Search

Background: Renal volume (RV) is associated with renal function and with a variety of cardiovascular risk factors (CVRFs). We analysed RV using magnetic resonance imaging (MRI) in a large population-based study (Study of Health in Pomerania; SHIP-TREND) to find sex- and age-specific reference values for RV and to test the influence of several markers on RV. The main objective is to describe reference values for RV in people from the general population without kidney disease. Methods: 1815 participants without kidney disease (930 women) aged 21–81 years were included in our study. Right and left RV with and without body surface area (BSA) indexation were compared among three age groups (22–39 years, 40–59 years, 60–81 years) by median and interquartile range and tested separately in women and men. Results: The estimated glomerular filtration rate (eGFR), serum uric acid, and right and left RV were higher in men compared to women (all p < 0.001). Left kidneys were larger than right kidneys (both sexes). With age, RV showed a continuously decreasing trend in women and an upside-down U-shaped relation in men. In multivariable linear regression models, current smoking (β = 14.96, 95% CI 12.12; 17.79), BSA (β = 97.66, 95% CI 90.4; 104.93), diastolic blood pressure (β = 0.17, 95% CI 0.01; 0.32), and eGFR (β = 0.57, 95% CI 0.50; 0.65) were positively associated with both left and right RV, whereas uric acid (β = −0.03, 95% CI −0.05; −0.01) showed an inverse association with RV. Interestingly, the same eGFR correlated with higher RV in men compared to women. Conclusion: Reference values for RV are different for age groups and sex. For any given age, female kidneys are smaller than male kidneys. RV associates positively with eGFR, but for any chosen eGFR, renal volume in females is lower compared to males. RV decreases with age, but in men showed a U-shaped correlation. This may reflect hyperfiltration and glomerular hypertrophy associated with the presence of CVRF in middle-aged males.

There are many different notions of models in different areas of science that are often not aligned, making it difficult to discuss them across disciplines. In this study, we look at the differences between physical models and mental models as well as the difference between static and dynamic models. Semiotics provides a philosophical underpinning by explaining meaning-making. This allows for identifying a common ground between models in different areas. We use examples from natural sciences and linguistics to illustrate different approaches and concepts and to find commonalities. This study distinguishes between systems, models, and descriptions of models. This distinction allows us to understand the commonalities of mental and physical models in different areas.

Abstract Background In the time of the coronavirus disease 2019 (COVID-19) pandemic, in-person lectures had to be shifted to online learning. This study aimed to evaluate students’ and lecturers’ perception and effectiveness of a virtual inverted classroom (VIC) concept on clinical radiology in comparison to a historic control. Methods In the winter semester 2020/21, 136 fourth year medical students who completed the clinical radiology VIC during the pandemic, were included in the single centre, prospective study. Results were compared with a historic control that had finished the physical inverted classroom (PIC) in the immediately preceding year. The VIC consisted of an initial phase of self-determined preparation with learning videos and a second interactive phase of clinical case studies alternating between the virtual lecture hall and virtual buzz groups. At the end of the lecture series, students rated the lecture on a scale of 1 (most positive assessment) to 6 (most negative assessment) through an online survey platform. Additionally, they reported their impressions in free-form text. Lecturers were invited to comment on the VIC in a group interview. Main outcomes were final grades and student perception of the VIC. Results Students’ general impression of VIC was lower than that of PIC (median value of 3 [IQR 4, 2] and 1 [IQR 0, 0], p

Abstract Sorghum [Sorghum bicolor (L.) Moench] is an important food crop with a diverse gene pool residing in its wild relatives. A total of 15 sorghum accessions from the unexploited wild gene pool of the Sorghum genus, representing the five subgenera, were sequenced, and the complete chloroplast genomes and 99 common single‐copy concatenated nuclear genes were assembled. Annotation of the chloroplast genomes identified a total of 81 protein‐coding genes, 38 tRNA, and four rRNA genes. The gene content and gene order among the species was identical. A total of 153 nonsynonymous amino acid changes in 40 genes were identified across the species. Phylogenetic analysis of both the whole chloroplast genome and nuclear genes revealed a similar topology with two distinct clades within the genus. The species within the subgenera Eusorghum, Chaetosorghum, and Heterosorghum clustered in one clade, whereas the species within the subgenera Parasorghum and Stiposorghum clustered in a second clade. However, the subgenera Parasorghum and Stiposorghum were not monophyletic, suggesting the need for further research to resolve the relationships within this group. The close relationship between the two monotypic subgenera Chaetosorghum and Heterosorghum suggests that species within these subgenera could be considered as one group. This analysis provides an improved understanding of the genetic relationships within the Sorghum genus and defines diversity in wild sorghum species that may be useful for crop improvement.

