metal concentrations and metal concentrations in soil pore water. The results showed that at depth 0–15 cm SCP (mine soil + compost, grown with B. juncea) had a significantly lower CaCl₂-extractable Cu, Pb, Ni and Zn concentration than STP (mine soil + technosol, grown with B. juncea) over the time (P < 0.05). At depths 15, 30 and 45 cm, STP and SCP had lower Cu pore water concentration than S over the time. The highest translocation factor (TF) values for all metals (Cu, Pb, Ni and Zn) were observed at time 1 (3 months) in the settling pond soils treated with technosol and B. juncea L. The conclusions of this experiment revealed that SCP compared to STP caused a higher reduction on Cu, Pb, Ni and Zn phytoavailable concentrations in the first depths.

Cyclooxygenase and lipoxygenase gene expression in the inflammogenesis of breast cancer

Abstract

We examined the expression of major inflammatory genes, cyclooxygenase-1 and 2 (COX1, COX2) and arachidonate 5-lipoxygenase (ALOX5) in 1090 tumor samples of invasive breast cancer from The Cancer Genome Atlas (TCGA). Mean cyclooxygenase expression (COX1 + COX2) ranked in the upper 99th percentile of all 20,531 genes and surprisingly, the mean expression of COX1 was more than tenfold higher than COX2. Highly significant correlations were observed between COX2 with eight tumor-promoting genes (EGR2, IL6, RGS2, B3GNT5, SGK1, SLC2A3, SFRP1 and ETS2) and between ALOX5 and ten tumor promoter genes (CD33, MYOF1, NLRP1, GAB3, CD4, IFR8, CYTH4, BTK, FGR, CD37). Expression of CYP19A1 (aromatase) was significantly correlated with COX2, but only in tumors positive for ER, PR and HER2. Tumor-promoting genes correlated with the expression of COX1, COX2, and ALOX5 are known to effectively increase mitogenesis, mutagenesis, angiogenesis, cell survival, immunosuppression and metastasis in the pathogenesis of breast cancer.

Hierarchical protein export mechanism of the bacterial flagellar type III protein export apparatus

Abstract

The bacterial flagellum is supramolecular motility machinery consisting of the basal body, the hook and the filament. Flagellar proteins are translocated across the cytoplasmic membrane via a type III protein export apparatus, diffuse down the central channel of the growing structure and assemble at the distal end. Flagellar assembly begins with the basal body, followed by the hook and finally the filament. The completion of hook assembly is the most important morphological checkpoint of the sequential flagellar assembly process. When the hook reaches its mature length of about 55 nm in Salmonella enterica, the type III protein export apparatus switches export specificity from proteins required for the structure and assembly of the hook to those responsible for filament assembly, thereby terminating hook assembly and initiating filament assembly. Three flagellar proteins, namely FliK, FlhB and FlhA, are responsible for this substrate specificity switching. Upon completion of the switching event, interactions among FlhA, the cytoplasmic ATPase complex and flagellar type III export chaperones establish the assembly order of the filament at the hook tip. Here, we describe our current understanding of a hierarchical protein export mechanism used in flagellar type III protein export.

Infection risk in gyms during physical exercise

Abstract

This study aimed to analyze the risk of infection (influenza and tuberculosis) for individuals participating in physical exercise. This was achieved by assessment of carbon dioxide (CO₂) concentrations, and examination of the physical characteristics of a number of gyms to determine whether there was a relationship to CO₂ levels. This study was performed in three different gyms ventilated with either split system or central system air conditioners. The risk of airborne infection (percent of susceptible persons infected) was estimated for each gym using the Wells-Riley model. The risk of infection increased during periods of peak occupancy where the ventilation required by occupants was greater. In each gym, the highest risk of infection occurred during the evening where occupancy and CO₂ levels were high. The infection risk for influenza was high in all situations due to the high quantum generation rate for this agent. This study suggests that inefficient ventilation in gyms is a significant problem, with high CO₂ concentrations resulting in impaired air quality and high health risks to users, including increased risk of infections such as influenza and tuberculosis.

Characterization, preparation, and uses of nanomagnetic Fe 3 O 4 impregnated onto fish scale as more efficient adsorbent for Cu 2+ ion adsorption

Abstract

In this research, the Cu²⁺ ion adsorption from aqueous solution was investigated by fish scale (FS) and nanomagnetic (Fe₃O₄) loaded fish scale (MFS) from fishery biomass. We characterized the structure and morphology of synthesized magnetic adsorbent by Fourier transform infrared spectroscopy (FTIR), FESEM, and XRD. The FTIR and XRD tests confirmed the collagen fibers, apatite crystals, and nanomagnetite particles presence in the MFS structure. The isotherm models of Langmuir, Freundlich, and Dubinin-Radushkevich were exerted to the empirical equilibrium data, by which was found that the Langmuir equation have the best fit to the experimental data in comparison to the other isotherm equations. The maximum capacities of monolayer coverage of FS and MFS for adsorption of Cu²⁺ ions were achieved, respectively, 61.73 and 103.1 mg g⁻¹ based on Langmuir isotherm at 45 °C. It was also discovered that the Cu²⁺ ion adsorption onto MFS was totally a physisorption-controlled process. It was perceived that the model of pseudo-second order rate kinetics also could be applied for predicting of studied adsorption processes. Here, the adsorption was a spontaneous and endothermic process because of the negative and the positive values of ∆G⁰ and ∆H⁰, respectively. The reusability potential of the used adsorbents was studied, so that the results showed an efficiency of 76.5 and 83.92% for FS and MFS, respectively, after four adsorption-desorption cycles.

Development of bark-based magnetic iron oxide particle (BMIOP), a bio-adsorbent for removal of arsenic (III) from water

Abstract

Novel low-cost bark-based magnetic iron oxide particles (BMIOPs) were synthesized and investigated for the removal of As(III) in drinking water. The synthesized BMIOP had a saturation magnetization value of 38.62 emug⁻¹ which was found to be enough for the magnetic separation of exhausted BMIOP after As(III) adsorption. Parameters like agitation speed, adsorbent dosage, contact time, pH, temperature, and initial concentration were thoroughly investigated. Langmuir, Freundlich, and Dubinin–Radushkevich isotherms were used for the modeling of experiments and observed a maximum adsorption (19.61 mg g⁻¹) of As(III) by Langmuir isotherm. Kinetics of As(III) sorption were well correlated with the coefficients in pseudo-first-order than the pseudo-second-order rate equation. Thermodynamic parameter investigation revealed that As(III) sorption process is endothermic, feasible, and spontaneous. BMIOP emerged as less expensive adsorbent for the abatement of arsenic ion from the drinking water. BMIOP showed 13.58 mg g⁻¹ adsorption capacity when As(V) alone is present, while it is 9.43 and 7.04 mg g⁻¹ for As(V) and As(III), respectively, when present together in the water.

Graphical Abstract

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Cluster Randomized Test-Negative Design (CR-TND) Trials: A Novel and Efficient Method to Assess the Efficacy of Community Level Dengue Interventions

Abstract

Cluster randomized trials are the gold standard for assessing efficacy of community-level interventions, such as vector control strategies against dengue. We describe a novel cluster randomized trial methodology with a test-negative design, which offers advantages over traditional approaches. It utilizes outcome-based sampling of patients presenting with a syndrome consistent with the disease of interest, who are subsequently classified as test-positive cases or test-negative controls on the basis of diagnostic testing. We use simulations of a cluster trial to demonstrate validity of efficacy estimates under the test-negative approach. This demonstrates that, provided study arms are balanced for both test-negative and test-positive illness at baseline and that other test-negative design assumptions are met, the efficacy estimates closely match true efficacy. We also briefly discuss analytical considerations for an odds ratio-based effect estimate arising from clustered data, and outline potential approaches to analysis. We conclude that application of the test-negative design to certain cluster randomized trials could increase their efficiency and ease of implementation.

