An exhaled breath gas sensor system for near-infrared ammonia measurement and kidney diagnostics.

Breath analysis enables rapid, noninvasive diagnosis of human health by identifying and quantifying exhaled biomarker. Here, we demonstrated an exhaled breath sensing method using the near-infrared laser spectroscopy, and sub parts-per-million (ppm) level ammonia detection inside the exhaled gas was achieved employing a distributed feedback laser centered at 1512 nm and Kalman filtering algorithm. Integration of the ammonia sensor was realized for exhaled breath analysis of kidney patients, and a dual operation mechanism with static and dynamic modes was proposed to make this method applicable for real-time and comprehensive pre-diagnosis of kidney disease.

Natural language processing pipeline to extract prostate cancer-related information from clinical notes.

OBJECTIVES: To develop an automated pipeline for extracting prostate cancer-related information from clinical notes. MATERIALS AND METHODS: This retrospective study included 23,225 patients who underwent prostate MRI between 2017 and 2022. Cancer risk factors (family history of cancer and digital rectal exam findings), pre-MRI prostate pathology, and treatment history of prostate cancer were extracted from free-text clinical notes in English as binary or multi-class classification tasks. Any sentence containing pre-defined keywords was extracted from clinical notes within one year before the MRI. After manually creating sentence-level datasets with ground truth, Bidirectional Encoder Representations from Transformers (BERT)-based sentence-level models were fine-tuned using the extracted sentence as input and the category as output. The patient-level output was determined by compilation of multiple sentence-level outputs using tree-based models. Sentence-level classification performance was evaluated using the area under the receiver operating characteristic curve (AUC) on 15% of the sentence-level dataset (sentence-level test set). The patient-level classification performance was evaluated on the patient-level test set created by radiologists by reviewing the clinical notes of 603 patients. Accuracy and sensitivity were compared between the pipeline and radiologists. RESULTS: Sentence-level AUCs were ≥ 0.94. The pipeline showed higher patient-level sensitivity for extracting cancer risk factors (e.g., family history of prostate cancer, 96.5% vs. 77.9%, p < 0.001), but lower accuracy in classifying pre-MRI prostate pathology (92.5% vs. 95.9%, p = 0.002) and treatment history of prostate cancer (95.5% vs. 97.7%, p = 0.03) than radiologists, respectively. CONCLUSION: The proposed pipeline showed promising performance, especially for extracting cancer risk factors from patient's clinical notes. CLINICAL RELEVANCE STATEMENT: The natural language processing pipeline showed a higher sensitivity for extracting prostate cancer risk factors than radiologists and may help efficiently gather relevant text information when interpreting prostate MRI. KEY POINTS: When interpreting prostate MRI, it is necessary to extract prostate cancer-related information from clinical notes. This pipeline extracted the presence of prostate cancer risk factors with higher sensitivity than radiologists. Natural language processing may help radiologists efficiently gather relevant prostate cancer-related text information.

CD57 defines a novel cancer stem cell that drive invasion of diffuse pediatric-type high grade gliomas.

BACKGROUND: Diffuse invasion remains a primary cause of treatment failure in pediatric high-grade glioma (pHGG). Identifying cellular driver(s) of pHGG invasion is needed for anti-invasion therapies. METHODS: Ten highly invasive patient-derived orthotopic xenograft (PDOX) models of pHGG were subjected to isolation of matching pairs of invasive (HGGINV) and tumor core (HGGTC) cells. RESULTS: pHGGINV cells were intrinsically more invasive than their matching pHGGTC cells. CSC profiling revealed co-positivity of CD133 and CD57 and identified CD57+CD133- cells as the most abundant CSCs in the invasive front. In addition to discovering a new order of self-renewal capacities, i.e., CD57+CD133- > CD57+CD133+ > CD57-CD133+ > CD57-CD133- cells, we showed that CSC hierarchy was impacted by their spatial locations, and the highest self-renewal capacities were found in CD57+CD133- cells in the HGGINV front (HGGINV/CD57+CD133- cells) mediated by NANOG and SHH over-expression. Direct implantation of CD57+ (CD57+/CD133- and CD57+/CD133+) cells into mouse brains reconstituted diffusely invasion, while depleting CD57+ cells (i.e., CD57-CD133+) abrogated pHGG invasion. CONCLUSION: We revealed significantly increased invasive capacities in HGGINV cells, confirmed CD57 as a novel glioma stem cell marker, identified CD57+CD133- and CD57+CD133+ cells as a new cellular driver of pHGG invasion and suggested a new dual-mode hierarchy of HGG stem cells.

