bluuebunny/crossref_metadata_2025 huggingface dataset:
Elbow Injuries Detected on Magnetic Resonance Imaging in Athletes Participating in the Rio de Janeiro 2016 Summer Olympic Games
Authors: Alizai Hamza , Engebretsen Lars , Jarraya Mohamed , Roemer Frank W. , Guermazi Ali
Published: November 2019

Background

Athletes are prone to both acute and chronic overuse injuries of the elbow joint. The purpose of this study was to describe the frequency, anatomic distribution, and severity of magnetic resonance imaging (MRI)–detected elbow joint injuries among athletes who competed in the Rio de Janeiro 2016 Summer Olympics.

Methods

All sports injuries reported by the National Olympic Committee medical teams and the Organizing Committee medical staff during the 2016 Summer Olympics were analyzed. Magnetic resonance imaging was performed at the International Olympic Committee's polyclinic within the Olympic Village, using 3- and 1.5-T scanners. The MRIs were read centrally and retrospectively by musculoskeletal radiologists with expertise in sports injuries. The distribution of elbow joint injuries by anatomic location and sports discipline and the severity of injuries were recorded.

Results

A total of 1101 injuries were reported in the 11,274 athletes from 207 teams at the Games. Central review of MRI revealed elbow joint injuries in 15 athletes (60% male; median age, 22 years; range, 18–39 years). Ligamentous injuries were most common, with injuries of the ulnar collateral ligament being the most prevalent (n = 12; 80%), followed by the common flexor tendon (n = 8; 53%). Osseous injuries were far less common (n = 3; 20%), with no acute fractures seen. Weightlifting (n = 4; 27%) and judo (n = 4; 27%) athletes were most commonly affected.

Conclusion

Magnetic resonance imaging–detected elbow injuries during the 2016 Summer Olympics affected mainly the ulnar collateral ligament and the common flexor tendon, with the highest occurrence in weight lifting and judo.
Combined Qualitative and Quantitative Assessment of Low-Attenuation Renal Lesions Improves Identification of Renal Malignancy on Noncontrast Computed Tomography
Authors: Picard Melissa , Shah Neil , Flemming Brian , Kovacs Mark , Freeman Kyle , Burchett Phillip F. , Giovagnoli Dante A. , Hardie Andrew D.
Published: November 2019

Objective

The objective of this study was to assess renal lesions measuring less than 20 Hounsfield units (HU) on noncontrast computed tomography (NCT).

Methods

Twenty-one (18.1%) of 116 consecutive pathologically proven renal cell carcinomas measured less than 20 HU on NCT and were compared with 40 confirmed benign cysts also measuring less than 20 HU. All lesions were assessed qualitatively (heterogeneous or homogenous) by 3 blinded readers and quantitatively with commercially available textural analysis software. Finally, a combined assessment was performed.

Results

Qualitative assessment performed well (sensitivity, 76%–90%; specificity, 70%–88%). Quantitative assessment revealed mean positive pixels as having the highest performance (area under the curve, 0.912; sensitivity, 90%; specificity, 80% at a cutoff value of 21). The combined assessment, using the mean positive pixel cutoff, improved the sensitivity (reader 1, 100%; reader 2, 95%; and reader 3, 95%).

Conclusion

Qualitative and quantitative assessments have relatively good performance, but the combination can nearly eliminate renal cell carcinomas being missed on NCT.
Surveillance Magnetic Resonance Imaging in Detecting the Second Breast Cancer in Women With a Personal History of Breast Cancer
Authors: Liu Haiquan , Hua Yanqing , Peng Weijun , Zhang Xun
Published: November 2019

Objective

The objective of this study was to evaluate the diagnostic performance of magnetic resonance imaging (MRI) in detecting the secondary breast cancer among women with a personal history of the lesion.

Materials and Methods

We retrospectively reviewed breast MRI examinations performed between 2007 and 2011. A total of 798 women with a history of breast cancer were included in the study. Cancer detection rate, positive predictive value (PPV), recall rate, sensitivity, and specificity were assed. Cancer detection rate was stratified by interval after surgery of the primary breast cancer. Also, we derived 1 comparison group from the women for comparing the performance of x-ray mammography, ultrasound, and MRI in detecting the second breast cancer.

Results

Of the 798 patients, 47 of the 49 secondary breast carcinomas were detected by MRI. The sensitivity and specificity of MRI in detecting the secondary lesions were 95.9% and 96.3%, respectively. The recall rate was 9.5%, and the PPV was 61.8%. Cancer detection rate of MRI examinations performed at more than 36 months after initial surgery was significantly higher than that at 36 months or less after initial surgery (13.7% vs 3.6, P < 0.001). In comparison group, the sensitivity and specificity of MRI, mammography, and ultrasound were 96.7% and 96.1%, 48.4% and 93.9%, and 77.4% and 96.1%, respectively.

