Search

In a prior study we demonstrated that the presence of face masks impairs the human capability of accurately inferring emotions conveyed through facial expressions, at all ages. The degree of impairment posed by face covering was notably more pronounced in children aged between three and five years old. In the current study, we conducted the same test as a follow-up after one year from the onset of the COVID-19 pandemic, when the requirement of wearing face masks was holding in almost all circumstances of everyday life when social interactions occur. The results indicate a noteworthy improvement in recognizing facial expressions with face masks among children aged three to five, compared to the pre-pandemic settings. These findings hold a significant importance, suggesting that toddlers effectively mitigated the social challenges associated with masks use: they overcame initial environmental limitations, improving their capability to interpret facial expressions even in the absence of visual cues from the lower part of the face. [ABSTRACT FROM AUTHOR]

In a prior study we demonstrated that the presence of face masks impairs the human capability of accurately inferring emotions conveyed through facial expressions, at all ages. The degree of impairment posed by face covering was notably more pronounced in children aged between three and five years old. In the current study, we conducted the same test as a follow-up after one year from the onset of the COVID-19 pandemic, when the requirement of wearing face masks was holding in almost all circumstances of everyday life when social interactions occur. The results indicate a noteworthy improvement in recognizing facial expressions with face masks among children aged three to five, compared to the pre-pandemic settings. These findings hold a significant importance, suggesting that toddlers effectively mitigated the social challenges associated with masks use: they overcame initial environmental limitations, improving their capability to interpret facial expressions even in the absence of visual cues from the lower part of the face. [ABSTRACT FROM AUTHOR]

Introduction: Despite the progress made in multidisciplinary care, there has been little improvement in the oncologic outcomes of oral cavity squamous cell carcinomas (OSCCs). In the latest edition of the TNM staging, "depth of invasion" (DOI) has recently been introduced as one of the criteria for determining the T stage, alongside other factors. DOI is widely recognized as an independent risk factor for nodal metastases and is a crucial consideration in the preoperative staging of OSCCs, along with measurements of tumor thickness (TT). While various diagnostic methods exist for assessing DOI, intraoral ultrasonography (IOUS) has gained popularity for its efficacy in evaluating OSCCs. Methods: This study sought to evaluate the diagnostic accuracy and reliability of ultrahigh-frequency ultrasound (UHFUS) in assessing oral cavity lesions compared to histopathological analysis. Results: The results revealed strong reliability in ultrasonographic measurements (ICC TT: 0.94; ICC DOI: 0.97) and distinct ultrasonographic features specific to different oral pathologies. This highlights the potential of UHFUS as a non-invasive imaging tool for precise diagnostic evaluations. Conclusions: Despite limitations such as a small sample size and focus on specific lesions, these promising results suggest that UHFUS could significantly enhance oral lesion diagnostics. Further research involving larger cohorts is necessary to validate and build upon these initial findings. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer remains a significant global health concern, demanding effective detection methods. This study explores Contrast-Enhanced Mammography (CEM), an alternative to digital mammography, for its potential in correlating with breast cancer prognostic factors. Analyzing 182 lesions in 114 women, the research identifies associations between CEM features (such as spiculated margins and irregular shape) and key prognostic factors, including tumor grade and molecular markers. Notable findings suggest that certain CEM characteristics may predict aspects of breast cancer behavior, providing valuable insights for personalized treatment decisions. While acknowledging study limitations, the results highlight the promise of CEM in contributing to our understanding of breast cancer biology and guiding clinical approaches. Further research is essential to validate and expand upon these findings. Breast cancer, a major contributor to female mortality globally, presents challenges in detection, prompting exploration beyond digital mammography. Contrast-Enhanced Mammography (CEM), integrating morphological and functional information, emerges as a promising alternative, offering advantages in cost-effectiveness and reduced anxiety compared to MRI. This study investigates CEM's correlation with breast cancer prognostic factors, encompassing histology, grade, and molecular markers. In a retrospective analysis involving 114 women, CEM revealed diverse lesion characteristics. Statistical analyses identified correlations between specific CEM features, such as spiculated margins and irregular shape, and prognostic factors like tumor grade and molecular markers. Notably, spiculated margins predicted lower grade and HER2 status, while irregular shape correlated with PgR and Ki-67 status. The study emphasizes CEM's potential in predicting breast cancer prognosis, shedding light on tumor behavior. Despite the limitations, including sample size and single-observer analysis, the findings advocate for CEM's role in stratifying breast cancers based on biological characteristics. CEM features, particularly spiculated margins, irregular shape, and enhancement dynamics, may serve as valuable indicators for personalized treatment decisions. Further research is crucial to validate these correlations and enhance CEM's clinical utility in breast cancer assessment. [ABSTRACT FROM AUTHOR]

Purpose: Clinical evidence suggests an association between comorbidities and outcome in patients with glioblastoma (GBM). We hypothesised that the internal carotid artery (ICA) calcium score could represent a promising prognostic biomarker in a competing risk analysis in patients diagnosed with GBM. Methods: We validated the use of the ICA calcium score as a surrogate marker of the coronary calcium score in 32 patients with lung cancer. Subsequently, we assessed the impact of the ICA calcium score on overall survival in GBM patients treated with radio-chemotherapy. Results: We analysed 50 GBM patients. At the univariate analysis, methyl-guanine-methyltransferase gene (MGMT) promoter methylation (p = 0.048), gross total tumour resection (p = 0.017), and calcium score (p = 0.011) were significant prognostic predictors in patients with GBM. These three variables also maintained statistical significance in the multivariate analysis. Conclusions: the ICA calcium score could be a promising prognostic biomarker in GBM patients. [ABSTRACT FROM AUTHOR]

Our radiology department conducted an assessment of 300 neonatal radiographs in the neonatal intensive care unit over almost two years. The purpose was to evaluate the correct positioning of intravascular venous catheters. Our case series revealed that out of a total of 95 cases with misplaced devices, 59 were umbilical venous catheters and 36 were peripherally inserted central catheters. However, all of the central venous catheters were found to be properly positioned. Misplacements of neonatal intravascular devices were found to occur more frequently than expected. The scientific literature contains several articles highlighting the potential complications associated with misplaced devices. Our goal is to highlight the potential misplacements and associated complications that radiologists may encounter while reviewing conventional radiology imaging. Based on our experience, which primarily involved placing UVCs and PICCs, we discovered that conventional radiology is the most effective method for assessing proper device placement with the lowest possible radiation exposure. Given the high number of neonatal vascular device placement procedures, it is essential for radiologists to maintain a high level of vigilance and stay updated on the latest developments in this field. [ABSTRACT FROM AUTHOR]

Pleural mesothelioma (PM) is an aggressive disease that has a strong causal relationship with asbestos exposure and represents a major challenge from both a diagnostic and therapeutic viewpoint. Despite recent improvements in patient care, PM typically carries a poor outcome, especially in advanced stages. Therefore, a timely and effective diagnosis taking advantage of currently available imaging techniques is essential to perform an accurate staging and dictate the most appropriate treatment strategy. Our aim is to provide a brief, but exhaustive and up-to-date overview of the role of multimodal medical imaging in the management of PM. [ABSTRACT FROM AUTHOR]