Transcriptional and physiological analyses uncover the mineralization and uptake mechanisms of phytic acid in symbiotically grown Vicia faba plants.

Legume-rhizobia symbiosis requires high phosphorus (P) in the form of ATP to convert atmospheric nitrogen (N) into ammonia. The fixed ammonia is converted to NH4+ by H+-ATPase via protonation. To the best of our knowledge, most of these research works resort to using only inorganic P (Pi) to the neglect of the organic P (Po) counterpart. As it stands, the potential regulating roles of plasma membrane (PM) H+-ATPases during legume-rhizobia symbiosis in response to phytic acid supply and how it alters and modulates the regulation of PM H+-ATPases remain obscure. To contribute to the above hypothesis, we investigate the mechanisms that coordinately facilitate the growth, uptake, and transcript expression of PM H+-ATPase gene isoforms in response to different P sources when hydroponically grown Vicia faba plants were exposed to three P treatments, viz., low- and high-Pi (2.0 and 200 µM KH2PO4; LPi and HPi), and phytic acid (200 µM; Po) and inoculated with Rhizobium leguminosarum bv. viciae 384 for 30 days. The results consistently reveal that the supply of Po improved not only the growth and biomass, but also enhanced photosynthetic parameters, P uptake and phosphatase activities in symbiotically grown Vicia faba relative to Pi. The supply of Po induced higher transcriptional expression of all PM H+-ATPase gene isoforms, with possible interactions between phosphatases and H+-ATPase genes in Vicia faba plants when exclusively reliant on N derived from nodule symbiosis. Overall, preliminary results suggest that Po could be used as an alternative nutrition in symbiotic crops to improve plant growth.

Extracellular vesicles secreted by 3D tumor organoids are enriched for immune regulatory signaling biomolecules compared to conventional 2D glioblastoma cell systems.

Background: Newer 3D culturing approaches are a promising way to better mimic the in vivo tumor microenvironment and to study the interactions between the heterogeneous cell populations of glioblastoma multiforme. Like many other tumors, glioblastoma uses extracellular vesicles as an intercellular communication system to prepare surrounding tissue for invasive tumor growth. However, little is known about the effects of 3D culture on extracellular vesicles. The aim of this study was to comprehensively characterize extracellular vesicles in 3D organoid models and compare them to conventional 2D cell culture systems. Methods: Primary glioblastoma cells were cultured as 2D and 3D organoid models. Extracellular vesicles were obtained by precipitation and immunoaffinity, with the latter allowing targeted isolation of the CD9/CD63/CD81 vesicle subpopulation. Comprehensive vesicle characterization was performed and miRNA expression profiles were generated by smallRNA-sequencing. In silico analysis of differentially regulated miRNAs was performed to identify mRNA targets and corresponding signaling pathways. The tumor cell media and extracellular vesicle proteome were analyzed by high-resolution mass spectrometry. Results: We observed an increased concentration of extracellular vesicles in 3D organoid cultures. Differential gene expression analysis further revealed the regulation of twelve miRNAs in 3D tumor organoid cultures (with nine miRNAs down and three miRNAs upregulated). MiR-23a-3p, known to be involved in glioblastoma invasion, was significantly increased in 3D. MiR-7-5p, which counteracts glioblastoma malignancy, was significantly decreased. Moreover, we identified four miRNAs (miR-323a-3p, miR-382-5p, miR-370-3p, miR-134-5p) located within the DLK1-DIO3 domain, a cancer-associated genomic region, suggesting a possible importance of this region in glioblastoma progression. Overrepresentation analysis identified alterations of extracellular vesicle cargo in 3D organoids, including representation of several miRNA targets and proteins primarily implicated in the immune response. Conclusion: Our results show that 3D glioblastoma organoid models secrete extracellular vesicles with an altered cargo compared to corresponding conventional 2D cultures. Extracellular vesicles from 3D cultures were found to contain signaling molecules associated with the immune regulatory signaling pathways and as such could potentially change the surrounding microenvironment towards tumor progression and immunosuppressive conditions. These findings suggest the use of 3D glioblastoma models for further clinical biomarker studies as well as investigation of new therapeutic options.