Conclusions

Surveillance MRI for women with a personal history of breast cancer has high sensitivity in finding the secondary malignancies with a reasonable recall rate and PPV.
Ovarian Cancer Genetics and Implications for Imaging and Therapy
Authors: Elsherif Sherif B. , Faria Silvana C. , Lall Chandana , Iyer Revathy , Bhosale Priya R.
Published: November 2019

Ovarian cancer is the second most common gynecologic malignancy in the United States. Ovarian cancer has a dismal prognosis when diagnosed at an advanced stage. Therapy for these cancers is determined not only by stage but also by their heterogeneous pathologic features, genetic mutations, and biology. In this review, we will discuss types of epithelial ovarian cancer, and their associated genetic mutations and the implications for imaging and treatment.
Computed Tomography Findings Associated With 30-Day Mortality in Patients With Malignant Superior Vena Cava Syndrome
Authors: Tamir Shlomit , Friehmann Tal , Ratzon Roy , Livneh Nir , Spectre Galia , Atar Eli , Grubstien Ahuva , Raanani Pia , Brenner Baruch , Leader Avi
Published: November 2019

Objective

The objective of this study was to identify radiological and clinical factors associated with early mortality in malignant superior vena cava syndrome (SVCS).

Materials and Methods

Chest computed tomography studies of 127 patients with malignancy-associated SVCS were retrospectively reviewed. Involvement of SVC and tributaries, pleural and pericardial effusions, pulmonary artery involvement, and ancillary findings were documented. Univariate and multivariate models determined associations between radiological and clinical variables, and 30-day mortality.

Results

Thirty-day mortality rate was 16.5% (n = 21). Factors associated with 30-day mortality on univariate analysis included age, cancer stage, SVCS clinical severity, left jugular vein obstruction, number of involved veins, pulmonary arteries involvement, and presence of pleural effusions. Age, SVCS clinical severity, number of veins involved, and pleural effusions were positively associated with 30-day mortality on multivariate analysis.

Conclusions

Selected clinical and radiological variables are associated with early death in malignant SVCS. These factors may identify a subgroup of patients who may benefit from treatment escalation.
Associations Between Apparent Diffusion Coefficient Values and the Prognostic Factors of Breast Cancer
Authors: Choi Bo Bae
Published: November 2019

Objectives

Breast imaging can offer great information about breast cancer heterogeneity. The purpose of this study was to analyze the relationship between apparent diffusion coefficient (ADC) values and various prognostic factors and investigate whether ADC values are useful for breast cancer diagnosis, evaluation of treatment response, and determination of prognosis.

Methods

A total of 111 cases of breast cancer were included in this study. Magnetic resonance findings were recorded according to the Breast Imaging Reporting and Data System magnetic resonance imaging lexicon. Diffusion-weighted imaging rim sign and minimum, maximum, and difference ADC values (ADCdiff) were also evaluated.

Results

ADCdiffwas related to all prognostic factors such as histological grade, Ki-67, tumor size, molecular subtype, axillary node metastasis, lymphvascular invasion, internal enhancement pattern, intratumoral high T2 signal, peritumoral edema, and diffusion-weighted imaging rim sign, whereas minimum and maximum ADC values showed variable associations.

Conclusions

Apparent diffusion coefficient values were shown to be correlated with many proven or possible prognostic factors of breast cancer. In particular, ADCdiffcan reflect tumor heterogeneity and showed higher correlation.
Imaging of Pulmonary Atresia With Ventricular Septal Defect
Authors: Abdel Razek Ahmed Abdel Khalek , Al-Marsafawy Hala , Elmansy Maha
Published: November 2019

The aim of this article was to review computed tomography angiography and magnetic resonance angiography of pulmonary atresia with ventricular septal defect. This disorder is a rare complex congenital heart disease. Preoperative imaging of pulmonary atresia with ventricular septal defect with computed tomography angiography and magnetic resonance angiography is important for complete anatomical delineation and planning for treatment. Preoperative imaging used for assessment of the main pulmonary artery (its size, valve, and confluence), aortopulmonary collaterals (its origin, insertion, course, and size), presence of patent ductus arteriosus, other sources of collaterals as bronchial and coronary arteries, and pattern of pulmonary arborization. Imaging can detect associated aortic, pulmonary venous and coronary anomalies, and other congenital heart disease. Postoperative imaging after unifocalization and stent is for assessment of patency, stenosis, and occlusion of stent or perivascular lesions as seroma.
Impact of Preprocedure Time-Out Checklist for Computed Tomography–Guided Procedures on Workflow and Patient Safety
Authors: Dommaraju Sujithraj , Siewert Bettina , O'Bryan Bridget , Swedeen Suzanne , Appel Elisabeth , Nakhaei Masoud , Camacho Andres , Brook Olga R.
Published: November 2019

Objective

The objective of this study was to assess the impact of preprocedural time-out on workflow and patient safety in computed tomography (CT)–guided procedures.

Methods

In this institutional review board–approved, Health Insurance Portability and Accountability Act–compliant study, preprocedure time-out was assessed by an independent observer in CT-guided procedures performed from January 16, 2018, to May 15, 2018. Anonymous survey of 302 radiology team members involved in image-guided procedures about preprocedure time-out was performed using REDCap.

Results

Preprocedure time-out for 100 CT-guided procedures (biopsies, drainages, ablations) was observed. Procedures were recruited per observer availability and thus were nonconsecutive and nonrandom. Preprocedure time-out was performed in 100 procedures (100%). Median duration was 60 seconds (interquartile range, 60–71 seconds). Scripted checklist was followed in 52 cases (52/100, 52%). Omissions from the preprocedure time-out were identified in 40 cases (40/100, 40%) and were much more frequent when scripted checklist was not used (30/48 [63%] vs 10/52 [19%], P < 0.005). One case (1/100, 1%) was postponed due to abnormal coagulation parameters discovered during the time-out. Three cases (3/100, 3%) were delayed by 3 minutes to address other safety issues. In additional 14 cases (14/100, 14%), safety issues were raised during the time-out, which were resolved in less than 30 seconds.

