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To compare whole-body MRI (WB-MRI) with diffusion-weighted imaging (DWI), FDG-PET/CT, and bone marrow biopsy (BMB), for the evaluation of bone marrow involvement (BMI) in patients with newly diagnosed lymphoma.This retrospective study was approved by our Institutional Review Board. Two independent radiologists and one nuclear medicine specialist reviewed all WB-MRI and FDG-PET/CT scans prospectively performed on 104 patients with newly diagnosed lymphoma (53 males; 47 Hodgkin; mean age: 44 years; range, 15-86 years) between 2013 and 2015. The delay between imaging scans and BMBs was up to 10 days. The diagnostic accuracy of WB-MRI (1.5 Tesla MR scanner, with T1w, T2w-STIR, and DWI sequences) was evaluated using BMB and FDG-PET/CT as the reference standard. We applied Cohen's kappa coefficient to assess the inter-observer agreement in WB-MRI interpretation and to compare WB-MRI, FDG-PET/CT and BMB. The Student's t test was done to compare pelvic marrow ADC values of patients with positive and negative BMB. A P-value of 0.01 was considered significant.Inter-observer agreement was excellent (k = 0.937). Agreement between WB-MRI and FDG-PET/CT was excellent, with a k = 0.935. Agreement between WB-MRI and BMB was moderate (k = 0.489), and fair between FDG-PET/CT and BMB (k = 0.370). WB-MRI and FDG-PET/CT were falsely negative in four indolent non-Hodgkin lymphomas with BMI 30% of marrow cellularity. Conversely, WB-MRI and FDG-PET/CT detected all cases with a BMI30% of marrow cellularity. Mean ADC values in patients with positive and negative BMB were not significantly different (P = 0.049).WB-MRI and FDG-PET/CT are valuable tools for the assessment of BMI.3 J. Magn. Reson. Imaging 2017;45:1082-1089.

Perceived control (PC) and boredom are academic risk factors that undermine motivation and performance in competitive achievement settings (Pekrun, Goetz, Daniels, Stupnisky, & Perry, 2010; Perry, Hladkyj, Pekrun, & Pelletier, 2001). Attribution-based motivation treatments (attributional retraining: AR) can assist students who exhibit single-risk factors, but AR efficacy remains unexamined for students with multiple-occurring risk factors in online learning environments. In a prepost randomized treatment study, AR was administered to students who differed in PC (low, high) and boredom (low, high) in an online, 2-semester course. For students with co-occurring risk factors (low PC–high boredom), AR (vs. no-AR) recipients performed better on a posttreatment course test, had higher control-related beliefs, and were twice as likely to remain in the course. AR (vs. no-AR) treatment effects were absent for students not having co-occurring risk factors. These results advance research on attribution-based motivation treatments for students who exhibit co-occurring academic risk factors in online learning environments. (PsycINFO Database Record (c) 2018 APA, all rights reserved)

In 2017, the International Agency for Research on Cancer classified welding fumes as “carcinogenic to humans” (Group 1). Both mild steel (MS) welding, where fumes lack carcinogenic chromium and nickel, and stainless steel (SS) increase lung cancer risk in welders; therefore, further research to better understand the toxicity of the individual metals is needed. The objectives were to (1) compare the pulmonary toxicity of chromium (as Cr(III) oxide [Cr2O3] and Cr (VI) calcium chromate [CaCrO4]), nickel [II] oxide (NiO), iron [III] oxide (Fe2O3), and gas metal arc welding-SS (GMAW-SS) fume; and (2) determine if these metal oxides can promote lung tumors. Lung tumor susceptible A/J mice (male, 4–5 weeks old) were exposed by oropharyngeal aspiration to vehicle, GMAW-SS fume (1.7 mg), or a low or high dose of surrogate metal oxides based on the respective weight percent of each metal in the fume: Cr2O3 + CaCrO4 (366 + 5 μg and 731 + 11 μg), NiO (141 and 281 μg), or Fe2O3 (1 and 2 mg). Bronchoalveolar lavage, histopathology, and lung/liver qPCR were done at 1, 7, 28, and 84 days post-aspiration. In a two-stage lung carcinogenesis model, mice were initiated with 3-methylcholanthrene (10 μg/g; intraperitoneal; 1x) or corn oil then exposed to metal oxides or vehicle (1 x/week for 5 weeks) by oropharyngeal aspiration. Lung tumors were counted at 30 weeks post-initiation. Results indicate the inflammatory potential of the metal oxides was Fe2O3 > Cr2O3 + CaCrO4 > NiO. Overall, the pneumotoxic effects were negligible for NiO, acute but not persistent for Cr2O3 + CaCrO4, and persistent for the Fe2O3 exposures. Fe2O3, but not Cr2O3 + CaCrO4 or NiO significantly promoted lung tumors. These results provide experimental evidence that Fe2O3 is an important mediator of welding fume toxicity and support epidemiological findings and the IARC classification.

Although an active pursuit of health goals is typically adaptive, there may be circumstances in very late life when it is not. Our 10-year study of community-dwelling individuals (n = 220, 79-98 years-old) examined whether investing substantial effort into personal health (high selective primary control) in the absence of help-seeking strategies (low compensatory primary control) jeopardized survival for very old adults who varied in functional independence (low, high). Cox proportional hazard models showed selective primary control (SPC) predicted 10-year mortality risk for only those with low compensatory primary control (CPC) and high initial functional independence. For these individuals, each standard deviation increase in SPC predicted a 101% higher risk of death. Results are consistent with the lines-of-defense model (Heckhausen et al., 2013) and suggest that, for very old adults with little previous need for help-seeking strategies, tenacious self-reliance (high SPC, low CPC) may have life-shortening consequences. (PsycINFO Database Record