Pharmacometric models were used to investigate the utility of biomarkers in predicting the efficacy (Crohn's Disease Activity Index [CDAI]) of brazikumab and provide a data‐driven framework for precision therapy for Crohn's disease (CD). In a phase IIa trial in patients with moderate to severe CD, treatment with brazikumab, an anti‐interleukin 23 monoclonal antibody, was associated with clinical improvement. Brazikumab treatment effect was determined to be dependent on the baseline IL‐22 (BIL22) or baseline C‐reactive protein (BCRP; predictive biomarkers), and placebo effect was found to be correlated with the baseline CDAI (a prognostic biomarker). A maximal total inhibition on CDAI input function of 50.6% and 42.4% was predicted for patients with extremely high BIL22 or BCRP, compared to a maximal total inhibition of 20.9% and 17.8% for patients with extremely low BIL22 or BCRP, respectively, which were mainly due to the placebo effect. We demonstrated that model‐derived baseline biomarker levels that achieve 50% of maximum unbound systemic concentration of 22.8 pg/mL and 8.03 mg/L for BIL22 and BCRP as the cutoffs to select subpopulations can effectively identify high‐response subgroup patients with improved separation of responders when compared to using the median values as the cutoff. This work exemplifies the utility of pharmacometrics to quantify biomarker‐driven responses in biologic therapies and distinguish between predictive and prognostic biomarkers, complementing clinical efforts of identifying subpopulations with higher likelihood of response to brazikumab. [ABSTRACT FROM AUTHOR]

Introduction: The Coronavirus Disease 2019 (COVID-19) has disrupted health services worldwide. The evidence on the impact of the pandemic on cancer care provision, however, is conflicting. We aimed to audit the management of patients diagnosed with early breast cancer (EBC) during the pandemic in a large, tertiary-level cancer center in Italy. Methods: We conducted a cross-sectional study to track the route to first treatment for patients diagnosed with EBC during 2019, 2020, and 2021. We abstracted data for all consecutive patients referred to the Veneto Institute of Oncology (Padua, Italy). We defined as point of contact (POC) the date of the first consultation with a breast cancer specialist of the breast unit. First treatment was defined as either upfront surgery or neoadjuvant chemotherapy (NACT). Results: We reviewed medical records for 878 patients for whom an MDT report during 2019-2021 (April through June) was available. Of these, 431 (49%) were eligible. The proportion of screen-detected tumors was larger in 2019 and 2021 than in 2020 (59%). Conversely, the proportion of screen-detected tumors was offset by the proportion of palpable tumors in 2020 (P = .004). Distribution of tumor and nodal stage was unchanged over time, but in situ tumors were slightly fewer in 2020 than in 2019 or 2021. The adjusted odds ratio for treatment delay (45 days or more) was 0.87 for 2020 versus 2019 (95% CI, 0.5-1.53) and 0.9 for 2021 versus 2019 (95% CI, 0.52-1.55). Conclusions: There was no evidence for major changes in the management of patients with EBC during 2019-2021 and no treatment delays were observed. Our findings suggest that more women presented with palpable nodules at diagnosis, but the stage distribution did not change over time. Validation on a larger cohort of patients is warranted to robustly assess the impact of the COVID-19 pandemic on treatment practices for patients with EBC. This article evaluates the impact on the distribution of disease parameters and time to care of patients with breast cancer during the SARS-CoV2 pandemic, using data from an audit of the management of patients diagnosed with early breast cancer during the pandemic in a large cancer center in Italy. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to investigate the intersection between crowdfunding (CF), open innovation (OI) and responsible innovation (RI) and identify the emerging trends and gaps in research and new paths for CF research in the future. In addition, this paper proposes a conceptual framework and propositions. Design/methodology/approach: This paper is structured in line with the systematic literature review protocol. After reading all the titles, keywords and abstracts, 172 papers focused on OI and RI were selected for this research. Finally, 27 papers that are based on dimensions related to responsible OI were selected for the study. Findings: Due to CF's multidisciplinary nature, the scientific literature on the role of CF in endorsing responsible OI for shared value co-creation appears fragmented and redundant. Several emerging trends and gaps of research and new paths for CF research in the future arise regarding research methodology and theoretical perspective. Originality/value: To the best of the authors' knowledge, this is the first study investigating the intersection between CF OI and RI. [ABSTRACT FROM AUTHOR]

Introduction: Patients with triple-negative breast cancer (TNBC) achieving a pathological complete response (pCR) after neoadjuvant chemotherapy have a better event-free survival. The role of gut microbiome in early TNBC is underexplored. Methods: Microbiome was analyzed by 16SrRNA sequencing. Results: Twenty-five patients with TNBC treated with neoadjuvant anthracycline/taxane-based chemotherapy were included. Fifty-six percent achieved a pCR. Fecal samples were collected before (t0), at 1 (t1), and 8 weeks (t2) from chemotherapy. Overall, 68/75 samples (90.7%) were suitable for microbiome analysis. At t0, pCR group showed a significantly higher α-diversity as compared with no-pCR, (P =.049). The PERMANOVA test on β-diversity highlighted a significant difference in terms of BMI (P = 0.039). Among patients with available matched samples at t0 and t1, no significant variation in microbiome composition was reported over time. Conclusions: Fecal microbiome analysis in early TNBC is feasible and deserves further investigation in order to unravel its complex correlation with immunity and cancer. The gut microbiome has gained attention as a potential biomarker in patients with cancer; however, little is known about the role of gut microbiome in modulating response to standard neoadjuvant chemotherapy in patients diagnosed with early stage triple-negative breast cancer (TNBC). This article assesses the feasibility of gut microbiome analysis in patients undergoing neoadjuvant chemotherapy for early stage TNBC, evaluates its impact on treatment response and association with clinicopathologic factors, and describes longitudinal changes before and after exposure to chemotherapy. [ABSTRACT FROM AUTHOR]

The spleen, often referred to as the "forgotten organ", plays numerous important roles in various diseases. Recently, there has been an increased interest in the application of radiomics in different areas of medical imaging. This systematic review aims to assess the current state of the art and evaluate the methodological quality of radiomics applications in spleen imaging. A systematic search was conducted on PubMed, Scopus, and Web of Science. All the studies were analyzed, and several characteristics, such as year of publication, research objectives, and number of patients, were collected. The methodological quality was evaluated using the radiomics quality score (RQS). Fourteen articles were ultimately included in this review. The majority of these articles were published in non-radiological journals (78%), utilized computed tomography (CT) for extracting radiomic features (71%), and involved not only the spleen but also other organs for feature extraction (71%). Overall, the included papers achieved an average RQS total score of 9.71 ± 6.37, corresponding to an RQS percentage of 27.77 ± 16.04. In conclusion, radiomics applications in spleen imaging demonstrate promising results in various clinical scenarios. However, despite all the included papers reporting positive outcomes, there is a lack of consistency in the methodological approaches employed. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to investigate consumers' reactions to a new kind of green food product that is the so-called lab-grown meat (LGM). This kind of meat does not derive from animal or vegetal cultures but is produced on the basis of "tissue-engineering" technologies, by injecting muscle tissue from an animal into a cell culture, allowing cells to "grow" outside the animal's body. By considering the similar nutritional characteristics of traditional types of meat, and the potential in terms of sustainability, the authors investigate the effect of the advertising, communication focus promoting LGM-based meat, on consumers' willingness to buy (WTB) and word-of-mouth (WOM), by shedding light on the moderator role of consumers' environmentalism and status consumption orientation tendency in influencing such relationship. Design/methodology/approach: Through an exploratory research design, the authors conducted a study based on a two-cell experiment that manipulated the advertising communication focus by using a hamburger made of synthetic meat related to a fictitious brand called "Gnam", to manipulate the advertising communication focus (sustainability vs. taste), then evaluating consumers' WTB, WOM, environmentalism and status consumption orientation. Findings: Results show that the communication focus (sustainability vs. taste) exerts a positive effect on consumers' WTB and WOM, and how such effect is magnified both by consumers' environmentalism and status consumption orientation, in the attempt to show other a green status and their green consumption tendency. Research limitations/implications: Despite the promising results, the study does not consider other consumers' individual differences, i.e. as for the role of age, or cultural differences. Practical implications: Practically, this study suggests marketers and managers how to design effective marketing campaigns to incentivise LGM-based food products purchase, and promote positive WOM, on the basis of certain consumers' individual differences useful to segment their clientele in terms of environmentalism, and status consumption orientation tendency. Social implications: Socially, this study may contribute to incentivising the use of alternative forms of meat as a food product not deriving from animal or vegetal culture, coherently with recent sustainability worldwide claimed goals. Originality/value: This is the first paper to investigate consumers' reactions to LGM-based food products, by shedding light on the fundamental role of consumers' individual differences. [ABSTRACT FROM AUTHOR]