The current study re-examines an exceptional case of a serial killer incarcerated since a decade ago. "Jacob" is the first serial killer apprehended in Israel. His known actions were committed during the eighties of the last century, and continued for eleven years. The victims were elderly individuals, including both his parents. Shortly after incarceration he became overtly schizophrenic and underwent five hospitalisations. The case is re-examined in view of changes, both in the perpetrator's diagnosis and criminal legislation. Was Jacob doomed to become a serial killer, or could his fate be avoided through early professional intervention? Were the killings presenting symptoms of a psychotic or pre-psychotic phase? Should he be eligible for a retrial? What would have been his position with the current law in view of the new 300A(a) clause ("Reduced Punishment") of the Israeli Criminal Code? Could he ever be released back to the community? These are some of the questions to be addressed. [ABSTRACT FROM AUTHOR]

Non-invasive automatic screening for Alzheimer’s disease has the potential to improve diagnostic accuracy while lowering healthcare costs. Previous research has shown that patterns in speech, language, gaze, and drawing can help detect early signs of cognitive decline. In this paper, we describe a highly multimodal system for unobtrusively capturing data during real clinical interviews conducted as part of cognitive assessments for Alzheimer’s disease. The system uses nine different sensor devices (smartphones, a tablet, an eye tracker, a microphone array, and a wristband) to record interaction data during a specialist’s first clinical interview with a patient, and is currently in use at Karolinska University Hospital in Stockholm, Sweden. Furthermore, complementary information in the form of brain imaging, psychological tests, speech therapist assessment, and clinical meta-data is also available for each patient. We detail our data-collection and analysis procedure and present preliminary findings that relate measures extracted from the multimodal recordings to clinical assessments and established biomarkers, based on data from 25 patients gathered thus far. Our findings demonstrate feasibility for our proposed methodology and indicate that the collected data can be used to improve clinical assessments of early dementia.

Abstract Cell death, autophagy and endosomal sorting contribute to many physiological, developmental and immunological processes in plants. They are mechanistically interconnected and interdependent, but the molecular basis of their mutual regulation has only begun to emerge in plants. Here, we describe the identification and molecular characterization of CELL DEATH RELATED ENDOSOMAL FYVE/SYLF PROTEIN 1 (CFS1). The CFS1 protein interacts with the ENDOSOMAL SORTING COMPLEX REQUIRED FOR TRANSPORT I (ESCRT-I) component ELCH (ELC) and is localized at ESCRT-I-positive late endosomes likely through its PI3P and actin binding SH3YL1 Ysc84/Lsb4p Lsb3p plant FYVE (SYLF) domain. Mutant alleles of cfs1 exhibit auto-immune phenotypes including spontaneous lesions that show characteristics of hypersensitive response (HR). Autoimmunity in cfs1 is dependent on ENHANCED DISEASE SUSCEPTIBILITY 1 (EDS1)-mediated effector-triggered immunity (ETI) but independent from salicylic acid. Additionally, cfs1 mutants accumulate the autophagy markers ATG8 and NBR1 independently from EDS1. We hypothesize that CFS1 acts at the intersection of autophagosomes and endosomes and contributes to cellular homeostasis by mediating autophagosome turnover.

This paper discusses the possibilities and ways of determining the impact of classical Latin literature in the Middle Ages, taking as an example the four centuries from the ninth to the twelfth and using the four most relevant parameters: the literary influence, the explicit statements, the holdings of libraries, and the production of manuscripts. As for the influence, imitation is by far the most significant criterion, whereas quotations may often be second hand, and reminiscences fortuitous. Library catalogues, though rather rare for our period, can give useful information on the characteristics of the holdings at different periods of time. It is impossible to know if the books mentioned were actually read, but if the additions to the lists of holdings are correctly dated, the added information show which new texts were considered indispensable at a given moment. Finally, if certain precautions are taken in interpreting the numbers, the extant manuscripts and fragments allow us partly to identify the most widely diffused texts for the whole period, partly to follow the evolution of the grammar curriculum and to determine for each of the four centuries the popularity of the works that were not read in the schools. A comparison between the data from the catalogues and those from the manuscripts shows many disparities, especially for most of the Ovidian poems and for short texts, which easily disappear when they are not bound with other works. As a result, it is after all the surviving manuscripts that appear to constitute the most reliable approach for measuring the popularity of a given text.