A total of 137 (45%) of 302 survey responses from 54 radiologists (39%), 55 technologists (40%), and 28 nurses (20%) were received. Forty-eight respondents (48/137, 35%) encountered a procedure that was cancelled or delayed as a result of information identified during time-out. Ninety-six percent (131/137) of respondents stated that time-out improves teamwork, 98% (134/137) stated that it enhances communication between the team members, and 93% (127/137) stated that it identifies and resolves problems and ambiguities.

Conclusions

Scripted preprocedure time-out for CT-guided procedures takes approximately 1 minute to execute and detects safety issues in 18% of cases.
Airway Epithelial Hepcidin Coordinates Lung Macrophages and Immunity Against Bacterial Pneumonia
Authors: Yang Yang , Zeng CongLi , Yang ShiYue , Zhang Yan , Song ShengWen , Liu SiJin , Shu Qiang , Fang XiangMing , Chen QiXing
Published: November 2019

Background:

Hepcidin is a liver-derived master regulator of iron metabolism through its molecular target ferroportin, the only known mammalian iron exporter. Accumulated evidence has shown the important roles of hepatic hepcidin in host defense and infections. Hepcidin is also expressed by airway epithelial cells. However, the function of epithelial hepcidin during bacterial pneumonia remains unknown.

Methods:

Pneumonia was induced in hepcidin-1-deficient and wild-type mice using the most common bacterial agents, and the effects of hepcidin on survival, bacterial burden, iron status, and macrophage phagocytosis after bacterial pneumonia were assessed.

Results:

Hepcidin levels decreased in airway epithelium during common pneumonia, while lung macrophage-derived ferroportin levels and pulmonary iron concentrations increased. Lack of hepcidin in the airway epithelium worsened the outcomes of pneumonia. Manipulation of hepcidin level in the airway epithelium in mice with macrophage-specific ferroportin deletion did not affect the progress of pneumonia. Increased pulmonary iron concentration not only facilitated bacterial growth but also led to the defective phagocytic function of lung macrophages via activation of RhoA GTPase through oxidation of RhoGDI. Furthermore, enhancing the hepcidin level in the airway epithelium rescued mice from lethal bacterial pneumonia.

Conclusions:

These findings identify an uncharacterized important role of airway epithelial hepcidin in protection against bacterial pneumonia and provide the basis for novel alternative therapeutic strategies for combatting bacterial pneumonia in future translational research.
Evaluation of the Patterns of Learning in the Labor Cervical Examination
Authors: Nitsche Joshua F. , Goodridge Elizabeth , Kim Sung Min , Wong Theresa , Brost Brian C.
Published: November 2019

Objective

The aim of the study was to evaluate patterns of skill acquisition in the labor cervical examination in novice providers, such as the change in accuracy and overestimation and underestimation over time and the impact of dilation and effacement on accuracy.

Methods

In this descriptive longitudinal study, medical students each performed 120 simulated cervical examinations. Accuracy and how often students overestimated and underestimated dilation and effacement during was determined for each set of 10 repetitions. Accuracy data were grouped and compared by dilation (1–3, 4–6, and 7–10 cm) and effacement (90%, 75%, 50%, and 25%).

Results

Student accuracy in dilation significantly improved throughout the course of the study (P < 0.001). At the beginning of the study, students more often overestimated dilation, but this decreased over time (P < 0.001). In addition, the accuracy of the students' estimations was 84%, 62%, and 52% for dilations of 1–3, 4–6, and 7–10 cm, respectively (P < 0.001). Student accuracy in effacement significantly improved throughout the course of the study (P < 0.001). At the beginning of the study, students more often overestimated effacement, but as training progressed, more students tended to overestimate and underestimate equally often (P < 0.001). In addition, accuracy of the students' estimations was 93%, 88%, 81%, and 35% for effacements of 90%, 75%, 50%, and 25%, respectively (P < 0.001).

Conclusions

Knowing that students tend to overestimate cervical dilation and effacement early in training and that cervices of high dilation and low effacement are more difficult to assess will be helpful in designing more efficient cervical examination training regimens.
Benefits and Limitations of Transurethral Resection of the Prostate Training With a Novel Virtual Reality Simulator
Authors: Schulz Gerald B. , Grimm Tobias , Kretschmer Alexander , Stief Christian G. , Jokisch Friedrich , Karl Alexander
Published: November 2019

Purpose

Profound endourological skills are required for optimal postoperative outcome parameters after transurethral resection of the prostate (TURP). We investigated the Karl Storz (Tuttlingen, Germany) UroTrainer for virtual simulation training of the TURP.

Materials and Methods

Twenty urologists underwent a virtual reality (VR) TURP training. After a needs analysis, performance scores and self-rated surgical skills were compared before and after the curriculum, the realism of the simulator was assessed, and the optimal level of experience for VR training was evaluated. Statistical testing was done with SPSS 25.

Results

Forty percent of participants indicated frequent intraoperative overload during real-life TURP and 80% indicated that VR training might be beneficial for endourological skills development, underlining the need to advance classical endourological training. For the complete cohort, overall VR performance scores (P = 0.022) and completeness of resection (P < 0.001) significantly improved. Self-rated parameters including identification of anatomical structures (P = 0.046), sparing the sphincter (P = 0.002), and handling of the resectoscope (P = 0.033) became significantly better during the VR curriculum. Participants indicated progress regarding handling of the resectoscope (70%), bleeding control (55%), and finding the correct resection depth (50%). Although overall realism and handling of the resectoscope was good, virtual bleeding control and correct tissue feedback should be improved in future VR simulators. Seventy percent of participants indicated 10 to 50 virtual TURP cases to be optimal and 80% junior residents to be the key target group for VR TURP training.

