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Congenital CMV infection (cCMV) is the most common congenital infection with 10–15% of cases developing symptomatic disease. Early antiviral treatment is of essence when symptomatic disease is suspected. Recently, the use of neonatal imaging has been implicated as a prognostic tool for long term sequalae among asymptomatic newborns at high risk. Even though neonatal MRI is commonly used in neonatal symptomatic cCMV disease, it is less often used in asymptomatic newborns, mainly due to cost, access and difficulty to perform. We have therefore developed an interest in assessing the use of fetal imaging as an alternative. Our primary aim was to compare the fetal and neonatal MRIs in a small cohort 10 asymptomatic neonates with congenital CMV infection. We performed a single-center retrospective cohort study (case-series) on a convenience sample of children born from January 2014 to March 2021 with confirmed congenital CMV infection who had undergone both fetal and neonatal MRIs. We created a checklist of relevant cerebral abnormalities and asked 4 blinded radiologists to assess the MRIs (2 for each, namely fetal and neonatal) and then compared the findings between the fetal and neonatal imaging as well as the concordance in reporting of abnormalities within each category. Overall concordance between prenatal and postnatal scans was high (70%). When comparing the two blinded reports for each MRI, we found high levels of concordance: 90% concordance for fetal MRIs and 100% for neonatal MRIs. The most common abnormalities identified in both fetal and neonatal scans were "abnormal white matter hyperintensity" and "subependymal cysts." Even though this is a small descriptive study, it indicates that fetal MRI could potentially provide us with similar information as neonatal imaging. This study could form the basis for subsequent larger future studies. [ABSTRACT FROM AUTHOR]

Byline: S. Konitsiotis (1), A. Glantzouni (2), M. I. Argyropoulou (2), T. Tsapoga (3), M. Elisaf (3), S. C. Efremidis (2) Author Affiliation: (1) Dept. of Neurology, University of Ioannina Medical School, 45110, Ioannina, Greece (2) Dept. of Radiology, University of Ioannina Medical School, Ioannina, Greece (3) Dept. of Internal Medicine, University of Ioannina Medical School, Ioannina, Greece Article History: Received Date: 02/12/2002 Accepted Date: 20/03/2003

Although CT is not considered the examination of choice for the detection and characterisation of adnexal diseases, adnexal masses may be incidentally detected during CT examination performed for other clinical indications. Most adnexal incidentalomas are benign, and therefore may not require further investigation, follow-up or intervention; however, few of them may prove malignant. Multidetector CT has improved the diagnostic performance of the technique in the detection and differentiation of adnexal mass lesions. Radiologists should be able to recognise the normal CT appearance of the ovaries and the CT characteristics of various adnexal incidentalomas. This may obviate unnecessary imaging evaluation and allow optimal treatment planning. Regarding the management of adnexal lesions incidentally found on CT, recommendations based on the collective experience of the members of the American College of Radiology Incidental Findings Committee II have recently been presented. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess the environmental performance of medium-sized bottled water producers. More specifically, the research incorporates a multiple case study approach by conducting life cycle assessment (LCA) for three organisations located in Kosovo that produce and distribute bottled water in the local and other European markets. The Supply Chain Environmental Analysis Tool (SCEnAT) was used to assess the carbon emissions caused by the activities within the supply chains of these companies. It was found that greenhouse gas (GHG) emissions are created mainly due to the use of plastic pallets, plastic cups and electricity. Upon identifying the hotspots (where emissions account for more than 10% of the total emissions), a number of potential interventions to lower the overall emissions are proposed. As indicated, proactive green supply chain management practices can help SMEs in the sector improve their environmental impact and reduce their operations costs. [ABSTRACT FROM AUTHOR]

Summary: Background: The introduction of adalimumab in the management of hidradenitis suppurativa (HS) raises questions regarding the cost‐efficacy of treatment. Objectives: To explore cost‐efficacy of treatment with anti‐tumour necrosis factor (TNF) agents in a real‐world cohort. Methods: Patients with Hurley stage II and III HS with ≥ 1 year of follow‐up and at least three visits per year from September 2003 to December 2016 were analysed. Patient visits were divided into two categories – visits for treatment with agents blocking TNF or visits for other therapies. The cost of exacerbations was calculated based on the cost of items provided in current price lists or by the national health insurance agency in cases of hospitalization. Effectiveness of anti‐TNF agents was calculated by assessing containment of exacerbations. The primary study end point was the cost‐savings achieved using anti‐TNF agents. Results: Overall, 1211 patient visits for 250 patients were analysed. Total containment of exacerbations was found in 25·1% of visits involving other therapies and in 63·4% of visits involving anti‐TNF agents. The cost‐savings per patient visit for patients receiving anti‐TNF agents vs. other therapies was €178·92. The odds ratio for the total containment of exacerbations among patients with Hurley stage II and III was 4·86 and 6·03, respectively (P = 0·466). Treatment with anti‐TNF agents was an independent variable affecting annual cost as shown by two‐way analysis of variance. In Hurley stage III HS, mean annual cost was €8309·60 under other therapies compared with €3264·20 using anti‐TNF agents (P = 0·004). Conclusions: Treatment with anti‐TNF agents achieves significant cost–benefit through containment of HS exacerbations. The efficacy of anti‐TNF agents was similar for both disease stages. What's already known about this topic? The cost of managing exacerbations of hidradenitis suppurativa (HS) is generally expected to be substantial.A cost‐savings analysis has never been published following the registration of adalimumab for the treatment of HS. What does this study add? Treatment with anti‐tumour necrosis factor (TNF) agents achieves a significant cost–benefit through containment of HS exacerbations.The efficacy of anti‐TNF agents was similar for patients with HS at Hurley stage II and Hurley stage III. Linked Comment: Micheletti. Br J Dermatol 2019; 180:988–989. Plain language summary available online Respond to this article [ABSTRACT FROM AUTHOR]

The aim of this research is to investigate the corporate governance frameworks of listed Swiss bank, to evaluate their performance across several indicators and identify strengths and weaknesses of their internal guidelines and code of best practice. More specifically, we use the OECD Principles of Corporate Governance, the Basel Committee Guidance on Corporate Governance for Banks and the Swiss Code of Best Practices for Corporate Governance to develop a framework to evaluate the corporate governance of Swiss banks relative to factors such as board structure, board composition, transparency, compensation and risk management To meet the aim of the research, we collect qualitative data from publicly available yearly reports, corporate governance documents and codes of conduct from a sample of listed Swiss banks. We find that, overall, Swiss banks have a sound corporate governance framework. However, board gender diversity is low. Also, there are differences between smaller and bigger banks in board composition. Our findings contribute to the understanding of the corporate governance structure of listed Swiss banks and they can be a useful tool for the banks, which can use our findings to implement enhancements to their corporate governance frameworks.