Aims: Evaluating the prognostic role of radiomic features in liver-limited metastatic colorectal cancer treated with first-line therapy at baseline and best response among patients undergoing resection. Patients & methods: Among patients enrolled in TRIBE2 (NCT02339116), the association of clinical and radiomic data, extracted by SOPHiA-DDM™ with progression-free and overall survival (OS) in the overall population and with disease-free survival/postresection OS in those undergoing resection was investigated. Results: Among 98 patients, radiomic parameters improved the prediction accuracy of our model for OS (area under the curve: 0.83; sensitivity: 0.85; specificity: 0.73; accuracy: 0.78), but not progression-free survival. Of 46 resected patients, small-distance high gray-level emphasis was associated with shorter disease-free survival and high gray-level zone emphasis/higher kurtosis with shorter postresection OS. Conclusion: Radiomic features should be implemented as tools of outcome prediction for liver-limited metastatic colorectal cancer. In colorectal liver metastases, radiomics could be a valid tool for predicting prognosis in patients receiving first-line treatment and for stratification of patients based on the risk of relapse after curative resection. [ABSTRACT FROM AUTHOR]

We sought to compare native T1 mapping to conventional late gadolinium enhancement (LGE) and T2-STIR techniques in a cohort of consecutive patients undergoing cardiac MRI (CMR). CMR was performed in 323 patients, 206 males (64%), mean age 54 ± 8 years, and in 27 age- and sex- matched healthy controls. In T2-STIR images, myocardial hyperintensity suggesting edema was found in 41 patients (27%). LGE images were positive in 206 patients (64%). T1 mapping was abnormal in 171 (49%). In 206 patients (64%), a matching between LGE and native T1 was found. T1 was abnormal in 32 out of 41 (78%) with edema in T2-STIR images. Overall, LGE and/or T2-STIR were abnormal in 209 patients, whereas native T1 was abnormal in 154 (52%). Conventional techniques and T1 mapping were concordant in 208 patients (64%). In 39 patients, T1 mapping was positive despite negative conventional techniques (12%). T1 mapping was able in conditions with diffuse myocardial damage such as cardiac amyloidosis, scleroderma, and Fabry disease (additive role in 42%). In contrast, T1 mapping was less effective in cardiac disease with regional distribution of myocardial damage such as myocardial infarction, HCM, and myocarditis. In conclusion, conventional LGE/T2-STIR and T1 mapping are complementary techniques and should be used together in every CMR examination. [ABSTRACT FROM AUTHOR]

Objectives: The prognostic role of left ventricular (LV) papillary muscle abnormalities in patients with preserved LV systolic ejection fraction (LVEF) is unknown. We sought to evaluate the prognosis role of LV papillary muscle abnormalities by CMR in patients with ventricular arrhythmias, preserved LVEF with no cardiac disease. Methods: A total of 391 patients with > 500/24 h premature ventricular complexes and/or with non-sustained ventricular tachycardia (NSVT), preserved LVEF, and no cardiac disease were enrolled. Different features of LV papillary muscles were considered: supernumerary muscles, papillary thickness, the attachment, late gadolinium enhancement (LGE). Dark-Paps was defined as end-systolic signal hypointensity of both papillary muscles in early post-contrast cine CMR images. Mitral valve prolapse, mitral annular disjunction (MAD), and myocardial LGE were considered. Results: Dark-Paps was found in 79 (20%) patients and was more frequent in females. It was associated with higher prevalence of mitral valve prolapse and MAD. During a median follow-up of 2534 days, 22 hard cardiac events occurred. At Kaplan-Meier curve analysis, patients with Dark-Paps were at higher risk of events than those without (p < 0.0001). Dark-Paps was significantly associated with hard cardiac events in all the multivariate models. Dark-Paps improved prognostic estimation when added to NSVT (p = 0.0006), to LGE (p = 0.005) and to a model including NSVT+LGE (p = 0.014). Dark-Paps allowed a significant net reclassification when added to NSVT (NRI 0.30, p = 0.03), to LGE (NRI 0.25, p = 0.04), and to NSVT + LGE (NRI 0.32, p = 0.02). Conclusions: In LV papillary muscles, Dark-Paps is a novel prognostic marker in patients with ventricular arrhythmias and preserved ejection fraction. Key Points: • Papillary muscle abnormalities are seen in patients with ventricular arrhythmias and preserved left ventricular ejection fraction. • Early post-contrast hypointensity of papillary muscles in end-systolic cine images (Dark-Paps) is a novel prognostic marker in patients with ventricular arrhythmias and preserved ejection fraction. • Dark-Paps had an additive prognostic role over late gadolinium enhancement and non-sustained ventricular tachycardia. [ABSTRACT FROM AUTHOR]

Entering a new era of green investing powered by advanced automation not only offers higher transparency but also paves the way for an innovative financial product for retail investors. Green bonds are a type of bonds that are used to finance environmentally sustainable projects. Accordingly, the entities issuing a green bond commit themselves to utilizing the raised funds for financing projects that bring about positive environmental outcomes, such as initiatives in renewable energy or sustainable infrastructure. Blockchain technologies have the potential to sustain green bonds by increasing transparency and accountability in the issuance and use of the funds raised from green bonds. In this paper, we investigate the effects of blockchain technologies in sustaining green bonds exchange on investors' behaviors. By leveraging on a sample of 551 international participants, results revealed the mediator role of investors' environmental concern, and the moderator role of their innovativeness. Specifically, statistical analysis revealed that their attitude toward green bonds proposed on the basis of blockchain technologies increase positively investors' willingness to buy through the effects of their environmental concern. Moreover, this effect is stronger among those investors characterized by higher level of innovativeness tendency. [ABSTRACT FROM AUTHOR]