Tim‐3 exacerbates kidney ischaemia/reperfusion injury through the TLR‐4/NF‐κB signalling pathway and an NLR‐C4 inflammasome activation

Clinical &Experimental Immunology, EarlyView.

Correction to: Morphological characteristics of chronic total occlusion: predictors of different strategies for long-segment femoral arterial occlusions

Abstract

The original version of this article unfortunately contained mistakes. The legends to Figs. 2–4 were incorrectly interchanged. The correct versions are given below. The original article has been corrected.

Baseline neutrophil‐to‐lymphocyte ratio in patients with advanced melanoma treated with immune checkpoint inhibitors: reply from the authors

British Journal of Dermatology, EarlyView.

Reply to: Frequency of squamous cell carcinoma in situ (SCCIS) and SCC in re‐excisions of biopsy‐proven cutaneous SCCIS

British Journal of Dermatology, EarlyView.

Whole-body ultra-low dose CT using spectral shaping for detection of osteolytic lesion in multiple myeloma

Abstract

Objectives

The aim of this study was to investigate the radiation dose and image quality of a whole-body low-dose CT (WBLDCT) using spectral shaping at 100 kV (Sn 100 kV) for the assessment of osteolytic lesions in patients with multiple myeloma.

Methods

Thirty consecutive patients were retrospectively selected, who underwent a WBLDCT on a third-generation dual-source CT (DSCT) (Sn 100 kV, ref. mAs: 130). They were matched with patients, who were examined on a second-generation DSCT with a standard low-dose protocol (100 kV, ref. mAs: 111). Objective and subjective image quality, radiation exposure as well as the frequency of osteolytic lesions were evaluated.

Results

All scans were of diagnostic image quality. Subjective overall image quality was significantly higher in the study group (p = 0.0003). Objective image analysis revealed that signal intensities, signal-to-noise ratio and contrast-to-noise ratio of the bony structures were equal or significantly higher in the control group. There was no significant difference in the frequency of osteolytic lesions (p = 0.259). The median effective dose of the study protocol was significantly lower (1.45 mSv vs. 5.65 mSv; p < 0.0001).

Conclusion

WBLDCT with Sn 100 kV can obtain sufficient image quality for the depiction of osteolytic lesions while reducing the radiation dose by approximately 74%.

Key points

• Spectral shaping using tin filtration is beneficial for whole-body low-dose CT

• Sn 100 kV yields sufficient image quality for depiction of osteolytic lesions

• Whole-body low-dose CT can be performed with a median dose of 1.5 mSv

Use of the Kwak Thyroid Image Reporting and Data System (K-TIRADS) in differential diagnosis of thyroid nodules: systematic review and meta-analysis

Abstract

Purpose

The purpose of this systematic literature review was to assess the usefulness of the Thyroid Image Reporting and Data System (K-TIRADS) classification proposed by Kwak for differentiation of thyroid nodules.

Material and methods

Four literature databases were searched for relevant articles through early January 2017. A meta-analysis was performed to calculate pooled sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-) and diagnostic odds ratio (DOR). The area under the curve (AUC) from the pooled receiver operating characteristic (ROC) was used to assess the usefulness of this classification for differentiation of thyroid nodules. Meta-analysis was conducted by using meta-analysis software.

Results

We analysed six publications describing 10,926 nodules. Pooled sensitivity, specificity, LR+, LR-, DOR, and AUC for pooled ROC were 0.983 (95 % CI 0.976–0.989), 0.552 (95 % CI 0.542–0.562), 2.666 (95 % CI 1.692–4.198), 0.05 (95 % CI 0.035–0.072), 51.020 (95 % CI 15.241–170.79) and 0.938, respectively.

Conclusions

Kwak TIRADS has high sensitivity and low specificity. Thus, it is very useful to discard the benign cases and to reduce the number of biopsies.

Key Points

• Routine, adequate standardization of thyroid nodules ultrasound classification is mandatory.

• Kwak TIRADS parameters are accurate for differentiating focal thyroid lesions.

• Kwak TIRADS system is simple to apply.

• Kwak TIRADS system may become a useful diagnostic tool.

Significance of hyperechoic marks observed during high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules

Abstract

Objective

To examine the association between the appearance of hyperechoic marks (HEMs) during high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules and nodule shrinkage at 6 months.

Methods

One hundred and thirty-six patients who underwent HIFU for benign thyroid nodule were analysed. An independent person carefully examined the B-mode ultrasonography screen for the appearance of HEMs after each pulse. The proportion of HEMs (%) was calculated by: [(Number of pulses that resulted in HEMs) / (Total number of pulses given per treatment) × 100] while the nodule shrinkage was measured by volume reduction ratio (VRR) = [Baseline volume–volume at 6 months]/[Baseline volume] * 100. Treatment success was defined as VRR ≥ 50 %.

Results

Patients with HEMs (n=91) had significantly greater 6-month VRR than those without HEMs (n=45) (65.76 % vs. 36.76 %, p<0.001). By regression analysis, after adjusting for age and energy per pulse, smaller nodule volume at baseline (OR 1.143, 95 % CI 1.038–1.256, p=0.006) and appearance of HEMs (OR 275.44, 95 % CI 26.63–2848.98, p<0.001) were independent predictors for treatment success.

Conclusions

The appearance of HEMs during treatment was an independent determinant of treatment success following single-session HIFU ablation of benign thyroid nodule.

Key Points

• HIFU is a safe and effective treatment for benign thyroid nodules.

• Lower BMI and greater applied power increase likelihood of hyperechoic marks.

• The appearance of hyperechoic marks during HIFU affects subsequent treatment outcome.

Demystifying liver iron concentration measurements with MRI

Abstract

This Editorial comment refers to the article: Non-invasive measurement of liver iron concentration using 3-Tesla magnetic resonance imaging: validation against biopsy. D'Assignies G, et al. Eur Radiol Nov 2017.

Key Points

• MRI is a widely accepted reliable tool to determine liver iron concentration.

• MRI cannot measure iron directly, it needs calibration.

• Calibration curves for 3.0T are rare in the literature.

• The study by d'Assignies et al. provides valuable information on this topic.

• Evaluation of liver iron overload should no longer be restricted to experts.

Gallbladder wall oedema and ascites are independent predictors of progression to hepatic veno-occlusive disease for children with hematopoietic stem cell transplantation

Abstract

Objectives

To evaluate the predictive value of ultrasonography in children with clinically suspicious hepatic veno-occlusive disease (VOD) after hematopoietic stem cell transplantation (HSCT).

Methods

Among 216 children who underwent HSCT, 70 also underwent colour Doppler ultrasonography. Of these, 59 had only one sign/symptom, which did not fulfil the diagnostic criteria (clinical suspicion of VOD) at that time. VOD was confirmed in 20 patients (VOD group), while 39 had other conditions (non-VOD group). The following findings were reviewed and compared between groups: left portal vein (peak velocity, direction), left hepatic artery (peak-systolic/end-diastolic velocities, resistive index), middle hepatic vein (peak velocity, phasicity), hepatomegaly, splenomegaly, gallbladder wall thickness, and ascites.

Results

The VOD group showed significantly higher reversed flow in portal vein (P = 0.011), peak systolic velocity of left hepatic artery (P = 0.028), monophasicity of middle hepatic vein (P = 0.015), hepatomegaly (P = 0.001), gallbladder wall thickness (P < 0.001), and ascites (P < 0.001). Multivariate regression revealed that gallbladder wall thickness and ascites (odds ratio = 35.370, 56.393) were associated with VOD.

Conclusions

The presence of reversed flow in portal vein, increased peak systolic velocity of hepatic artery, monophasicity of hepatic vein, hepatomegaly, gallbladder wall thickness, and ascites were significantly associated with progression to VOD in children with clinically suspicious VOD after HSCT.