Rationale and objectives Whether expectations about future health are adaptive or maladaptive in late life likely depends on the extent to which they conform to or defy a future reality of declining health. Our premise was that, when adults face a downward spiral in health, it can be adaptive to realistically expect poorer future health and maladaptive to unrealistically expect good health. Method This 18-year-long study of community-dwelling older Canadians (n = 132, 72–98 years) involved a baseline interview to identify those who anticipated heath would decline (pessimistic expectation) or improve/remain stable (optimistic expectation). We determined initial (baseline) health status by assessing the severity of chronic conditions. An objective within-person measure of actual health change was derived by documenting hospital admissions (HAs) over time to capture a continuum that ranged from no declines (HAs remained stable) to greater declines in health (increasing numbers of HAs). Our a priori hypotheses examined the effects of health expectations (pessimistic, optimistic) and actual health change on the outcomes of depressive symptoms and mortality. Results Support was found for our premise that it is adaptive to be realistic when forecasting future health, at least at low levels of initial chronic condition severity. Regression analyses showed that realistically pessimistic (vs. unrealistically optimistic) expectations predicted significantly fewer depressive symptoms and a lower risk of death. The results also supported our premise that it is maladaptive to be unrealistically optimistic when health subsequently declines in reality: The risk of death was 313% higher for those with optimistic expectations that were unrealistic (vs. realistic). Conclusion These findings provide insights for health care professionals regarding the messages they communicate to their patients. Together, they imply that, when good health is slipping away, it seems optimal to encourage a healthy dose of realism.

Recent experimental evidence indicates significant pulmonary toxicity of multiwalled carbon nanotubes (MWCNTs), such as inflammation, interstitial fibrosis, granuloma formation, and carcinogenicity. Although numerous studies explored the adverse potential of various CNTs, their comparability is often limited. This is due to differences in administered dose, physicochemical characteristics, exposure methods, and end points monitored. Here, we addressed the problem through sparse classification method, a supervised machine learning approach that can reduce the noise contained in redundant variables for discriminating among MWCNT-exposed and MWCNT-unexposed groups. A panel of proteins measured from bronchoalveolar lavage fluid (BAL) samples was used to predict exposure to various MWCNT and determine markers that are attributable to MWCNT exposure and toxicity in mice. Using sparse support vector machine–based classification technique, we identified a small subset of proteins clearly distinguishing each exposure. Macrophage-derived chemokine (MDC/CCL22), in particular, was associated with various MWCNT exposures and was independent of exposure method employed, that is, oropharyngeal aspiration versus inhalation exposure. Sustained expression of some of the selected protein markers identified also suggests their potential role in MWCNT-induced toxicity and proposes hypotheses for future mechanistic studies. Such approaches can be used more broadly for nanomaterial risk profiling studies to evaluate decisions related to dose/time–response relationships that could delineate experimental variables from exposure markers.

Welding generates a complex aerosol of incidental nanoparticles and cytotoxic metals, such as chromium (Cr), manganese (Mn), nickel (Ni), and iron (Fe). The goal was to use both in vivo and in vitro methodologies to determine the mechanisms by which different welding fumes may damage the lungs. Sprague-Dawley rats were treated by intratracheal instillation (ITI) with 2.0 mg of gas metal arc-mild steel (GMA-MS) or manual metal arc-stainless steel (MMA-SS) fumes or saline (vehicle control). At 1, 3, and 10 days, bronchoalveolar lavage (BAL) was performed to measure lung toxicity. To assess molecular mechanisms of cytotoxicity, RAW264.7 cells were exposed to both welding fumes for 24 h (0–100 μg/ml). Fume composition was different: MMA-SS (41% Fe, 29% Cr, 17% Mn, 3% Ni) versus GMA-MS (85% Fe, 14% Mn). BAL indicators of lung injury and inflammation were increased by MMA-SS at all time points and by GMA-MS at 3 and 10 days after exposure. RAW264.7 cells exposed to MMA-SS had elevated generation of reactive oxygen species (ROS), protein-HNE (P-HNE) adduct formation, activation of ERK1/2, and expression of cyclooxygenase-2 (COX-2) compared to GMA-MS and control. Increased generation of ROS due to MMA-SS exposure was confirmed by increased expression of Nrf2 and heme oxygenase-1 (HO-1). Results of in vitro studies provide evidence that stainless steel welding fume mediate inflammatory responses via activation of ROS/P-HNE/ERK1/2/Nrf2 signaling pathways. These findings were corroborated by elevated expression of COX-2, Nrf2, and HO-1 in homogenized lung tissue collected 1 day after in vivo exposure.

Liver involvement in patients with sickle cell anemia/trait includes a wide range of alterations, from mild liver function test abnormalities to cirrhosis and acute liver failure. Approximately 15–30% of patients with sickle cell anemia present cirrhosis at autopsy. The pathogenesis of cirrhosis is usually related to chronic hepatitis B or C infection or to iron overload resulting from the many transfusions received by these patients in their lifetime. Thus, cirrhosis has been described almost exclusively in patients with sickle cell anemia, while only mild liver abnormalities have been associated with the sickle cell trait. In the present case study, we describe a young Mediterranean man carrying a sickle cell trait (Hb Sβ+ thalassemia) who developed liver cirrhosis being negative for hepatitis C and B viruses or for other causes of cirrhosis and not receiving chronic blood transfusions.

Limited information exists regarding the health risks associated with inhaling aerosols that are generated during resistance spot welding of metals treated with adhesives. Toxicology studies evaluating spot welding aerosols are non-existent. A resistance spot welding aerosol generator and inhalation exposure system was developed. The system was designed by directing strips of sheet metal that were treated with an adhesive to two electrodes of a spot welder. Spot welds were made at a specified distance from each other by a computer-controlled welding gun in a fume collection chamber. Different target aerosol concentrations were maintained within the exposure chamber during a 4-h exposure period. In addition, the exposure system was run in two modes, spark and no spark, which resulted in different chemical profiles and particle size distributions. Complex aerosols were produced that contained both metal particulates and volatile organic compounds (VOCs). Size distribution of the particles was multi-modal. The majority of particles were chain-like agglomerates of ultrafine primary particles. The submicron mode of agglomerated particles accounted for the largest portion of particles in terms of particle number. Metal expulsion during spot welding caused the formation of larger, more spherical particles (spatter). These spatter particles appeared in the micron size mode and accounted for the greatest amount of particles in terms of mass. With this system, it is possible to examine potential mechanisms by which spot welding aerosols can affect health, as well as assess which component of the aerosol may be responsible for adverse health outcomes.