Direct Implantation of Patient Brain Tumor Cells into Matching Locations in Mouse Brains for Patient-Derived Orthotopic Xenograft Model Development.

Background: Despite multimodality therapies, the prognosis of patients with malignant brain tumors remains extremely poor. One of the major obstacles that hinders development of effective therapies is the limited availability of clinically relevant and biologically accurate (CRBA) mouse models. Methods: We have developed a freehand surgical technique that allows for rapid and safe injection of fresh human brain tumor specimens directly into the matching locations (cerebrum, cerebellum, or brainstem) in the brains of SCID mice. Results: Using this technique, we successfully developed 188 PDOX models from 408 brain tumor patient samples (both high-and low-grade) with a success rate of 72.3% in high-grade glioma, 64.2% in medulloblastoma, 50% in ATRT, 33.8% in ependymoma, and 11.6% in low-grade gliomas. Detailed characterization confirmed their replication of the histopathological and genetic abnormalities of the original patient tumors. Conclusions: The protocol is easy to follow, without a sterotactic frame, in order to generate large cohorts of tumor-bearing mice to meet the needs of biological studies and preclinical drug testing.

Blending Indigenous and western science: Quantifying cultural burning impacts in Karuk Aboriginal Territory.

The combined effects of Indigenous fire stewardship and lightning ignitions shaped historical fire regimes, landscape patterns, and available resources in many ecosystems globally. The resulting fire regimes created complex fire-vegetation dynamics that were further influenced by biophysical setting, disturbance history, and climate. While there is increasing recognition of Indigenous fire stewardship among western scientists and managers, the extent and purpose of cultural burning is generally absent from the landscape-fire modeling literature and our understanding of ecosystem processes and development. In collaboration with the Karuk Tribe Department of Natural Resources, we developed a transdisciplinary Monte Carlo simulation model of cultural ignition location, frequency, and timing to simulate spatially explicit cultural ignitions across a 264,399-ha landscape within Karuk Aboriginal Territory in northern California. Estimates of cultural ignition parameters were developed with Tribal members and knowledge holders using existing interviews, historical maps, ethnographies, recent ecological studies, contemporary maps, and generational knowledge. Spatial and temporal attributes of cultural burning were explicitly tied to the ecology of specific cultural resources, fuel receptivity, seasonal movement patterns, and spiritual practices. Prior to colonization, cultural burning practices were extensive across the study landscape with an estimated 6972 annual ignitions, averaging approximately 6.5 ignitions per Indigenous fire steward per year. The ignition characteristics we document align closely with data on historical fire regimes and vegetation but differ substantially from the location and timing of contemporary ignitions. This work demonstrates the importance of cultural burning for developing and maintaining the ecosystems present at the time of colonization and underscores the need to work collaboratively with Indigenous communities to restore ecocultural processes in these systems.

Machine learning forecasting of solar PV production using single and hybrid models over different time horizons.

