Single-nucleus and spatial landscape of the sub-ventricular zone in human glioblastoma

The sub-ventricular zone (SVZ) is the most well-characterized neurogenic area in the mammalian brain. We previously showed that in 65% of patients with glioblastoma (GBM), the SVZ is a reservoir of cancer stem-like cells that contribute to treatment resistance and emergence of recurrence. Here, we built a single-nucleus RNA-sequencing-based microenvironment landscape of the tumor mass (T_Mass) and the SVZ (T_SVZ) of 15 GBM patients and 2 histologically normal SVZ (N_SVZ) samples as controls. We identified a mesenchymal signature in the T_SVZ of GBM patients: tumor cells from the T_SVZ relied on the ZEB1 regulatory network, whereas tumor cells in the T_Mass relied on the TEAD1 regulatory network. Moreover, the T_SVZ microenvironment was predominantly characterized by tumor-supportive microglia, which spatially co-exist and establish heterotypic interactions with tumor cells. Lastly, differential gene expression analyses, predictions of ligand-receptor and incoming/outgoing interactions, and functional assays revealed that the IL-1β/IL-1RAcP and Wnt-5a/Frizzled-3 pathways are therapeutic targets in the T_SVZ microenvironment. Our data provide insights into the biology of the SVZ in GBM patients and identify specific targets of this microenvironment.

The Society for Pediatric Radiology Magnetic Resonance Imaging and Emergency and Trauma Imaging Committees' consensus protocol recommendation for rapid MRI for evaluating suspected appendicitis in children

The imaging evaluation of acute abdominal pain in children with suspected appendicitis has evolved to include rapid abdominopelvic MRI (rMRI) over recent years. Through a collaborative effort between the Magnetic Resonance Imaging (MRI) and Emergency and Trauma Imaging Committees of the Society for Pediatric Radiology (SPR), we conducted a survey on the utilization of rMRI to assess practice specifics and protocols. Subsequently, we present a proposed consensus rMRI protocol derived from the survey results, literature review, and discussion and consensus between committee members.

Enhancing defense against rice blast disease: Unveiling the role of leaf endophytic firmicutes in antifungal antibiosis and induced systemic resistance

Rice remains the primary staple for more than half of the world's population, yet its cultivation faces numerous challenges, including both biotic and abiotic stresses. One significant obstacle is the prevalence of rice blast disease, which substantially diminishes productivity and increases cultivation costs due to frequent fungicide applications. Consequently, the presence of fungicide residues in rice raises concerns about compliance with international maximum residue limits (MRLs). While host resistance has proven effective, it often remains vulnerable to new variants of the Magnaporthe oryzae pathogen. Therefore, there is a critical need to explore innovative management strategies that can complement or enhance existing methods. An unexplored avenue involves harnessing endophytic bacterial communities. To this end, the present study investigates the potential of eleven endophytic Bacillus spp. in suppressing Pyricularia oryzae, promoting plant growth, and eliciting a defense response through phyllobacterization. The results indicate that the secreted metabolome and volatilome of seven tested isolates demonstrate inhibitory effects against P.oryzae, ranging from a minimum of 40% to a maximum of 70%. Bacillus siamensis L34, B. amyloliquefaciens RA37, B. velezensis L12, and B. subtilis B18 produce antifungal antibiotics targeting P.oryzae. Additionally, B. subtilis S4 and B. subtilis S6 emerge as excellent inducers of systemic resistance against blast disease, as evidenced by elevated activity of biochemical defense enzymes such as peroxidase, polyphenol oxidase, and total phenol content. However, a balance between primary metabolic activity (e.g., chlorophyll content, chlorophyll fluorescence, and photosynthetic rate) and defense activity is observed. Furthermore, specific endophytic Bacillus spp. significantly stimulates defense-related genes, including OsPAD4, OsFMO1, and OsEDS1. These findings underscore the multifaceted potential of endophytic Bacillus in managing blast disease through antibiosis and induced systemic resistance. In conclusion, this study highlights the promising role of endophytic Bacillus spp. as a viable option for blast disease management. Their ability to inhibit the pathogen and induce systemic resistance makes them a valuable addition to the existing strategies. However, it is crucial to consider the trade-off between primary metabolic activity and defense response when implementing these bacteria-based approaches.

Photoelectrochemistry of a photosystem I - Ferredoxin construct on ITO electrodes

In this study, photobioelectrodes based on a ferredoxin-modified photosystem I (PSI-Fd) from Thermosynechococcus vestitus have been prepared and characterized regarding the direct electron transfer between PSI-Fd and the electrode. The modified PSI with the covalently linked ferredoxin (Fd) on its stromal side has been immobilized on indium-tin-oxide (ITO) electrodes with a 3-dimensional inverse-opal structure. Compared to native PSI, a lower photocurrent and a lower onset potential of the cathodic photocurrent have been observed. This can be mainly attributed to a different adsorption behavior of the PSI-Fd-construct onto the 3D ITO. However, the overall behavior is rather similar to PSI. First experiments have been performed for applying this PSI-Fd photobioelectrode for enzyme-driven NADPH generation. By coupling the electrode system with ferredoxin-NADP+-reductase (FNR), first hints for the usage of photoelectrons for biosynthesis have been collected by verifying NADPH generation.

Novel and sustainable green sulfur-doped carbon nanospheres via hydrothermal process for Cd (II) ion removal

Herein, the synthesis, characterization, and adsorption performance of a novel green sulfur-doped carbon nanosphere (S-CNs) is studied to eliminate Cd (II) ions from water effectively. S-CNs were characterized using different techniques including Raman spectroscopy, powder X-ray diffraction (PXRD), scanning electron microscopy (SEM) with energy dispersive X-ray analysis (EDX), , Brunauer-Emmett-Teller (BET) specific surface area analysis and Fourier transform infrared spectrophotometry (FT-IR), were performed. The efficient adsorption of the Cd (II) ions onto S-CNs strongly depended on pH, initial concentration of Cd (II) ions, S-CNs dosage, and temperature. Four isotherm models (Langmuir, Freundlich, Temkin & Redlich Peterson) were tested for modeling. Out of four, Langmuir showed more applicability than the other three models, with a Q_max value of 242.72 mg/g. Kinetic modeling studies suggest a superior fit of the obtained experimental data with the Elovich equation (linear) and pseudo-second-order (non-linear) rather than other linear and non-linear models. Data obtained from thermodynamic modeling indicates that using S-CNs for Cd (II) ions adsorption is a spontaneous and endothermic . The current work recommends using better and recyclable S-CNs to uptake excess Cd (II) ions.

Assessment of Brain Magnetic Resonance and Spectroscopy Imaging Findings and Outcomes After Pediatric Cardiac Arrest

Importance

Morbidity and mortality after pediatric cardiac arrest are chiefly due to hypoxic-ischemic brain injury. Brain features seen on magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) after arrest may identify injury and aid in outcome assessments.

Objective

To analyze the association of brain lesions seen on T2-weighted MRI and diffusion-weighted imaging and N-acetylaspartate (NAA) and lactate concentrations seen on MRS with 1-year outcomes after pediatric cardiac arrest.

Design, Setting, and Participants

This multicenter cohort study took place in pediatric intensive care units at 14 US hospitals between May 16, 2017, and August 19, 2020. Children aged 48 hours to 17 years who were resuscitated from in-hospital or out-of-hospital cardiac arrest and who had a clinical brain MRI or MRS performed within 14 days postarrest were included in the study. Data were analyzed from January 2022 to February 2023.

Exposure

Brain MRI or MRS.