Conclusions

There is a need to improve training the TURP and VR simulators might be a valuable supplement, especially for urologists beginning with the endourological desobstruction of the prostate.
Public Solicitation and The Canadian Media: Two Cases of Living Liver Donation, Two Different Stories
Authors: Marcon Alessandro R , Caulfield Timothy , Toews Maeghan
Published: November 2019

Background

. Two stories of public solicitation for living liver donors received substantial Canadian media attention in 2015: The Wagner family, with twin toddlers, each needing transplants, and Eugene Melnyk, wealthy owner of a professional hockey team. This study compared the print media coverage of these 2 stories to understand how public solicitation was portrayed and whether coverage differed depending on the individual making the plea.

Methods.

We conducted a content analysis on 155 relevant Canadian newspaper articles published between January 1, 2015 and December 31, 2016. Articles were analyzed for their description of public solicitation, benefits and issues associated with public solicitation, and overall tone with respect to public solicitation.

Results.

The foregrounding of public solicitation and associated ethical issues featured heavily in articles focused on Melnyk but were largely absent when discussing the Wagner family. The fairness of Melnyk's solicitation was the most prominent ethical issue raised. Laws and policies surrounding public solicitation also featured in the Melnyk story but not in articles focused on the Wagners. Public solicitation was portrayed more negatively in the Melnyk articles, but overall, was portrayed positively in relation to both Melnyk and the Wagner family.

Conclusions.

Public solicitation was generally portrayed as a positive phenomenon in Canadian print media, yet there were stark differences in how these cases were presented. The Wagner story was largely portrayed as a human-interest piece about a family in dire circumstances, whereas Melnyk's wealth, status, and influence raised questions of the fairness of his transplant.
Insights Into the Experience of Liver Transplant Recipients With Alcoholic Liver Disease: A Descriptive Qualitative Study
Authors: Hochheimer Martin , Moreland Melissa L. , Tuten Michelle , LaMattina John , Connelly Mark , Sacco Paul
Published: November 2019

Background.

Alcoholic liver disease (ALD) due to alcohol use disorder (AUD) is the primary cause of liver transplantation (LT) in the United States. Studies have found that LT recipients experience a range of physical and emotional difficulties posttransplantation including return to alcohol use, depression, and anxiety. The aim of this study is to better understand the experiences of LT recipients with ALD because they recovered posttransplant to inform the development of a patient-centered intervention to assist patients during recovery.

Methods.

Using qualitative methods, researchers conducted semi-structured interviews with 16 ALD LT recipients. The primary topics of the interview were physical recovery, mental health, substance use including alcohol and tobacco use, and financial experiences. Common patient themes were identified and coded.

Results.

Within the domain of physical health, patients stressed that undergoing LT was a near-death experience, they were helpless, changes in weight influenced their perception of their illness, and they have ongoing medical problems. In the domain of mental health, patients described cognitive impairments during their initial recovery, difficulty in processing the emotions of having a terminal condition, ongoing depression, anxiety, and irritability. The patients also described their perception of having AUD, the last time they used alcohol and their attitude to AUD treatment posttransplant. Patients also described their reliance on one member of their social support network for practical assistance during their recovery and identified one member of their medical team as being of particular importance in providing emotional as well as medical support during recovery.

Conclusions.

The patient’s description of their lived experience during the months following transplant informed the development of a patient-centered intervention that colocates behavioral health components with medical treatment that helps broaden their social network while addressing topics that emerged from this study.
Evaluation of Intrahepatic Lactate/Pyruvate Ratio As a Marker for Ischemic Complications Early After Liver Transplantation—A Clinical Study
Authors: von Platen Anna , D’Souza Melroy A. , Rooyackers Olav , Nowak Greg
Published: November 2019

Background.

Lactate/pyruvate ratio has been introduced as a sensitive marker for ischemia in the transplanted liver. In the present study, we aimed to evaluate lactate/pyruvate ratio measured in the liver by microdialysis as a marker for ischemic complications early after liver transplantation.

Methods.

Forty-five patients undergoing liver transplantation were included in the study. A microdialysis catheter was placed in the liver graft directly following liver transplantation and the metabolites lactate and pyruvate measured for up to 6 days and the lactate/pyruvate ratio calculated. The association between increased intrahepatic lactate/pyruvate ratio and ischemic complications was studied.

Results.

One of 45 patients developed hepatic arterial thrombosis. Forty-four events with increased lactate/pyruvate ratio were identified in 24 patients. In none of the 24 patients that had a raised lactate/pyruvate ratio could we detect occurrence of any ischemic complication. In the patient that did have hepatic arterial thrombosis, the lactate/pyruvate ratio did not show a significant prolonged rise.

Conclusions.

An increase in the intrahepatic lactate/pyruvate ratio is not necessarily indicative of ischemic complications and is thus not a reliable marker for monitoring of clinically significant ischemia in the liver early after transplantation.
Whole Body CT Imaging in Deceased Donor Screening for Malignancies
Authors: Mensink Jacobus W. , Pol Robert A. , Nijboer Willemijn N. , Erasmus Michiel E. , de Jonge Jeroen , de Vries Kirsten M. , van der Jagt Michel F. , van der Kaaij Niels P. , van de Poll Marcel C.G. , Alwayn Ian P.J. , Braat Andries E.
Published: November 2019

Background.