This study uses operational data from a 180 kWp grid-connected solar PV system to train and compare the performance of single and hybrid machine learning models in predicting solar PV production a day-ahead, a week-ahead, two weeks ahead and one month-ahead. The study also analyses the trend in solar PV production and the effect of temperature on solar PV production. The performance of the models is evaluated using R2 score, mean absolute error and root mean square error. The findings revealed the best-performing model for the day ahead forecast to be Artificial Neural Network. Random Forest gave the best performance for the two-week and a month-ahead forecast, while a hybrid model composed of XGBoost and Random Forest gave the best performance for the week-ahead prediction. The study also observed a downward trend in solar PV production, with an average monthly decline of 244.37 kWh. Further, it was observed that an increase in the module temperature and ambient temperature beyond 47 °C and 25 °C resulted in a decline in solar PV production. The study shows that machine learning models perform differently under different time horizons. Therefore, selecting suitable machine learning models for solar PV forecasts for varying time horizons is extremely necessary.

Almond hulls and shells as an alternative fiber source in limit-fed growing beef cattle diets.

Almond hulls and shells are a by-product of almond production that can be incorporated as a feed ingredient in beef cattle diets. Three experiments were conducted to determine the effects of hammermill screen size on almond hull and shell bulk density and inclusion of ground or non-ground almond hulls and shells in limit-fed growing diets on growth performance, diet digestibility, and ruminal fermentation characteristics of beef cattle. In experiment 1, almond hulls and shells were ground with a laboratory-scale hammermill using no screen, a 11.1-mm screen, a 19.1-mm screen, or a 25.4-mm screen. Each screen-size treatment was ground at three separate time points (n= 3 replications/treatment). Grinding almond hulls and shells with no screen increased bulk density by 111% and minimized proportions of fine particles; therefore, almond hulls and shells ground using no screen were included as a treatment in the following experiments. In experiment 2, 364 steers (initial body weight [BW]: 257±â€…20.7 kg) were blocked by truckload (n = 4), stratified by BW, and assigned to pen within block. Pens were randomly assigned to 1 of 4 experimental diets (n= 10 pens/treatment). The control diet (CON) contained (DM basis) 39.5% dry-rolled corn, 7.5% supplement, 40% wet-corn gluten feed, and 13% prairie hay. Non-ground (13AH) or ground (13GAH) almond hulls and shells replaced prairie hay and were fed at 13% of diet DM or non-ground almond hulls and shells were fed at 26% of diet DM and replaced 13% prairie hay and 13% dry-rolled corn (26AH). Diets were limit-fed at 2.2% of BW daily (DM basis) for 56 d. Overall average daily gains (ADG) were greater (P ≤ 0.05) for CON, 13AH, and 13GAH compared with 26AH. In addition, ADG from days 14 to 56 were greater (P= 0.03) for 13GAH and tended to be greater (P = 0.09) for 13AH compared with CON. Experiment 3 was a 4 × 4 replicated Latin square in which 8 ruminally cannulated heifers (initial BW = 378 ±â€…44.0 kg) were fed diets from experiment 2. Apparent dry matter digestibility did not differ (P = 0.21) among treatments. Total ruminal volatile fatty acid concentrations were greater (P ≤ 0.03) for 13GAH and 13AH compared with 26AH and tended (P = 0.06) to be greater for 13GAH compared with CON. Overall, almond hulls and shells can be utilized as an alternative to prairie hay in limit-fed growing diets without negatively influencing rates of gain or diet digestibility.

Image Quality and Radiation Exposure in Abdominal Angiography: A Head-to-Head Comparison of Conventional Detector-Dose-Driven Versus Contrast-to-Noise Ratio-Driven Exposure Control at Various Source-to-Image Receptor Distances and Collimations in a Pilot Phantom and Animal Study.