Main Outcomes and Measures

The primary outcome was an unfavorable outcome (either death or survival with a Vineland Adaptive Behavior Scales, Third Edition, score of <70) at 1 year after cardiac arrest. MRI brain lesions were scored according to region and severity (0 = none, 1 = mild, 2 = moderate, 3 = severe) by 2 blinded pediatric neuroradiologists. MRI Injury Score was a sum of T2-weighted and diffusion-weighted imaging lesions in gray and white matter (maximum score, 34). MRS lactate and NAA concentrations in the basal ganglia, thalamus, and occipital-parietal white and gray matter were quantified. Logistic regression was performed to determine the association of MRI and MRS features with patient outcomes.

Results

A total of 98 children, including 66 children who underwent brain MRI (median [IQR] age, 1.0 [0.0-3.0] years; 28 girls [42.4%]; 46 White children [69.7%]) and 32 children who underwent brain MRS (median [IQR] age, 1.0 [0.0-9.5] years; 13 girls [40.6%]; 21 White children [65.6%]) were included in the study. In the MRI group, 23 children (34.8%) had an unfavorable outcome, and in the MRS group, 12 children (37.5%) had an unfavorable outcome. MRI Injury Scores were higher among children with an unfavorable outcome (median [IQR] score, 22 [7-32]) than children with a favorable outcome (median [IQR] score, 1 [0-8]). Increased lactate and decreased NAA in all 4 regions of interest were associated with an unfavorable outcome. In a multivariable logistic regression adjusted for clinical characteristics, increased MRI Injury Score (odds ratio, 1.12; 95% CI, 1.04-1.20) was associated with an unfavorable outcome.

Conclusions and Relevance

In this cohort study of children with cardiac arrest, brain features seen on MRI and MRS performed within 2 weeks after arrest were associated with 1-year outcomes, suggesting the utility of these imaging modalities to identify injury and assess outcomes.

Removal of Pb ions using green Co3O4 nanoparticles: Simulation, modeling, adsorption, and biological studies

Chemical co-precipitation synthesized novel and green cobalt-oxide nanoparticles (Co₃O₄-NPs) utilizing cobalt nitrate as cobalt precursors. FTIR, Raman, scanning electron microscopy, UV visible, X-ray powder diffraction, and BET was used to analyze the surface characteristics, composition, and morphology, of the NPs. These green Co₃O₄-NPs were employed to remove Pb ions from simulated wastewater solutions at various pH, adsorbate, temperature, and dose concentrations. At dose 20 mg/L, pH 6.0, 20 mg/L (Pb(II) solution, 25 °C of temperature, and 45 min for equilibrium, nearly 99.44% of Pb ions were removed. To evaluate the kinetic data, four different kinetic equations were used. The data fit the Elovich rate equation better than the other three models. Thermodynamic and isothermal studies were also evaluated, and the maximum adsorption capacity of 450.45 mg/g was observed at 298.15 K. 0.1 M HNO_3, and 0.1 HCl were used to regenerate used Co₃O₄-NPs. Simulation results show the strong correlation of the Co atom in the Co₃O₄-NPs generates active delocalized surface states, which are energetically most favorable for heavy metal (Pb ions) adsorption and removal, supporting the experimental outcomes. In concluding remarks, green Co₃O₄-NPs can also be used as an adsorbent to remove Pb ions from wastewater bodies.

Design and simulation of Advanced intelligent deep learning MPPT approach to enhance power extraction of 1000 W grid connected Photovoltaic System

The world’s energy offer has been beneath an incredible pressure because of the speedy depletion of fossil resources, energy security, environmental issues and therefore the ever-increasing fashionable living sophistication. The problem of persistent hikes in oil costs, climate threats and soaring energy demand has pleased the worldwide interest to exploiting and investment in renewable sorts of energy (RE), alternative energy specially. A electrical phenomenon, PV system is simple to put in, has no moving components, is sort of freed from maintenance, reduced vulnerability to power loss and is expandable. Despite these benefits, PV energy prices significantly on top of fossil fuels. This can be because of its lower effectiveness and better prices. In PV systems tracking MPPT in effective manner is still the problem. In this paper, the 1000 W grid connected PV system has been taken for analysis of various MPPT techniques. Grid connected PV system modeled, tested under totally different irradiation conditions and conjointly for partial shading conditions. additional it’s enforced under partial shading condition for early MPPT ways, improvement methodology,at finally adopted deep learning methodology for the system and therefore the obtained results were compared with different methods.

Ecological effects, remediation, distribution, and sensing techniques of chromium

Chromium is detected in most ecosystems due to the increased anthropogenic activities in addition to that developed from natural pollution. Chromium contamination in the food chain results due to its persistent and non-degradable nature. The release of chromium in the ecosystem accretes and thereafter impacts different life forms, including humans, aquatic and terrestrial organisms. Leaching of chromium into the ground and surface water triggers several health ailments, such as dermatitis, eczematous skin, allergic reactions, mucous and skin membrane ulcerations, allergic asthmatic reactions, bronchial carcinoma and gastroenteritis. Physiological and biological treatments for the removal of chromium have been discussed in depth in the present communication. Adsorption and biological treatment methods are proven to be alternatives to chemical removal techniques in terms of cost-effectiveness and low sludge formation. Chromium sensing is an alternative approach for regular monitoring of chromium in different water bodies. This review intended to explore different classes of sensors for chromium monitoring. However, the spectrochemical methods are more sensitive in chromium ions sensing than electrochemical methods. Future study should focus on miniaturization for portability and on-site measurements without requiring a large instrument provides a good aspect for future research.

“Multilocus sequence analysis for population diversity of indigenous entomopathogenic fungus Beauveria bassiana and its bio-efficacy against the cassava mite, Tetranychus truncatus Ehara (Acari: Tetranychidae)”

Beauveria bassiana is an entomopathogenic fungus that causes the white muscadine disease in insects. The majority of entomopathogenic fungi are soil and insect borne, 15 soil samples were collected from seven different locations during 2021, from January to December. Similarly, during 2022, March to December, 15 fungus-infected insect specimens were collected from five different locations hence soil and insect samples from various ecosystems were collected. As a result, 30 B. bassiana isolates from 11 different geographical areas were identified using morphological characteristics and multilocus sequence data in this investigation. The taxonomical positions of the isolates were determined using morphological characteristics and phylogenetic inferences based on three loci (Internal Transcribed Sequence, Elongation Factor-1α, and B. bassiana chitinase 1). In phylogenetic analysis of B. bassiana, the Maximum Likelihood analytical method produced distinct tree topology when compared to Neighbor-joining and minimum evolution. Three isolates viz., Bb3, Bb7 and Bb20 were found closely linked with reference isolate (KTU-24) and other showed the higher population diversity among them. The genetic distances of 30 B. bassiana isolates revealed that 15 were not closely related (D varied from 0.003 to 0.036). The pathogenicity of B. bassiana isolates from various hosts along with one commercial formulation (Beveroz) was assessed against Tetranychus truncatus under in vitro conditions by a completely randomized design (CRD) experiment. The same experiment was repeated thrice to confirm the pathogenicity of B. bassiana against T. truncatus. Later, the collected T. truncatus mortality data was converted into corrected mortality by using the Abbott formula and the values were examined using analysis of variance (ANOVA) in SPSS 23.0 software. Duncan’s Multiple Comparison Test was also done to compare the percentage mortality rates among the 30 B. bassiana isolates. The recorded results showed that the Bb6, Bb15 and Bb12 isolates caused significantly higher mortality of T. truncatus, i.e., 97.73, 96.73 and 94.50% respectively, than the other isolates. This study showed the relativeness among the B. bassiana isolates and establishes their bio-efficacy against T. truncatus, which further can be used for commercialization as bio-pesticide.

