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Abstract Converging evidence indicates that extra-embryonic yolk sac is the source of both macrophages and endothelial cells in adult mouse tissues. Prevailing views are that these embryonically derived cells are maintained after birth by proliferative self-renewal in their differentiated states. Here we identify clonogenic endothelial-macrophage (EndoMac) progenitor cells in the adventitia of embryonic and postnatal mouse aorta, that are independent of Flt3-mediated bone marrow hematopoiesis and derive from an early embryonic CX3CR1+ and CSF1R+ source. These bipotent progenitors are proliferative and vasculogenic, contributing to adventitial neovascularization and formation of perfused blood vessels after transfer into ischemic tissue. We establish a regulatory role for angiotensin II, which enhances their clonogenic and differentiation properties and rapidly stimulates their proliferative expansion in vivo. Our findings demonstrate that embryonically derived EndoMac progenitors participate in local vasculogenic responses in the aortic wall by contributing to the expansion of endothelial cells and macrophages postnatally.

Introduction: Acute pulmonary embolism is a life-threatening condition that can lead to sudden death. Pulmonary Artery Hypertension (PAH) can be found in the setting of acute pulmonary embolism. The Egg and Banana sign and Carina Crossover (CCO) sign are seen in PAH, which are present on Computed Tomographic scans (CT scans). Aim: To determine the accuracy of CT scans, the Egg and Banana sign, and CCO sign seen in PAH in the evaluation of pulmonary embolism. Materials and Methods: This retrospective, cross-sectional study was conducted from May 2019 to May 2021 in the Department of Radiodiagnosis at Father Muller Medical College Hospital in Mangalore, Karnataka, India. The CT scans of 102 consecutive patients who underwent CT Pulmonary Angiography (CTPA) for suspected pulmonary embolism were evaluated for the presence of the CCO sign and Egg and Banana sign. The CCO sign was considered positive when the right Pulmonary Artery (PA) was seen crossing anterior to the carina at its bifurcation. The Egg and Banana sign was considered present when the PA was found lateral to the aortic arch, with the PA described as the Egg and the arch as the Banana. The results were statistically analysed using Statistical Package for Social Sciences version 3.0. Results: Pulmonary embolism was seen in 26 out of 102 cases, with a mean age of 60.2±16.27 years. Pulmonary embolism was absent in 76 cases with a mean age of 55.8±17.11. An equal gender distribution was seen in 26 cases of pulmonary embolism. The Egg and Banana sign was found in 8 out of 26 patients with pulmonary embolism and had a specificity of 78.9%, negative predictive value of 76.92%, and diagnostic accuracy of 66%. The CCO sign was seen in 14 out of 26 cases of pulmonary embolism and had a higher specificity of 81.58% and diagnostic accuracy of 74.51%. The CCO sign had a statistically significant value in detecting pulmonary embolism. Conclusion: According to the study, the CCO sign had a higher accuracy in detecting pulmonary embolism compared to the Egg and Banana sign. The accuracy was further improved when combined with other signs of pulmonary embolism.

Context: Obstetric sonography is one of the cornerstones in radiology. The exposure of radiology residents in this field is not adequate during their residency life; hence, simulation techniques can be used to bridge the knowledge gap and improve their skills. Aims: The study aimed to evaluate the impact of high-fidelity obstetric sonography simulation in resident training and competency testing. Design: The study design involves interventional longitudinal cohort study. Methods: The study was conducted among 15 radiology residents with the use of Vimedix high-fidelity Ultrasonography simulator. Seven sessions were conducted, following which the evaluation of the training program was done using the Kirkpatrick training evaluation model. The resident's reaction was recorded using the questionnaire, and the change in knowledge was ascertained by the pretest and posttest. A change in behavior was recorded using a questionnaire in the 6-month follow-up. Results: All the domains showed a positive trend after the session three and session seven. The residents were more confident and had an overall improved satisfaction of 97.4% regarding training. The Cronbach's alpha test for this study was 0.812 for session three and 0.867 for session seven. An upward trend was seen in the results of the pretest and posttest scores with P < 0.01. The average pretest mean score was 11.3, and the average posttest mean score was 21.4. A 6-month follow-up showed nearly 95% of the individuals found simulation to be helpful in their daily day-to-day practice. Conclusions: High-fidelity simulators can be used as an adjunct to conventional training in obstetric sonography training of radiology residents.