INTRODUCTION:Morphological characterization of leg arteries is of significant importance to detect vascular remodeling triggered by atherosclerotic changes. We determined reference values of vessel diameters and assessed prevalence of stenosis and arterial variations of the lower limb arteries in a healthy male population sample. METHODS:Gadolinium-enhanced magnetic resonance angiography at 1.5 Tesla was performed in 756 male participants (median age = 52 years, range = 21-82 years) of the population-based Study of Health in Pomerania. Vessel diameters were measured in 9 predefined segments of the pelvic and leg arteries and 95th percentiles were used for upper reference values of means of left and right side arteries. RESULTS:Reference values of vascular diameters decreased from proximal to distal arteries: common iliac = 1.18cm; internal iliac = 0.75cm; external iliac = 1.03cm; proximal femoral = 1.02cm; distal femoral = 0.77cm; popliteal = 0.69cm; anterior tibial = 0.42cm; posterior tibial = 0.38cm; fibular = 0.40cm. Body-surface area indexed reference values increased with age in all segments. A number of 53 subjects (7.0%) had at least one stenosis, mainly in the lower leg arteries anterior tibial (n = 28, 3.7%), posterior tibial (n = 18, 2.4%) and fibular (n = 20, 2.6%). The risk of stenosis increased considerably with age (odds ratio = 1.08; p

OBJECTIVES:To investigate acoustic noise reduction, image quality and white matter lesion detection rates of cranial magnetic resonance imaging (MRI) scans acquired with and without sequence-based acoustic noise reduction software. MATERIAL AND METHODS:Thirty-one patients, including 18 men and 13 women, with a mean age of 58.3±14.5 years underwent cranial MRI. A fluid-attenuated inversion recovery (FLAIR) sequence was acquired with and without acoustic noise reduction using the Quiet Suite (QS) software (Siemens Healthcare). During data acquisition, peak sound pressure levels were measured with a sound level meter (Testo, Typ 815). In addition, two observers assessed subjective image quality for both sequences using a five-point scale (1 very good-5 inadequate). Signal-to-noise ratio (SNR) was measured for both sequences in the following regions: white matter, gray matter, and cerebrospinal fluid. Furthermore, lesion detection rates in white matter pathologies were evaluated by two observers for both sequences. Acoustic noise, image quality including SNR and white matter lesion detection rates were compared using the Mann-Whitney-U-test. RESULTS:Peak sound pressure levels were slightly but significantly reduced using QS, P≤0.017. Effective sound pressure, measured in Pascal, was decreased by 19.7%. There was no significant difference in subjective image quality between FLAIR sequences acquired without/with QS: observer 1: 2.03/2.07, P = 0.730; observer 2: 1.98/2.10, P = 0.362. In addition, SNR was significantly increased in white matter, P≤0.001, and gray matter, P = 0.006, using QS. The lesion detection rates did not decline utilizing QS: observer 1: P = 0.944 observer 2: P = 0.952. CONCLUSIONS:Sequence-based noise reduction software such as QS can significantly reduce peak sound pressure levels, without a loss of subjective image quality and increase SNR at constant lesion detection rates.

The effects of process parameters (adhesive spread, press time, and applied pressure) on the response parameter (shear strength) of pine wood bonded with PVAc were studied. Response surface methodology was applied for design of experiments and for analysis of results. A mathematical model was developed to establish the relationship between the process parameters and response parameters. The results showed that the major factors were adhesive spread and applied pressure. The shear strength increased as the adhesive spread and applied pressure increased within certain ranges.

Objective: To evaluate an online intervention for adults with ADHD that aimed to improve organizational skills and attention with the help of smartphone applications. Method: Participants (n = 57) were recruited and assessed through questionnaires and telephone interviews. Diagnoses of ADHD were confirmed for 83% of the participants, 5% most probably had the diagnoses, and 12% did not fulfill all diagnostic criteria despite high levels of symptoms. Participants were randomized between the intervention (n = 29) and a wait-list control group (n = 28). The 6-week intervention involved support from a coach in finding a routine for organizing everyday life with the help of smartphone applications. The primary outcome measure was ASRS Inattention. Secondary outcomes were ASRS sub-scale Hyperactivity and measures of depression, anxiety, stress, quality of life and general level of functioning. Blind evaluators also assessed improvement in organization and inattention at post treatment. Result: The participants receiving the Living Smart course reduced their average scores on ASRS-Inattention from 28.1 (SD = 4.5) to 22.9 (SD = 4.3) which was a significantly larger reduction than found in the control group. 33% of participants were considered clinically significantly improved according to the blind evaluator, compared to 0% in the control group. The same results were found when only participants with a confirmed diagnose were included in the analyses. Conclusion: Adults with ADHD seem to be able to use smartphone applications to organize their everyday life and can be taught how to do this via online interventions.