Digital Breast Tomosynthesis (DBT) is a cutting-edge technology introduced in recent years as an in-depth analysis of breast cancer diagnostics. Compared with 2D Full-Field Digital Mammography, DBT has demonstrated greater sensitivity and specificity in detecting breast tumors. This work aims to quantitatively evaluate the impact of the systematic introduction of DBT in terms of Biopsy Rate and Positive Predictive Values for the number of biopsies performed (PPV-3). For this purpose, we collected 69,384 mammograms and 7894 biopsies, of which 6484 were Core Biopsies and 1410 were stereotactic Vacuum-assisted Breast Biopsies (VABBs), performed on female patients afferent to the Breast Unit of the Istituto Tumori "Giovanni Paolo II" of Bari from 2012 to 2021, thus, in the period before, during and after the systematic introduction of DBT. Linear regression analysis was then implemented to investigate how the Biopsy Rate had changed over the 10 year screening. The next step was to focus on VABBs, which were generally performed during in-depth examinations of mammogram detected lesions. Finally, three radiologists from the institute's Breast Unit underwent a comparative study to ascertain their performances in terms of breast cancer detection rates before and after the introduction of DBT. As a result, it was demonstrated that both the overall Biopsy Rate and the VABBs Biopsy Rate significantly decreased following the introduction of DBT, with the diagnosis of an equal number of tumors. Besides, no statistically significant differences were observed among the three operators evaluated. In conclusion, this work highlights how the systematic introduction of DBT has significantly impacted the breast cancer diagnostic procedure, by improving the diagnostic quality and thereby reducing needless biopsies, resulting in a consequent reduction in costs. [ABSTRACT FROM AUTHOR]

Purpose: To assess the ability of apparent diffusion coefficient (ADC) measurements in predicting the histological grade of endometrial cancer. A secondary goal was to assess the agreement between MRI and surgical staging as an accurate measurement. Methods: Patients with endometrial cancers diagnosed between 2018–2020 and having received both MRI and surgical staging were retrospectively enrolled. Patients were characterized according to histology, tumor size, FIGO stage (MRI and surgical stage), and functional MRI parameters (DCE and DWI/ADC). Statistical analysis was performed to determine if an association could be identified between ADC variables and histology grade. Secondarily, we assessed the degree of agreement between the MRI and surgical stages according to the FIGO classification. Results: The cohort included 45 women with endometrial cancer. Quantitative analysis of ADC variables did not find a statistically significant association with histological tumor grades. DCE showed higher sensitivity than DWI/ADC in the assessment of myometrial invasion (85.00% versus 65.00%) with the same specificity (80.00%). A good agreement between MRI and histopathology for the FIGO stage was found (kappa of 0.72, p < 0.01). Differences in staging between MRI and surgery were detected in eight cases, which could not be justified by the interval between MRI and surgery. Conclusions. ADC values were not useful for predicting endometrial cancer grade, despite the good agreement between MRI interpretation and histopathology of endometrial cancer staging at our center. [ABSTRACT FROM AUTHOR]

Objectives: The recently proposed standardized reporting and data system for somatostatin receptor (SSTR)–targeted PET/CT SSTR-RADS 1.0 showed promising first results in the assessment of diagnosis and treatment planning with peptide receptor radionuclide therapy (PRRT) in neuroendocrine tumors (NET). This study aimed to determine the intra- and interreader agreement of SSTR-RADS 1.0. Methods: SSTR-PET/CT scans of 100 patients were independently evaluated by 4 readers with different levels of expertise according to the SSTR-RADS 1.0 criteria at 2 time points within 6 weeks. For each scan, a maximum of five target lesions were freely chosen by each reader (not more than three lesions per organ) and stratified according to the SSTR-RADS 1.0 criteria. Overall scan score and binary decision on PRRT were assessed. Intra- and interreader agreement was determined using the intraclass correlation coefficient (ICC). Results: Interreader agreement using SSTR-RADS 1.0 for identical target lesions (ICC ≥ 0.91) and overall scan score (ICC ≥ 0.93) was excellent. The decision to state "functional imaging fulfills requirements for PRRT and qualifies patient as potential candidate for PRRT" also demonstrated excellent agreement among all readers (ICC ≥ 0.86). Intrareader agreement was excellent even among different experience levels when comparing target lesion–based scores (ICC ≥ 0.98), overall scan score (ICC ≥ 0.93), and decision for PRRT (ICC ≥ 0.88). Conclusion: SSTR-RADS 1.0 represents a highly reproducible and accurate system for stratifying SSTR-targeted PET/CT scans with high intra- and interreader agreement. The system is a promising approach to standardize the diagnosis and treatment planning in NET patients. Key Points: • SSTR-RADS 1.0 offers high reproducibility and accuracy. • SSTR-RADS 1.0 is a promising method to standardize diagnosis and treatment planning for patients with NET. [ABSTRACT FROM AUTHOR]

Background and Objective: In the USA, cabozantinib was approved for the treatment of patients aged ≥ 12 years with radioiodine-refractory differentiated thyroid cancer (DTC) who progressed on prior vascular endothelial growth factor (VEGFR)-targeted therapy based on the Phase 3 COSMIC-311 trial, which evaluated cabozantinib 60 mg/day versus placebo. Approved dosing is 60 mg/day for adults and for pediatric patients aged ≥ 12 years with body surface area (BSA) ≥ 1.2 m2, and 40 mg/day for pediatric patients aged ≥ 12 years with BSA < 1.2 m2. This report describes a population pharmacokinetic (PopPK) and exposure–response analysis of COSMIC-311. Methods: A PopPK model was developed using concentration-time data from COSMIC-311 and 6 other cabozantinib studies. The final (full) PopPK model was used to simulate the effect of sex, body weight, race, and patient population. For exposure–response analysis, derived datasets from COSMIC-311 were constructed for time-to-event analyses of progression-free survival (PFS) and safety endpoints. Results: The PopPK analysis included 4746 cabozantinib PK samples from 1745 patients and healthy volunteers. Body weight had minimal impact on cabozantinib exposure but increasing body weight was associated with increased apparent volume of distribution. Based on model-based simulation, adolescents < 40 kg had higher maximum plasma concentration at steady state of cabozantinib 60 mg/day compared to adults. Allometric scaling simulation in adolescents < 40 kg demonstrated higher exposure with 60 mg/day relative to adults receiving the same dose, while exposure with 40 mg/day in adolescents < 40 kg was similar to 60 mg/day in adults. The exposure–response analysis included 115 patients. There was no clear relationship between PFS or dose modification and cabozantinib exposure. A statistically significant relationship was demonstrated for cabozantinib exposure and hypertension (Grade ≥ 3) and fatigue/asthenia (Grade ≥ 3). Conclusions: These results support the dosing strategy implemented in COSMIC-311 and the BSA-based label recommendations for adolescents. The cabozantinib dose should be reduced to manage adverse events as indicated. [ABSTRACT FROM AUTHOR]