OBJECTIVES: This phantom and animal pilot study aimed to compare image quality and radiation exposure between detector-dose-driven exposure control (DEC) and contrast-to-noise ratio (CNR)-driven exposure control (CEC) as functions of source-to-image receptor distance (SID) and collimation. MATERIALS AND METHODS: First, an iron foil simulated a guide wire in a stack of polymethyl methacrylate and aluminum plates representing patient thicknesses of 15, 25, and 35 cm. Fluoroscopic images were acquired using 5 SIDs ranging from 100 to 130 cm and 2 collimations (full field of view, collimated field of view: 6 × 6 cm). The iron foil CNRs were calculated, and radiation doses in terms of air kerma rate were obtained and assessed using a multivariate regression. Second, 5 angiographic scenarios were created in 2 anesthetized pigs. Fluoroscopic images were acquired at 2 SIDs (110 and 130 cm) and both collimations. Two blinded experienced readers compared image quality to the reference image using full field of view at an SID of 110 cm. Air kerma rate was obtained and compared using t tests. RESULTS: Using DEC, both CNR and air kerma rate increased significantly at longer SID and collimation below the air kerma rate limit. When using CEC, CNR was significantly less dependent of SID, collimation, and patient thickness. Air kerma rate decreased at longer SID and tighter collimation. After reaching the air kerma rate limit, CEC behaved similarly to DEC. In the animal study using DEC, image quality and air kerma rate increased with longer SID and collimation (P < 0.005). Using CEC, image quality was not significantly different than using longer SID or tighter collimation. Air kerma rate was not significantly different at longer SID but lower using collimation (P = 0.012). CONCLUSIONS: CEC maintains the image quality with varying SID and collimation stricter than DEC, does not increase the air kerma rate at longer SID and reduces it with tighter collimation. After reaching the air kerma rate limit, CEC and DEC perform similarly.

Near-Infrared Off-Axis Cavity-Enhanced Optical Frequency Comb Spectroscopy for CO2/CO Dual-Gas Detection Assisted by Machine Learning.

Cavity-enhanced direct frequency comb spectroscopy (CE-DFCS) is widely used as a highly sensitive gas sensing technology in various gas detection fields. For the on-axis coupling incidence scheme, the detection accuracy and stability are seriously affected by the cavity-mode noise, and therefore, stable operation inevitably requires external electronic mode-locking and sweeping devices, substantially increasing system complexity. To address this issue, we propose off-axis cavity-enhanced optical frequency comb spectroscopy from both theoretical and experimental aspects, which is applied to the detection of single- and dual-gas of carbon monoxide (CO) and carbon dioxide (CO2) in the near-infrared. An erbium-doped fiber frequency comb with a repetition frequency of ∼41.709 MHz is coupled into a resonant cavity with a length of ∼360 mm in an off-axis manner, exciting numerous high-order modes to effectively suppress cavity-mode noise. The performance of multiple machine learning models is compared for the inversion of a single/dual gas concentration. A few absorbance spectra are collected to build a sample data set, which is then utilized for model training and learning. The results demonstrate that the Particle Swarm Optimization Support Vector Machine (PSO-SVM) model achieves the highest predictive accuracy for gas concentration and is ultimately applied to the detection system. Based on Allan deviation, the detection limit for CO in single-gas detection can reach 8.247 parts per million by volume (ppmv) by averaging 87 spectra. Meanwhile, for simultaneous CO2/CO measurement with highly overlapping absorbance spectra, the LoD can be reduced to 13.196 and 4.658 ppmv, respectively. The proposed optical gas sensing technique indicates the potential for the development of a field-deployable and intelligent sensor system capable of simultaneous detection of multiple gases.

Folded-optics-based quartz-enhanced photoacoustic and photothermal hybrid spectroscopy.

