Assessing breast arterial calcification in mammograms and its implications for atherosclerotic cardiovascular disease risk.

PURPOSE: Breast arterial calcifications (BAC) are incidentally observed on mammograms, yet their implications remain unclear. We investigated lifestyle, reproductive, and cardiovascular determinants of BAC in women undergoing mammography screening. Further, we investigated the relationship between BAC, coronary arterial calcifications (CAC) and estimated 10-year atherosclerotic cardiovascular (ASCVD) risk. METHODS: In this cross-sectional study, we obtained reproductive history and CVD risk factors from 215 women aged 18 or older who underwent mammography and cardiac computed tomographic angiography (CCTA) within a 2-year period between 2007 and 2017 at hospital. BAC was categorized as binary (present/absent) and semi-quantitatively (mild, moderate, severe). CAC was determined using the Agatston method and recorded as binary (present/absent). Adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated, accounting for age as a confounding factor. ASCVD risk over a 10-year period was calculated using the Pooled Cohort Risk Equations. RESULTS: Older age, systolic and diastolic blood pressures, higher parity, and younger age at first birth (≤28 years) were significantly associated with greater odds of BAC. Women with both BAC and CAC had the highest estimated 10-year risk of ASCVD (13.30 %). Those with only BAC (8.80 %), only CAC (5.80 %), and no BAC or CAC (4.40 %) had lower estimated 10-year risks of ASCVD. No association was detected between presence of BAC and CAC. CONCLUSIONS: These findings support the hypothesis that BAC on a screening mammogram may help to identify women at potentially increased risk of future cardiovascular disease without additional cost and radiation exposure.

Unilateral axillary adenopathy in the setting of COVID-19 vaccine: Follow-up.

With the Pfizer-BioNTech, Moderna, and now Johnson and Johnson COVID-19 vaccines readily available to the general population, the appearance of vaccine-induced axillary adenopathy on imaging has become more prevalent. We are presenting follow up to the first reported four cases of vaccine induced unilateral axillary adenopathy on imaging to our knowledge, which demonstrate expected self-resolving adenopathy. Our hope is that by providing this follow-up and reviewing current management guidelines, clinicians as well as patients will appreciate that this is an expected, benign, and self-resolving finding. In addition, we hope to quell any vaccine hesitancy brought about by recent mainstream media attention to this topic and ultimately empower patients to receive both the COVID-19 vaccine and undergo routine screening mammography, as both are vital to their health.

Unilateral axillary Adenopathy in the setting of COVID-19 vaccine.

With the recent U.S. Food and Drug Administration (FDA)-approval and rollout of the Pfizer-BioNTech and Moderna COVID-19 vaccines, it is important for radiologists to consider recent COVID-19 vaccination history as a possible differential diagnosis for patients with unilateral axillary adenopathy. Hyperplastic axillary nodes can be seen on sonography after any vaccination but are more common after a vaccine that evokes a strong immune response, such as the COVID-19 vaccine. As the differential of unilateral axillary adenopathy includes breast malignancy, it is crucial to both thoroughly evaluate the breast for primary malignancy and to elicit history of recent vaccination. As COVID-19 vaccines will soon be available to a larger patient population, radiologists should be familiar with the imaging features of COVID-19 vaccine induced hyperplastic adenopathy and its inclusion in a differential for unilateral axillary adenopathy. Short-term follow-up for unilateral axillary adenopathy in the setting of recent COVID-19 vaccination is an appropriate recommendation, in lieu of immediately performing potentially unnecessary and costly axillary lymph node biopsies.

Crohn's pericarditis identified with point-of-care ultrasonography: A case report.

We report the case of a 71-year-old male with Crohn's disease, shortness of breath, and chest pain that highlights cardiac involvement in inflammatory bowel disease and the role of point-of-care ultrasonography using an alternate cardiac ultrasound window in making the diagnosis of Crohn's pericarditis. The role of ultrasonography in diagnosis and management of inflammatory bowel disease focuses primarily on intestinal pathology. Cardiac involvement is a rare but clinically impactful extraintestinal manifestation, the diagnosis of which benefits from ultrasonography if the clinician performing and interpreting the exam is aware of the possibility and understands the potential value of whole-body ultrasonography as part of a physical exam.

Performance of 2D Synthetic Mammography Versus Digital Mammography in the Detection of Microcalcifications at Screening.