Spot welding is used in the automotive and aircraft industries, where high-speed, repetitive welding is needed to join thin sections of metal. Epoxy adhesives are applied as sealers to the metal seams. Pulmonary function abnormalities and airway irritation have been reported in spot welders, but no animal toxicology studies exist. Therefore, the goal of this study was to investigate vascular, immune and lung toxicity measures after exposure to these metal fumes in an animal model. Male Sprague-Dawley rats were exposed by inhalation to 25 mg/m³ to either mild-steel spot welding aerosols with sparking (high metal, HM) or without sparking (low metal, LM) for 4 h/d for 3, 8 and 13 d. Shams were exposed to filtered air. Bronchoalveolar lavage (BAL), lung gene expression and ex vivo BAL cell challenge were performed to assess lung toxicity. Lung resistance (R(L)) was evaluated before and after challenge with inhaled methacholine (MCh). Functional assessment of the vascular endothelium in isolated rat tail arteries and leukocyte differentiation in the spleen and lymph nodes via flow cytometry was also done. Immediately after exposure, baseline R(L) was significantly elevated in the LM spot welding aerosols, but returned to control level by 24 h postexposure. Airway reactivity to MCh was unaffected. Lung inflammation and cytotoxicity were mild and transient. Lung epithelial permeability was significantly increased after 3 and 8 d, but not after 13 d of exposure to the HM aerosol. HM aerosols also caused vascular endothelial dysfunction and increased CD4+, CD8+ and B cells in the spleen. Only LM aerosols caused increased IL-6 and MCP-1 levels compared with sham after ex vivo LPS stimulation in BAL macrophages. Acute inhalation of mild-steel spot welding fumes at occupationally relevant concentrations may act as an irritant as evidenced by the increased R(L) and result in endothelial dysfunction, but otherwise had minor effects on the lung.

Scopo: Parte della stadiazione dei linfomi prevede la valutazione dell'interessamento del midollo osseo (IMO) mediante biopsia osteo-midollare (BOM) [1]. Tuttavia, secondo le ultime linee guida, la BOM non è più indicata per lo studio dei linfomi di Hodgkin [2]. La TC/PET è la tecnica di imaging standard per la stadiazione dei linfomi FDG-avidi, mentre la TC è indicata nei pazienti con istotipi non FDG-avidi [1]. Molti studi hanno dimostrato affidabilità ed elevata accuratezza diagnostica della Risonanza Magnetica Whole Body (RM-WB) nella stadiazione dei linfomi [3,4]. Lo scopo del nostro studio è stato quello di confrontare RM-WB, TC/PET e BOM, nella valutazione dell’IMO in pazienti con linfoma. Materiali e metodi: Due radiologi e un medico nucleare hanno riesaminato rispettivamente le RM-WB e le TC/PET eseguite all’esordio in 104 pazienti con linfoma (53 maschi; 47 Hodgkin; età media: 44, range 15-86). Quattro pazienti non hanno eseguito la TC/PET e 21 pazienti con linfoma di Hodgkin non sono stati sottoposti a BOM perchè non più indicata in questi pazienti [2]. Nella RM-WB abbiamo considerato il midollo osseo interessato da malattia in presenza di focali aree midollari ipointense in T1w o marcatamente disomogenee con intensità di segnale inferiore a quella dei muscoli. Le stesse aree dovevano essere iperintense in T2w-STIR e DWI (b=800 s/mm2) [5]. La TC/PET è stata considerata positiva in caso di focale o diffusa captazione di FDG superiore a quella del fegato. La diffusa e omogenea captazione midollare di FDG nei linfomi di Hodgkin non è stata considerata positiva per IMO [6]. E’ stata valutata l’accuratezza diagnostica della RM-WB rispetto a TC/PET e BOM. Il coefficiente di Cohen è stato utilizzato per valutare la concordanza inter-osservatore nell’interpretazione delle RM-WB e per comparare RM-WB, TC/PET e BOM. Abbiamo calcolato i valori di ADC del midollo delle ossa pelviche e un t-test di student è stato utilizzato per comparare i valori dei pazienti con BOM negativa (Gruppo A) e BOM positiva con percentuale di IMO ≤30% (Gruppo B) e >30% (Gruppo C) della cellularità midollare. Un valore di p30% della cellularità midollare identificati dalla BOM. Il valore medio di ADC nei pazienti di Gruppo A è stato 0.51±0.10 mm2/s, Gruppo B 0.51±0.09 mm2/s e Gruppo C 0.60±0.09 mm2/s, senza differenze statisticamente significative. Le Figura 1 e 2 mostrano due casi rappresentativi del nostro studio. Conclusioni: RM-WB e TC/PET sono due indagini affidabili e complementari alla BOM nell'identificazione dell’IMO in pazienti con linfoma e potrebbero fungere da guida per biopsie mirate nei casi sospetti, evitando un alto numero di BOM negative. I valori di ADC non sono utili nella valutazione dell’IMO. Informazioni Personali: Dr. Domenico Albano, MD, Dipartimento di Scienze Radiologiche, Di.Bi.Med., Università di Palermo, Via del Vespro 27, 90127 Palermo, Italia Note Bibliografiche: 1. Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging and response assessment of Hodgkin and Non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 2014;32:3059-3068. 2. Cheson BD. Staging and response assessment in lymphomas: the new Lugano classification. Chin Clin Oncol 2015;4:5. 3. Albano D, Patti C, La Grutta L, et al. Comparison between whole-body MRI with diffusion-weighted imaging and PET/CT in staging newly diagnosed FDG-avid lymphomas. Eur J Radiol 2016;85:313-318. 4. Kwee TC, Vermoolen MA, Akkerman EA, et al. Whole-body MRI, including diffusion-weighted imaging, for staging lymphoma: comparison with CT in a prospective multicenter study. J Magn Reson Imaging 2014;40:26-36. 5. Yasumoto M, Nonomura Y, Yoshimura R, et al. MR detection of iliac bone marrow involvement by malignant lymphoma with various MR sequences including diffusion-weighted echo-planar imaging. Skeletal Radiol 2002;31:263-269. 6. El-Galaly TC, d’Amore F, Mylam KJ, et al. Routine bone marrow biopsy has little or no therapeutic consequence for positron emission tomography/computed tomography-staged treatment-naive patients with Hodgkin lymphoma. J Clin Oncol 2012;30:4508–