In most western countries, the median donor age is increasing. The incidence of malignancies in older populations is increasing as well. To prevent donor-derived malignancies we evaluated radiologic donor screening in a retrospective donor cohort.

Methods.

This study analyzes the efficacy of a preoperative computed tomography (CT) scan on detecting malignancies. All deceased organ donors in the Netherlands between January 2013 and December 2017 were included. Donor reports were analyzed to identify malignancies detected before or during organ procurement. Findings between donor screening with or without CT-scan were compared.

Results.

Chest or abdominal CT-scans were performed in 17% and 18% of the 1644 reported donors respectively. Screening by chest CT-scan versus radiograph resulted in 1.5% and 0.0% detected thoracic malignancies respectively. During procurement no thoracic malignancies were found in patients screened by chest CT compared with 0.2% malignancies in the radiograph group. Screening by abdominal CT-scan resulted in 0.0% malignancies, compared with 0.2% in the abdominal ultrasound group. During procurement 1.0% and 1.3% malignancies were found in the abdominal CT-scan and ultrasound groups, respectively.

Conclusions.

Screening by CT-scan decreased the perioperative detection of tumors by 30%. A preoperative CT-scan may be helpful by providing additional information on (aberrant) anatomy to the procuring or transplanting surgeon. In conclusion, donor screening by CT-scan could decrease the risk of donor-derived malignancies and prevents unnecessary procurements per year in the Netherlands.
Clinical phenotype, radiological features, and treatment of myelin oligodendrocyte glycoprotein-immunoglobulin G (MOG-IgG) optic neuritis
Authors: Chen John J. , Bhatti M. Tariq
Published: November 2019

Purpose of review

To review the clinical characteristics, radiological manifestations and treatment of myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G (IgG) optic neuritis.

Recent findings

Serum antibodies to MOG have recently been found to be a biomarker of MOG-IgG-associated disorder (MOGAD), a demyelinating disease distinct from both multiple sclerosis (MS) and aquaporin-4-IgG neuromyelitis optica spectrum disorder (AQP4-IgG-positive NMOSD). The phenotype of MOGAD is broad and includes optic neuritis, transverse myelitis, and acute demyelinating encephalomyelitis (ADEM). Optic neuritis is the most common presentation in adults, whereas ADEM is the most common presentation in children. Clinical characteristics suggestive of MOG-IgG optic neuritis include recurrent optic neuritis, prominent disc edema, and perineural enhancement of the optic nerve on magnetic resonance imaging. Although the nadir of vision loss is severe with MOG-IgG optic neuritis, the recovery is typically better than AQP4-IgG optic neuritis and therefore has a favorable overall prognosis. Patients with relapsing disease will often need chronic immunotherapy. Rituximab, azathioprine, mycophenolate mofetil, and monthly intravenous immune globulin are the most commonly utilized treatments.

MOGAD is a unique entity that is separate from both MS and AQP4-IgG-positive NMOSD. Recognition of the clinical and radiologic features allow for the correct diagnosis. Future randomized trials will determine the optimal treatment for MOGAD.
Vertigo and dizziness in the emergency room
Authors: Zwergal Andreas , Dieterich Marianne
Published: November 2019

Purpose of review

To provide an update on diagnostic algorithms for differential diagnosis of acute vertigo and dizziness and swift identification of potentially harmful causes.

Recent findings

About 25% of patients with acute vertigo and dizziness have a potentially life-threatening diagnosis, including stroke in 4–15%. Diagnostic work-up relies on the combination of symptom features (triggers, duration, history of vertigo/dizziness, accompanying symptoms) and a comprehensive vestibular, ocular motor, and balance exam. The latter includes head impulse, head-shaking nystagmus, positional nystagmus, gaze-holding, smooth pursuit, skew deviation, and Romberg's test. Recent standardized diagnostic algorithms (e.g., HINTS, TriAGe+) suggest the combination of several elements to achieve a good diagnostic accuracy in differentiation of central and peripheral vestibular causes. Neuroimaging with MRI must be applied and interpreted with caution, as small strokes are frequently overlooked, especially in the acute setting (false-negative rate of up to 50%).

Diagnostic differentiation of acute vertigo and dizziness remains a complex task, which can be tackled by a structured clinical assessment focusing on symptom characteristics and constellations of ocular motor and vestibular findings. Specific challenges arise in cases of transient or atypical vestibular syndromes.
Plasma levels of 3-methoxy-4-hydroxyphenylglycol levels, number of hospitalization and cognitive function predicts the cognitive effect of atypical antipsychotic monotherapy in patients with acute schizophrenia
Authors: Hori Hikaru , Yoshimura Reiji , Katsuki Asuka , Atake Kiyokazu
Published: November 2019