OBJECTIVE. The purpose of this study is to compare the performance of 2D synthetic mammography (SM) to that of full-field digital mammography (FFDM) in the detection of microcalcifications and to evaluate radiologists' preference between the two imaging modalities for assessing calcifications. MATERIALS AND METHODS. A fully crossed, mode-balanced, paired-case (n = 160), retrospective, multireader (n = 3) performance study was implemented to compare screening mammograms acquired with digital breast tomosynthesis and both FFDM and SM between 2015 and 2017. The study cohort included 70 patients with mammograms recalled for microcalcifications (35 with malignant findings and 35 with benign findings) and was supplemented with 90 patients with mammograms with negative findings. In separate sessions, readers interpreted SM or FFDM images by recording a BI-RADS assessment and the probability of malignancy. In a final session that included 70 mammograms with microcalcifications, readers recorded their subjective assessment of microcalcification conspicuity and diagnostic confidence. RESULTS. There was no difference in diagnostic accuracy as assessed by comparing the likelihood of malignancy based on the AUC of plotted ROCs, with AUCs of 91% (95% CI, 83-97%) and 88% (95% CI, 79-95%) observed for SM and FFDM, respectively (p = 0.392), and with noninferiority of SM compared with FFDM (p = 0.011). No significant difference was observed between SM and FFDM in terms of sensitivity (77% vs 73%, respectively; p = 0.366) or negative predictive value (84% vs 82%, respectively; p = 0.598). The specificity and positive predictive value of SM were lower than those of FFDM (91% vs 98%, respectively [p = 0.034], and 87% vs 96%, respectively [p = 0.034]). All readers found calcifications to be more conspicuous on SM (p < 0.0001); however, no significant difference in subjective diagnostic confidence was seen. CONCLUSION. SM is noninferior to FFDM in the detection of microcalcifications. Despite the increased conspicuity of microcalcifications on SM, the subjective diagnostic confidence in the two modalities is comparable.

Structural changes from heating amber and copal as observed by nuclear magnetic resonance spectroscopy.

Structural changes caused by heating of fossilized (amber) and semifossilized (copal) resins have been examined by nuclear magnetic resonance spectroscopy. A set of 28 samples was constituted to include different geographical sources, degrees of maturation, colors, and structural groupings. The onset of structural alterations was determined by observation of the lowest temperature at which spectral changes occurred. Both proton spectra in solution and carbon-13? spectra in the solid state then were recorded of cooled samples after heating for 12 hr at temperature increments, until liquification of the sample began. The spectra of both nuclides exhibit loss of a few peaks, broadening of most peaks, and enhancement of the unsaturated or aromatic region at the expense of saturated resonances. Such changes are irreversible and lead to a harder and less soluble material on cooling. The changes parallel those that occur with maturation of fossil resins or materials that lead to coal.

Software tool for internal standard based normalization of lipids, and effect of data-processing strategies on resulting values.

BACKGROUND: Lipidomics, the comprehensive measurement of lipids within a biological system or substrate, is an emerging field with significant potential for improving clinical diagnosis and our understanding of health and disease. While lipids diverse biological roles contribute to their clinical utility, the diversity of lipid structure and concentrations prove to make lipidomics analytically challenging. Without internal standards to match each lipid species, researchers often apply individual internal standards to a broad range of related lipids. To aid in standardizing and automating this relative quantitation process, we developed LipidMatch Normalizer (LMN) http://secim.ufl.edu/secim-tools/ which can be used in most open source lipidomics workflows. RESULTS: LMN uses a ranking system (1-3) to assign lipid standards to target analytes. A ranking of 1 signifies that both the lipid class and adduct of the internal standard and target analyte match, while a ranking of 3 signifies that neither the adduct or class match. If multiple internal standards are provided for a lipid class, standards with the closest retention time to the target analyte will be chosen. The user can also signify which lipid classes an internal standard represents, for example indicating that ether-linked phosphatidylcholine can be semi-quantified using phosphatidylcholine. LMN is designed to work with any lipid identification software and feature finding software, and in this study is used to quantify lipids in NIST SRM 1950 human plasma annotated using LipidMatch and MZmine. CONCLUSIONS: LMN can be integrated into an open source workflow which completes all data processing steps including feature finding, annotation, and quantification for LC-MS/MS studies. Using LMN we determined that in certain cases the use of peak height versus peak area, certain adducts, and negative versus positive polarity data can have major effects on the final concentration obtained.

Accuracy of Synthetic 2D Mammography Compared With Conventional 2D Digital Mammography Obtained With 3D Tomosynthesis.