Whole body MRI (WB-MRI) is a non invasive technique increasingly used to stage (1-4) and follow-up (5-8) patients with malignancies such as lymphoproliferative disorders. It is now recognized as a promising tool that provides high quality anatomical imaging and a multiparametric approach of the ent

Purpose: The purpose of our retrospective study was to assess the incidence of osteonecrosis in patients who received different chemotherapies. Methods and Materials: We evaluated the Whole Body Magnetic Resonance (WB-MRI) scans performed on 42 patients with Hodgkin Lymphoma treated by three chemotherapy regimens (6 ABVD, 2 ABVD + 4 BEACOPP, 2 ABVD + 8 BEACOPP), excluding the patients with main risk factors for osteonecrosis. Results: Six out of 7 patients (85.7%) who received 8 BEACOPP and 1 out of 5 patients (20%) treated by 4 BEACOPP presented osteonecrosis, with a statistically significant difference of frequency between the two groups of patients (p

Hodgkin's lymphoma is a very common haematological neoplasm with high possibilities of response to treatment. On the other hand, therapies are often responsible for clinically relevant complications. Among these is osteonecrosis, generally determined by the high dosages of corticosteroids included in the chemotherapeutic protocols, which lead to bone ischemia through multifactorial mechanisms such as hypercoagulability and increase of intraosseous pressure due to hyperplasia of the adipose component. We report the case of a 29-year-old man with resistant Hodgkin's lymphoma undergoing chemotherapy which determined the appearance of multifocal osteonecrosis detected by Magnetic Resonance whole body.

Scopo: Il dibattito in merito ai reperti incidentali sta divenendo emergente in molti settori radiologici, quali l’ambico cardiaco, addominale, neurologico, senologico, pediatrico, soprattutto con metodiche quali la RM e la TC. Lo scopo del nostro studio è stato di valutare l’utilità della Risonanza Magnetica Whole Body (RM-WB) nell’identificazione di reperti incidentali in pazienti con linfoma. Materiali e metodi: Sono state revisionate le RM-WB eseguite su 114 pazienti (65 maschi; età mediana 45,2 anni, range 15-86) con diagnosi istologica di linfoma (47 Hodgkin, 67 Non-Hodgkin). I reperti incidentali sono stati classificati in tre classi: non significativi (classe 1), moderatamente significativi (classe 2), significativi (classe 3). Un test Chi quadro (χ2) è stato utilizzato per valutare la significatività statistica delle differenze nella frequenza dei reperti incidentali sulla base di età (≤ 50 e > 50 anni), sesso ed istologia. Risultati: Sono stati individuati uno o più reperti incidentali nelle RM-WB eseguite in 91/114 pazienti (79,8%). I reperti incidentali più frequenti sono stati di classe 1 (43%). In 7 pazienti (6,1%) sono stati riscontrati reperti incidentali di rilevanza clinica maggiore (classe 3), che hanno richiesto approfondimento diagnostico o immediato trattamento. I reperti incidentali sono stati più frequenti nei pazienti oltre i 50 anni con una differenza statisticamente significativa rispetto a pazienti ≤ 50 anni (χ2 = 8,42, p < 0,05), mentre non sono state trovate differenze statisticamente significative legate a sesso (χ2 = 0,17, p > 0,05) ed istologia (χ2 = 0,24, p > 0,05). Le figure 1, 2 e 3 mostrano alcuni casi rappresentativi del nostro studio. Conclusioni: In letteratura, parecchi studi hanno analizzato i reperti incidentali in RM-WB, effettuate sulla popolazione sana [1,2]. Il nostro lavoro è il primo che ricerca reperti incidentali in pazienti con noto linfoma e sottoposti a RM-WB. Ci sono molti vantaggi clinici, sociali ed economici associati alla diagnosi dei reperti incidentali: in primo luogo, la diagnosi precoce di una malattia porta ad un suo tempestivo trattamento con miglioramento della prognosi; in secondo luogo, la diagnosi precoce occasionale di molte malattie riduce i costi per il sistema sanitario nazionale; alcuni di questi reperti risultano essere molto utili nel caso di intervento chirurgico; infine, una valutazione approfondita delle caratteristiche cliniche dei pazienti fornisce dei dati utili ai fini della prognosi. Tuttavia, esistono conseguenze negative quali ad esempio il riscontro di un numero considerevole di lesioni accidentali, non caratterizzabili con precisione con le sole immagini RM-WB, con la conseguente possibilità si sovrastimare un reperto sospetto. E’ fondamentale pertanto trovare un equilibrio tra i benefici associati ad una diagnosi precoce ed i rischi di sottoporre il paziente ad ulteriori indagini non necessarie. Nel nostro studio la percentuale dei reperti occasionali (79.8%), simile alle percentuali precedentemente riportate in analoghi studi [3,4], cresce all’aumentare dell’età dei pazienti e non è dipendente dal sesso. La RM-WB è una tecnica promettente che evita l’esposizione a radiazioni ionizzanti e la somministrazione di mezzo di contrasto e consente di individuare reperti incidentali, offrendo la possibilità di ottenere una diagnosi precoce di patologie asintomatiche anche clinicamente rilevanti. Informazioni Personali: Dr. Domenico Albano, MD, Dipartimento di Scienze Radiologiche, Di.Bi.Med., Università di Palermo, Via del Vespro 27, 90127 Palermo, Italia Note Bibliografiche: 1. Cieszanowski A, Maj E, Kulisiewicz P et al (2014) Non-contrast-enhanced whole-body magnetic resonance imaging in the general population: the incidence of abnormal findings in patients 50 years old and younger compared to older subjects. PLoS One 26;9:e107840 2. Lo GG, Ai V, Au-Yeung KM, Chan JK, Li KW, Chien D (2008) Magnetic resonance whole body imaging at 3 Tesla: feasibility and findings in a cohort of asymptomatic medical doctors. Hong Kong Med J 14:90-96 3. Cieszanowski A, Maj E, Kulisiewicz P et al (2014) Non-contrast-enhanced whole-body magnetic resonance imaging in the general population: the incidence of abnormal findings in patients 50 years old and younger compared to older subjects. PLoS One 26;9:e107840 4. Lo GG, Ai V, Au-Yeung KM, Chan JK, Li KW, Chien D (2008) Magnetic resonance whole body imaging at 3 Tesla: feasibility and findings in a cohort of asymptomatic medical doctors. Hong Kong Med J 14:90-96