Background: Benign renal tumors, such as renal oncocytoma (RO), can be erroneously diagnosed as malignant renal cell carcinomas (RCC), because of their similar imaging features. Computer-aided systems leveraging radiomic features can be used to better discriminate benign renal tumors from the malignant ones. The purpose of this work was to build a machine learning model to distinguish RO from clear cell RCC (ccRCC). Method: We collected CT images of 77 patients, with 30 cases of RO (39%) and 47 cases of ccRCC (61%). Radiomic features were extracted both from the tumor volumes identified by the clinicians and from the tumor's zone of transition (ZOT). We used a genetic algorithm to perform feature selection, identifying the most descriptive set of features for the tumor classification. We built a decision tree classifier to distinguish between ROs and ccRCCs. We proposed two versions of the pipeline: in the first one, the feature selection was performed before the splitting of the data, while in the second one, the feature selection was performed after, i.e., on the training data only. We evaluated the efficiency of the two pipelines in cancer classification. Results: The ZOT features were found to be the most predictive by the genetic algorithm. The pipeline with the feature selection performed on the whole dataset obtained an average ROC AUC score of 0.87 ± 0.09. The second pipeline, in which the feature selection was performed on the training data only, obtained an average ROC AUC score of 0.62 ± 0.17. Conclusions: The obtained results confirm the efficiency of ZOT radiomic features in capturing the renal tumor characteristics. We showed that there is a significant difference in the performances of the two proposed pipelines, highlighting how some already published radiomic analyses could be too optimistic about the real generalization capabilities of the models. [ABSTRACT FROM AUTHOR]

Tailoring treatment in patients with Hodgkin lymphoma (HL) is paramount to maximize outcomes while avoiding unnecessary toxicity. We aimed to compare the performance of SUVmax reduction (ΔSUVmax%) and the PET ratio (rPET) versus the Deauville score (DS) for assessing the chemotherapy response in pediatric HL patients undergoing 18F-FDG PET-CT. Fifty-two patients with biopsy-proven HL (aged 8–16 years) were enrolled at baseline, interim (after the second or third chemotherapy round) and post-therapy (on completion of first-line chemotherapy). Interim and post-therapy DS, ΔSUVmax% and rPET were compared as response predictors. Patients were classified as responders or non-responders based on a 24-month clinical follow-up. Interim DS showed a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of 100%, 80.4%, 100%, 40% and 82.7%, respectively, in predicting the therapy response. Post-therapy DS showed a sensitivity, specificity, PPV, NPV and accuracy of 66.7%, 97.8%, 95.7%, 80% and 94.2%, repsectively. Interim ΔSUVmax% showed a sensitivity, specificity, PPV, NPV and accuracy of 83.3%, 82.6%, 97.4%, 38.5% and 82.7%, respectively, with a 56.3% cutoff. Post-therapy ΔSUVmax% showed a sensitivity, specificity, PPV, NPV and accuracy of 83.3%, 84.8%, 97.5%, 41.7% and 84.6%, respectively, with a 76.8% cutoff. Compared to ΔSUVmax%, DS showed a significantly higher sensitivity, specificity (p < 0.05) and NPV (p < 0.01). The sensitivity, specificity, PPV, NPV and accuracy of rPET in predicting the therapy response at 24 months were 76.1%, 100%, 100%, 35.3% and 78.8%, respectively, with a cut-off of 1.31. DS and rPET showed comparable predictive performance (p > 0.58). In conclusion, DS is an easier method with better performance than ΔSUVmax% and rPET in predicting the chemotherapy response in pediatric HL patients. [ABSTRACT FROM AUTHOR]

Copyright of Biotropica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Due to the rich vascularization and lymphatic drainage of the pulmonary tissue, lung metastases (LM) are not uncommon in patients with cancer. Radiomics is an active research field aimed at the extraction of quantitative data from diagnostic images, which can serve as useful imaging biomarkers for a more effective, personalized patient care. Our purpose is to illustrate the current applications, strengths and weaknesses of radiomics for lesion characterization, treatment planning and prognostic assessment in patients with LM, based on a systematic review of the literature. [ABSTRACT FROM AUTHOR]

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To develop a structured reporting (SR) template for whole-body CT examinations of polytrauma patients, based on the consensus of a panel of emergency radiology experts from the Italian Society of Medical and Interventional Radiology. Methods: A multi-round Delphi method was used to quantify inter-panelist agreement for all SR sections. Internal consistency for each section and quality analysis in terms of average inter-item correlation were evaluated by means of the Cronbach's alpha (Cα) correlation coefficient. Results: The final SR form included 118 items (6 in the "Patient Clinical Data" section, 4 in the "Clinical Evaluation" section, 9 in the "Imaging Protocol" section, and 99 in the "Report" section). The experts' overall mean score and sum of scores were 4.77 (range 1–5) and 257.56 (range 206–270) in the first Delphi round, and 4.96 (range 4–5) and 208.44 (range 200–210) in the second round, respectively. In the second Delphi round, the experts' overall mean score was higher than in the first round, and standard deviation was lower (3.11 in the second round vs 19.71 in the first round), reflecting a higher expert agreement in the second round. Moreover, Cα was higher in the second round than in the first round (0.97 vs 0.87). Conclusions: Our SR template for whole-body CT examinations of polytrauma patients is based on a strong agreement among panel experts in emergency radiology and could improve communication between radiologists and the trauma team. [ABSTRACT FROM AUTHOR]

Purpose: In the phase 3 CheckMate 9ER trial, intravenous nivolumab (240 mg every 2 weeks) plus oral cabozantinib (40 mg/day) improved progression-free survival (PFS) versus sunitinib as first-line therapy for advanced renal cell carcinoma (RCC). To support cabozantinib dosing with the combination, this exposure–response analysis characterized the relationship of cabozantinib exposure with clinical endpoints. Methods: Dose modification was allowed with cabozantinib (holds and reductions) to manage adverse events (AEs). The population pharmacokinetics analysis was updated and used to generate individual predicted cabozantinib exposure measures. Kaplan–Meier plots and time-to-event Cox proportional hazard (CPH) exposure–response models characterized the relationship of cabozantinib exposure with PFS, dose modifications, and selected AEs. Results: Kaplan–Meier plots showed no clear difference in PFS across cabozantinib exposure quartiles. Cabozantinib exposure did not significantly affect the hazard of PFS in the CPH base model nor in the final model. In contrast, baseline albumin and nivolumab clearance had a significant effect on PFS. There was no significant relationship between cabozantinib clearance and risk of dose modification, but a significant relationship was identified between cabozantinib exposure and Grade ≥ 1 palmar-plantar-erythrodysesthesia and Grade ≥ 3 diarrhea in the exposure–response analysis. Conclusion: To optimize individual cabozantinib exposure, these data support the dose modification strategies in CheckMate 9ER for cabozantinib in patients with advanced RCC when combined with nivolumab. [ABSTRACT FROM AUTHOR]

The article underlines the issues surrounding international (second) ship-registers from a labour law perspective. The registers specifically analysed are the French, German, and Italian registers. The spread of international registers in the EU is bringing the working conditions onboard European ships into line with those prevalent in developing countries. Moreover, these registers can lead to wage dumping and pay discrimination, creating challenges for the employment prospects of European seafarers. Consequently, on a few occasions their legitimacy in relation to constitutional principles and European law has been questioned. Given their impact on workers, the author believes international registers cannot be considered a viable solution to the shipping crisis affecting the European Union Member States. [ABSTRACT FROM AUTHOR]