Although the effects of atypical antipsychotics with regard to improving neurocognitive function are not sufficiently high. The present study applied an atypical antipsychotic monotherapy for patients with acute schizophrenia to (1) examine the percentage of patients who respond well to this treatment, (2) explore the factors that predict response (e.g. the improvement of neurocognition), and (3) identify the factors associated with improved neurocognitive function. We studied 40 patients with acute schizophrenia who had received atypical antipsychotic monotherapy for 24 weeks. The following parameters were evaluated at baseline and 24 weeks after the start of treatment: psychotic symptoms, neurocognitive function, and blood biological markers including homovanillic acid, 3-methoxy-4-hydroxyphenylglycol, and brain-derived neurotrophic factor. Marked improvements in neurocognitive function were noted in 7.5%–25% of patients. The factors that significantly predicted neurocognitive function improvement were the frequency of hospitalization (verbal memory and verbal fluency), 3-methoxy-4-hydroxyphenylglycol (verbal fluency and executive function), and verbal memory (working memory). Approximately 20% of the patients showed good response to treatment with antipsychotics. Frequency of hospitalization, 3-methoxy-4-hydroxyphenylglycol level, and other parameters predicted responsiveness to these drug therapies. Thus, it might be useful to apply these factors to predict responses to treatment.
Association between previous high-dose antipsychotic therapy and brexpiprazole discontinuation after the initiation of brexpiprazole in patients with schizophrenia or schizoaffective disorder
Authors: Yoshimura Yusaku , Shimizu Hiroma , Yamashita Rieko , Washida Kenji , Takeda Toshihiko , Aoki Shozo
Published: November 2019

The objective of this study was to identify the factors associated with brexpiprazole discontinuation after initiating brexpiprazole in patients with schizophrenia or schizoaffective disorder. All patients with schizophrenia or schizoaffective disorder who were started on brexpiprazole in our institution between May 2018 and April 2019 were retrospectively screened. The continuation rate of brexpiprazole during a follow-up period of 16 weeks was examined. Multivariate Cox regression analysis was conducted to identify predictors of brexpiprazole discontinuation. During the follow-up period, 52 out of 120 patients (43.4%) discontinued brexpiprazole. Thirty-three subjects discontinued due to a lack of efficacy, eight more due to intolerability and a further 11 for other reasons. The continuation rate of brexpiprazole among patients who were previously on high-dose antipsychotics (chlorpromazine-equivalent doses > 800 mg) was significantly lower than that in those who were previously on low-dose antipsychotics (chlorpromazine-equivalent doses ≤ 800 mg). The Cox regression analysis showed that only having been subject to a high dose of their previous antipsychotics was independently associated with an increased risk of brexpiprazole discontinuation (P < 0.001). Patients who were previously on high-dose antipsychotics discontinued brexpiprazole mainly due to inefficacy. Previous high-dose antipsychotic therapy is an independent risk factor for brexpiprazole discontinuation in patients with schizophrenia or schizoaffective disorder.
Effect of N-acetylcysteine on clozapine-induced sialorrhea in schizophrenic patients: a case series
Authors: Uzun Özcan , Bolu Abdullah , Çelik Cemil
Published: November 2019

Clozapine is an atypical antipsychotic demonstrated to be superior in the treatment of refractory schizophrenia. Despite all this effectiveness, it has side effects that can be serious and bothersome. Sialorrhea is the most common adverse drug reaction that occurs during clozapine treatment. It is usually persistent, may impair the patient’s quality of life and reduce treatment compliance. However, there is limited evidence to guide possible treatment strategies for sialorrhea. N-Acetylcysteine (NAC) is a powerful antioxidant. It acts directly as a scavenger of free radicals, in particular oxygen radicals. The antioxidant NAC also modulates glutamatergic, neurotrophic and inflammatory pathways. The first time we examined and reported the effect of NAC (1200–2400 mg/day) on clozapine-induced sialorrhea in a patient group of five patients. After four weeks of follow-up, the severity of sialorrhea decreased significantly with NAC augmentation. There were no significant side effects of NAC as measured by the UKU scale.
Sediminibacillus terrae sp. nov., a moderate halophile isolated from non-saline farm soil
Authors: Wu Qiu-Lei , Chen Jin-Hua , Deng Li-Ying , Liu Zhi-Xiong , He Jian-Wu , Liu Zhu-Xiang , Yang Ling-Ling , Tang Shu-Kun , Chen Yi-Guang
Published: November 2019

A Gram-stain-positive, moderately halophilic, strictly aerobic, endospore-forming, rod-shaped bacterium, strain JSM 102062T, was isolated from a non-saline farm soil sample collected from Dehang Canyon in Hunan, PR China. Growth occurred with 0.5–20 % (w/v) NaCl (optimum 4–7 %) at pH 5.5–11.0 (optimum pH 8.0) and at 20–50 °C (optimum 30–35 °C). Contained cell-wall peptidoglycan based on meso-diaminopimelic acid and possessed menaquinone-7 (MK-7) as the major respiratory isoprenoid quinone. The major cellular fatty acids were anteiso-C15 : 0, anteiso-C17 : 0 and iso-C16 : 0. The polar lipid pattern consisted of diphosphatidylglycerol, phosphatidylglycerol, five unidentified phospholipids and an unidentified glycolipid. The DNA G+C content was 44.1 mol%. Phylogeny based on 16S rRNA gene sequences indicated that strain JSM 102062T belonged to the genus

Sediminibacillus

, sharing high 16S rRNA gene sequence similarities to

Sediminibacillus halophilus

EN8dT (99.4 %) and

Sediminibacillus albus

NHBX5T (98.3 %). The whole genomic analysis showed that strain JSM 102062T constituted a different taxon separated from the recognized

Sediminibacillus

species. Combined data from phenotypic and genotypic studies demonstrated that strain JSM 102062T represents a noval species of the genus