Obiettivi didattici: Illustrare i principali artefatti ed insidie nella valutazione della Risonanza Magnetica Whole Body (RM-WB) dopo revisione di 331 RM-WB eseguite in pazienti con linfoma. Introduzione: La RM-WB con imaging pesato in diffusione (DWI) è un esame che consente uno studio total body con elevata risoluzione di contrasto, evitando l’esposizione a radiazioni ionizzanti e la somministrazione di mezzo di contrasto [1]. Nel 2004 Takahara ha introdotto una sequenza DWI con tecniche di soppressione del segnale chiamata DWIBS [2]. Questa consente di acquisire rapidamente immagini di multiple aree del corpo sfruttando l’imaging parallelo SENSE che incrementa la risoluzione e riduce gli artefatti da interaccia con l’aria, l’acquisizione a respiro libero che allunga il tempo di scansione ma incrementa il rapporto segnale-rumore e una soppressione omogenea del grasso con tecnica STIR. Questo ha consentito di estendere l’utilizzo della RM-WB in vari ambiti oncologici ed in particolare per lo studio di pazienti con linfomi [3]. Tuttavia, l’interpretazione delle immagini sul piano coronale può inizialmente risultare impegnativa e vi sono limiti riconosciuti delle sequenze DWI. In questo lavoro, sfruttando i nostri due anni di esperienza nell'utilizzo della RM-WB nello studio dei linfomi, illustriamo i principati pitfalls che i radiologi dovrebbero conoscere per evitare un’errata interpretazione delle immagini. Descrizione: Nel mediastino, pulsatilità cardiaca e respiro possono causare errore nel calcolo della mappa ADC a causa dell’alta sensibilità della DWI al movimento (Figura 1). Per tale motivo è necessario visualizzare anche le sequenze morfologiche (T1w, T2w-STIR). Frequenti sono artefatti ghost nel mediastino, legati anch’essi alla pulsatilità cardiaca, che si riducono con FOV più ampi e modificando la direzione di codifica di fase (Figura 2). Artefatti nelle interfacce aria-tessuti producono focale aumento del segnale e si riducono aumentando la matrice e riducendo il FOV. Strutture quali milza, sistema nervoso, endometrio, mostrano iperintensità in DWI che può nascondere piccole lesioni ma d’altra parte può far interpretare strutture normali come localizzazioni di malattia (Figura 3). Una corretta interpretazione del midollo osseo richiede conoscenza delle alterazioni cui esso va incontro con età e terapie. Emangiomi (Figura 4), osteonecrosi da steroidi e edema da biopsia osteomidollare (Figura 5), possono produrre aree di aumentato segnale in DWI anche nelle sequenze ad alto b, che non vanno interpretate per sedi di malattia. Il T2-shine e dark through effect (Figura 6) possono causare sia falsi positivi che falsi negativi nelle immagini DWI e nella mappa ADC. Infine, sono frequenti spots iperintensi in DWI nei tessuti molli, causati da vasi, gangli e piccoli linfonodi, che non vanno interpretati come sedi di malattia. Conclusioni: La valutazione delle RM-WB non può prescindere da un’adeguata conoscenza dei principali artefatti e delle insidie diagnostiche che possono essere causa di errori. Per una corretta interpretazione dell’esame RM-WB è necessaria la valutazione sia delle sequenze funzionali che morfologiche. Note Bibliografiche: 1. Mayerhoefer ME, Karanikas G, Kletter K, Prosch H, Kiesewetter B, Skrabs C et al. Evaluation of diffusion-weighted MRI for pretherapeutic assessment and staging of lymphoma: results of a prospective study in 140 patients. Clin Cancer Res 2014;20:2984-93. 2. Takahara T, Imai Y, Yamashita T, Yasuda S, Nasu S, Van Cauteren M. Diffusion weighted whole body imaging with background body signal suppression (DWIBS): technical improvement using free breathing, STIR and high resolution 3D display. Radiat Med 2004; 22:275-82. 3. Albano D, Patti C, La Grutta L, Agnello F, Grassedonio E, Mulè A et al. Comparison between whole-body MRI