Sea level changes in coastal areas significantly influence port activities (e.g., the safety of navigation). Along Italian coastlines, sea level variations are mainly due to astronomical tides (well known, due to gravitational attraction between Earth, Moon and Sun); however, during the last fifteen years, a high number of "anomalous" tides has been observed: the study of the phenomenon has allowed to attribute its cause to variations in atmospheric pressure (the so-called meteorological tides: sea level drops when atmospheric pressure increases and vice versa); the statistical analysis of acquired data made it possible to evaluate the hydrobarometric transfer factor (a local parameter which represents the correlation between atmospheric pressure changes and consequent sea level variations): it was found that it is usually much larger within gulfs or port basins than offshore areas, where a pressure change of 1 hPa results in a sea level variation of about 1 cm; the statistical analysis described in the following, and aimed at correctly estimating the hydrobarometric transfer factor in harbors, can play a fundamental role in optimizing the management of port waters: its results allow to forecast meteorological tides and therefore future sea level (and depth) variations in a given port basin. The results of the study conducted in the port of La Spezia (North Western Italy) are presented here, together with possible applications on port activities and harbor water management. [ABSTRACT FROM AUTHOR]

NAVIGATOR is an Italian regional project boosting precision medicine in oncology with the aim of making it more predictive, preventive, and personalised by advancing translational research based on quantitative imaging and integrative omics analyses. The project's goal is to develop an open imaging biobank for the collection and preservation of a large amount of standardised imaging multimodal datasets, including computed tomography, magnetic resonance imaging, and positron emission tomography data, together with the corresponding patient-related and omics-related relevant information extracted from regional healthcare services using an adapted privacy-preserving model. The project is based on an open-source imaging biobank and an open-science oriented virtual research environment (VRE). Available integrative omics and multi-imaging data of three use cases (prostate cancer, rectal cancer, and gastric cancer) will be collected. All data confined in NAVIGATOR (i.e., standard and novel imaging biomarkers, non-imaging data, health agency data) will be used to create a digital patient model, to support the reliable prediction of the disease phenotype and risk stratification. The VRE that relies on a well-established infrastructure, called D4Science.org, will further provide a multiset infrastructure for processing the integrative omics data, extracting specific radiomic signatures, and for identification and testing of novel imaging biomarkers through big data analytics and artificial intelligence. [ABSTRACT FROM AUTHOR]

Fabry disease (FD) is an X-linked inheritable storage disease caused by a deficiency of alpha-galactosidase causing lysosomal overload of sphingolipids. FD cardiomyopathy is characterized by left ventricular (LV) hypertrophy and should be considered in differential diagnosis with all the other causes of LV hypertrophy. An early diagnosis of FD is very important because the enzyme replacement therapy (ERT) may change the fate of patients by blocking both cardiac and systemic involvement and improving prognosis. Diagnosis may be relatively easy in young patients with the typical signs and symptoms of FD, but in male patients with late onset of disease and in females, diagnosis may be very challenging. Morphological and functional aspects are not specific to FD, which cannot be diagnosed or excluded by echocardiography. Cardiac magnetic resonance (CMR) with tissue characterization capability is an accurate technique for the differential diagnosis of LV hypertrophy. The finding of decreased myocardial T1 value in LV hypertrophy is specific to FD. Late gadolinium enhancement (LGE) is found in the late stage of the disease, but it is useful to predict the cardiac response to ERT and to stratify the prognosis. [ABSTRACT FROM AUTHOR]

Performing a correct architectural design is essential to satisfy the quality requirements of a software. In this phase, the high-level components that will compose the system, as well as their relationships, are defined. Since the architects must struggle with complex and challenging tasks in this phase, providing them with advanced and helpful tools and methods is suitable. For example, MDD-based approaches are a valuable means to deal with the complexity during the software development process, particularly during the architectural design stage. However, despite the notable benefits of this type of approaches, the architects are often sceptical about adopting new technologies. Hence, before formally adopting new methods or tools, it is suitable to consider the opinion of those using them. In that sense, this paper aims to describe the results of an assessment of an MDA-based approach to support the architectural design. This assessment was carried out applying the Iadov neutrosophic technique. This technique has been extensively applied in a wide variety of domains to analyze the satisfaction level of potential users of different proposals. The results indicate a high satisfaction level of potential users of the assessed approach. [ABSTRACT FROM AUTHOR]

Ribociclib plus an aromatase inhibitor and ovarian function suppression is the preferred first-line option for pre-/perimenopausal women with hormone receptor-positive/human epidermal growth factor receptor-2-negative advanced or metastatic breast cancer. We opened an italian managed access program (MAP) that permitted access to ribociclib to selected patients and allowed to collect informative results on the clinical impact of the therapy. The MAP (April 2018–May 2020) included 64 premenopausal patients, with characteristics similar to those of the MONALEESA-7 trial. Of 57 patients with a known response, 48 (84.2%) achieved a clinical benefit (i.e., complete response, N = 7 (12.3%); partial response, N = 17 (29.8%); stable disease, N = 24 (42.1%)), while 9 (15.8%) experienced tumor progression. Some patients (N = 15–23.4%) needed ribociclib dose reduction because of adverse events. Thereafter, the treatment was well tolerated, and no new safety signals emerged. Our study is the first reported Italian real-world evidence of ribociclib effectiveness in premenopausal HR+/HER2− advanced breast cancer patients. Response and clinical benefit rates were particularly encouraging compared with those of the ribociclib group of MONALEESA-7. Our work confirms that ribociclib in combination with endocrine therapy is highly effective in the treatment of premenopausal HR+/HER2− advanced breast cancer patients with an expected safety profile. [ABSTRACT FROM AUTHOR]

Background: There is an unmet need for new biomarkers able to predict both the outcomes of up–front therapy and the compliance of elderly patients diagnosed with glioblastoma. For this purpose, temporal muscle thickness is a promising tool to be investigated. Methods: Data from 52 glioblastoma patients older than 65 years, treated with post-operative radio or radio-chemotherapy and referred to Pisa University Hospital, were retrieved. The thickness of temporal muscle (TMT) was divided into quartiles and correlated with overall survival (Our primary endpoint). Survival curves were calculated using Kaplan–Meier method, and log-rank test was used to evaluate the differences between curves. Results: Patients in the lower quartile of TMT, with TMT thinner than 7 mm, have survived longer; both univariate and multivariate analyses showed a statistically significant correlation between TMT and overall survival (P = 0.012 and P = 0.003, respectively). Conclusion: Future prospective and more extensive studies focused on elderly glioblastoma patients are needed to confirm the role of TMT as prognostic value on OS and to help explaining this association. [ABSTRACT FROM AUTHOR]

The use of artificial intelligence (AI) and radiomics in the healthcare setting to advance disease diagnosis and management and facilitate the creation of new therapeutics is gaining popularity. Given the vast amount of data collected during cancer therapy, there is significant concern in leveraging the algorithms and technologies available with the underlying goal of improving oncologic care. Radiologists will attain better precision and effectiveness with the advent of AI technology, making machine-assisted medical services a valuable and important option for future oncologic medical care. As a result, it is critical to figure out which specific radiology activities are best positioned to gain from AI and radiomics models and methods of oncologic imaging, while also considering the algorithms' capabilities and constraints. Our purpose is to overview the current evidence and future prospects of AI and radiomics algorithms used in oncologic imaging efforts with an emphasis on the three most frequent cancers worldwide, i.e., lung cancer, breast cancer and colorectal cancer. We discuss how AI and radiomics could be used to detect and characterize cancers and assess therapy response. [ABSTRACT FROM AUTHOR]