Key Points

• Ultrasonography with Doppler can help predict progression to VOD.

• Gallbladder wall oedema and ascites are the independent predictors of progression to VOD.

Impact of noncardiac findings in patients undergoing CT coronary angiography: a substudy of the Scottish computed tomography of the heart (SCOT-HEART) trial

Abstract

Objectives

Noncardiac findings are common on coronary computed tomography angiography (CCTA). We assessed the clinical impact of noncardiac findings, and potential changes to surveillance scans with the application of new lung nodule guidelines.

Methods

This substudy of the SCOT-HEART randomized controlled trial assessed noncardiac findings identified on CCTA. Clinically significant noncardiac findings were those causing symptoms or requiring further investigation, follow-up or treatment. Lung nodule follow-up was undertaken following the 2005 Fleischner guidelines. The potential impact of the 2015 British Thoracic Society (BTS) and the 2017 Fleischner guidelines was assessed.

Results

CCTA was performed in 1,778 patients and noncardiac findings were identified in 677 (38%). In 173 patients (10%) the abnormal findings were clinically significant and in 55 patients (3%) the findings were the cause of symptoms. Follow-up imaging was recommended in 136 patients (7.6%) and additional clinic consultations were organized in 46 patients (2.6%). Malignancy was diagnosed in 7 patients (0.4%). Application of the new lung nodule guidelines would have reduced the number of patients undergoing a follow-up CT scan: 68 fewer with the 2015 BTS guidelines and 78 fewer with the 2017 Fleischner guidelines; none of these patients subsequently developed malignancy.

Conclusions

Clinically significant noncardiac findings are identified in 10% of patients undergoing CCTA. Application of new lung nodule guidelines will reduce the cost of surveillance, without the risk of missing malignancy.

Key Points

• Clinically significant noncardiac findings occur in 10% of patients undergoing CCTA.

• Noncardiac findings may be an important treatable cause of chest pain

• Further imaging investigations for noncardiac findings were recommended in 8% of patients after CCTA.

• New lung nodule follow-up guidelines will result in cost savings.

Apparent diffusion coefficient mapping using diffusion-weighted MRI: impact of background parenchymal enhancement, amount of fibroglandular tissue and menopausal status on breast cancer diagnosis

Abstract

Objectives

To investigate the impact of background parenchymal enhancement (BPE), amount of fibroglandular tissue (FGT) and menopausal status on apparent diffusion coefficient (ADC) values in differentiation between malignant and benign lesions.

Methods

In this HIPAA-compliant study, mean ADC values of 218 malignant and 130 benign lesions from 288 patients were retrospectively evaluated. The differences in mean ADC values between benign and malignant lesions were calculated within groups stratified by BPE level (high/low), amount of FGT (dense/non-dense) and menopausal status (premenopausal/postmenopausal). Sensitivities and specificities for distinguishing malignant from benign lesions within different groups were compared for statistical significance.

Results

The mean ADC value for malignant lesions was significantly lower compared to that for benign lesions (1.07±0.21 x 10⁻³ mm²/s vs. 1.53±0.26 x 10⁻³ mm²/s) (p<0.0001). Using the optimal cut-off point of 1.30 x 10⁻³ mm²/s, an area under the curve of 0.918 was obtained, with sensitivity and specificity both of 87 %. There was no statistically significant difference in sensitivities and specificities of ADC values between different groups stratified by BPE level, amount of FGT or menopausal status.

Conclusions

Differentiation between benign and malignant lesions on ADC values is not significantly affected by BPE level, amount of FGT or menopausal status.

Key Points

• ADC allows differentiation between benign and malignant lesions.

• ADC is useful for breast cancer diagnosis despite different patient characteristics.

• BPE, FGT or menopause do not significantly affect sensitivity and specificity.

Prospective study aiming to compare 2D mammography and tomosynthesis + synthesized mammography in terms of cancer detection and recall. From double reading of 2D mammography to single reading of tomosynthesis

Abstract

Objectives

To evaluate tomosynthesis compared with 2D-mammography in cancer detection and recalls in a screening-programme, and assess performing synthesized instead of 2D, and compare double reading of 2D with single reading of tomosynthesis.

Methods

Women (age 50–69 years) participating in the screening-programme were included. 2D-mammography and tomosynthesis were performed. There were four reading models: 2D-mammography (first); 2D-mammography (second); tomosynthesis + synthesized (third); tomosynthesis + synthesized + 2D (fourth reading). Paired double reading of 2D (first+second) and tomosynthesis (third+fourth) were analysed.

Results

In 16,067 participants, there were 98 cancers and 1,196 recalls. Comparing double reading of 2D with single reading of tomosynthesis, there was an increase of 12.6 % in cancer detection with the third reading (p= 0.043) and 6.9 % with the fourth reading (p=0.210), and a decrease in recalls of 40.5 % (p<0.001) and 44.4 % (p<0.001), respectively. With double reading of both techniques, there was an increase in cancer detection of 17.4 % (p = 0.004) and a decrease in recalls of 12.5 % (p = 0.001) with tomosynthesis.

Conclusion

Single reading of tomosynthesis plus synthesized increased cancer detection and decreased recalls compared with double reading 2D. 2D did not improve results when added to tomosynthesis.

Key Points

• Tomosynthesis increases cancer detection and decreases recall rates versus 2D mammography.

• Synthesized-mammography avoids performing 2D, showing higher cancer detection.

• Single reading of tomosynthesis + synthesized is feasible as a new practice.

Correction to: Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting

Abstract

The article Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting, written by [§§§ AuthorNames §§§]

Fat necrosis after abdominal surgery: A pitfall in interpretation of FDG-PET/CT

Abstract

Objective

We describe FDG-PET/CT findings of postoperative fat necrosis in patients following abdominal surgery, and evaluate their changes in size and FDG uptake over time.

Methods

FDG-PET/CT scans from January 2007–January 2016 containing the term 'fat necrosis' were reviewed. Lesions meeting radiological criteria of fat necrosis in patients with prior abdominal surgery were included.

Results

Forty-four patients, 30 males, mean age 68.4 ± 11.0 years. Surgeries: laparotomy (n=37; 84.1 %), laparoscopy (n=3; 6.8 %), unknown (n=4; 9.1 %). CTs of all lesions included hyperdense well-defined rims surrounding a heterogeneous fatty core. Sites: peritoneum (n=34; 77 %), omental fat (n=19; 43 %), subcutaneous fat (n=8; 18 %), retroperitoneum (n=2; 5 %). Mean lesion long axis: 33.6±24.9 mm (range: 13.0–140.0). Mean SUVmax: 2.6±1.1 (range: 0.6–5.1). On serial CTs (n=34), lesions decreased in size (p=0.022). Serial FDG-PET/CT (n=24) showed no significant change in FDG-avidity (p=0.110). Mean SUVmax did not correlate with time from surgery (p=0.558) or lesion size (p=0.259).

Conclusion

Postsurgical fat necrosis demonstrated characteristic CT features and may demonstrate increased FDG uptake. However, follow-up of subsequent imaging scans showed no increases in size or FDG-avidity. Awareness of this entity is important to avoid misinterpretation of findings as recurrent cancer.

Key Points

• Postsurgical fat necrosis may mimic cancer in FDG-PET/CT.

• Follow-up of fat necrosis showed no increase in FDG intensity.

• CT follow-up showed a decrease in lesion size.

• FDG uptake did not correlate with time lapsed from surgery.

Can histogram analysis of MR images predict aggressiveness in pancreatic neuroendocrine tumors?

Abstract

Objectives

To evaluate MRI derived whole-tumour histogram analysis parameters in predicting pancreatic neuroendocrine neoplasm (panNEN) grade and aggressiveness.