Scopo Scopo del nostro studio è stato quello di comparare la RM whole body (RM-WB) con la PET/TC nella stadiazione dei linfomi FDG-avidi. Materiale e metodi 68 pazienti (37 maschi, età mediana 42 anni, range 15-86) con diagnosi istologica di Linfoma (37 Hodgkin, 16 Diffuso B a grandi cellule, 10 Follicolare, 5 Mantellare) sono stati sottoposti a RM-WB e PET/TC prima del trattamento. Sono stati valutati e confrontati sensibilità, specificità, valore predittivo positivo e negativo (PPV e NPV) della RM-WB e PET/TC, quest’ultima considerata come standard di riferimento. Lo stadio Ann Arbor (AA) ottenuto con RM-WB (sequenze DWIBS assiali, T1w e T2w-STIR coronali, senza mezzo di contrasto) e con PET/TC è stato confrontato mediante la “k di Cohen”. Questo è stato poi confrontato con lo stadio patologico, ottenuto dopo biopsia osteomidollare o altre biopsie. Risultati La concordanza tra RM-WB e PET/TC è risultata eccellente con stadio AA uguale nel 91,2% dei casi (62/68 pazienti; k = 0,88). Abbiamo riscontrato una eccellente concordanza tra stadio AA di RM-WB e stadio patologico (92,6%; k = 0,88) e tra stadio AA di PET/TC e stadio patologico (94,1%; k = 0.92). In RM-WB abbiamo ottenuto valori di sensibilità e specificità nell’individuazione delle localizzazioni nodali rispettivamente del 98,11% e 97,49% (PPV 95,27% e NPV 99,01%). Conclusioni La RM-WB può essere considerata una tecnica promettente per la stadiazione dei linfomi FDGavidi, che consente di evitare l’esposizione a radiazioni ionizzanti e la somministrazione di mezzo di contrasto e potrebbe aiutare a prevenire

Scopo: Il trattamento del Linfoma di Hodgkin (LH) ha condotto al raggiungimento di elevati tassi di sopravvivenza [1]. Il protocollo ABVD (Doxorubicina, Bleomicina, Vinblastina e Dacarbazina) è stato considerato per molto tempo il regime chemioterapico standard nei pazienti con LH [2], grazie a una ben documentata efficacia e una scarsa tossicità. Molti studi hanno dimostrato la maggiore efficacia del protocollo BEACOPP (Bleomicina, Etoposide, Doxorubicina, Ciclofosfamide, Vincristina, Procarbazina, Prednisone) rispetto all'ABVD [3], al costo di una maggiore tossicità. L'osteonecrosi [ON] è una possibile complicanza della chemioterapia che può compromettere la qualità di vita del paziente, soprattutto se identificata in fase avanzata quando l'unico trattamento disponibile è la sostituzione protesica dell'articolazione danneggiata. Lo scopo del nostro studio è stato quello di valutare mediante la Risonanza Magnetica Whole Body (RM-WB) la frequenza di ON in pazienti con LH trattati con differenti protocolli chemioterapici. Materiali e metodi: Abbiamo revisionato retrospettivamente le RM-WB eseguite in 42 pazienti (20 maschi; età media 29,2 anni, range 15-58) con LH trattati con tre regimi chemioterapici: 6ABVD (gruppo A), 2ABVD+4BEACOPP (gruppo B), 2ABVD+8BEACOPP (gruppo C). Abbiamo escluso i pazienti con fattori di rischio maggiori per ON quali radioterapia, trauma, connettivopatie, pancreatite, insufficienza renale cronica, emoglobinopatie, malattia di Cushing, alcol, malattia di Gaucher, gravidanza. Tutti i pazienti sono stati sottoposti a RM-WB (1,5 T scanner RM, sequenze T1w e T2w-STIR coronali, DWIBS assiali) prima del trattamento, dopo due cicli di ABVD, dopo 4 cicli di BEACOPP e un mese dopo la fine del trattamento chemioterapico. Il test Chi quadro è stato utilizzato per confrontare la frequenze di ON nei tre gruppi di pazienti. Un valore di p

Animal toxicology studies suggest that workers exposed to carbon nanotubes or nanofibers (CNT/F) may experience pulmonary or systemic health effects; however, direct human evidence is lacking. Our study’s objective was to evaluate associations between CNT/F exposure andex vivoresponses of leukocytes challenged with secondary stimulants, adjusting for potential confounders, in a cross-sectional study. We measured multi-day exposure using CNT/F structure count (SC) and elemental carbon air concentrations among 102 U.S. workers. Demographic, lifestyle, and other occupational information was obtained via in-person interview. Workers’ whole blood was incubated for 18 hours with and without two microbial stimulants (lipopolysaccharide and staphylococcal enterotoxin type B) using TruCulture® technology to evaluate immune cell activity. Following incubation, collected supernatants were preserved and subsequently analyzed for cytokine and chemokine concentrations. The ratio of stimulant:null response for each protein was analyzed using multiple linear regression, principal components (PC) analysis, and Ingenuity® Pathway Analysis (IPA) to determine whether patterns of protein response were associated with CNT/F exposure. We found that CNT/F metrics (most consistently, the SC-based) were significantly (p

OBJECTIVE: Although amphibians are known Salmonella carriers, no such outbreaks have been reported. We investigated a nationwide outbreak of human Salmonella Typhimurium infections occurring predominantly among children from 2008 to 2011. METHODS: We conducted a matched case-control study. Cases were defined as persons with Salmonella Typhimurium infection yielding an isolate indistinguishable from the outbreak strain. Controls were persons with recent infection with Salmonella strains other than the outbreak strain and matched to cases by age and geography. Environmental samples were obtained from patients’ homes; traceback investigations were conducted. RESULTS: We identified 376 cases from 44 states from January 1, 2008, to December 31, 2011; 29% (56/193) of patients were hospitalized and none died. Median patient age was 5 years (range CONCLUSIONS: ADFs were the source of this nationwide pediatric predominant outbreak. Pediatricians should routinely inquire about pet ownership and advise families about illness risks associated with animals.