The movement of organisms or genes among resource patches is fundamental to the persistence of natural populations over time. Species occurring in rock outcrops may have difficulty maintaining genetic connectivity due to the natural disjunct distribution of these formations, which may lead to genetic differentiation. In this study, we tested the hypothesis of genetic isolation among populations of Deuterocohnia meziana on rock outcrops in Brazil. We evaluated genetic diversity and structure, number of migrants, and the contribution of pollen and seed to dispersal. Additionally, we used niche modelling to estimate the potential distribution of D. meziana and combined this with genetic data to identify potential dispersal routes under different climatic scenarios from the Quaternary. Deuterocohnia meziana showed high diversity and moderate genetic structure, low number of migrants and more efficient dispersal by pollen. Only populations separated by > 70 km showed genetic differentiation. Dispersal routes varied mainly in the intensity of the environmental suitability and indicated the present scenario as the most favourable for gene flow in D. meziana. Our findings contribute to the understanding of processes related to the connectivity and isolation of naturally fragmented populations, highlighting the role of biotic and abiotic drivers for genetic differentiation. [ABSTRACT FROM AUTHOR]

Background: Radiology is an essential tool in the management of a patient. The aim of this manuscript was to build structured report (SR) Mammography based in Breast Cancer. Methods: A working team of 16 experts (group A) was composed to create a SR for Mammography Breast Cancer. A further working group of 4 experts (group B), blinded to the activities of the group A, was composed to assess the quality and clinical usefulness of the SR final draft. Modified Delphi process was used to assess level of agreement for all report sections. Cronbach's alpha (Cα) correlation coefficient was used to assess internal consistency and to measure quality analysis according to the average inter-item correlation. Results: The final SR version was built by including n = 2 items in Personal Data, n = 4 items in Setting, n = 2 items in Comparison with previous breast examination, n = 19 items in Anamnesis and clinical context; n = 10 items in Technique; n = 1 item in Radiation dose; n = 5 items Parenchymal pattern; n = 28 items in Description of the finding; n = 12 items in Diagnostic categories and Report and n = 1 item in Conclusions. The overall mean score of the experts and the sum of score for structured report were 4.9 and 807 in the second round. The Cronbach's alpha (Cα) correlation coefficient was 0.82 in the second round. About the quality evaluation, the overall mean score of the experts was 3.3. The Cronbach's alpha (Cα) correlation coefficient was 0.90. Conclusions: Structured reporting improves the quality, clarity and reproducibility of reports across departments, cities, countries and internationally and will assist patient management and improve breast health care and facilitate research. [ABSTRACT FROM AUTHOR]

Background and objective: The systematic collection of medical images combined with imaging biomarkers and patient non-imaging data is the core concept of imaging biobanks, a key element for fuelling the development of modern precision medicine. Our purpose is to review the existing image repositories fulfilling the criteria for imaging biobanks. Methods: Pubmed, Scopus and Web of Science were searched for articles published in English from January 2010 to July 2021 using a combination of the terms: "imaging" AND "biobanks" and "imaging" AND "repository". Moreover, the Community Research and Development Information Service (CORDIS) database (https://cordis.europa.eu/projects) was searched using the terms: "imaging" AND "biobanks", also including collections, projects, project deliverables, project publications and programmes. Results: Of 9272 articles retrieved, only 54 related to biobanks containing imaging data were finally selected, of which 33 were disease-oriented (61.1%) and 21 population-based (38.9%). Most imaging biobanks were European (26/54, 48.1%), followed by American biobanks (20/54, 37.0%). Among disease-oriented biobanks, the majority were focused on neurodegenerative (9/33, 27.3%) and oncological diseases (9/33, 27.3%). The number of patients enrolled ranged from 240 to 3,370,929, and the imaging modality most frequently involved was MRI (40/54, 74.1%), followed by CT (20/54, 37.0%), PET (13/54, 24.1%), and ultrasound (12/54, 22.2%). Most biobanks (38/54, 70.4%) were accessible under request. Conclusions: Imaging biobanks can serve as a platform for collecting, sharing and analysing medical images integrated with imaging biomarkers, biological and clinical data. A relatively small proportion of current biobanks also contain images and can thus be classified as imaging biobanks. Key Points: • Imaging biobanks are a powerful tool for large-scale collection and processing of medical images integrated with imaging biomarkers and patient non-imaging data. • Most imaging biobanks retrieved were European, disease-oriented and accessible under user request. • While many biobanks have been developed so far, only a relatively small proportion of them are imaging biobanks. [ABSTRACT FROM AUTHOR]

Background: Radiofrequency ablation has been shown to be a safe and effective treatment for scar-related ventricular arrhythmias (VA). Recent preliminary studies have shown that real time integration of late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) images with electroanatomical map (EAM) data may lead to increased procedure efficacy, efficiency, and safety.Methods: VOYAGE is a prospective, randomized, multicenter controlled open label study designed to compare in terms of efficacy, efficiency, and safety a CMR aided/guided workflow to standard EAM-guided ventricular tachycardia (VT) ablation. Patients with an ICD or with ICD implantation expected within 1 month, with scar related VT, suitable for CMR and multidetector computed tomography (MDCT) will be randomized to a CMR-guided or CMR-aided approach, whereas subjects unsuitable for imaging or with image quality deemed not sufficient for postprocessing will be allocated to standard of care ablation. Primary endpoint is defined as VT recurrences (sustained or requiring appropriate ICD intervention) during 12 months follow-up, excluding the first month of blanking period. Secondary endpoints will include procedural efficiency, safety, impact on quality of life and comparison between CMR-guided and CMR-aided approaches. Patients will be evaluated at 1, 6 and 12 months.Discussion: The clinical impact of real time CMR-guided/aided ablation approaches has not been thoroughly assessed yet. This study aims at defining whether such workflow results in more effective, efficient, and safer procedures. If proven to be of benefit, results from this study could be applied in large scale interventional practice. Trial registrationClinicalTrials.gov, NCT04694079, registered on January 1, 2021. [ABSTRACT FROM AUTHOR]

Simple Summary: The objective of the study was to assess the radiomic features obtained by computed tomography (CT) examination as prognostic biomarkers in patients with colorectal liver metastases, in order to predict histopathological outcomes following liver resection. We obtained good performance considering the single significant textural metric in the identification of the front of tumor growth (expansive versus infiltrative) and tumor budding (high grade versus low grade or absent), in the recognition of mucinous type, and in the detection of recurrences. Purpose: We aimed to assess the efficacy of radiomic features extracted by computed tomography (CT) in predicting histopathological outcomes following liver resection in colorectal liver metastases patients, evaluating recurrence, mutational status, histopathological characteristics (mucinous), and surgical resection margin. Methods: This retrospectively approved study included a training set and an external validation set. The internal training set included 49 patients with a median age of 60 years and 119 liver colorectal metastases. The validation cohort consisted of 28 patients with single liver colorectal metastasis and a median age of 61 years. Radiomic features were extracted using PyRadiomics on CT portal phase. Nonparametric Kruskal–Wallis tests, intraclass correlation, receiver operating characteristic (ROC) analyses, linear regression modeling, and pattern recognition methods (support vector machine (SVM), k-nearest neighbors (KNN), artificial neural network (NNET), and decision tree (DT)) were considered. Results: The median value of intraclass correlation coefficients for the features was 0.92 (range 0.87–0.96). The best performance in discriminating expansive versus infiltrative front of tumor growth was wavelet_HHL_glcm_Imc2, with an accuracy of 79%, a sensitivity of 84%, and a specificity of 67%. The best performance in discriminating expansive versus tumor budding was wavelet_LLL_firstorder_Mean, with an accuracy of 86%, a sensitivity of 91%, and a specificity of 65%. The best performance in differentiating the mucinous type of tumor was original_firstorder_RobustMeanAbsoluteDeviation, with an accuracy of 88%, a sensitivity of 42%, and a specificity of 100%. The best performance in identifying tumor recurrence was the wavelet_HLH_glcm_Idmn, with an accuracy of 85%, a sensitivity of 81%, and a specificity of 88%. The best linear regression model was obtained with the identification of recurrence considering the linear combination of the 16 significant textural metrics (accuracy of 97%, sensitivity of 94%, and specificity of 98%). The best performance for each outcome was reached using KNN as a classifier with an accuracy greater than 86% in the training and validation sets for each classification problem; the best results were obtained with the identification of tumor front growth considering the seven significant textural features (accuracy of 97%, sensitivity of 90%, and specificity of 100%). Conclusions: This study confirmed the capacity of radiomics data to identify several prognostic features that may affect the treatment choice in patients with liver metastases, in order to obtain a more personalized approach. [ABSTRACT FROM AUTHOR]