Sediminibacillus

, for which the name Sediminibacillus terrae sp. nov. is proposed; the type strain is JSM 102062T (=CCTCC AB 2014166T = CGMCC 1.12957T=DSM 28949T=KCTC 33541T).
Population-specific and transethnic genome-wide analyses reveal distinct and shared genetic risks of coronary artery disease
Authors: Koyama Satoshi , Ito Kaoru , Terao Chikashi , Akiyama Masato , Horikoshi Momoko , Momozawa Yukihide , Matsunaga Hiroshi , Ieki Hirotaka , Ozaki Kouichi , Onouchi Yoshihiro , Takahashi Atsushi , Nomura Seitaro , Morita Hiroyuki , Akazawa Hiroshi , Kim Changhoon , Seo Jeong-sun , Higasa Koichiro , Iwasaki Motoki , Yamaji Taiki , Sawada Norie , Tsugane Shoichiro , Koyama Teruhide , Ikezaki Hiroaki , Takashima Naoyuki , Tanaka Keitaro , Arisawa Kokichi , Kuriki Kiyonori , Naito Mariko , Wakai Kenji , Suna Shinichiro , Sakata Yasuhiko , Sato Hiroshi , Hori Masatsugu , Sakata Yasushi , Matsuda Koichi , Murakami Yoshinori , Aburatani Hiroyuki , Kubo Michiaki , Matsuda Fumihiko , Kamatani Yoichiro , Komuro Issei
Published: November 2019

To elucidate the genetics of coronary artery disease (CAD) in the Japanese population, we conducted a large-scale genome-wide association study (GWAS) of 168,228 Japanese (25,892 cases and 142,336 controls) with genotype imputation using a newly developed reference panel of Japanese haplotypes including 1,782 CAD cases and 3,148 controls. We detected 9 novel disease-susceptibility loci and Japanese-specific rare variants contributing to disease severity and increased cardiovascular mortality. We then conducted a transethnic meta-analysis and discovered 37 additional novel loci. Using the result of the meta-analysis, we derived a polygenic risk score (PRS) for CAD, which outperformed those derived from either Japanese or European GWAS. The PRS prioritized risk factors among various clinical parameters and segregated individuals with increased risk of long-term cardiovascular mortality. Our data improves clinical characterization of CAD genetics and suggests the utility of transethnic meta-analysis for PRS derivation in non-European populations.
Photoproximity Profiling of Protein-Protein Interactions in Cells
Authors: McCutcheon David C. , Lee Gihoon , Carlos Anthony , Montgomery Jeffrey E. , Moellering Raymond E.
Published: November 2019

We report a novel photoproximity protein interaction (PhotoPPI) profiling method to map protein-protein interactions in vitro and in live cells. This approach utilizes a bioorthogonal, multifunctional chemical probe that can be targeted to a genetically encoded protein of interest (POI) through a modular SNAP-Tag/benzylguanine covalent interaction. A first generation photoproximity probe, PP1, responds to 365 nm light to simultaneously cleave a central nitroveratryl linker and a peripheral diazirine group, resulting in diffusion of a highly reactive carbene nucleophile away from the POI. We demonstrate facile probe loading, and subsequent interaction- and light-dependent proximal labeling of a model protein-protein interaction (PPI) in vitro. Integration of the PhotoPPI workflow with quantitative LC-MS/MS enabled un-biased interaction mapping for the redox regulated sensor protein, KEAP1, for the first time in live cells. We validated known and novel interactions between KEAP1 and the proteins PGAM5 and HK2, among others, under basal cellular conditions. By contrast, comparison of PhotoPPI profiles in cells experiencing metabolic or redox stress confirmed that KEAP1 sheds many basal interactions and becomes associated with known lysosomal trafficking and proteolytic proteins like SQSTM1, CTSD and LGMN. Together, these data establish PhotoPPI as a method capable of tracking the dynamic sub-cellular and protein interaction “social network” of a redox-sensitive protein in cells with high temporal resolution.

SYNOPSIS TOC
Automated identification of maximal differential cell populations in flow cytometry data
Authors: Yue Alice , Chauve Cedric , Libbrecht Maxwell , Brinkman Ryan R.
Published: November 2019

We introduce a new cell population score called SpecEnr (specific enrichment) and describe a method that discovers robust and accurate candidate biomarkers from flow cytometry data. Our approach identifies a new class of candidate biomarkers we define as driver cell populations, whose abundance is associated with a sample class (e.g. disease), but not as a result of a change in a related population. We show that the driver cell populations we find are also easily interpretable using a lattice-based visualization tool. Our method is implemented in the R package flowGraph, freely available on GitHub (github.com/aya49/flowGraph) and on BioConductor.
An Inflammatory Clock Predicts Multi-morbidity, Immunosenescence and Cardiovascular Aging in Humans
Authors: Sayed Nazish , Gao Tianxiang , Tibshirani Robert , Hastie Trevor , Cui Lu , Kuznetsova Tatiana , Rosenberg-Hasson Yael , Ostan Rita , Monti Daniela , Lehallier Benoit , Shen-Orr Shai , Maecker Holden T. , Dekker Cornelia L. , Wyss-Coray Tony , Franceschi Claudio , Jojic Vladimir , Haddad François , Montoya José G. , Wu Joseph C. , Furman David
Published: November 2019