Issue 3 of Interfaces: A Journal of Medieval European Literatures explores the theme of the rediscovery and canonization of the Roman classics in medieval Western European literary culture, beginning in the eleventh century and reaching a wide impact on literary and intellectual life in the twelfth century. It is headed by an article by Birger Munk Olsen whose immense and comprehensive work of cataloguing and analyzing the entire record of manuscripts containing Roman classics copied before 1200 is nearing completion (L‘étude des auteurs classiques aux XIe et XIIe siècles, 5 vols). Within our journal’s scope of medieval European literature we have found it both rewarding and fitting to take Munk Olsen’s work as a prism for what is a striking literary phenomenon across most geographies and chronologies of medieval Europe: the engagement with the pre-Christian classics. The catalogue and the synthesis by Munk Olsen put many kinds of new studies on a firm footing. In this issue of Interfaces we present three 'frontiers' or types of scholarship on the rediscovery and canonization of the Roman classics all taking their cue from the meticulous way L’étude has charted out this territory.

Pneumothoraces are the most frequently occurring complications of CT-guided percutaneous transthoracic pulmonary biopsies (PTPB). The aim of this study was to evaluate the influence of pre-diagnostic lung emphysema on the incidence and extent of pneumothoraces and to establish a risk stratification for the evaluation of the pre-procedure complication probability.CT-guided PTPB of 100 pre-selected patients (mean age 67.1±12.8 years) were retrospectively enrolled from a single center database of 235 PTPB performed between 2012-2014. Patients were grouped according to pneumothorax appearance directly after PTPB (group I: without pneumothorax, n = 50; group II: with pneumothorax, n = 50). Group II was further divided according to post-interventional treatment (group IIa: chest tube placement, n = 24; group IIb: conservative therapy, n = 26). For each patient pre-diagnostic percentage of emphysema was quantified using CT density analysis. Emphysema stages were compared between groups using bivariate analyses and multinomial logistic regression analyses.Emphysema percentage was significantly associated with the occurrence of post-interventional pneumothorax (p = 0.006). Adjusted for potential confounders (age, gender, lesion size and length of interventional pathway) the study yielded an OR of 1.07 (p = 0.042). Absolute risk of pneumothorax increased from 43.4% at an emphysema rate of 5% to 73.8% at 25%. No differences could be seen in patients with pneumothorax between percentage of emphysema and mode of therapy (p = 0.721).The rate of lung emphysema is proportionally related to the incidence of pneumothorax after CT-guided PTPB and allows pre-interventional risk stratification. There is no association between stage of emphysema and post-interventional requirement of chest tube placement.

The effect of sharpness angle on tool wear and the effect of tool wear on machined surface roughness were investigated in wood flour/polyethylene composite (WFPEC) peripheral up-milling using cemented tungsten carbide (TC) tools. It was shown that nose width and edge recession increased with increasing feeding length. During the milling process, the wear of the nose width was smallest for the tool with a sharpness angle of 45°, followed by tools with sharpness angles of 55° and 65°. The wear of edge recession was highest for the tool with a sharpness angle of 45°, followed by tools with sharpness angles of 55° and 65°. The nose width increased with increasing sharpness angle, the edge recession decreased with increasing sharpness angle, and the machined surface roughness increased with increasing sharpness angle after a feeding length of 40 m. The nose width had a positive effect on the machined surface roughness, and the machined surface roughness increased with increasing nose width. The edge recession had little effect on the machined surface roughness. The clearance face roughness of the worn tool increased with increasing sharpness angle. The analysis of the SEM micrographs and EDS of the clearance face of the worn tool showed that the wear mechanisms of the cemented tungsten carbide tool were oxidation and abrasion in the range tested during cutting. Thus, a slight wear of the edge recession is gained in exchange for a lower machined surface roughness by decreasing the sharpness angle.