Objectives: The relationship between glucose metabolism and tumor cellularity before chemo-radiotherapy in patients with head and neck squamous cell carcinoma (SCC) has never been compared with that of patients evaluated after treatment. This retrospective study analyzed the correlation between glucose metabolism parameters expressed by standardized uptake value (SUV) derived from 18F-fluorodeoxyglucose (18F-FDG) PET/CT and cellularity tumor parameters expressed by apparent diffusion coefficients (ADC) derived from diffusion-weighted (DW) MRI in untreated and treated patients with head and neck SCC. Methods: In 19 patients with no previous exposure to any treatment and 17 different chemo-radiotreated patients with head and neck SCC, we correlated the semi-quantitative uptake values (SUVmax, SUVpeak, and SUVmean) with the ADC functional parameters (ADCmin, ADCmean) including the standard deviation of ADC values (ADCsd). Results: No significant correlation was found between glucose metabolism parameters and ADCmin or ADCmean in untreated and treated patient groups. However, in untreated patients, significant inverse correlations were found between ADCsd and SUVmax (P = 0.039, r = −0.476), SUVpeak (P = 0.003, r = −0.652) and SUVmean (P = 0.039, r = −0.477). Analyses after chemo-radiotherapy in 17 patients showed no significant correlation between glucose metabolism parameters and DW MRI values, excluding a persistent significant (but lower intensity) inverse correlation between SUVpeak and ADCsd (P = 0.033, r = −0.519). Conclusions: The demonstrated relationships suggest complex interactions especially between metabolic activity and heterogeneity of tumoral tissue, which might play a complementary role in the assessment of head and neck SCC. Trial date of registration and registration number: Our retrospective study was registered on April 9th, 2020 by the Ethics Committee of the Coordinating Center "Area Vasta Nord Ovest" (CEAVNO) with Registration Number CEAVNO09042020. [ABSTRACT FROM AUTHOR]

During the coronavirus disease 19 (COVID-19) pandemic, extracorporeal membrane oxygenation (ECMO) has been proposed as a possible therapy for COVID-19 patients with acute respiratory distress syndrome. This pictorial review is intended to provide radiologists with up-to-date information regarding different types of ECMO devices, correct placement of ECMO cannulae, and imaging features of potential complications and disease evolution in COVID-19 patients treated with ECMO, which is essential for a correct interpretation of diagnostic imaging, so as to guide proper patient management. [ABSTRACT FROM AUTHOR]

Blockchain usage in healthcare, in radiology, in particular, is at its very early infancy. Only a few research applications have been tested, however, blockchain technology is widely known outside healthcare and widely adopted, especially in Finance, since 2009 at least. Learning by history, radiology is a potential ideal scenario to apply this technology. Blockchain could have the potential to increase radiological data value in both clinical and research settings for the patient digital record, radiological reports, privacy control, quantitative image analysis, cybersecurity, radiomics and artificial intelligence. Up-to-date experiences using blockchain in radiology are still limited, but radiologists should be aware of the emergence of this technology and follow its next developments. We present here the potentials of some applications of blockchain in radiology. [ABSTRACT FROM AUTHOR]

Reactive oxygen species (ROS) and DNA repair, respectively, promote and limit oncogenic transformation of B cells driven by Epstein-Barr virus (EBV). We have previously shown that EBV infection reduced autophagy in primary B lymphocytes and enhanced ROS and interleukin 6 (IL-6) release, promoting B-cell proliferation and immortalization. In this study, we explored the role of p62/SQSTM1, accumulated as a consequence of autophagy reduction in EBV-infected B lymphocytes, and found that it exerted a growth-suppressive effect in these cells. At the molecular level, we found that p62 counteracted IL-6 production and ROS increase by interacting with NRF2 and promoting mitophagy. Moreover, p62/NRF2 axis sustained the expression level of H2AX and ataxia-telangiectasia mutated (ATM), whose activation has been shown to have growth-suppressive effects during the first steps of EBV infection, before latency is established. In conclusion, this study shows for the first time that the accumulation of p62 and the activation of p62/axis counteracted EBV-driven proliferation of primary B lymphocytes. [ABSTRACT FROM AUTHOR]

We performed next-generation sequencing (NGS), phylogenetic analysis, gene flows, and N- and O-glycosylation prediction on SARS-CoV-2 genomes collected from lab-confirmed cases from different Italian regions. To this end, a total of 111 SARS-CoV-2 genomes collected in Italy between 29 January and 27 March 2020 were investigated. The majority of the genomes belonged to lineage B.1, with some descendant lineages. The gene flow analysis showed that the spread occurred mainly from the north to the center and to the south of Italy, as confirmed by epidemiological data. The mean evolutionary rate estimated here was 8.731 × 10−4 (95% highest posterior density, HPD intervals 5.809 × 10−4 to 1.19 × 10−3), in line with values reported by other authors. The dated phylogeny suggested that SARS-CoV-2 lineage B.1 probably entered Italy between the end of January and early February 2020. Continuous molecular surveillance is needed to trace virus circulation and evolution. [ABSTRACT FROM AUTHOR]

Immunology is a knowledge area of paramount importance in life sciences and health care professional education with diverse applications, as well as for a general public understanding of issues related to vaccination. However, many concepts are complex and difficult to understand based only on conventional classes or static images. The use of tools, such as educational software, may enhance the learning of dynamic molecular phenomena that occur in our bodies. Virtual Immunology is a software that aims to facilitate the learning of certain complex immunology concepts. Herein, we present the "Antigen-antibody interactions" module that was used and evaluated by 127 students and 3 teachers from medical schools from 2 universities, 1 public and 1 private, both in the state of Rio de Janeiro, Brazil. The pretest/posttest research design was used to assess student learning in a randomized sample. To evaluate user perceptions concerning software quality, 14 statements were analyzed using a Likert scale. Results indicate suitable evaluations from both students and teachers concerning the "Antigen-antibody module" as an auxiliary tool in immunology teaching. The software was well rated as an educational resource since it allows dynamically viewing immunological phenomena. In addition, its ease of use and immunological process visualization were the best-evaluated parameters by the students, who recommended this software module as an auxiliary learning tool. The use of the evaluated software may motivate students and aid in the understanding of immunology-related concepts, becoming a complementary tool that may enhance the teaching-learning process. [ABSTRACT FROM AUTHOR]