Use of Magnetic Resonance Imaging in Neuroprognostication After Pediatric Cardiac Arrest: Survey of Current Practices

BACKGROUND

Use of magnetic resonance imaging (MRI) as a tool to aid in neuroprognostication after cardiac arrest (CA) has been described, yet details of specific indications, timing, and sequences are unknown. We aim to define the current practices in use of brain MRI in prognostication after pediatric CA.

METHODS

A survey was distributed to pediatric institutions participating in three international studies. Survey questions related to center demographics, clinical practice patterns of MRI after CA, neuroimaging resources, and details regarding MRI decision support.

RESULTS

Response rate was 31% (44 of 143). Thirty-four percent (15 of 44) of centers have a clinical pathway informing the use of MRI after CA. Fifty percent (22 of 44) of respondents reported that an MRI is obtained in nearly all patients with CA, and 32% (14 of 44) obtain an MRI in those who do not return to baseline neurological status. Poor neurological examination was reported as the most common factor (91% [40 of 44]) determining the timing of the MRI. Conventional sequences (T1, T2, fluid-attenuated inversion recovery, and diffusion-weighted imaging/apparent diffusion coefficient) are routinely used at greater than 97% of centers. Use of advanced imaging techniques (magnetic resonance spectroscopy, diffusion tensor imaging, and functional MRI) were reported by less than half of centers.

CONCLUSIONS

Conventional brain MRI is a common practice for prognostication after CA. Advanced imaging techniques are used infrequently. The lack of standardized clinical pathways and variability in reported practices support a need for higher-quality evidence regarding the indications, timing, and acquisition protocols of clinical MRI studies.

A novel CaO nanocomposite cross linked graphene oxide for Cr(VI) removal and sensing from wastewater

A novel green nanocomposite has been prepared by immobilizing CaO nanoparticles (CaO NPs) on the surface of graphene oxide. Biogenic CaO-NPs were synthesized from Lala clamshells. Morphological and structural characterizations of the nanocomposite were studied extensively. The adsorption capacity (q_max) of the nanocomposite for removing Cr(VI) was 38.04 mg g^-1. In addition to this, the adsorption data were adequately simulated with Langmuir, Freundlich, Temkin, and pseudo-second-order models, suggesting that the adsorption process was the combination of external mass transfer and chemisorption. Electrostatic interaction was the dominant mechanism for Cr(VI) removal. In addition, the synthesized nanocomposites also serve as an excellent sensor for Cr(VI) sensing, with a limit of detection (LOD) of 0.02 μM utilizing electrochemical methods. Therefore, this green nanocomposite can simultaneously serve as an adsorbent and sensor for Cr(VI)removal from aqueous solutions.

Mortality Comparisons ‘At a Glance’: A Mortality Concentration Curve and Decomposition Analysis for India

This paper uses the concept of the Mortality Concentration Curve (M-Curve), which plots the cumulative proportion of deaths against the corresponding cumulative proportion of the population (arranged in ascending order of age), and associated measures, to examine mortality experience in India. A feature of the M-curve is that it can be combined with an explicit value judgement (an aversion to early deaths) in order to make welfare-loss comparisons. Empirical comparisons over time, and between regions and genders, are made. Furthermore, in order to provide additional perspective, selective results for the UK and New Zealand are reported. It is also shown how the M-curve concept can be used to separate the contributions to overall mortality of changes over time (or differences between population groups) to the population age distribution and age-specific mortality rates.

Brain and spine MRI findings in children presenting with TMCO1 mutation

Cerebro-facio-thoracic dysplasia (CFTD) is a developmental disorder characterized by distinctive craniofacial dysmorphism, global developmental delay, and skeletal anomalies. CTFD is the result of biallelic autosomal recessive loss of function mutations in the transmembrane and coiled-coil domains one protein (TMCO1) gene. Based on a population of 27 molecularly confirmed cases, classic brain morphologies associated with CFTD have been described in the literature. Previous studies have demonstrated only mild ventriculomegaly, corpus callosum abnormalities, frontotemporal atrophy, and three cases of associated epilepsy. We present previously undescribed brain MRI findings in two children presenting with seizures due to TMCO1 mutation. MR Imaging demonstrated hippocampal malrotation, olfactory bulb agenesis and olfactory sulcus hypoplasia in both children, pontine hypoplasia, and cochlear nerve agenesis in one child. We demonstrate that TMCO1 may play a more extensive and previously undescribed role in neurodevelopment thereby expanding the phenotype associated with CFTD.

Safety, regulatory and environmental issues related to breeding and international trade of edible insects in Africa

Insect breeding or farming for food and feed is an emerging enterprise that can address the ever-growing demand for protein and curb high unemployment rates in Africa and beyond. However, for the sector to prosper, its value chain needs to be regulated to ensure sustainability and safety for consumers and the environment. Although a few African countries, such as Kenya, Uganda and Rwanda, have promulgated standards on the use of insects as food and feed, greater efforts are needed in other countries, and relevant policies governing the sector need to be formulated. All over the globe, attention to the regulation of the edible insect sector is increasing, and more investment in the industry is foreseen. Safety issues such as identifying which species should be reared, substrate quality and traceability imposed by importing countries will be critical for expansion of the sector. This paper analyses safety, regulatory and environmental issues related to breeding and international trade of edible insects in Africa and provides case studies and recommendations for sustainable use of insects for food and feed.

"Invisible" Detergents Enable a Reliable Determination of Solution Structures of Native Photosystems by Small-Angle Neutron Scattering

Photosystems I (PSI) and II (PSII) are pigment-protein complexes capable of performing the light-induced charge separation necessary to convert solar energy into a biochemically storable form, an essential step in photosynthesis. Small-angle neutron scattering (SANS) is unique in providing structural information on PSI and PSII in solution under nearly physiological conditions without the need for crystallization or temperature decrease. We show that the reliability of the solution structure critically depends on proper contrast matching of the detergent belt surrounding the protein. Especially, specifically deuterated ("invisible") detergents are shown to be properly matched out in SANS experiments by a direct, quantitative comparison with conventional matching strategies. In contrast, protonated detergents necessarily exhibit incomplete matching so that related SANS results systematically overestimate the size of the membrane protein under study. While the solution structures obtained are close to corresponding high-resolution structures, we show that temperature and solution state lead to individual structural differences compared with high-resolution structures. We attribute these differences to the presence of a manifold of conformational substates accessible by protein dynamics under physiological conditions.

Nitrates in the environment: A critical review of their distribution, sensing techniques, ecological effects and remediation

Nitrate pollution is eminent in almost all the developing nations as a result of increased natural activities apart from anthropogenic pollution. The release of nitrates in more than critical quantities into the water bodies causes accretion impacts on living creatures, environmental receptors, and human vigour by accumulation through the food chain. Nitrates have recently acquired researchers' huge attention and extend their roots in environmental contamination of surface and groundwater systems. The presence of nitrate in high concentrations in surface and groundwater triggers several health problems, for instance, methemoglobinemia, diabetes, eruption of infectious disorders, harmfully influence aquatic organisms. Sensing nitrate is an alternate option for monitoring the distribution of nitrate in different water bodies. Here we review electrochemical, spectroscopic, and electrical modes of nitrate sensing. It is concluded that, among the various sensors discussed in this review, FET sensors are the most desirable choice. Their sensitivity, ease of use and scope for miniaturisation are exceptional. Advanced functional materials need to be designed to satiate the growing need for environmental monitoring. Different sources of nitrate contamination in ground and surface water can be estimated using different techniques such as nitrate isotopic composition, co contaminants, water tracers, and other specialized techniques. This review intends to explore the research work on remediation of nitrate from wastewater and soil using different processes such as reverse osmosis, chemical denitrification, biological denitrification, ion exchange, electrodialysis, and adsorption. Denitrification proves as a promising alternative over previously reported techniques in terms of their nitrate removal because of its high cost-effectiveness.