Folded-optics-based quartz-enhanced photoacoustic and photothermal hybrid spectroscopy (FO-QEPA-PTS) is reported for the first time. In FO-QEPA-PTS, the detection of the photoacoustic and photothermal hybrid signal is achieved through the use of a custom quartz tuning fork (QTF), thereby mitigating the issue of resonant frequency mismatch typically encountered in quartz-enhanced photoacoustic-photothermal spectroscopy employing multiple QTFs. A multi-laser beam, created by a multi-pass cell (MPC) with a designed single-line spot pattern, partially strikes the inner edge of the QTF and partially passes through the prong of the QTF, thereby generating photoacoustic and photothermal hybrid signals. To assess the performance of FO-QEPA-PTS, 1 % acetylene is selected as the analyte gas and the 2f signals produced by the photoacoustic, the photothermal, and their hybrid effects are measured. Comparative analysis against QEPAS and QEPTS reveals signal gain factors of ∼ 79 and ∼ 14, respectively, when these laser beams created by MPC excite the QTF operating at fundamental resonance mode in phase. In the FO-QEPA-PTS signal, the proportions of the photoacoustic and the photothermal effects induced by the multiple beams are ∼7 % and 93 %, respectively.

Mid-infrared auto-correction on-chip waveguide gas sensor based on 2f/1f wavelength modulation spectroscopy.

Compared to the most commonly used on-chip direct absorption spectroscopy (DAS) gas detection technique, the second harmonic (2f) based on-chip wavelength modulation spectroscopy (WMS) proposed by our group has the faculty to suppress noise and improve performance, but the accuracy of 2f WMS is easily affected by optical power variation. A mid-infrared auto-correction on-chip gas sensor based on 2f/1f WMS was proposed for decreasing the influence of the variation of optical power. The limit of detection of methane (CH4) obtained by a chalcogenide waveguide with a length of 10 mm is 0.031%. Compared with the 2f WMS, the maximum relative concentration error of the auto-correction on-chip gas sensor was decreased by ∼5.6 times. The measurement error is ≤2% in a temperature variation range of 30°C. This auto-correction sensor without a complicated manual calibration is helpful to the high accuracy measurement for on-chip integrated gas sensing.

[Spontaneous retroperitoneal and rectus sheath hematomas and their interventional therapy: a review]. / Spontane retroperitoneale und Rektusscheidenhämatome und ihre interventionelle Therapie: ein Review.

BACKGROUND: Retroperitoneal and rectus sheath hemorrhage (RRSH) has been described as a potentially fatal condition with mortality rates of up to 30 % due to the risk of exsanguination in combination with often nonspecific clinical symptoms. Patients at risk are > 65 years of age as well as those receiving anticoagulation/antiplatelet medicine. Classifications based on etiology consist of trauma, surgery, and/or underlying vascular pathologies, though spontaneous occurrences without precipitating factors have been reported and are expected to increase with the high number of patients undergoing anticoagulant therapy. METHOD: Analysis, summary, and discussion of published review articles and expert recommendations. RESULTS: The most commonly described symptom during clinical examination is abdominal pain. However, depending on the volume loss, clinical symptoms may include signs of abdominal compartment and hemorrhagic shock. Computed tomography angiography (CTA) with high sensitivity and specificity for the presence of active bleeding plays an important role in the detection of RH and RSH. Therapy management is based on different pillars, which include surgical and interventional measures in addition to conservative measures (volume replacement, optimization of coagulation parameters). Due to its lower invasiveness with simultaneously high technical and clinical success rates, interventional therapy in particular has gained increasing importance. CONCLUSION: Diagnostic and therapeutic workup of the patients by an interdisciplinary team is essential for optimal patient care. In case of transcatheter arterial embolization, a standardized approach to the detection of bleeding sites within the vascular territory of the core hematoma appears to favorably influence success and patient outcome. KEY POINTS: · The clinical presentation of retroperitoneal and rectus sheath hematomas can be very heterogeneous and nonspecific. Quick diagnosis is essential due to the relatively high mortality rate (approx. 12-30 %).. · The main risk factors are age > 65 years and the intake of anticoagulants, the use of which has increased 2.5 times in the last 10 years. Coagulopathies, retroperitoneal masses, and hemodialysis are less common causes.. · Computed tomography angiography (CTA) has a high sensitivity and specificity for the presence of active bleeding and has replaced diagnostic subtraction angiography (DSA).. · Treatment should be performed in a multidisciplinary setting with the inclusion of internal medicine, radiology, and surgery. The main indications for embolization are the detection of active contrast extravasation on CTA and the presence of abdominal pain. In cases without active bleeding and with stable vital parameters, conservative treatment measures can be sufficient. Surgical treatment is often reserved for treatment-refractory bleeding with symptoms of abdominal compartment.. · A systematic standardized approach to the detection of bleeding on DSA seems to have advantages regarding technical and clinical success rates.. CITATION FORMAT: · Becker LS, Dewald CLA et al. Spontaneous retroperitoneal and rectus sheath hematomas and their interventional therapy: a review. Fortschr Röntgenstr 2024; 196: 163 - 175.