Methods

Pre-operative MR of 42 consecutive patients with panNEN >1 cm were retrospectively analysed. T1-/T2-weighted images and ADC maps were analysed. Histogram-derived parameters were compared to histopathological features using the Mann-Whitney U test. Diagnostic accuracy was assessed by ROC-AUC analysis; sensitivity and specificity were assessed for each histogram parameter.

Results

ADC_entropy was significantly higher in G2-3 tumours with ROC-AUC 0.757; sensitivity and specificity were 83.3 % (95 % CI: 61.2–94.5) and 61.1 % (95 % CI: 36.1–81.7). ADC_kurtosis was higher in panNENs with vascular involvement, nodal and hepatic metastases (p= .008, .021 and .008; ROC-AUC= 0.820, 0.709 and 0.820); sensitivity and specificity were: 85.7/74.3 % (95 % CI: 42–99.2 /56.4–86.9), 36.8/96.5 % (95 % CI: 17.2–61.4 /76–99.8) and 100/62.8 % (95 % CI: 56.1–100/44.9–78.1). No significant differences between groups were found for other histogram-derived parameters (p >.05).

Conclusions

Whole-tumour histogram analysis of ADC maps may be helpful in predicting tumour grade, vascular involvement, nodal and liver metastases in panNENs. ADC_entropy and ADC_kurtosis are the most accurate parameters for identification of panNENs with malignant behaviour.

Key Points

• Whole-tumour ADC histogram analysis can predict aggressiveness in pancreatic neuroendocrine neoplasms.

• ADC entropy and kurtosis are higher in aggressive tumours.

• ADC histogram analysis can quantify tumour diffusion heterogeneity.

• Non-invasive quantification of tumour heterogeneity can provide adjunctive information for prognostication.

Myocardial perfusion in patients with suspected coronary artery disease: comparison between 320-MDCT and rubidium-82 PET

Abstract

Objectives

Despite advances in non-invasive myocardial perfusion imaging (MPI) evaluation, computed tomography (CT) multiphase MPI protocols have not yet been compared with the highly accurate rubidium-82 positron emission tomography (⁸²RbPET) MPI. Thus, this study aimed to evaluate agreement between ⁸²RbPET and 320-detector row CT (320-CT) MPI using a multiphase protocol in suspected CAD patients.

Methods

Forty-four patients referred for MPI evaluation were prospectively enrolled and underwent dipyridamole stress ⁸²RbPET and multiphase 320-CT MPI (five consecutive volumetric acquisitions during stress). Statistical analyses were performed using the R software.

Results

There was high agreement for recognizing summed stress scores ≥ 4 (kappa 0.77, 95% CI 0.55–0.98, p < 0.001) and moderate for detecting SDS ≥ 2 (kappa 0.51, 95% CI 0.23–0.80, p < 0.001). In a per segment analysis, agreement was high for the presence of perfusion defects during stress and rest (kappa 0.75 and 0.82, respectively) and was moderate for impairment severity (kappa 0.58 and 0.65, respectively). The 320-CT protocol was safe, with low radiation burden (9.3 ± 2.4 mSv).

Conclusions

There was a significant agreement between dipyridamole stress 320-CT MPI and ⁸²RbPET MPI in the evaluation of suspected CAD patients of intermediate risk. The multiphase 320-CT MPI protocol was feasible, diagnostic and with relatively low radiation exposure.

Key Points

• Rubidium-82 PET and 320-MDCT can perform MPI studies for CAD investigation.

• There is high agreement between rubidium-82 PET and 320-MDCT for MPI assessment.

• Multiphase CT perfusion protocols are feasible and with low radiation.

• Multiphase CT perfusion protocols can identify image artefacts.

A simple method for bone age assessment: the capitohamate planimetry

Abstract

Objectives

To determine if the capitohamate (CH) planimetry could be a reliable indicator of bone age, and to compare it with Greulich-Pyle (GP) method.

Methods

This retrospective study included 391 children (age, 1–180 months). Two reviewers manually measured the areas of the capitate and hamate on plain radiographs. CH planimetry was defined as the measurement of the sum of areas of the capitate and hamate. Two reviewers independently applied the CH planimetry and GP methods in 109 children whose heights were at the 50th percentile of the growth chart.

Results

There was a strong positive correlation between chronological age and CH planimetry measurement (right, r = 0.9702; left, r = 0.9709). There was no significant difference in accuracy between CH planimetry (84.39–84.46 %) and the GP method (85.15–87.66 %) (p ≥ 0.0867). The interobserver reproducibility of CH planimetry (precision, 4.42 %; 95 % limits of agreement [LOA], −10.5 to 13.4 months) was greater than that of the GP method (precision, 8.45 %; LOA, −29.5 to 21.1 months).

Conclusions

CH planimetry may be a reliable method for bone age assessment.

Key Points

• Bone age assessment is important in the work-up of paediatric endocrine disorders.

• Radiography of the left hand is widely used to estimate bone age.

• Capitatohamate planimetry is a reliable and reproducible method for assessing bone age.

Computed tomography findings in ABO-incompatible living donor liver transplantation recipients with biliary strictures

Abstract

Objectives

To evaluate CT findings of biliary strictures in ABO-incompatible living donor liver transplantation (LDLT) recipients, with emphasis on associated 1-month post-transplantation CT findings, and evaluate clinical outcomes.

Methods

Of 351 ABO-incompatible recipients, we retrospectively evaluated CT scans in 65 recipients with biliary stricture. The biliary strictures on CT scans were classified as type A (perihilar) and type B (diffuse). Precedent CT abnormality patterns and the presence of a periportal halo sign at 1-month post-transplantation were evaluated. For each patient, clinical outcomes were evaluated.

Results

Of 65 ABO-incompatible recipients with biliary strictures, 36.9% had type B strictures. Compared with biliary strictures at diagnosis, similar CT abnormality patterns were observed for 84.4% in type A and 86.4% in type B strictures at 1-month post-transplantation. Complex periportal halo signs on the 1-month post-transplantation CT were more frequently noted for type B than type A strictures (86.4% vs. 3.1%, P < 0.001). Progressive clinical outcomes were more frequently observed for type B than type A strictures (79.2% vs. 26.8%, P < 0.001), with a significantly shorter graft survival time (46.4 months vs. 90.8 months, P < 0.001).

Conclusion

CT abnormality patterns and complex periportal halo signs on 1-month post-transplantation CT may be clinically useful for managing biliary strictures in ABO-incompatible LDLT recipients.

Key Points

• Of ABO-incompatible LDLT recipients, type B biliary stricture incidence was 6.8%.

• Of type B strictures, 86.4% exhibited similar CT abnormality patterns at 1-month post-transplantation.

• Complex periportal halo at 1 month was significantly associated with type B strictures.

• Progressive clinical outcomes were more frequently observed in type B strictures.

Spectral multi-energy CT texture analysis with machine learning for tissue classification: an investigation using classification of benign parotid tumours as a testing paradigm

ABSTRACT

Objective

There is a rich amount of quantitative information in spectral datasets generated from dual-energy CT (DECT). In this study, we compare the performance of texture analysis performed on multi-energy datasets to that of virtual monochromatic images (VMIs) at 65 keV only, using classification of the two most common benign parotid neoplasms as a testing paradigm.

Methods

Forty-two patients with pathologically proven Warthin tumour (n = 25) or pleomorphic adenoma (n = 17) were evaluated. Texture analysis was performed on VMIs ranging from 40 to 140 keV in 5-keV increments (multi-energy analysis) or 65-keV VMIs only, which is typically considered equivalent to single-energy CT. Random forest (RF) models were constructed for outcome prediction using separate randomly selected training and testing sets or the entire patient set.

Results

Using multi-energy texture analysis, tumour classification in the independent testing set had accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 92%, 86%, 100%, 100%, and 83%, compared to 75%, 57%, 100%, 100%, and 63%, respectively, for single-energy analysis.