The effect of chip thickness, rake angle, and edge radius on cutting forces and chip morphology in wood plastic composites (WPCs) orthogonal cutting was investigated. Three types of WPCs, Wood flour/polyethylene composite (WFPEC), wood flour/polypropylene composite (WFPPC), and wood flour/polyvinyl chloride composite (WFPVCC), that were tested exhibited different behavior with respect to the machinability aspects. The cutting forces of WFPVCC were the highest, followed by WFPPC and WFPEC. The most significant factor on the parallel cutting force of these three types of WPCs was the chip thickness, which explained more than 90%, contribution of total variation, while rake angle, edge radius, and the interactions between these factors had small contributions. The most significant factor on the normal cutting force of WPCs was also the chip thickness, which accounted for more than 60% of the total variation. The chips produced included long continuous chips, short continuous chips, flake chips, and granule chips when cutting these three types of WPCs.

Future power production in Europe is expected to include large shares of variable wind and solar power production. Norway, with approximately half of the hydropower reservoir capacity in Europe, can contribute to balance the variability. The aim of this paper is to assess how such a role may impact the Norwegian hydropower system in terms of production pattern of the plants, changes in reservoir level and water values. The study uses a stochastic optimization and simulation model and analyses an eHighway2050 scenario combined with increases in the hydropower production capacities in Norway. The capacity increases from ca. 31 GW in the present system to 42 and 50 GW respectively. The study uses 75 years with stochastic wind, solar radiation, temperature and inflow data. The results show that the hydropower system is able to partly balance the variable production and significantly reduce the power prices for the analyzed case. The paper shows that some of the power plants utilize their increased capacity, while other plants do not due to hydrological constraints and model limitations. The paper discusses how the modelling can be further improved in order to quantify more of the potential impacts on the future power system.

PURPOSE:To investigate predictors of technical success and complications of computed tomography (CT)-guided percutaneous transthoracic needle biopsy of potentially malignant pulmonary tumors. MATERIAL AND METHODS:From 2008 to 2009, technical success and rate of complications of CT-guided percutaneous transthoracic lung needle biopsies of patients with suspicious pulmonary tumors were retrospectively evaluated. The influence on technical success and rate of complications was assessed for intervention-related predictors (lesion diameter, length of biopsy pathway, number of pleural transgressions, and needle size) and patient-related predictors (age, gender, reduced lung function). In addition, technical success and rate of complications were compared between different interventional radiologists. RESULTS:One hundred thirty-eight patients underwent biopsies by 15 interventional radiologists. The overall technical success rate was 84.1% and was significantly different between interventional radiologists (range 25%-100%; p

O artigo se propõe a examinar a recepção da literatura clássica grega e latina dos séculos IX ao XII, baseando-se nos manuscritos e fragmentos conservados das obras de um corpus de cinqüenta autores gregos e cinqüenta autores latinos. Os resultados da pesquisa mostram que os testemunhos no Ocidente são singularmente mais numerosos que os de Bizâncio. Para as vinte e cinco obras mais conhecidas, assinalamos, por exemplo, cerca de três mil cópias de textos latinos contra aproximadamente duzentos textos gregos, o que torna problemático o estabelecimento de estatísticas signi?cativas para o domínio bizantino. Esse desvio pode ser explicado de muitas formas, antes de tudo pelo papel importante, no Ocidente, dos clássicos no ensino dos mosteiros, que fazem copiar em seus scriptoria coleções geralmente consideráveis de livros escolares. Em Bizâncio, ao contrário, os mosteiros, tendo uma concepção bem diversa da cultura monástica, parecem não ter tido nenhum papel na transmissão da literatura antiga. Assim sendo, os livros clássicos deviam encontrar-se essencialmente nas bibliotecas privadas dos amadores esclarecidos ou dos mestres, e eram menos estáveis e numerosas do que as pessoas morais do Ocidente.

Thanks to its huge water storage capacity, Norway has an excess of energy generation at annual scale, although significant regional disparity exists. On average, the Mid-Norway region has an energy deficit and needs to import more electricity than it exports. We show that this energy deficit can be reduced with an increase in wind generation and transmission line capacity, even in future climate scenarios where both mean annual temperature and precipitation are changed. For the considered scenarios, the deficit observed in winter disappears, i.e., when electricity consumption and prices are high. At the annual scale, the deficit behaviour depends more on future changes in precipitation. Another consequence of changes in wind production and transmission capacity is the modification of electricity exchanges with neighbouring regions which are also modified both in terms of average, variability and seasonality.