Tailoring freshwater diets towards boosted immunity and pancreas disease infection robustness in Atlantic salmon post smolts

The aim of the current study was to investigate how freshwater diets impact on immunity in Atlantic salmon smolts in freshwater, during transfer to seawater and in post smolts during the seawater stage with and without pancreas disease (PD) infection. Three specific freshwater diets were prepared: (i) A diet similar in composition to commercial salmon freshwater diets (Standard diet); (ii) A diet composed of vegetable oils (rapeseed, palm and linseed oils) mimicking the fat composition in aquatic insects - the natural diet of wild salmon in freshwater (Fatty acid diet); (iii) A diet enriched with possible immune modulating amino acids including dl-methionine, l-lysine, l-threonine and taurine (Amino acid diet). After seawater transfer, all fish were fed the same commercial diet. Head kidneys were extracted, and their leukocytes isolated from smolts right before transfer to seawater, from post smolts one and six weeks after transfer to seawater, and from post smolts in seawater after 8 weeks of ongoing PD infection. In addition, to provoke bacterial or virus induced inflammation in vitro, the individual leukocyte suspension from all fish were stimulated by lipopolysaccharide (LPS) or polyinosinic acid: polycytidylic acid (PIC). The transfer of smolts from fresh-to seawater changed the transcription of several types of genes. Particularly in isolates from fish fed the Standard or Fatty acid diet in freshwater, overall gene transcription (IL-1β, CD83, INF-γ, cox2, cd36, MGAT2, catalase) declined. However, the Amino acid diet stimulated the LPS induced gene transcription of IL-1β, CD83, Cox2, and INF-γ at this stage. In freshwater smolts, PIC stimulated leukocytes showed higher transcription level of Mx and viperin in the Fatty acid and Amino acid diet groups compared to the Standard diet group. In seawater post smolts, Mx and viperin responded similarly to PIC challenge in all diet groups. Furthermore, leukocytes isolated from PD infected fish, continued responding to PIC, regardless of freshwater diet.

ACTA2-Related Dysgyria: An Under-Recognized Malformation of Cortical Development

BACKGROUND AND PURPOSE

Pathogenic variants in the ACTA2 gene cause a distinctive arterial phenotype that has recently been described to be associated with brain malformation. Our objective was to further characterize gyral abnormalities in patients with ACTA2 pathogenic variants as per the 2020 consensus recommendations for the definition and classification of malformations of cortical development.

MATERIALS AND METHODS

We performed a retrospective, multicentric review of patients with proved ACTA2 pathogenic variants, searching for the presence of malformations of cortical development. A consensus read was performed for all patients, and the type and location of cortical malformation were noted in each. The presence of the typical ACTA2 arterial phenotype as well as demographic and relevant clinical data was obtained.

RESULTS

We included 13 patients with ACTA2 pathogenic variants (Arg179His mutation, n = 11, and Arg179Cys mutation, n = 2). Ninety-two percent (12/13) of patients had peri-Sylvian dysgyria, 77% (10/13) had frontal dysgyria, and 15% (2/13) had generalized dysgyria. The peri-Sylvian location was involved in all patients with dysgyria (12/12). All patients with dysgyria had a characteristic arterial phenotype described in ACTA2 pathogenic variants. One patient did not have dysgyria or the characteristic arterial phenotype.

CONCLUSIONS

Dysgyria is common in patients with ACTA2 pathogenic variants, with a peri-Sylvian and frontal predominance, and was seen in all our patients who also had the typical ACTA2 arterial phenotype.

Diethylcarbamazine citrate-fortified salt for lymphatic filariasis elimination in India

Lymphatic filariasis (LF) is a vector-borne neglected tropical disease, causing permanent disability. The disease is debilitating and widespread, leading to tremendous productivity and economic loss. The Government of India (GOI) prioritized the elimination of LF through the annual mass drug administration (MDA) programme in 2004 and continued with a single dose of diethylcarbamazine citrate (DEC), 6 mg/kg of body weight, plus albendazole annually over a period of 5-6 years. The GOI had set the target to achieve LF elimination by 2015 and now by 2030. The progress so far has been suboptimal. Much remains to be done as about 84 per cent of the total 328 endemic districts are still under MDA. The major challenge in implementing MDA is poor compliance. It is necessary to have a feasible alternative strategy addressing the above challenge to achieve the desired goal of LF elimination. At this juncture, a well-researched approach, i.e. the use of DEC-fortified salt, also advocated by the World Health Organization, as a unique form of MDA, is proposed. As per this strategy, a low dose of DEC (0.2% w/w) is added to the cooking salt at the manufacturing facility of iodized salt and consumed by the LF-endemic communities for about two years. Many examples of successful use of this strategy for LF elimination in small- and large-scale trials have been documented in India and several other endemic countries in the world. Implementing DEC-iodine-fortified salt is a safe, less expensive, more efficient and prompt approach for achieving the elimination of LF in India. Adverse effects are none or minor and self-limiting. The DEC-fortified salt strategy can easily piggyback on the existing countrywide deployment of iodized salt under the National Iodine Deficiency Disorders Control Programme (NIDDCP), which has achieved a great success in reducing iodine-deficiency disorders such as hypothyroidism. This existing robust programme can be leveraged to launch DEC-fortified salt for the community. If implemented appropriately, this strategy will ensure the complete cessation of LF transmission within two years from its introduction. If the said strategy is implemented in 2022, it is expected that India will be able to achieve the LF elimination by 2024, much before the global target of 2030.

Sustainable removal of Cr(VI) using graphene oxide-zinc oxide nanohybrid: Adsorption kinetics, isotherms and thermodynamics

Metal-based adsorbents are limited for hexavalent chromium [Cr(VI)] adsorption from aqueous solutions because of their low adsorption capacities and slow adsorption kinetics. In the present study, decorated zinc oxide (ZnO) nanoparticles (NPs) on graphene oxide (GO) nanoparticles were synthesized via the solvothermal process. The deposition of ZnO NPs on graphene oxide for the nanohybrid (ZnO-GO) improves Cr(VI) mobility in the nanocomposite or nanohybrid, thereby improving the Cr(VI) adsorption kinetics and removal capacity. Surface deposition of ZnO on graphene oxide was characterized through Fourie Transform Infra-red (FTIR), UV-Visible, X-ray Diffraction (XRD), Field Emission Scanning Electron Microscopy (FESEM), Energy Dispersive Spectroscopy (EDS), and Brunauer-Emmett-Teller (BET) techniques. These characterizations suggest the formation of ZnO-GO nanocomposite with a specific area of 32.95 m²/g and pore volume of 0.058 cm²/g. Batch adsorption analysis was carried to evaluate the influence of operational parameters, equilibrium isotherm, adsorption kinetics and thermodynamics. The removal efficiency of Cr(VI) increases with increasing time and adsorbent dosage. FTIR, FESEM and BET analysis before and after the adsorption studies suggest the obvious changes in the surface functionalization and morphology of the ZnO-GO nanocomposites. The removal efficiency increases from high-acidic to neutral pH and continues to decrease under alkaline conditions as well. Mathematical modeling validates that the adsorption follows Langmuir isotherm and fits well with the pseudo 2nd order kinetics (Type 5) model, indicating a homogeneous adsorption process. The thermodynamics study reveals that Cr(VI) adsorption on ZnO-GO is spontaneous, endothermic, and entropy-driven. A negative value of Gibb's Free Energy represents the thermodynamic spontaneity and feasibility of the sorption process. To the best of our knowledge, this is the first study of Cr(VI) removal from aqueous solution using this hybrid nanocomposite at near-neutral pH. The synthesized nanocomposites prove to be excellent candidates for Cr(VI) removal from water bodies and natural wastewater systems.