Conclusions

Multi-energy texture analysis demonstrates superior performance compared to single-energy texture analysis of VMIs at 65 keV for classification of benign parotid tumours.

Key Points

• We present and validate a paradigm for texture analysis of DECT scans.

• Multi-energy dataset texture analysis is superior to single-energy dataset texture analysis.

• DECT texture analysis has high accura\cy for diagnosis of benign parotid tumours.

• DECT texture analysis with machine learning can enhance non-invasive diagnostic tumour evaluation.

To share or not to share? Expected pros and cons of data sharing in radiological research

Abstract

The aims of this paper are to illustrate the trend towards data sharing, i.e. the regulated availability of the original patient-level data obtained during a study, and to discuss the expected advantages (pros) and disadvantages (cons) of data sharing in radiological research. Expected pros include the potential for verification of original results with alternative or supplementary analyses (including estimation of reproducibility), advancement of knowledge by providing new results by testing new hypotheses (not explored by the original authors) on pre-existing databases, larger scale analyses based on individual-patient data, enhanced multidisciplinary cooperation, reduced publication of false studies, improved clinical practice, and reduced cost and time for clinical research. Expected cons are outlined as the risk that the original authors could not exploit the entire potential of the data they obtained, possible failures in patients' privacy protection, technical barriers such as the lack of standard formats, and possible data misinterpretation. Finally, open issues regarding data ownership, the role of individual patients, advocacy groups and funding institutions in decision making about sharing of data and images are discussed.

Key Points

• Regulated availability of patient-level data of published clinical studies (data-sharing) is expected.

• Expected benefits include verification/advancement of knowledge, reduced cost/time of research, clinical improvement.

• Potential drawbacks include faults in patients' identity protection and data misinterpretation.

Feasibility study of MR-guided transgluteal targeted in-bore biopsy for suspicious lesions of the prostate at 3 Tesla using a freehand approach

Abstract

Objective

The aim of our study was (1) to establish an in-bore targeted biopsy of suspicious prostate lesions, avoiding bowel penetration using a transgluteal approach and (2) to assess operator setup, patient comfort and safety aspects in the clinical setting for freehand real-time MR-guidance established for percutaneous procedures in an open MR-scanner.

Material and methods

30 patients with suspect prostate lesions were biopsied in a cylindrical 3T-MRI system using a transgluteal approach in freehand technique. One to three biopsies were sampled using continuous dynamic imaging. Size, location and visibility of the lesion, intervention time, needle artefact size, interventional complications and histopathological diagnosis were recorded.

Results

All biopsies were technically successful. Nineteen patients showed evidence of prostate carcinoma. Cancer detection rate was 50 % in patients with previously negative TRUS-biopsy. The average intervention time was 26 min including a learning curve as the time was 13 min by the end of the study. No antibiotic prophylaxis was performed as none of the patients showed signs of infection.

Conclusions

MR-guided targeted freehand biopsies of prostate lesions using a transgluteal approach are both technically feasible and time efficient in a standard closed-bore 3T-MR scanner as well as safe for the individual patient.

Key Points

• Open-bore freehand interventional principles were adapted to closed-bore systems.

• Prostate MR-guided freehand biopsies were feasible in a clinical setting.

• A transgluteal approach provides a short and simplified work flow.

• An inoculation of the prostate with bowel flora is avoided.

• The intervention time is comparable to the stereotactic approach.

The myth of the myth of supervenience

Abstract

Supervenience is necessary co-variation between two sets of entities (properties, facts, objects, etc.). In the good old days, supervenience was considered a useful philosophical tool with a wide range of applications in the philosophy of mind, metaethics, epistemology, and elsewhere. In recent years, however, supervenience has fallen out of favor, giving place to grounding, realization, and other, more metaphysically "meaty", notions. The emerging consensus is that there are principled reasons for which explanatory theses cannot be captured in terms of supervenience, or as the slogan goes: "Supervenience Is Nonexplanatory" (SIN). While SIN is widely endorsed, it is far from clear what it amounts to and why we should believe it. In this paper, I will distinguish various theses that could be meant by it, and will argue that none of them is both interesting and plausible: on some interpretations of 'explanatory', we have no reason to believe that supervenience is unexplanatory, while on other interpretations, supervenience is indeed unexplanatory, but widely accepted textbook cases of explanatory relations come out as unexplanatory, too. This result raises doubts as to whether there is any interesting sense in which SIN is true, and suggests that the contemporary consensus about supervenience is mistaken.

Emission and combustion profile study of unmodified research engine propelled with neat biofuels

Abstract

The current work focuses on the experimental investigation to analyze the combustion and emission characteristics of a direct injection diesel engine fueled with neat biodiesel (BD100) and different proportions of cyclohexanol blends as a fuel additive in various volume fractions. Cyclohexanol is dispersed into a neat biodiesel in a volume fraction of 10, 20, and 30 vol%. The biodiesel is produced from neem oil by the conventional transesterification process. The experimental results revealed that with the increased cyclohexanol fraction, the combustion was found smooth. The addition of cyclohexanol has a positive influence on various physical and chemical properties of neat biodiesel. The in-cylinder pressure is comparatively low for diesel followed by cyclohexanol and biodiesel blends when compared with neat biodiesel. This is due to shorter ignition delay period. The heat-release rate of neat biodiesel is the highest among all fuels. The overall HC emission of BD70COH30 is 12.19% lower than BD100 and 16.34% lower than diesel. The overall CO₂ emission of BD70COH30 is 13.91% higher than BD100 and 19.5% higher than diesel. The overall NO_x emission of BD70COH30 is 5.31% lower than BD100 at all load engine operations. The presence of 10, 20, and 30% of cyclohexanol in biodiesel decreased smoke emissions as compared with neat biodiesel and diesel. The overall smoke emission of BD70COH30 is 19.23% lower than BD100 and 25.51% lower than diesel. The overall CO emission of cyclohexanol blended with biodiesel by 30 vol% (BD70COH30) is 17% lower than neat biodiesel and 21.8% lower than diesel. Based on the outcome of this study, neem oil biodiesel and cyclohexanol blends can be employed as a potential alternative fuel for existing unmodified diesel engines owing to its lesser emission characteristics.

Therapeutic effect of the alkaloid extract of the cyanobacterium Spirulina platensis on the lipid profile of hypercholesterolemic male rabbits

Abstract

The authors' objectives are to investigate the therapeutic effect of alkaloid extract of cyanobacteria Spirulina platensis on the lipid profile of hypercholesterolemic male rabbits and to identify the active compounds in the alkaloid extract. Male rabbits were divided into four groups of six animals. The intact rabbits in the first group served as a negative control. The second group served as a positive control (hypercholesterolemic rabbits). Over a 4-week period, hypercholesterolemic rabbits in the third group received a low dose of alkaloid extract (33 mg/kg), and the hypercholesterolemic rabbits in the fourth group received a high dose (66 mg/kg). The results revealed that both doses of alkaloid extract significantly decreased levels of cholesterol, triglycerides, low-density lipoproteins (LDL), and very low-density lipoproteins (VLDL) when compared to the control group, whereas the high-density lipoproteins (HDL) increased significantly compared to the control group. The active compounds in the alkaloid extract were identified using GC-mass. The most abundant compounds found in the extract were 1-(+)-ascorbic acid 2,6-dihexadecanoate, 9,12-octadecadienoic acid (Z, Z)-, hexadecanoic acid, 2-hydroxy-1- (hydroxymethyl) ethyl ester, and gamolenic acid.

Automatic segmentation of stereoelectroencephalography (SEEG) electrodes post-implantation considering bending

Abstract

Purpose

The accurate and automatic localisation of SEEG electrodes is crucial for determining the location of epileptic seizure onset. We propose an algorithm for the automatic segmentation of electrode bolts and contacts that accounts for electrode bending in relation to regional brain anatomy.