To assess the therapeutic outcome after endovascular repair of iliac arterial lesions (IALs) using a self-expandable Nitinol stent graft system.Between July 2006 and March 2013, 16 patients (13 males, mean age: 68 years) with a self-expandable Nitinol stent graft. A total of 19 lesions were treated: nine true aneurysms, two anastomotic aneurysms, two dissections, one arteriovenous fistula, two type 1B endoleaks after endovascular aneurysm repair, one pseudoaneurysm, and two perforations after angioplasty. Pre-, intra-, and postinterventional imaging studies and the medical records were analyzed for technical and clinical success and postinterventional complications.The primary technical and clinical success rate was 81.3% (13/16 patients) and 75.0% (12/16), respectively. Two patients had technical failure due to persistent type 1A endoleak and another patient due to acute stent graft thrombosis. One patient showed severe stent graft kinking on the first postinterventional day. In two patients, a second intervention was performed. The secondary technical and clinical success rate was 87.5% (14/16) and 93.8% (15/16). The minor complication rate was 6.3% (patient with painful hematoma at the access site). The major complication rate was 6.3% (patient with ipsilateral deep vein thrombosis). During median follow-up of 22.4 months, an infection of the aneurysm sac in one patient and a stent graft thrombosis in another patient were observed.Endovascular repair of various IALs with a self-expandable Nitinol stent graft is safe and effective.

OBJECTIVE:To compare the accuracy of a semi-quantitative proton resonance frequency shift (PRFS) thermal mapping interface and an alternative qualitative T1 thermometry model in predicting tissue necrosis in an established routine setting of MRI-guided laser ablation in the human liver. MATERIALS AND METHODS:34 cases of PRFS-guided (GRE) laser ablation were retrospectively matched with 34 cases from an earlier patient population of 73 individuals being monitored through T1 magnitude image evaluation (FLASH 2D). The model-specific real-time estimation of necrotizing thermal impact (above 54 °C zone and T1 signal loss, respectively) was correlated in size with the resulting necrosis as shown by lack of enhancement on the first-day contrast exam (T1). Matched groups were compared using the Mann-Whitney test. RESULTS:Online PRFS guidance was available in 33 of 34 cases. Positive size correlation between calculated impact zone and contrast defect at first day was evident in both groups (p < 0.0004). The predictive error estimating necrosis was median 21% (range 1 %-52%) in the PRFS group and 61 % (range 22-84%) in the T1 magnitude group. Differences in estimating lethal impact were significant (p = 0.004), whereas the real extent of therapy-induced necrosis showed no significant difference (p > 0.28) between the two groups. CONCLUSION:PRFS thermometry is feasible in a clinical setting of thermal hepatic tumor ablation. As an interference-free MR-tool for online therapy monitoring its accuracy to predict tissue necrosis is superior to a competing model of thermally induced alteration of the T1 magnitude signal.

PURPOSE: To evaluate changes in nucleus pulposus volume as a potential parameter for the effects of disc decompression. METHODS: Fifty-two discs (T8 to L1) were extracted from 26 pigs and separated into thoracic (T8 to T11) and thoracolumbar discs (T12 to L1). The discs were imaged using 7.1 Tesla ultrahigh-field magnetic resonance imaging (MRI) with acquisition of axial T2-weighted turbo spin-echo sequences for determination of baseline and postinterventional nucleus pulposus volumes. Volumes were calculated using OsiriX® (http://www.osirix-viewer.com). After randomization, one group was treated with nucleoplasty, while the placebo group was treated with an identical procedure but without coblation current. The readers analyzing the MR images were blinded to the kind of procedure performed. Baseline and postinterventional volumes were compared between the nucleoplasty and placebo group. RESULTS: Average preinterventional nucleus volume was 0.799 (SD: 0.212) ml. Postinterventional volume reduction in the nucleoplasty group was significant at 0.052 (SD: 0.035) ml or 6.30% (p

OBJECTIVE: The technical evolution of endografts for the interventional management of infrarenal abdominal aortic aneurysms (AAA) has allowed a continuous expansion of indications. This study compares the established Talent endograft with its successor, the Endurant endograft, taking individual aortoiliac anatomy into account. METHODS: From June 2007 to December 2010, 35 patients with AAA were treated with a Talent endograft (33 men) and 36 patients with an Endurant endograft (34 men). Aortoiliac anatomy was evaluated in detail using preinterventional computed tomography angiography. The 30-day outcome of both groups were compared regarding technical and clinical success as well as complications including endoleaks. RESULTS: The Endurant group included more patients with unfavorable anatomy (kinking of pelvic arteries, p = 0.017; shorter proximal neck, p = 0.084). Primary technical success was 91.4% in the Talent group and 100% in the Endurant group (p = 0.115). Type 1 endoleaks occurred in 5.7% of patients in the Talent group and in 2.8% of those in the Endurant group (p = 0.614). Type 3 endoleaks only occurred in the Talent group (2.9% of patients; p = 0.493). Type 2 endoleaks were significantly less common in the Endurant group than in the Talent group (8.3% versus 28.6%; p = 0.035). Rates of major and minor complications were not significantly different between both groups. Primary clinical success was significantly better in the Endurant group (97.2%) than in the Talent group (80.0%) (p = 0.028). CONCLUSION: Endurant endografts appear to have better technical and clinical outcome in patients with difficult aortoiliac anatomy, significantly reducing the occurrence of type 2 endoleaks.