Adsorption and detoxification of pharmaceutical compounds from wastewater using nanomaterials: A review on mechanism, kinetics, valorization and circular economy

Antibiotics overuse, inappropriate conduct, and discharge have led to adverse effects on various ecosystems. The occurrence of antibiotics in surface and drinking water is a matter of global concern. It is responsible for multiple disorders, including disruption of endocrine hormones and high chronic toxicity. The hospitals, pharmaceutical industries, households, cattle farms, and aquaculture are the primary discharging sources of antibiotics into the environment. This review provides complete detail on applying different nanomaterials or nanoparticles for the efficient removal of antibiotics from the diverse ecosystem with a broader perspective. Efforts have been made to focus on the degradation pathways and mechanism of antibiotic degradation using nanomaterials. More light has been shed on applying nanostructures in photocatalysis, which would be an economical and efficient solution. The nanoscale material or nanoparticles have incredible potential for mineralizing pharmaceutical compounds in aqueous solutions at low cost, easy handling characteristics, and high efficacy. Furthermore, nanoparticles can absorb the pharmaceutical by-products and wastes at a minimum cost as they can be easily recycled. With the increasing number of research in this direction, the valorization of pharmaceutical wastes and by-products will continue to expand as we progress from old conventional approaches towards nanotechnology. The utilization of nanomaterials in pharmaceutical wastewater remediation is discussed with a major focus on valorization, energy generation, and minimization and its role in the circular economy creating sustainable development.

Building Bridges Between Social Work and Prenatal Psychology

This issue of Clinical Social Work and Health Intervention is dedicated to decea- sed co-founder of our Journal and President of the International Society of Prenatal and Perinatal Psychology and Medicine, Director of the First Department of Peri- natal Psychology and Medicine, Honorary Doctor and holder of Honorary Degrees and Medals of multiple Universities in Poland, Czechoslovakia, Italy, Malaysia, etc, Doctor of Medicine and Psychology and Editor in chief of four Medical Journ- als: Acta Neurosa Superioris Rediviva, Neuroendocrinology Letters, Clinical Social Work and Health Intervention and Int. Journal of Prenatal and Perinatal Psychology and Medicine (1-4). Together with his spouse Lili Maas, ArtD., who added to the exact science, arts and her heart and love, all of those Journals were not only reading of naked facts and theories, or science but both were teaching us to accept psycho- logy, social work and medicine as art culture and love, what is more than science and knowledge, more than facts. (From the letter of St. Paul and two letters of St. Peter, New Testament)

Biotechnological interventions for the sustainable management of a global pest, whitefly (Bemisia tabaci)

Whiteflies (Bemisia tabaci) are polyphagous invasive hemipteran insects that cause serious losses of important crops by directly feeding on phloem sap and transmitting pathogenic viruses. These insects have emerged as a major threat to global agriculture and food security. Chemically synthesized insecticides are currently the only option to control whiteflies, but the ability of whiteflies to evolve resistance against insecticides has made the management of these insects very difficult. Natural host-plant resistance against whiteflies identified in some crop plants has not been exploited to a great extent. Genetic engineering approaches, such as transgenics and RNA interference (RNAi), are potentially useful for the control of whiteflies. Transgenic plants harboring insecticidal toxins/lectins developed via nuclear or chloroplast transformation are a promising vehicle for whitefly control. Double-stranded RNAs (dsRNAs) of several insect genes, delivered either through microinjection into the insect body cavity or orally via an artificial diet and transiently or stably expressed in transgenic plants, have controlled whiteflies in model plants and in some crops at the laboratory level, but not at the field level. In this review, we highlight the merits and demerits of each delivery method along with strategies for sustained delivery of dsRNAs via fungal entomopathogen/endosymbiont or nontransgenic RNAi approaches, foliar sprays, root absorption or nanocarriers as well as the factors affecting efficient RNAi and their biosafety issues. Genome sequencing and transcriptome studies of whitefly species are facilitating the selection of appropriate genes for RNAi and gene-editing technology for the efficient and resilient management of whiteflies and their transmitted viruses.

Efficient Harvesting of Safe Edible Grasshoppers: Evaluation of Modified Drums and Light-Emitting Diode Bulbs for Harvesting Ruspolia differens (Orthoptera: Tettigoniidae) in Uganda

Ruspolia differens (Serville) (Orthoptera: Tettigoniidae) is a delicacy in many African countries. It is commonly mass-harvested from the wild using light traps consisting of energy-intensive mercury bulbs which pollute the environment when poorly disposed. The catch is collected using open-ended drums which are inefficient in retaining the insects. The drums also collect nontarget insects including those that produce toxic chemicals (such as pederin) that cause severe burns to human skin. To prevent escape of trapped R. differens, trappers apply potentially hazardous substances like waste cooking oil on the walls of drums. Here, we modified the collection drum by fitting a funnel to retain R. differens; and partitioned it into three compartments with wire meshes of variable sizes to filter nontarget insects. Additionally, we replaced mercury bulbs with light-emitting diode (LED) bulbs which are energy-efficient. We evaluated the performance of the modified R. differens trap (modified drums and LED bulbs) compared to the current collection drums and mercury bulbs. The catch of R. differens in the modified drums was comparable to that of current drums. Nontarget insects were significantly filtered from the catch collected in modified drums compared to the current drums. Further, LED bulbs of 400 W trapped a comparable quantity of R. differens as 400 W mercury bulbs, but with less than half the consumption of electricity compared to the mercury bulbs. We concluded that modified R. differens light traps have better energy-use efficiency and ensure safety to collectors, processors, and consumers.

Twelve-week secukinumab treatment is consistently efficacious for moderate-to-severe psoriasis regardless of prior biologic and non-biologic systemic treatment: Post hoc analysis of six randomised trials

Background

The efficacy of biologic therapies is greater among biologic‐naïve vs. biologic‐experienced psoriasis patients. However, little is known as to whether prior use of other systemic therapies impacts secukinumab efficacy in patients with moderate‐to‐severe psoriasis.

Objective

To investigate the impact of prior exposure to systemic therapies upon the efficacy and safety of secukinumab 300 mg for moderate‐to‐severe psoriasis.

Methods

Post hoc analysis of six randomised controlled trials (RCTs) comparing secukinumab with placebo, ustekinumab or etanercept at 12 weeks of treatment. Data comparing secukinumab with placebo and ustekinumab were meta‐analysed, while comparisons between secukinumab and etanercept were from a single RCT. Four subgroups of patients were assessed: (i) naïve to non‐biologic systemics (NBS) and biologics; (ii) exposed to NBS but naïve to biologics; (iii) naïve to NBS but exposed to biologics; and (iv) exposed to NBS and biologics. Outcomes of interest included the following: investigator’s global assessment (IGA) score, absolute psoriasis area and severity index (PASI) response, PASI 75, PASI 90 and PASI 100 responses, and dermatology life quality index (DLQI). Safety was also assessed.