Classification of Diverticular Disease (CDD) - assessment of the intra- and interobserver agreement in abdominal CT scans.

PURPOSE: Along with ultrasound, computed tomography (CT) is one of the imaging modalities of choice in patients with suspected diverticular disease (DD). Recently, a newer Classification of Diverticular Disease (CDD) has been proposed. However, its reliability in daily radiological practice has never been proven. Therefore, our aim was to evaluate the intra- and interobserver agreement of the CDD in abdominal CT scans. METHODS: In this retrospective study, 481 CT scans of patients with suspected DD were included. Two readers (one board-certified radiologist with 6 years of experience, one 3 rd year radiology resident) individually evaluated all CTs in two reading sessions using the CDD. A composite endpoint of a prior consensus reading, follow-up, and intraoperative findings served as the reference. Intra- and interobserver agreement were calculated using Cohen-k statistic. RESULTS: DD was present in 317 cases (66 %), mostly classified as CDD stage 0, 1b, and 2a (28 %, 30 %, und 14 %). Intraobserver agreement was almost perfect for both readers (kappa 0.93 and 0.88). Interobserver agreement was high and improved from substantial (kappa 0.77) in the first reading session to almost perfect (kappa 0.84) in the second reading session. The interobserver agreement was best for CDD types 0 (diverticulosis) and 2c (free perforated diverticulitis) (mean kappa 0.83 and 0.86) and poorest for CDD types 1a (diverticulitis without phlegmon) and 2b (covered diverticulitis with macroabscess) (mean kappa 0.17 and 0.38). Intra- and interobserver agreement of acute uncomplicated (CDD type 1) and acute complicated diverticulitis (CDD type 2) were substantial to almost perfect (mean kappa 0.63-0.86). Agreement with the reference was almost perfect for both observers (mean kappa 0.86 and 0.82). Administration of rectal contrast did not significantly improve the diagnosis. CONCLUSION: The CDD is a classification based on relatively clear imaging characteristics, which can be readily applied by radiologists with different expertise. In our study, the CDD had a high intra- and interobserver agreement, enabling a reliable therapy-related categorization of DD. KEY POINTS: · The Classification of Diverticular Disease (CDD) is an easy-to-use classification for diverticular disease based on relatively clear image features.. · The CDD can be applied equally by radiologists with different levels of experience in the clinical routine.. · The high intra- and interobserver agreement indicates high reliability in the therapy-relevant classification of diverticulitis on CT..

Mineral and Carbon Metabolic Adjustments in Nodules of Symbiotically Grown Faba Bean (Vicia faba L.) Varieties in Response to Organic Phosphorus Supplementation.