Context: The diagnosis of COVID-19 relies on the reverse transcriptase-polymerase chain reaction (RT-PCR) obtained from the respiratory tract secretions. Due to various factors, there is a possibility of getting an inaccurate result. The false-negative result would be dangerous as the affected individual would not be subjected to quarantine and would go on to infect others. Hence, there is a need for an alternative in diagnosing COVID-19. Aims: To assess the correlation of computed tomography (CT) findings, laboratory parameters, and outcomes in COVID-19 suspect patients. Design: The study design involves retrospective study. Materials and Methods: RT-PCR-negative COVID suspect individuals were taken. Laboratory parameters such as serum ferritin, serum lactate dehydrogenase (LDH), serum D-dimer, and serum C-reactive protein (CRP) were considered. CT findings in these patients were determined. These parameters were statistically analyzed. Statistical Analysis Used: Frequency, percentage distribution, mean standard deviation, median, interquartile range, and Kruskal–Wallis test. Results: There was a statistically significant correlation between the serum LDH, serum ferritin, and serum CRP with the CT severity findings in RT-PCR-negative COVID suspect individuals. The predominant CT finding was ground-glass opacities. Conclusions: In conclusion, the laboratory parameters and CT findings can be used as an alternative in the diagnosis of COVID-19 in RT-PCR-negative individuals.

Sampath Malathi,1 Perumal Nandhakumar,2 Velayudham Pandiyan,2 Thomas J Webster,3 Sengottuvelan Balasubramanian1 1Department of Inorganic Chemistry, Guindy Campus, University of Madras, Chennai, Tamil Nadu, India; 2Department of Veterinary Biochemistry, Madras Veterinary College, Chennai, Tamil Nadu, India; 3Department of Chemical Engineering, Northeastern University, Boston, USA Background: Insulin is the drug therapy for patients with insulin-dependent diabetes mellitus. A number of attempts have been made in the past to overcome the problems associated with the oral delivery of insulin, but with little success. Orally administered insulin has encountered with many difficulties such as rapid degradation and poor intestinal absorption. The potential use of d-α-tocopherol poly(ethylene glycol) 1000 succinate (TPGS)-emulsified poly(ethylene glycol) (PEG)-capped poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NPs) was investigated for sustained delivery of insulin (IS).Objective: To investigate the efficacy of TPGS-emulsified PEG-capped PLGA NPs (TPPLG NPs) as a potential drug carrier for the oral delivery of insulin.Methods: A series of biodegradable low-molecular-weight PLGA (80/20 [PLG4] and 70/30 [PLG6]) copolymers were synthesized by melt polycondensation. The commercial insulin-loaded TPGS-emulsified PEG-capped PLGA NPs (ISTPPLG NPs) were synthesized by water–oil–water emulsion solvent evaporation method. The physical and chemical properties of PLGA copolymers, particle size, zeta potential, and morphology of the NPs were examined. The in vivo studies of ISTPPLG NPs were carried out in diabetic rats by oral administration.Results: The maximum encapsulation efficiency of ISTPPLG6 NPs was 78.6%±1.2%, and the mean diameter of the NPs was 180±20 nm. The serum glucose level was significantly (twofold) decreased on treatment with ISTPPLG NPs, and there was a threefold decrease with insulin-loaded PLGA (70/30) NPs when compared to that of free insulin-treated diabetic rats. The results show that the oral administration of ISTPPLG6 NPs is an effective method of reducing serum glucose level for a period of 24 hours. Histopathological studies reveal that ISTPPLG NPs could restore the damage caused by streptozotocin in the liver, kidneys, and pancreas, indicating its biocompatibility and regenerative effects.Conclusion: ISTPPLG6 NPs can act as potential drug carriers for the oral delivery of insulin. Keywords: drug delivery, polymer nanoparticles, poly(ethylene glycol), tocopherol poly(ethylene glycol) 1000 succinate, hypoglycemic effect, histopathology