STUDY DESIGN: We assessed volume following nucleoplasty disc decompression in lower lumbar spines from cadaveric pigs using 7.1Tesla magnetic resonance imaging (MRI). PURPOSE: To investigate coblation-induced volume reductions as a possible mechanism underlying nucleoplasty. METHODS: We assessed volume following nucleoplastic disc decompression in pig spines using 7.1-Tesla MRI. Volumetry was performed in lumbar discs of 21 postmortem pigs. A preoperative image data set was obtained, volume was determined, and either disc decompression or placebo therapy was performed in a randomized manner. Group 1 (nucleoplasty group) was treated according to the usual nucleoplasty protocol with coblation current applied to 6 channels for 10 seconds each in an application field of 360°; in group 2 (placebo group) the same procedure was performed but without coblation current. After the procedure, a second data set was generated and volumes calculated and matched with the preoperative measurements in a blinded manner. To analyze the effectiveness of nucleoplasty, volumes between treatment and placebo groups were compared. RESULTS: The average preoperative nucleus volume was 0.994 ml (SD: 0.298 ml). In the nucleoplasty group (n = 21) volume was reduced by an average of 0.087 ml (SD: 0.110 ml) or 7.14%. In the placebo group (n = 21) volume was increased by an average of 0.075 ml (SD: 0.075 ml) or 8.94%. The average nucleoplasty-induced volume reduction was 0.162 ml (SD: 0.124 ml) or 16.08%. Volume reduction in lumbar discs was significant in favor of the nucleoplasty group (p

Imidacloprid (IMI), an insecticide from the neonicotinoid group widely used in agriculture, has drawn attention due to its potential harmful effects on non-target species, including bird populations. In the present work, we investigated the effect of IMI on avian semen by in vitro exposure of rooster spermatozoa to this pesticide. The semen was collected twice a week. Samples collected on one day were pooled and incubated with the following IMI concentrations: 0 mM, 0.5 mM, 5 mM, 10 mM, and 50 mM at 36°C for 3 h. Comprehensive semen analysis was carried out after 1 h and 3 h of incubation, evaluating sperm motility parameters with the CASA system and using flow cytometry to assess membrane integrity, mitochondrial activity, acrosome integrity, chromatin structure, intracellular calcium level and apoptosis markers such as: early apoptosis and caspase activation and lipid peroxidation. The results of the first experiment suggest that low concentrations of IMI have a different effect on sperm motility compared to higher concentrations. In IMI samples, we also observed a lower percentage of cells with a high level of calcium ions compared to the control, and a lower level of lipid peroxidation. We concluded that IMI may act as a blocker of calcium channels, preventing the influx of these ions into the cell. To confirm this mechanism, we conducted a second experiment with calcium channel blockers: SNX 325, MRS-1845, and Nifedipine. The results of this experiment confirmed that the mechanism of action of IMI largely relies on the blockade of calcium channels in rooster sperm. Blocking the influx of calcium ions into the cell prevents the formation of Ca²⁺-dependent pores, thereby preventing an increase in cell membrane permeability, ultimately blocking early apoptosis and lipid peroxidation in chicken spermatozoa., Competing Interests: DISCLOSURES The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Rationale: Respiratory conditions account for a large proportion of health care spending in the United States. A full characterization of spending across multiple conditions and over time has not been performed. Objectives: To estimate health care spending in the United States for 11 respiratory conditions from 1996 to 2016, providing detailed trends and an evaluation of factors associated with spending growth. Methods: We extracted data from the Institute of Health Metrics and Evaluation's Disease Expenditure Project Database, producing annual estimates in spending for 38 age and sex groups, 7 types of care, and 3 payer types. We performed a decomposition analysis to estimate the change in spending associated with changes in each of five factors (population growth, population aging, disease prevalence, service usage, and service price and intensity). Measurements and Main Results: Total spending across all respiratory conditions in 2016 was $170.8 billion (95% confidence interval [CI], $164.2-179.2 billion), increasing by $71.7 billion (95% CI, $63.2-80.8 billion) from 1996. The respiratory conditions with the highest spending in 2016 were asthma and chronic obstructive pulmonary disease, contributing $35.5 billion (95% CI, $32.4-38.2 billion) and $34.3 billion (95% CI, $31.5-37.3 billion), respectively. Increasing service price and intensity were associated with 81.4% (95% CI, 70.3-93.0%) growth from 1996 to 2016. Conclusions: U.S. spending on respiratory conditions is high, particularly for chronic conditions like asthma and chronic obstructive pulmonary disease. Our findings suggest that service price and intensity, particularly for pharmaceuticals, should be a key focus of attention for policymakers seeking to reduce health care spending growth.