Results

One thousand three hundred and eighty‐three patients were included in the secukinumab vs. placebo meta‐analysis: 1776 in the secukinumab vs. ustekinumab meta‐analysis and 653 in the within‐trial analyses of secukinumab vs. etanercept. For all subgroups, secukinumab was significantly more efficacious than placebo for all outcomes measured. Secukinumab generated greater responses in biologic‐naïve patients, while prior NBS had a negligible impact on treatment response. Furthermore, secukinumab was more efficacious than both ustekinumab and etanercept on many outcomes, with an even greater difference for biologic‐naïve than biologic‐exposed patients. Safety results were consistent with individual clinical trial results.

Conclusions

Twelve‐week treatment with secukinumab 300 mg is consistently more efficacious than placebo, etanercept and ustekinumab in patients with moderate‐to‐severe psoriasis, regardless of prior exposure to biologics or NBS. Secukinumab had a comparable safety profile to both etanercept and ustekinumab.

Volumetric and dosimetric impact of MRI in delineation of gross tumor volume of non-spinal vertebral metastases treated with stereotactic ablative radiation therapy

PURPOSE

To investigate the Gross Tumor Volumes (GTV) and its dosimetric impact of magnetic resonance imaging (MRI) assisted contouring for non-spinal metastasis treated with stereotactic ablative body radiotherapy (SABR).

MATERIAL AND METHODS

Five observer contours on CT (GTV_CT) and CT+MR (GTV_CT+MR) were evaluated against expert team contours (GTV_EC) for 14 selected cases. Dice Similarity Index (DSC) and Geographical Miss Index (GMI) quantify observer variation. We also analyze the maximum dose (D_max) and dose received by 0.35cc (D_0.35cc) of the spinal cord (SC) for GTV_CT and GTV_CT+MR, where optimization parameters and priorities were unchanged. Percent rank function is also evaluated for SC doses.

RESULTS

The mean DSC and GMI scores for the CT-only dataset are 0.6974 and 0.2851 and for CT+MR dataset is 0.7764 and 0.1907 respectively. Statistically, significant results were found for mean GTV volumes between GTV_EC versus GTV_CT and GTV_CT versus GTV_CT+MR (P<0.001). Dosimetric analysis of D_max and D_0.35cc exceeded 84.2% and 88.5% of times its respective threshold doses for CT-only dataset, whereas for the CT+MR dataset, it exceeded only by 18% and 15.7% times. 'Percent rank' function analysis for SC doses also indicates the same.

CONCLUSION

This study supports MRI fusion for GTV and OAR delineation for non-spinal metastasis. Our study showed that the dosimetric analysis is vital for observer variation studies and the addition of the MR data set is significant to improve the confidence of Stereotactic treatments.

Perspective: Vitamin D deficiency and COVID-19 severity - plausibly linked by latitude, ethnicity, impacts on cytokines, ACE2 and thrombosis

BACKGROUND

SARS-CoV-2 coronavirus infection ranges from asymptomatic through to fatal COVID-19 characterized by a 'cytokine storm' and lung failure. Vitamin D deficiency has been postulated as a determinant of severity.

OBJECTIVES

To review the evidence relevant to vitamin D and COVID-19.

METHODS

Narrative review.

RESULTS

Regression modelling shows that more northerly countries in the Northern Hemisphere are currently (May 2020) showing relatively high COVID-19 mortality, with an estimated 4.4% increase in mortality for each 1 degree latitude north of 28 degrees North (P = 0.031) after adjustment for age of population. This supports a role for ultraviolet B acting via vitamin D synthesis. Factors associated with worse COVID-19 prognosis include old age, ethnicity, male sex, obesity, diabetes and hypertension and these also associate with deficiency of vitamin D or its response. Vitamin D deficiency is also linked to severity of childhood respiratory illness. Experimentally, vitamin D increases the ratio of angiotensin-converting enzyme 2 (ACE2) to ACE, thus increasing angiotensin II hydrolysis and reducing subsequent inflammatory cytokine response to pathogens and lung injury.

CONCLUSIONS

Substantial evidence supports a link between vitamin D deficiency and COVID-19 severity but it is all indirect. Community-based placebo-controlled trials of vitamin D supplementation may be difficult. Further evidence could come from study of COVID-19 outcomes in large cohorts with information on prescribing data for vitamin D supplementation or assay of serum unbound 25(OH) vitamin D levels. Meanwhile, vitamin D supplementation should be strongly advised for people likely to be deficient.

Oncology Gold Standard® practical consensus recommendations for the use of monoclonal antibodies in the management of squamous cell carcinoma of head and neck

We present the 2017 Oncology Gold Standard Practical Consensus Recommendation for use of monoclonal antibodies in the management of advanced squamous cell carcinoma of head neck region.

India's lockdown: an interim report

The world has continued to change rapidly since the last version of this article was written on May 20, 2020. Yet, as this article goes to press, we are aware of two realities; first, that we cannot perennially chase a moving target, but second, that nothing about the fundamental trends that we have identified appear to have changed. India is firmly in the throes of a vicious pandemic that we can only hope will abate with the development of an effective vaccine. Our plea for the widespread provision of adequate health and medical facilities, adequate protection for the elderly, and transfers to those severely affected by the lockdown are absolutely unchanged in the face of the latest data. In contrast, the brutal enforcement of a lockdown with none of these accompanying measures can only worsen outcomes for the poorest and most vulnerable among the population.

The potential source for composite flours as food ingredient from local grown crops

The market of composite flour is growing as consumer nowadays choosing a healthy diet as personal preference. The suitability of the composite flour for use as intermediate or finish food ingredients highly depends on its physicochemical properties and its nutritional value. In this study, four types of local fruit crops (particularly their seeds) namely rambutan, cempedak, durian and nangka were dried and ground into powder form. The physicochemical properties such as bulk density, pH, water absorption capacity (WAC), oil absorption capacity (OAC), foam stability (FS), foam capacity (FC) as well as gelatinization properties of these composite flour were studied. Mineral content and heavy metal analytes were also determined. Results for bulk density from the least to the higher amount was 0.54±0.00 g/mL, 0.57±0.00 g/mL, 0.58±0.01 g/mL, 0.66±0.00 g/mL , 0.70±0.00 g/mL and 0.72±0.00 g/mL for rambutan flour, cempedak flour, tapioca flour, nangka flour, wheat flour and durian flour, respectively. Both cempedak flour and nangka flour showed the lowest pH value (5.72±0.01, 5.73±0.00), followed by rambutan flour and durian flour (6.67±0.00, 6.90±0.00) which similar to that tapioca flour and wheat flour (6.65±0.1, 6.08±0.0), respectively. Rambutan flour, cempedak flour and wheat flours showed the highest value in% of foam stability meanwhile these composite flours showed the lowest value in% of foam capacity. Results for water absorption capacity (WAC) and oil absorption capacity (OAC) in a range of 6% to 42% and 8% to 12% respectively, however, durian flour obtained the highest value for WAC while the value for OAC was the lowest. All of the composite flour possesses gelling properties at 13% concentration except for cempedak flour which completely gels at 20% of concentration. Rambutan flour showed the highest mineral analyte particularly in Zinc (107.19±0.17) and Copper (14.22±0.27) followed by nangka flour [Zinc (64.20±0.32) and Copper (10.40±0.12)] and durian flour [Zinc (52.38±0.42) and Copper (7.97±0.05)]. Level of heavy metal toxicity was under risk for all types of composite flour.