Phosphorus (P) is a major limiting factor for legume and symbiotic nitrogen fixation (SNF). Although overall adaptations of legumes to P supplementation have been extensively studied in connection with inorganic P, little information is currently available regarding nodulation or SNF responses to organic P (Po) in hydroponics. We investigated the mineral and carbon metabolism of Po-induced nodules of two contrasting faba bean varieties grown hydroponically under inorganic P (Pi), viz., in P-deficient (2 µM KH2PO4, -Pi), sufficient-P (200 µM KH2PO4, +Pi), and phytic acid (200 µM, Po) conditions, and were inoculated with Rhizobium leguminosarum bv. viciae 3841 and grown for 30 days. The results consistently reveal similar growth and biomass partitioning patterns between +Pi and Po, with both varying substantially from -Pi. In comparison, +Pi and Po observed equivalent accumulations of overall elemental P concentrations, with both increasing by 114 and 119%, respectively, relative to -Pi. A principal component analysis on metabolites showed a clear separation of the -Pi treatment from the others, with +Pi and Po correlating closely together, highlighting the nonsignificant differences between them. Additionally, the δ15N abundance of shoots, roots, and nodules was not significantly different between treatments and varieties and exhibited negative δ15N signatures for all tissues. Our study provides a novel perspective on mineral and carbon metabolism and their regulation of the growth, functioning, and reprogramming of nodules upon phytate supply.

Clinical practice.

Basal ganglia and thalamus (BGT) hypoxic-ischaemic brain injury is currently the most contentious issue in cerebral palsy (CP) litigation in South Africa (SA), and merits a consensus response based on the current available international literature. BGT pattern injury is strongly associated with a preceding perinatal sentinel event (PSE), which has a sudden onset and is typically unforeseen and unpreventable. Antepartum pathologies may result in fetal priming, leading to vulnerability to BGT injury by relatively mild hypoxic insults. BGT injury may uncommonly follow a gradual-onset fetal heart rate deterioration pattern, of duration ≥1 hour. To prevent BGT injury in a clinical setting, the interval from onset of PSE to delivery must be short, as little as 10 - 20 minutes. This is difficult to achieve in any circumstances in SA. Each case needs holistic, multidisciplinary, unbiased review of all available antepartum, intrapartum and postpartum and childhood information, aiming at fair resolution without waste of time and resources.

Enhancing Indigenous Food Sovereignty and Community Health Through the Karuk Agroecosystem Resilience Initiative: We Are Caring for It: xúus nu'éethti.

Indigenous communities in the United States experience some of the highest rates of food insecurity and diet-related diseases despite an abundance of food assistance programs and other public health interventions. New approaches that center Indigenous perspectives and solutions are emerging and urgently needed to better understand and address these challenges. This Practice Note shares lessons learned from ongoing collaboration between the Karuk Tribe and University of California, Berkeley researchers and other partners to assess and enhance food sovereignty among Tribes and Tribal communities in the Klamath River Basin. Through two participatory research and extension projects, we demonstrate the importance of centering Indigenous knowledge to strengthen research findings and identify more culturally appropriate solutions to community identified food access, health, and ecosystem challenges. Key findings suggest that approaches to food sovereignty and community health must emanate from the community, be approached holistically, reflect community values and priorities, and center Indigenous land stewardship.

A Clinical Review of Mesenteric Panniculitis.

Mesenteric panniculitis (MP) is a benign condition characterized by chronic inflammation and fibrosis of adipose tissue mainly of the small bowel mesentery. MP is commonly detected incidentally on cross-sectional imaging of the abdomen and can be asymptomatic in up to nearly half of patients. The most frequent clinical symptom reported is abdominal pain, followed by bloating/distention, diarrhea, constipation, vomiting, anorexia, weight loss, fever, malaise, and nausea. On computed tomography, MP is seen as a mass-like area of increased fat attenuation within the small bowel mesentery, usually located in the left upper quadrant of the abdomen. This mass-like area envelops mesenteric vessels and displaces adjacent bowel segments. Lymph nodes are frequently seen within the area of mesenteric abnormality. One of the most common differential diagnoses of MP is lymphoma, and positron emission tomography/computed tomography may be performed if there is suspicion of a concurrent underlying malignancy. Because of the benign nature of MP, treatment decisions should be guided by severity of symptoms and presence of complications. First-line medical treatment is prednisone and tamoxifen. Surgery is reserved for cases of recurrent bowel obstruction. This article provides a review of MP, including its epidemiology, pathophysiology, clinical presentation, imaging findings, and treatment.