Background: Spending on cardiovascular disease and cardiovascular risk factors (cardiovascular spending) accounts for a significant portion of overall US health care spending. Our objective was to describe US adult cardiovascular spending patterns in 2016, changes from 1996 to 2016, and factors associated with changes over time., Methods: We extracted information on adult cardiovascular spending from the Institute for Health Metrics and Evaluation's disease expenditure project, which combines data on insurance claims, emergency department and ambulatory care visits, inpatient and nursing care facility stays, and drug prescriptions to estimate >85% of all US health care spending. Cardiovascular spending (2016 US dollars) was stratified by age, sex, type of care, payer, and cardiovascular cause. Time trend and decomposition analyses quantified contributions of epidemiology, service price and intensity (spending per unit of utilization, eg, spending per inpatient bed-day), and population growth and aging to the increase in cardiovascular spending from 1996 to 2016., Results: Adult cardiovascular spending increased from $212 billion in 1996 to $320 billion in 2016, a period when the US population increased by >52 million people, and median age increased from 33.2 to 36.9 years. Over this period, public insurance was responsible for the majority of cardiovascular spending (54%), followed by private insurance (37%) and out-of-pocket spending (9%). Health services for ischemic heart disease ($80 billion) and hypertension ($71 billion) led to the most spending in 2016. Increased spending between 1996 and 2016 was primarily driven by treatment of hypertension, hyperlipidemia, and atrial fibrillation/flutter, for which spending rose by $42 billion, $18 billion, and $16 billion, respectively. Increasing service price and intensity alone were associated with a 51%, or $88 billion, cardiovascular spending increase from 1996 to 2016, whereas changes in disease prevalence were associated with a 37%, or $36 billion, spending reduction over the same period, after taking into account population growth and population aging., Conclusions: US adult cardiovascular spending increased by >$100 billion from 1996 to 2016. Policies tailored to control service price and intensity and preferentially reimburse higher quality care could help counteract future spending increases caused by population aging and growth.

Background: Melanoma brain metastases historically portend a dismal prognosis, but recent advances in immune checkpoint inhibitors (ICIs) have been associated with durable responses in some patients. There are no validated imaging biomarkers associated with outcomes in patients with melanoma brain metastases receiving ICIs. We hypothesized that radiomic analysis of magnetic resonance images (MRIs) could identify higher-order features associated with survival., Methods: Between 2010 and 2019, we retrospectively reviewed patients with melanoma brain metastases who received ICI. After volumes of interest were drawn, several texture and edge descriptors, including first-order, Haralick, Gabor, Sobel, and Laplacian of Gaussian (LoG) features were extracted. Progression was determined using Response Assessment in Neuro-Oncology Brain Metastases. Univariate Cox regression was performed for each radiomic feature with adjustment for multiple comparisons followed by Lasso regression and multivariate analysis., Results: Eighty-eight patients with 196 total brain metastases were identified. Median age was 63.5 years (range, 19-91 y). Ninety percent of patients had Eastern Cooperative Oncology Group performance status of 0 or 1 and 35% had elevated lactate dehydrogenase. Sixty-three patients (72%) received ipilimumab, 11 patients (13%) received programmed cell death protein 1 blockade, and 14 patients (16%) received nivolumab plus ipilimumab. Multiple features were associated with increased overall survival (OS), and LoG edge features best explained the variation in outcome (hazard ratio: 0.68, P = 0.001). In multivariate analysis, a similar trend with LoG was seen, but no longer significant with OS. Findings were confirmed in an independent cohort., Conclusion: Higher-order MRI radiomic features in patients with melanoma brain metastases receiving ICI were associated with a trend toward improved OS., (© The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)