Methods

Co-registered post-implantation CT, pre-implantation MRI, and brain parcellation images are used to create regions of interest to automatically segment bolts and contacts. Contact search strategy is based on the direction of the bolt with distance and angle constraints, in addition to post-processing steps that assign remaining contacts and predict contact position. We measured the accuracy of contact position, bolt angle, and anatomical region at the tip of the electrode in 23 post-SEEG cases comprising two different surgical approaches when placing a guiding stylet close to and far from target point. Local and global bending are computed when modelling electrodes as elastic rods.

Results

Our approach executed on average in 36.17 s with a sensitivity of 98.81% and a positive predictive value (PPV) of 95.01%. Compared to manual segmentation, the position of contacts had a mean absolute error of 0.38 mm and the mean bolt angle difference of \(0.59^{\circ }\) resulted in a mean displacement error of 0.68 mm at the tip of the electrode. Anatomical regions at the tip of the electrode were in strong concordance with those selected manually by neurosurgeons, \(ICC(3,k)=0.76\) , with average distance between regions of 0.82 mm when in disagreement. Our approach performed equally in two surgical approaches regardless of the amount of electrode bending.

Conclusion

We present a method robust to electrode bending that can accurately segment contact positions and bolt orientation. The techniques presented in this paper will allow further characterisation of bending within different brain regions.

Global rigid registration of CT to video in laparoscopic liver surgery

Abstract

Purpose

Image-guidance systems have the potential to aid in laparoscopic interventions by providing sub-surface structure information and tumour localisation. The registration of a preoperative 3D image with the intraoperative laparoscopic video feed is an important component of image guidance, which should be fast, robust and cause minimal disruption to the surgical procedure. Most methods for rigid and non-rigid registration require a good initial alignment. However, in most research systems for abdominal surgery, the user has to manually rotate and translate the models, which is usually difficult to perform quickly and intuitively.

Methods

We propose a fast, global method for the initial rigid alignment between a 3D mesh derived from a preoperative CT of the liver and a surface reconstruction of the intraoperative scene. We formulate the shape matching problem as a quadratic assignment problem which minimises the dissimilarity between feature descriptors while enforcing geometrical consistency between all the feature points. We incorporate a novel constraint based on the liver contours which deals specifically with the challenges introduced by laparoscopic data.

Results

We validate our proposed method on synthetic data, on a liver phantom and on retrospective clinical data acquired during a laparoscopic liver resection. We show robustness over reduced partial size and increasing levels of deformation. Our results on the phantom and on the real data show good initial alignment, which can successfully converge to the correct position using fine alignment techniques. Furthermore, since we can pre-process the CT scan before surgery, the proposed method runs faster than current algorithms.

Conclusion

The proposed shape matching method can provide a fast, global initial registration, which can be further refined by fine alignment methods. This approach will lead to a more usable and intuitive image-guidance system for laparoscopic liver surgery.

IPCAI 2018 Special Issue: Information Processing for Computer-Assisted Interventions, 9th International Conference 2018—Part 1

Treatment outcome and prognostic factors of tonsillectomy for palmoplantar pustulosis and pustulotic arthro‐osteitis: A retrospective subjective and objective quantitative analysis of 138 patients

The Journal of Dermatology, EarlyView.

General dependencies and causality analysis of road traffic fatalities in OECD countries

Abstract

The road traffic accidents were responsible for material and human loss which was equal to 2.8 to 5% of gross national product (GNP). However, literature does not explore the elasticity coefficients and nexus of road traffic fatalities with foreign direct investment, health expenditures, trade openness, mobile subscriptions, the number of researchers in R&D department, and environmental particulate matter. This study filled this research gap by exploring the nexus between road traffic fatalities, foreign direct investment, health expenditures, trade openness, mobile subscriptions, the number of researchers, and environmental particulate matter in Organization for Economic Cooperation and Development (OECD) countries by using panel data from 1995 to 2015. The panel Autoregressive Distributed Lag (ARDL) bound test was used for the detection of cointegration between the variables after checking the stationarity in selected variables with different panel unit root tests. Panel vector error correction model explored the causality of road traffic fatalities, foreign direct investment, PM2.5 in the environment, and trade openness in the long run. Road traffic fatalities showed short run bi-directional causality with foreign direct investment and health expenditures. The short run bi-directional causality was also observed between trade and foreign direct investment and cellular mobile subscriptions and foreign direct investment. The panel fully modified ordinary least square (FMOLS) and panel dynamic ordinary least square (DOLS) showed the 0.947% reduction in road fatalities for 1% increase in the health expenditures in OECD countries. The significant reduction in road fatalities was also observed due to 1% increase in trade openness and researchers in R&D, which implies the importance of trade and research for road safety. It is required to invest in the health sector for the safety of precious human lives like the hospitals with latest medical equipment and improvement in the emergency services in the country. The research and development activities should be enhanced especially for the health and transportation sectors. The trade of environment-friendly technology should be promoted for the protection of environment.

Chronic co-exposure to chlorpyrifos and deltamethrin pesticides induces alterations in serum lipids and oxidative stress in Wistar rats: mitigating role of alpha-lipoic acid

Abstract

The study evaluated the effect of combination of chlorpyrifos (CPF) and deltamethrin (DLT) on serum lipid profiles and oxidative stress in rats, and the mitigating role of alpha-lipoic acid (ALA). Thirty male rats were used for the 120-day study. Serum samples obtained at termination were evaluated for the levels of triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL), malondialdehyde (MDA), and the activities of antioxidant enzymes. The levels of low-density lipoprotein-cholesterol (LDL), very low-density lipoprotein-cholesterol (VLDL), and atherogenic index (AI) were calculated. The pesticide combination elevated the levels of TG, TC, LDL, VLDL, AI, and MDA, and decreased HDL level, and activities of CAT, SOD, and GPx. The alterations induced by CPF and DLT were alleviated by ALA, partly through its antioxidant properties. In conclusion, co-exposure to DLT and CPF altered serum lipids and increased oxidative stress changes in the rats, which were ameliorated by ALA.

Identification of toxic substances in phenol-acetone wastewater on activated sludge and selective toxicity removal performance with ferrous pretreatment

Abstract

We investigated the effects of toxic wastewater generated during the production of phenol-acetone on activated sludge and tested pretreatment methods to selectively remove the toxicity. We found that the microbial activity in the activated sludge was inhibited by the wastewater, in which cumene hydroperoxide (CHP) with a medium effective concentration (EC₅₀) of 225 mg L⁻¹ was the main toxic substance. We tested one pretreatment method with ferrous iron to selectively remove the CHP. The CHP decomposition process, which mainly produced acetophenone, was very quick. The CHP was selectively transformed into low-toxicity organics, and a maximum of 92% was removed when 1.08 mmol L⁻¹ of ferrous iron was added, for a reaction time of 10 min, a pH of 5, and a temperature of 25 °C, and the resulting wastewater only slightly inhibited the oxygen uptake rate of activated sludge. The acclimation of activated sludge was accelerated, and a COD removal rate of more than 85% was achieved within a week. Our results confirm that ferrous iron provides a cost-effective method to selectively remove toxins from wastewater.