To compare whole body RMI (WB-RMI) and FDG-PET/CT for staging newly diagnosed FDG-avid lymphoma

Epidemiologic studies suggest an increased risk of lung cancer with exposure to welding fumes, but controlled animal studies are needed to support this association. Oropharyngeal aspiration of collected “aged” gas metal arc–stainless steel (GMA–SS) welding fume has been shown by our laboratory to promote lung tumor formation in vivo using a two-stage initiation–promotion model. Our objective in this study was to determine whether inhalation of freshly generated GMA-SS welding fume also acts as a lung tumor promoter in lung tumor-susceptible mice. Male A/J mice received intraperitoneal (IP) injections of corn oil or the chemical initiator 3-methylcholanthrene (MCA; 10 μg/g) and 1 week later were exposed by whole-body inhalation to air or GMA-SS welding aerosols for 4 h/d × 4 d/w × 9 w at a target concentration of 40 mg/m(3). Lung nodules were enumerated at 30 weeks post-initiation. GMA-SS fume significantly promoted lung tumor multiplicity in A/J mice initiated with MCA (16.11 ± 1.18) compared to MCA/air-exposed mice (7.93 ± 0.82). Histopathological analysis found that the increased number of lung nodules in the MCA/GMA-SS group were hyperplasias and adenomas, which was consistent with developing lung tumorigenesis. Metal deposition analysis in the lung revealed a lower deposited dose, approximately fivefold compared to our previous aspiration study, still elicited a significant lung tumorigenic response. In conclusion, this study demonstrates that inhaling GMA-SS welding fume promotes lung tumorigenesis in vivo which is consistent with the epidemiologic studies that show welders may be at an increased risk for lung cancer.

Approximately 25 million children in the United States are obese or at risk of becoming obese, with anticipated negative consequences for individual health as well as the nation's future health-care costs. Effective interventions to prevent obesity require more than educating individuals. To bring about change, we must deploy tactics at multiple levels, from community facilities like parks and bike paths to foods offered in schools. The Spectrum of Prevention proposed in 1999 by L. Cohen and S. Smith first described this approach. UC Cooperative Extension (UCCE) has helped evaluate large-scale community-based obesity prevention programs and has experience aligning county nutrition programs with new dietary guidelines. This UCCE expertise enables UC to develop more effective obesity prevention strategies and to influence policy addressing childhood obesity. Notably, UCCE's expertise in nutrition and obesity prevention will be applied to implementing a new intervention program. The new program employs multiple components including UC Cooperative Extension materials and community networks and is designed to impact factors contributing to risk for childhood obesity.

Graphical abstract, Highlights • An automated welder was designed to expose animals to galvanized spot welding fume. • Generated particles generally were in the submicron and ultrafine size ranges. • The primary metals present in galvanized spot welding fumes were iron and zinc. • Zinc appeared to be the causative agent in the development of acute lung inflammation., Resistance spot welding is a common process to join metals in the automotive industry. Adhesives are often used as sealers to seams of metals that are joined. Anti-spatter compounds sometimes are sprayed onto metals to be welded to improve the weldability. Spot welding produces complex aerosols composed of metal and volatile compounds (VOCs) which can cause lung disease in workers. Male Sprague-Dawley rats (n = 12/treatment group) were exposed by inhalation to 25 mg/m3 of aerosol for 4 h/day × 8 days during spot welding of galvanized zinc (Zn)-coated steel in the presence or absence of a glue or anti-spatter spray. Controls were exposed to filtered air. Particle size distribution and chemical composition of the generated aerosol were determined. At 1 and 7 days after exposure, bronchoalveolar lavage (BAL) was performed to assess lung toxicity. The generated particles mostly were in the submicron size range with a significant number of nanometer-sized particles formed. The primary metals present in the fumes were Fe (72.5%) and Zn (26.3%). The addition of the anti-spatter spray and glue did affect particle size distribution when spot welding galvanized steel, whereas they had no effect on metal composition. Multiple VOCs (e.g., methyl methacrylate, acetaldehyde, ethanol, acetone, benzene, xylene) were identified when spot welding using either the glue or the anti-spatter spray that were not present when welding alone. Markers of lung injury (BAL lactate dehydrogenase) and inflammation (total BAL cells/neutrophils and cytokines/chemokines) were significantly elevated compared to controls 1 day after exposure to the spot welding fumes. The elevated pulmonary response was transient as lung toxicity mostly returned to control values by 7 days. The VOCs or the concentrations that they were generated during the animal exposures had no measurable effect on the pulmonary responses. Inhalation of galvanized spot welding fumes caused acute lung toxicity most likely due to the short-term exposure of particles that contain Zn.

Reaching out to faculty about library resources and services is an ongoing and sometimes mysterious process for vendors and librarians alike—one that, when effective, can contribute a higher ROI and improved collaboration between libraries and publishers. However, it can be a challenge to reach that sweet spot between “effective” and “annoying,” especially in the face of seemingly nonresponsive faculty. A physical and life sciences librarian and former head of collection development and acquisitions from the University of Central Florida (UCF), and a Springer account development specialist, who works closely with academic librarians, weigh in on four different issues about improving outreach and identifying opportunities for outreach and collaboration.

Welding fume inhalation causes pulmonary toxicity, including susceptibility to infection. We hypothesized that airway epithelial ion transport is a target of fume toxicity, and investigated the effects of fume particulates from manual metal arc-stainless steel (MMA-SS) and gas metal arc-mild steel (GMA-MS) on ion transport in normal human bronchial epithelium (NHBE) cultured in air-interface. MMA-SS particles, more soluble than GMA-MS particles, contain Cr, Ni, Fe and Mn; GMA-MS particles contain Fe and Mn. MMA-SS or GMA-MS particles (0.0167–166.7 μg/cm 2 ) were applied apically to NHBEs. After 18 h transepithelial potential difference (V t ), resistance (R t ), and short circuit current ( I sc ) were measured. Particle effects on Na + and Cl¯ channels and the Na + ,K + ,2Cl¯-cotransporter were evaluated using amiloride (apical), 5-nitro-2-[(3-phenylpropyl)amino]benzoic acid (NPPB, apical), and bumetanide (basolateral), respectively. MMA-SS (0.0167–16.7 μg/cm 2 ) increased basal V t . Only 16.7 μg/cm 2 GMA-MS increased basal V t significantly. MMA-SS or GMA-MS exposure potentiated I sc responses (decreases) to amiloride and bumetanide, while not affecting those to NPPB, GMA-MS to a lesser degree than MMA-SS. Variable effects on R t were observed in response to amiloride, and bumetanide. Generally, MMA-SS was more potent in altering responses to amiloride and bumetanide than GMA-MS. Hyperpolarization occurred in the absence of LDH release, but decreases in V t , R t , and I sc at higher fume particulate doses accompanied LDH release, to a greater extent for MMA-SS. Thus, Na + transport and Na + ,K + ,2Cl¯-cotransport are affected by fume exposure; MMA-MS is more potent than GMA-MS. Enhanced Na + absorption and decreased airway surface liquid could compromise defenses against infection.