The Presence of Anemia in Children with Abusive Head Trauma

OBJECTIVES

To evaluate the incidence of anemia in patients with abusive head trauma (AHT), noninflicted traumatic brain injury (TBI), and physical abuse without AHT and the effect of anemia on outcome.

STUDY DESIGN

In a retrospective, single-center cohort study, we included children under the age of 3 years diagnosed with either AHT (n = 75), noninflicted TBI (n = 77), or physical abuse without AHT (n = 60) between January 1, 2014, and December 31, 2016. Neuroimaging was prospectively analyzed by pediatric neuroradiologists. Primary outcome was anemia at hospital presentation. Secondary outcomes included unfavorable outcome at hospital discharge, defined as a Glasgow Outcome Scale between 1 and 3, and intracranial hemorrhage (ICH) volume.

RESULTS

Patients with AHT had a higher rate of anemia on presentation (47.3%) vs noninflicted TBI (15.6%) and physical abuse without AHT (10%) (P < .001). Patients with AHT had larger ICH volumes (33.3 mL [10.1-76.4 mL] vs 1.5 mL [0.6-5.2 mL] ; P < .001) and greater ICH/total brain volume percentages than patients with noninflicted TBI (4.6% [1.4-8.2 %] vs 0.2% [0.1-0.7%]; P < .001). Anemia was associated with AHT (OR, 4.7; 95% CI, 2.2-10.2) and larger ICH/total brain volume percentage (OR, 1.1; 95% CI, 1.1-1.2) in univariate analysis. Unfavorable outcome at hospital discharge was associated with anemia (OR, 4.4; 95% CI, 1.6-12.6) in univariate analysis, but not after controlling for covariates.

CONCLUSIONS

Patients with AHT were more likely to present to the hospital with anemia and increased traumatic ICH volume than patients with noninflicted TBI or physical abuse without AHT. Children with anemia and AHT may be at increased risk for an unfavorable outcome.

Comparative transcriptomics revealed differential regulation of defense related genes in Brassica juncea leading to successful and unsuccessful infestation by aphid species

Productivity of Indian mustard (B. juncea), a major oil yielding crop in rapeseed-mustard group is heavily inflicted by mustard aphid, L. erysimi. Mustard aphid, a specialist aphid species on rapeseed-mustard crops, rapidly multiplies and colonizes the plants leading to successful infestation. In contrary, legume specific cowpea aphid, A. craccivora when released on B. juncea plants fails to build up population and thus remains unsuccessful in infestation. In the present study, differential host response of B. juncea to the two aphid species, one being successful insect-pest and the other being unsuccessful on it has been studied based on transcriptome analysis. Differential feeding efficiency of the two aphid species on mustard plants was evident from the amount of secreted honeydews. Leaf-transcriptomes of healthy and infested plants, treated with the two aphid species, were generated by RNA sequencing on Illumina platform and de novo assembly of the quality reads. A comparative assessment of the differentially expressed genes due to treatments revealed a large extent of overlaps as well as distinctness with respect to the set of genes and their direction of regulation. With respect to host-genes related to transcription factors, oxidative homeostasis, defense hormones and secondary metabolites, L. erysimi led to either suppression or limited activation of the transcript levels compared to A. craccivora. Further, a comprehensive view of the DEGs suggested more potential of successful insect-pests towards transcriptional reprogramming of the host. qRT-PCR based validation of randomly selected up- and down-regulated transcripts authenticated the transcriptome data.

Feasibility and reproducibility of shear wave elastography in pediatric cranial ultrasound

BACKGROUND

Head ultrasound (US) is commonly used to evaluate the neonatal brain but may be limited by its lack of sensitivity and specificity. Ultrasound shear wave elastography (SWE) might provide additional information to conventional gray-scale imaging.

OBJECTIVE

To assess whether SWE of brain parenchyma can be (1) successfully performed at a large academic medical center where US technologists perform the majority of examinations and (2) used to detect intracranial pathology.

MATERIALS AND METHODS

Pediatric patients undergoing head ultrasound underwent simultaneous SWE examination. We included normal examinations (n=70) and those with intracranial pathology (n=8) for analysis. We analyzed inter-reader variability and examination success rates and assessed the stiffness of white matter and deep gray nuclei in normal and pathological states across multiple gestational age groups.

RESULTS

Average gestational age of the term, pre-term and extreme pre-term groups were 38.4±1.2 weeks, 29.0±3.7 weeks and 28.3±3.1 weeks, respectively. Overall examination success rate was 79.5%. We observed a decrease in the SWE examination time from the first month (5.9±3.7 min) to the second month (4.1±1.7 min; P=0.01). Forty-one repeat examinations were performed on 14 children by different technologists, with an intraclass correlation coefficient (ICC) of 0.91. Mean stiffness in the periventricular white matter was lower than in the deep gray nuclei in all gestational age groups: term group (1.3 m/s vs. 1.5 m/s, P<0.001), pre-term (1.3 m/s vs. 1.4 m/s P=0.12), and extremely preterm group (1.2 m/s vs. 1.4 m/s, P=0.001). Mean stiffness for the deep gray nuclei differed between the term (1.5±0.3 m/s) and pre-term (1.4±0.2 m/s) groups (P<0.01). No significant differences in white matter stiffness were seen in relation to gestational age. Infants with large intraparenchymal hemorrhage had increased white matter stiffness (1.3±0.1 m/s) and deep gray nuclei stiffness (1.6±0.2 m/s) compared to full-term infants with normal head ultrasounds. These differences approached statistical significance with P=0.09 and P=0.06, respectively.

CONCLUSION

We demonstrated that SWE performed by pediatric sonography technologists is reproducible. We found differences in stiffness between deep gray nuclei and periventricular white matter across multiple age groups.

Fracture of femoral component in an Oxford® unicompartmental knee replacement with displaced posterior fragment: a case report

Femur component fracture is very rare with Oxford^® unicompartmental knee replacement. We report a case from the UK with displacement and rotation of the broken femoral component posterior to the peg. Potential predisposing factors include polywear with metal on metal articulation. The patient had excellent results following revision arthroplasty.

Application of a Novel Ultra-High Resolution Multi-Detector CT in Quantitative Imaging of Trabecular Microstructure

PURPOSE

To evaluate the performance of a novel ultra-high resolution multi-detector CT scanner (Canon Aquilion Precision UHR CT), capable of visualizing ~150 μm details, in quantitative assessment of bone microarchitecture. Compared to conventional CT, the spatial resolution of UHR CT begins to approach the size of the trabeculae. This might enable measurements of microstructural correlates of osteoporosis, osteoarthritis, and other bone disease.