Retention and release of hexavalent and trivalent chromium by chitosan, olive stone activated carbon, and their blend

Abstract

Shrimp shells and waste of olive stones were used as feedstock for the preparation of chitosan and activated carbon. The adsorption of Cr^VI and Cr^III species in aqueous solution by the materials prepared and their blend were studied by using the well-known kinetic and isotherm models, Fourier transform infrared spectroscopy and scanning electron microscope. It was demonstrated that the rates of adsorption were controlled by diffusion inside particles and throughout the liquid film, and adsorption occurred spontaneously (− 26 < ∆G° < − 15 kJ/mol) in the range of 298–333 K, except for that involving Cr^III species and activated carbon. The maximum amounts of Cr species retained by the composite (146 mg of Cr^VI/g and 33 mg of Cr^III/g at 298 K) were three times greater than those of the basic constituents. Adsorption was markedly affected by temperature and pH, and Cr^VI species were substantially desorbed in acid mediums, particularly in acetic acid solution. The recovery of Cr^III species varied according to the adsorbent and the solution used. The immobilization of Cr^VI species (HCrO₄⁻ and CrO₄²⁻) and Cr^III species (Cr(OH)₂⁺ and Cr₃(OH)₄⁵⁺) by chitosan was accomplished by means of amine moieties and hydroxyls of D-glucosamine units of the biopolymer. The adsorption of Cr^VI species on activated carbon involved π electrons of aromatic rings as well as oxygenated sites (C–OH, C=O, C–O–C). In such a condition, Cr^VI was partially reduced into Cr^III. For the composite, the amino functional groups of chitosan and hydroxyls of both constituents were implicated in the linkage of the biopolymer and activated carbon, and the C–O–H and C–O–C functional groups of chitosan were involved in the retention of Cr^VI species. For Cr^III species, adsorption occurred preferentially on hydroxyls of the components, and consequently, the chains of the biopolymer recovered some flexibility.

A comparison between the four Geldart groups on the performance of a gas-phase annular fluidized bed photoreactor for volatile organic compound oxidation

Abstract

Heterogeneous photocatalytic oxidation (PCO) is a widely studied alternative for the elimination of volatile organic compounds (VOC) in air. In this context, research on novel photoreactor arrangements to enhance PCO rates is desired. Annular fluidized bed photoreactors (AFBPR) have yielded prominent results when compared to conventional thin film reactors. However, very few works aimed at optimizing AFBPR operation. In this study, TiO₂ photocalytic agglomerates were synthesized and segregated in specific size distributions to behave as Geldart groups A, B, C, and D fluidization. The TiO₂ agglomerates were characterized by XRD, FTIR spectra, and N₂ adsorption. Photocatalyst performances were compared in a 10-mm gapped AFBPR for degrading the model pollutant methyl-ethyl-ketone (MEK), using a 254-nm radiation source. Geldart group C showed to be inadequate for AFBPR operation due to the short operation range between fluidization and elutriation. In all the cases, photocatalytic reaction rates were superior to sole UV photolysis. Group A and group B demonstrated the highest reaction rates. Considerations based on mass transfer suggested that the reasons were enhanced UV distribution within the bed at lower flow rates and superior catalyst surface area at higher flow rates. Results also revealed that groups A, B, and D perform equally per catalyst area within an AFBPR if the fluidization numbers (FN) are high enough.

Notalgia paresthetica: cryolipolysis as a novel potential treatment

International Journal of Dermatology, EarlyView.

Acquired idiopathic generalised anhidrosis: A rare cause of sweating deficiency

Australasian Journal of Dermatology, EarlyView.

Trace elements concentration and distributions in coal and coal mining wastes and their environmental and health impacts in Shaanxi, China

Abstract

This study probe the probable impacts of coal mining pollution and its impacts on human's health and environment. A total of 144 samples including coal and coal wastes, soil, plants, foods, and water were collected from the Hancheng county and countryside of Shaanxi, China. All the samples were analyzed for trace elements using ICP-MS, OES, and AFS. Results showed that the concentration of Se, As, Cr, Cu, Pb, Cd, Co, Ni, Mo, U, Th (mgKg⁻¹), Fe, Mn, Al, Ti (%) etc., in coal and coal wastes were 7.5, 12.1, 275, 55, 54.2, 0.8, 14.8, 94.5, 8.9, 4.9, 17.2, 3.5, 0.02, 19, 0.7, respectively. While in soil 0.6, 12, 194, 27.5, 7.4, 0.6, 11.3, 83.4, 0.7, 1.7, 9.9, 3.1, 0.04, 10.5, and 0.4 for the above elements, respectively. In Hancheng foods, the average concentration of Se-0.09, As-0.15, Cr-1.8, Cu-3.2, Pb-0.4, Cd-0.02, Co-0.09, Ni-0.4, Mo-0.64, U-0.01, Th-0.03, Fe-129, Mn-15.6, Al-234, and Ti-5.2 in mgKg⁻¹, respectively, which are comparably higher than the countryside. The elemental concentration in groundwater of both areas was below the WHO-2004 standard. In Hancheng, the average daily intake (mgKg⁻¹bw/d) of Se 0.004–0.0038, As 0.004–0.13, Cr 0.055–0.06, Cd 0.001–0.004, Ni 0.018–13.91, Pb 0.05–0.001 adult-children, respectively. The toxic trace elements such as Cr, Cu, Mn, Pb, Ti, Cd, Co, Th, Fe, Al, and Mo caused non-carcinogenic risk with high morbidity in children than adults. By assessing environmental risks, coal and coal wastes caused high risk, food and plants faced moderate to high risk, while mountain and agriculture soil are prone to low to considerable risk. The pollution in Hancheng County is extreme as compared to the countryside. The study concluded that the contamination is geogenic in both the areas but coal mining enhance the metals contamination and has extensive impacts on the living community and environment of Hancheng areas.

Protective effects of Curcuma longa against neurobehavioral and neurochemical damage caused by cerium chloride in mice

Abstract

Cerium chloride (CeCl₃) is considered an environmental pollutant and a potent neurotoxic agent. Medicinal plants have many bioactive compounds that provide protection against damage caused by such pollutants. Curcuma longa is a bioactive compound-rich plant with very important antioxidant properties. To study the preventive and healing effects of Curcuma longa on cerium-damaged mouse brains, we intraperitoneally injected cerium chloride (CeCl₃, 20 mg/kg BW) along with Curcuma longa extract, administrated by gavage (100 mg/kg BW), into mice for 60 days. We then examined mouse behavior, brain tissue damage, and brain oxidative stress parameters. Our results revealed a significant modification in the behavior of the CeCl₃-treated mice. In addition, CeCl₃ induced a significant increment in lipid peroxidation, carbonyl protein (PCO), and advanced oxidation protein product levels, as well as a significant reduction in superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities. Acetylcholinesterase (AChE) activity remarkably increased in the brain of CeCl₃-treated mice. Histopathological observations confirmed these results. Curcuma longa attenuated CeCl₃-induced oxidative stress and increased the activities of antioxidant enzymes. It also decreased AChE activity in the CeCl₃-damaged mouse brain that was confirmed by histopathology. In conclusion, this study suggests that Curcuma longa has a neuroprotective effect against CeCl₃-induced damage in the brain.

Development and implementation of eco-genomic tools for aquatic ecosystem biomonitoring: the SYNAQUA French-Swiss program

Abstract

The effectiveness of environmental protection measures is based on the early identification and diagnosis of anthropogenic pressures. Similarly, restoration actions require precise monitoring of changes in the ecological quality of ecosystems, in order to highlight their effectiveness. Monitoring the ecological quality relies on bioindicators, which are organisms revealing the pressures exerted on the environment through the composition of their communities. Their implementation, based on the morphological identification of species, is expensive because it requires time and experts in taxonomy. Recent genomic tools should provide access to reliable and high-throughput environmental monitoring by directly inferring the composition of bioindicators' communities from their DNA (metabarcoding). The French-Swiss program SYNAQUA (INTERREG France-Switzerland 2017–2019) proposes to use and validate the tools of environmental genomic for biomonitoring and aims ultimately at their implementation in the regulatory bio-surveillance. SYNAQUA will test the metabarcoding approach focusing on two bioindicators, diatoms, and aquatic oligochaetes, which are used in freshwater biomonitoring in France and Switzerland. To go towards the renewal of current biomonitoring practices, SYNAQUA will (1) bring together different actors: scientists, environmental managers, consulting firms, and biotechnological companies, (2) apply this approach on a large scale to demonstrate its relevance, (3) propose robust and reliable tools, and (4) raise public awareness and train the various actors likely to use these new tools. Biomonitoring approaches based on such environmental genomic tools should address the European need for reliable, higher-throughput monitoring to improve the protection of aquatic environments under multiple pressures, guide their restoration, and follow their evolution.