OBJECTIVE. The purpose of this study was to compare the diagnostic performance of synthetic 2D imaging generated from 3D tomosynthesis (DBT) with traditional 2D full-field digital mammography (FFDM) by use of the most up-to-date software algorithm in an urban academic radiology practice. MATERIALS AND METHODS. The records of patients undergoing screening mammography with DBT, synthetic 2D imaging, and FFDM between August 13, 2014, and January 31, 2016, were retrospectively collected. The cohort included all biopsy-proven breast cancers detected with screening mammography during the study period (n = 89) and 100 cases of negative or benign (BI-RADS category 1 or 2) findings after 365 days of follow-up. In separate sessions, three readers blinded to outcome reviewed DBT plus synthetic 2D or DBT plus FFDM screening mammograms and assigned a BI-RADS category and probability of malignancy to each case. The diagnostic performance of each modality was assessed by calculating sensitivity and specificity. Reader performance was assessed by ROC analysis to estimate the AUC of the likelihood of malignancy. RESULTS. No statistically significant difference was found in diagnostic accuracy (sensitivity, specificity, positive predictive value, or negative predictive value) between DBT plus synthetic 2D mammography and DBT plus FFDM. There was no statistically significant difference between the AUC of DBT plus synthetic 2D mammography and the AUC of DBT plus FFDM for any reader. CONCLUSION. DBT plus synthetic 2D mammography performs as well as and not worse than DBT plus FFDM in measures of diagnostic accuracy and may be a viable alternative for decreasing radiation dose without sacrificing diagnostic performance.

A quantitative review of overjustification effects in persons with intellectual and developmental disabilities.

The overjustification hypothesis suggests that extrinsic rewards undermine intrinsic motivation. Extrinsic rewards are common in strengthening behavior in persons with intellectual and developmental disabilities; we examined overjustification effects in this context. A literature search yielded 65 data sets permitting comparison of responding during an initial no-reinforcement phase to a subsequent no-reinforcement phase, separated by a reinforcement phase. We used effect sizes to compare response levels in these two no-reinforcement phases. Overall, the mean effect size did not differ from zero; levels in the second no-reinforcement phase were equally likely to be higher or lower than in the first. However, in contrast to the overjustification hypothesis, levels were higher in the second no-reinforcement phase when comparing the single no-reinforcement sessions immediately before and after reinforcement. Outcomes consistent with the overjustification hypothesis were somewhat more likely when the target behavior occurred at relatively higher levels prior to reinforcement.

Examination of amber and related materials by NMR spectroscopy.

Examination of the solid-state (13)C and solution (1)H NMR spectra of fossilized resins (ambers) has generated five groupings of materials based on spectral characteristics. The worldwide Group A is associated with the botanical family of the Araucariaceae. The worldwide Group B is associated with the Dipterocarpaceae. Baltic amber or succinite (Group C) is related to Group A but with a disputed conifer source. Amber from Latin America, the Caribbean, and Africa is associated with the Fabaceae, the genus Hymenaea in particular. The minor Group E contains the rare fossil polystyrene. The spectra of jet indicate that it is a coal-like material with a rank between lignite and sub-bituminous coal.

Hidradenitis suppurativa: Mammographic and sonographic manifestations in two cases.

Hidradenitis suppurativa is a chronic debilitating disorder of the skin manifested by recurrent, painful, inflammatory, subcutaneous nodules. The lesions occur most commonly in the apocrine-gland-bearing skin sites such as the axillae and inguinal regions; they cause scarring and disfigurement from the formation of multiple abscesses and fistulous tracts within the skin. We report the radiologic manifestations of two cases of hidradenitis suppurativa in women who presented for breast imaging.

Suppression-induced forgetting on a free-association test.

The repeated suppression of thoughts in response to cues for their expression leads to forgetting on a subsequent test of cued recall (Anderson & Green, 2001). We extended this effect by using homograph cues and presenting them for free association following suppression practice. Cue-target pairs were first learned under integrating imagery instructions; then in the think/no-think phase students practised suppressing thoughts connected to some homograph cues, with or without the assistance of thought substitutes that changed their meaning. Below-baseline forgetting on the subsequent free-association test was found in the production of suppressed targets. Following aided suppression this effect was also obtained in the production of other responses denoting the target-related meaning of the homograph cues. Discussion emphasises the ecological value of the test; rarely do people deliberately attempt recall of unwanted thoughts.