METHODS

The UHR CT system features a 160-row x-ray detector with 250×250 μm pixels (measured at isocenter) and a custom-designed x-ray source with a 0.4×0.5 mm focal spot. Visualization of high contrast details down to ~150 μm has been achieved on this device, which is now commercially available for clinical use. To evaluate the performance of UHR CT in quantification of bone microstructure, we imaged a variety of human bone samples (including ulna, radius, and vertebrae) embedded in a ~16 cm diameter plastic cylinder and in an anthropomorphic thorax phantom (QRM-Thorax, QRM Gmbh). Helical UHR CT acquisitions (120 kVp tube voltage) were acquired at scan exposures of 375 mAs - 5 mAs. For comparison, the samples were also imaged using a Normal Resolution (NR) mode available on the scanner, involving 500 μm slice thickness, exposure of 50 mAs, and a focal spot of 0.6×1.3 mm. We obtained micro-CT (μCT) of the bone samples at ~28 μm voxel size as a gold-standard reference. Geometric measurements of bone microstructure were performed in 17 regions-of-interests (ROIs) distributed throughout the bones of the phantoms; image registration was used to place the ROIs at corresponding locations in the UHR CT and NR CT. Trabecular thickness Tb.Th, spacing Tb.Sp, and Bone Volume fraction BvTv were obtained. The UHR and NR imaging protocols were compared terms of correlations to μCT and error of trabecular measurements. The effect of dose on trabecular morphometry was also studied for the UHR CT. Furthermore, we evaluated the sensitivity of texture features of trabecular bone (recently proposed as an alternative to geometric indices of microstructure) to imaging protocol. Image texture evaluation was performed using ~150 regions of interest (ROIs) across all bone samples. Three-dimensional Gray Level Co-occurrence Matrix (GLCM) and Gray Level Run Length Matrix (GLRM) features were extracted for each ROI. We analyzed correlation and concordance correlation coefficient (CCC) of the mean ROI values of texture features obtained using the UHR and NR modes.

RESULTS

UHR CT reconstructions of bone samples clearly demonstrated improved visualization of the trabeculae compared to NR CT. UHR CT achieved substantially better correlations for all three metrics of bone microstructure, in particular for BvTv (correlation coefficient of 0.91 for UHR CT compared to 0.84 for NR CT) and TbSp (correlation of 0.74 for UHR CT and 0.047 for NR CT). The error obtained with UHR CT was generally smaller than that of NR CT. For TbSp, the mean deviation from μCT (averaged across all bone samples) was only ~0.07 for UHR CT, compared to 0.25 for NR CT. Analysis of reproducibility of texture features of trabecular bone between UHR CT and NR CT revealed fair correlations (>0.7) for the majority of GLCM features, but relatively poor CCC (e.g. 0.02 for Energy and 0.04 for Entropy). The magnitude of texture metrics is particularly affected by the enhanced spatial resolution of UHR CT.

CONCLUSION

The recently introduced UHR CT achieves improved correlation and reduced error in measurements of trabecular bone microstructure compared to conventional resolution CT. Future development of diagnostic strategies based on textural biomarkers derived from UHR CT will need to account for potential sensitivity of texture features to image resolution.

Rapid brain MRI protocols reduce head computerized tomography use in the pediatric emergency department

BACKGROUND

Rapid magnetic resonance imaging (MRI) protocols may be effective in the emergency department (ED) to evaluate nontraumatic neurologic complaints. We evaluate neuroimaging (rapid MRI [rMRI]), head computerized tomography [HCT], and full MRI) use following widespread implementation of rMRI protocols in a pediatric emergency department (ED).

METHODS

We conducted a retrospective study in a tertiary care pediatric ED of encounters with neuroimaging during two 9-month periods: one prior to (control period) and one after generalized availability of 4 rMRI protocols (rMRI period). The primary outcome was differences in neuroimaging rates between the two periods. Secondary outcomes included ED process measures, unsuccessful imaging, and undetected pathology, with full MRI within 14 days as the reference standard.

RESULTS

There were 1052 encounters with neuroimaging during the control and 1308 during the rMRI periods. Differences in neuroimaging between periods were 27.7% for rMRI (95% CI, 24.4, 31.0), - 21.5% for HCT (95% CI, - 25.5, - 17.5), and - 6.2% for full MRI (95% CI, - 9.3, - 3.1%.) Time to imaging (182 [IQR 138-255] versus 86 [IQR 52-137] minutes) as well as ED length of stay (396 [IQR 304-484] versus 257 [IQR 196-334] minutes) was longer for rMRI versus HCT (p < 0.01). Between the control and rMRI periods, there were differences in types of neuroimaging performed for patients with altered mental status, headache, seizure, shunt dysfunction, stroke, syncope, trauma, vomiting, infection, and other neurologic complaints (p < 0.05). rMRI studies were unsuccessful in 3.6% of studies versus 0.0% of HCTs (p < 0.01). The 22 unsuccessful rMRI studies were unsuccessful due to artifacts from dental hardware (n = 2) and patient motion (n = 20). None of the rMRI studies with full MRI follow-up imaging had undetected pathology; the false negative rate for the HCT exams was as high as 25%.

CONCLUSIONS

After routine ED use of 4 rMRI protocols, there was a more than 20% decrease in HCT use without missed diagnoses. Time to neuroimaging and length of stay were longer for rMRI than HCT, with higher rates of unsuccessful imaging. Despite these limitations, rMRI may be an alternative to HCT for nontraumatic complaints in the ED.

Role of size, alio-/multi-valency and non-stoichiometry in the synthesis of phase-pure high entropy oxide (Co,Cu,Mg,Na,Ni,Zn)O

Presence of multivalency/non-stoichiometry to accommodate a different-sized cation and maintaining electroneutrality were identified as the critical criteria for single-phase formation in multicomponent/high entropy systems.

Quantitative Evaluation of Bone Microstructure using High-Resolution Extremity Cone-Beam CT with a CMOS Detector

Purpose

A high-resolution cone-beam CT (CBCT) system for extremity imaging has been developed using a custom complementary metal-oxide-semiconductor (CMOS) x-ray detector. The system has spatial resolution capability beyond that of recently introduced clinical orthopedic CBCT. We evaluate performance of this new scanner in quantifying trabecular microstructure in subchondral bone of the knee.

Methods

The high-resolution scanner uses the same mechanical platform as the commercially available Carestream OnSight 3D extremity CBCT, but replaces the conventional amorphous silicon flat-panel detector (a-Si:H FPD with 0.137 mm pixels and a ~0.7 mm thick scintillator) with a Dalsa Xineos3030 CMOS detector (0.1 mm pixels and a custom 0.4 mm scintillator). The CMOS system demonstrates ~40% improved spatial resolution (FWHM of a ~0.1 mm tungsten wire) and ~4× faster scan time than FPD-based extremity CBCT (FPD-CBCT). To investigate potential benefits of this enhanced spatial resolution in quantitative assessment of bone microstructure, 26 trabecular core samples were obtained from four cadaveric tibias and imaged using FPD-CBCT (75 μm voxels), CMOS-CBCT (75 μm voxels), and reference micro-CT (μCT, 15 μm voxels). CBCT bone segmentations were obtained using local Bernsen's thresholding combined with global histogram-based pre-thresholding; μCT segmentation involved Otsu's method. Measurements of trabecular thickness (Tb.Th), spacing (Tb.Sp), number (Tb.N) and bone volume (BV/TV) were performed in registered regions of interest in the segmented CBCT and μCT reconstructions.

Results

CMOS-CBCT achieved noticeably improved delineation of trabecular detail compared to FPD-CBCT. Correlations with reference μCT for metrics of bone microstructure were better for CMOS-CBCT than FPD-CBCT, in particular for Tb.Th (increase in Pearson correlation from 0.84 with FPD-CBCT to 0.96 with CMOS-CBCT) and Tb.Sp (increase from 0.80 to 0.85). This improved quantitative performance of CMOS-CBCT is accompanied by a reduction in scan time, from ~60 sec for a clinical high resolution protocol on FPD-CBCT to ~17 sec for CMOS-CBCT.

Conclusion

The CMOS-based extremity CBCT prototype achieves improved performance in quantification of bone microstructure, while retaining other diagnostic capabilities of its FPD-based precursor, including weight-bearing imaging. The new system offers a promising platform for quantitative imaging of skeletal health in osteoporosis and osteoarthritis.