Bird diversity and dissimilarity show contrasting patterns along heavy metal pollution gradients in the Urals, Russia

Abstract

The effects of industrial pollution on bird diversity have been widely studied using traditional diversity measures, which assume all species to be equivalent. We compared species richness and Shannon index with distance-based measures of taxonomic, functional, and phylogenetic diversity (the abundance-weighted mean nearest taxon distances), which describe within-community dissimilarity at terminal branches. Analysis of dissimilarity can shed light on the processes underlying community assembly, i.e., environmental filtering decreases dissimilarity whereas competitive exclusion increases it. In the 2-year study near Karabash and Revda copper smelters in Russia, point counts of nesting birds and habitat descriptions were taken at 10 sites (40 plots) along each pollution gradient. The abundance and diversity of birds showed good repeatability in both regions. The total density of birds, number of species per plot, and Shannon diversity decreased at high toxic load in both regions. The taxonomic, functional, and phylogenetic nearest taxon distances showed the same pattern within regions. Species dissimilarity within communities increased with pollution in Karabash (due to loss of functionally similar species), but did not change in Revda (due to mass replacement of forest species by species of open habitats). Pollution-induced changes in bird communities near Karabash were greater due to the stronger deterioration of the forest ecosystems and less favorable natural conditions (more arid climate, lower diversity and vitality of the tree stand and understorey) compared to Revda. This study emphasizes the need for a multi-level approach to the analysis of bird communities using traditional indices of diversity, functional, taxonomic, or phylogenetic distances between species and environmental variables.

Tracking nitrate sources in the Chaohu Lake, China, using the nitrogen and oxygen isotopic approach

Abstract

The Chaohu Lake is highly polluted and suffers from severe eutrophication. Nitrate is a key form of nitrogen that can cause water quality degradation. In this study, hydrochemical and dual isotopic approaches were utilized to identify the seasonal variation of nitrate sources in the Chaohu Lake and its inflowing rivers. The average nitrate concentrations ([NO₃⁻]) of the lake and its inflowing rivers were 89.9 and 140.8 μmol L⁻¹, respectively. The isotopic values of δ¹⁵N–NO₃⁻ and δ¹⁸O–NO₃⁻ in the lake ranged from − 1.01 to + 16.67‰ and from − 4.39 to + 22.20‰, respectively. The two major rivers had distinct isotopic compositions, with average δ¹⁵N–NO₃⁻ values of + 17.52 and + 3.51‰, and average δ¹⁸O–NO₃⁻ values of + 2.71 and + 7.47‰ for the Nanfei River and Hangbu River, respectively. The results show that soil organic ammonium and urban wastewater discharge were the main sources of nitrate in the Chaohu Lake, and nitrate assimilation was an important process affected [NO₃⁻] and isotopic compositions, especially in the western Chaohu Lake. The elevated [NO₃⁻] and δ¹⁵N–NO₃⁻ values in the western Chaohu Lake indicate the high influence of human activities. Urban wastewater discharge was the primary nitrate source in the Nanfei River and soil organic ammonium was the main source in the Hangbu River. Although nitrate from direct atmospheric deposition was low, its strong flushing effect can substantially improve riverine [NO₃⁻] and nitrate loading from terrestrial ecosystem. The relatively high nitrate fluxes from the Hangbu River indicate that nitrogen loading from agricultural watershed is unneglectable in watershed nitrogen sources reduction strategies.

Simultaneous accelerated solvent extraction and purification for the determination of 13 organophosphate esters in soils by gas chromatography-tandem mass spectrometry

Abstract

Through the optimization of extraction, purification, and determination parameters, a reliable and convenient analytical method for the simultaneous determination of 13 organophosphate esters in soils was developed. The method is based on one-step extraction and purification by accelerated solvent extraction and analysis by gas chromatography-ion trap tandem mass spectrometry. Under the optimal conditions, the method detection limits and method quantitation limits ranged from 0.10 to 0.22 ng/g and from 0.33 to 0.72 ng/g, respectively. The recoveries obtained were in the range of 81.7–107%, and the relative standard deviations were less than 12%. As compared to other methods, this proposed method was simple and time and solvent saving. The developed method was successfully applied to analyze organophosphate esters in soil samples collected from Liaohe estuarine wetland, China. Thirteen organophosphate esters were detected in all of the soil samples which indicated that Liaohe estuarine wetland has polluted by organophosphate esters.

Minimally invasive approach to suppurated cervical lymphadenitis in children: Our experience on 60 patients

Clinical Otolaryngology, EarlyView.

Transcanal Approach for Type 2 Tympanoplasty with Incus Interposition Ossiculoplasty: Our Experience on 134 Patients

Clinical Otolaryngology, EarlyView.

A case of generalized acquired cutis laxa

International Journal of Dermatology, EarlyView.

Stress and psoriasis

International Journal of Dermatology, EarlyView.

Paraneoplastic arthritis in a patient with Sézary syndrome

International Journal of Dermatology, EarlyView.

Drug survival of secukinumab for moderate‐to‐severe plaque psoriasis

British Journal of Dermatology, EarlyView.

Declining prevalence of allergic contact dermatitis caused by tosylamide formaldehyde resin in nail polish

Contact Dermatitis, EarlyView.

Contact allergy caused by methylisothiazolinone in a mouthwash as the likely trigger of oral pemphigus vulgaris

Contact Dermatitis, EarlyView.

The effect of treatment with anti‐interleukin‐17 in patients with allergic contact dermatitis

Contact Dermatitis, Volume 78, Issue 6, Page 431-432, June 2018.

Fenofibrate photoallergy – relevance of patch and photopatch testing

Contact Dermatitis, Volume 78, Issue 6, Page 413-414, June 2018.

Tacrolimus‐induced symmetric drug‐related intertriginous and flexural exanthema (SDRIFE)

Contact Dermatitis, Volume 78, Issue 6, Page 414-416, June 2018.

Issue Information

Contact Dermatitis, Volume 78, Issue 6, Page i-i, June 2018.

Standard practices and awareness concerning p‐phenylenediamine among salons that provide eyelash dyeing services

Contact Dermatitis, Volume 78, Issue 6, Page 433-434, June 2018.

Psoriasis patients’ preference for an aerosol foam topical formulation

Journal of the European Academy of Dermatology and Venereology, EarlyView.

Topical propranolol for infantile haemangiomas: a systematic review

Journal of the European Academy of Dermatology and Venereology, EarlyView.

Commentary on ‘Changing prevalence of diabetes mellitus in bullous pemphigoid: it is the dipeptidyl peptidase‐4 inhibitors’

Journal of the European Academy of Dermatology and Venereology, EarlyView.

Medically unexplained dermatologic symptoms still a problem

Journal of the European Academy of Dermatology and Venereology, EarlyView.

Fluorofenidone inhibits UV‐A induced senescence in human dermal fibroblasts via the mammalian target of rapamycin‐dependent SIRT1 pathway

The Journal of Dermatology, EarlyView.

Hearing impairment: A secondary symptom in a congenital ichthyosiform erythroderma patient with ABCA12 mutations

The Journal of Dermatology, EarlyView.

Mutations in mevalonate pathway genes in patients with familial or sporadic porokeratosis

The Journal of Dermatology, EarlyView.

Comparative study of the bactericidal effects of indocyanine green‐ and methyl aminolevulinate‐based photodynamic therapy on Propionibacterium acnes as a new treatment for acne

The Journal of Dermatology, EarlyView.

Bart's syndrome in a family affected three consecutive generations with mutation c.6007G>A in COL7A1

The Journal of Dermatology, EarlyView.