While many diseases of aging have been linked to the immunological system, immune metrics with which to identify the most at-risk individuals are lacking. Here, we studied the blood immunome of 1001 individuals age 8-96 and derived an inflammatory clock of aging (iAge), which tracked with multi-morbidity and immunosenescence. In centenarians, iAge was on average, 40 years lower than their corresponding chronological age. The strongest contributor to this metric was the chemokine CXCL9, which was involved in cardiac aging, affected vascular function, and down-regulated Sirtuin-3, a longevity-associated molecule. Thus, our results identify an important link between inflammatory molecules and pathways known to govern lifespan.
Citizen science and aquatic macroinvertebrates: public engagement for catchment-scale pollution vigilance
Authors: Moolna Adam , Duddy Mike , Fitch Ben , White Keith
Published: November 2019

Citizen science aims to engage the wider population beyond scientists and statutory agencies, providing a catalyst for positive change and influencing policymakers and institutions. The Riverfly Partnership has been supporting a growing network of citizen science volunteers monitoring aquatic macroinvertebrates in rivers and streams across the United Kingdom since 2004. In Manchester, Salford and surrounding areas, Riverfly Partnership monitoring began in 2011 with volunteers from a catchment-wide fishing club. This provided a catalyst for broader public engagement, wider environmental projects, and the establishment of a new grassroots environmental charity. The vigilance of the network demonstrated its value by flagging a major pollution event wiping out all macroinvertebrates along 19 km of the River Irwell in April 2017. By evaluating monitoring data and the citizen science program’s impacts, we identify key lessons for taking forward public engagement in river catchment management both in Greater Manchester and elsewhere.
Diffusion Histology Imaging Combining Diffusion Basis Spectrum Imaging (DBSI) and Machine Learning Improves Detection and Classification of Glioblastoma Pathology
Authors: Ye Zezhong , Price Richard L. , Liu Xiran , Lin Joshua , Yang Qingsong , Sun Peng , Wu Anthony T. , Wang Liang , Han Rowland , Song Chunyu , Yang Ruimeng , Gary Sam E. , Mao Diane D. , Wallendorf Michael , Campian Jian L. , Li Jr-Shin , Dahiya Sonika , Kim Albert H. , Song Sheng-Kwei
Published: November 2019

Purpose

Glioblastoma (GBM) is one of the deadliest cancers with no cure. While conventional MRI has been widely adopted for examining GBM clinically, accurate neuroimaging assessment of tumor histopathology for improved diagnosis, surgical planning, and treatment evaluation, remains an unmet need in the clinical management of GBMs.

Experimental Design

We employ a novel Diffusion Histology Imaging (DHI) approach, combining diffusion basis spectrum imaging (DBSI) and machine learning, to detect, differentiate, and quantify areas of high cellularity, tumor necrosis, and tumor infiltration in GBM.

Results

Gd-enhanced T1W or hyper-intense FLAIR failed to reflect the morphological complexity underlying tumor in GBM patients. Contrary to the conventional wisdom that apparent diffusion coefficient (ADC) negatively correlates with increased tumor cellularity, we demonstrate disagreement between ADC and histologically confirmed tumor cellularity in glioblastoma specimens, whereas DBSI-derived restricted isotropic diffusion fraction positively correlated with tumor cellularity in the same specimens. By incorporating DBSI metrics as classifiers for a supervised machine learning algorithm, we accurately predicted high tumor cellularity, tumor necrosis, and tumor infiltration with 87.5%, 89.0% and 93.4% accuracy, respectively.

Conclusion

Our results suggest that DHI could serve as a favorable alternative to current neuroimaging techniques for guiding biopsy or surgery as well as monitoring therapeutic response in the treatment of glioblastoma.

Translational Relevance

Current clinical diagnosis, surgical planning, and assessment of treatment response for GBM patients relies heavily on gadolinium-enhanced T1-weighted MRI, which is non-specific for tumor growth and merely reflects a disrupted blood-brain barrier. The complex tumor microenvironment and spatial heterogeneity make GBM difficult to characterize using current clinical imaging modalities. In this study, we developed a novel imaging technique to characterize and accurately predict key histological features of GBM - high tumor cellularity, tumor necrosis, and tumor infiltration. While further validation in a larger cohort of patients is needed, the current proof-of-concept approach could provide a solution to resolve important clinical questions such as the identification of true tumor progression vs. pseudoprogression or radiation necrosis.
How past exposure to predation affects personality and behavioural plasticity?
Authors: Tariel Juliette , Plénet Sandrine , Luquet Émilien
Published: November 2019

When behaviour is observed multiple times on animals from the same population, between-individual difference in mean behaviour (personality) and in behavioural plasticity are often reported. While the developmental environment might explain such an individual difference, the effect of parental environment is still unexplored -a surprising observation as parental carry-over effect are now well-known to influence the average phenotype and plastic responses of offspring-.

We tested whether parental and developmental exposure to predator cues impacted the immediate behavioural predator-induced response in the snailPhysa acutaat both mean level (average response) and individual level (between-individual variation). Two generations of snails were reared in laboratory without or with exposure to predator cues. Then, escape behaviour was repeatedly assessed on adult snails in the presence or absence of predator cues.

Both parental and developmental exposure to predator cues acted additively towards a lower average behavioural plasticity. At the individual level, developmental exposure induced higher differentiation in personality trait but not in behavioural plasticity while parental environment did not influence the between-individual differences.

These results highlight that past environments can strongly influence behaviour at the population level and that they should be taken into consideration when investigating why individuals differ in behaviour.