Arc welding processes generate complex aerosols composed of potentially hazardous metal fumes and gases. Millions of workers worldwide are exposed to welding aerosols daily. A health effect of welding that is of concern to the occupational health community is the development of immune system dysfunction. Increased severity, frequency, and duration of upper and lower respiratory tract infections have been reported among welders. Specifically, multiple studies have observed an excess mortality from pneumonia in welders and workers exposed to metal fumes. Although several welder cohort and experimental animal studies investigating the adverse effects of welding fume exposure on immune function have been performed, the potential mechanisms responsible for these effects are limited. The objective of this report was to review both human and animal studies that have examined the effect of welding fume pulmonary exposure on local and systemic immune responses.

Objective: Interest exists for early monitoring of worker exposure to engineered nanomaterials. Here, we highlight quantitative systemic markers of early effects after carbon nanotube (CNT) exposure. Methods: Mice were exposed by pharyngeal aspiration to 40-μg CNT and harvested 24 hours, 7 days, and 28 days postexposure for measurements of whole blood, lung and extrapulmonary tissue gene expression, blood and bronchoalveolar lavage (BAL) differentials, and serum protein profiling. Results: Early effects included increased inflammatory blood gene expression and serum cytokines followed by an acute phase response (eg, CRP, SAA-1, SAP). Beyond 24 hours, there was a consistent increase in blood and BAL eosinophils. At 28 day, serum acute phase proteins with immune function including complement C3, apolipoproteins A-I and A-II, and α2-macroglobulin were increased. Conclusions: Carbon nanotube exposure resulted in measurable systemic markers but lacked specificity to distinguish from other pulmonary exposures.

Debate exists as to whether welding fume is carcinogenic, but epidemiological evidence suggests that welders are an at-risk population for development of lung cancer. Our objective was to expose, by inhalation, lung tumor susceptible (A/J) and resistant C57BL/6J (B6) mice to stainless steel (SS) welding fume containing carcinogenic metals and characterize the lung-inflammatory and tumorigenic response. Male mice were exposed to air or gas metal arc (GMA)-SS welding fume at 40 mg/m(3)×3 h/day for 6 and 10 days. At 1, 4, 7, 10, 14, and 28 days after 10 days of exposure, bronchoalveolar lavage (BAL) was done. Lung cytotoxicity, permeability, inflammatory cytokines, and cell differentials were analyzed. For the lung tumor study, gross tumor counts and histopathological changes were assessed in A/J mice at 78 weeks after 6 and 10 days of exposure. Inhalation of GMA-SS fume caused an early, sustained macrophage and lymphocyte response followed by a gradual neutrophil influx and the magnitudes of these differed between the mouse strains. Monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein-2 (MIP-2), and tumor necrosis factor-α (TNF-α) were increased in both strains while the B6 also had increased interleukin-6 (IL-6) protein. BAL measures of cytotoxicity and damage were similar between the strains and significantly increased at all time points. Histopathology and tumorigenesis were unremarkable at 78 weeks. In conclusion, GMA-SS welding fume induced a significant and sustained inflammatory response in both mouse strains with no recovery by 28 days. Under our exposure conditions, GMA-SS exposure resulted in no significant tumor development in A/J mice.

Research indicates that the financial literacy of U.S. teens is low, yet they have access to and spend a great deal of money each year. Teens were surveyed in 1998 (N = 323) and again in 2008 (N = 558) to determine what teens wanted to know about money and how they wanted to learn. Data were collected regarding teens’ sources of income, why money was important, the types of financial information they would like to learn, and how they would like to learn from seven counties in California—Alameda, Kern, Los Angeles, Riverside, San Diego, San Luis Obispo, and Santa Barbara. The findings indicate that teens are still interested in learning about many of the same financial topics identified in 1998, but their desire for web education has increased. These data can be used to develop programs that will interest teens.

Inhalation of multiwalled carbon nanotubes (MWCNT) causes systemic effects including vascular inflammation, endothelial dysfunction, and acute phase protein expression. MWCNTs translocate only minimally beyond the lungs, thus cardiovascular effects thereof may be caused by generation of secondary biomolecular factors from MWCNT-pulmonary interactions that spill over into the systemic circulation. Therefore, we hypothesized that induced matrix metalloproteinase-9 (MMP-9) is a generator of factors that, in turn, drive vascular effects through ligand-receptor interactions with the multiligand pattern recognition receptor, CD36. To test this, wildtype (WT; C57BL/6) and MMP-9(-/-)mice were exposed to varying doses (10 or 40 µg) of MWCNTs via oropharyngeal aspiration and serum was collected at 4 and 24 h postexposure. Endothelial cells treated with serum from MWCNT-exposed WT mice exhibited significantly reduced nitric oxide (NO) generation, as measured by electron paramagnetic resonance, an effect that was independent of NO scavenging. Serum from MWCNT-exposed WT mice inhibited acetylcholine (ACh)-mediated relaxation of aortic rings at both time points. Absence of CD36 on the aortic rings (obtained from CD36-deficient mice) abolished the serum-induced impairment of vasorelaxation. MWCNT exposure induced MMP-9 protein levels in both bronchoalveolar lavage and whole lung lysates. Serum from MMP-9(-/-)mice exposed to MWCNT did not diminish the magnitude of vasorelaxation in naive WT aortic rings, although a modest right shift of the ACh dose-response curve was observed in both MWCNT dose groups relative to controls. In conclusion, pulmonary exposure to MWCNT leads to elevated MMP-9 levels and MMP-9-dependent generation of circulating bioactive factors that promote endothelial dysfunction and decreased NO bioavailability via interaction with vascular CD36.