Development of matrix-specific standards for LA-ICP-MS zinc analysis in sand flathead (Platycephalus bassensis).

The use of laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) to analyse soft tissues is limited because of the lack of suitable certified reference materials resulting in difficulties with calibration. In this study, several laboratory-prepared thin agarose sections were tested as matrix-specific standards. Our results showed 1 mm thin agarose sections were suitable as calibration standards for LA-ICP-MS Zn analyses in fish muscle, especially when the signal intensity of 66Zn was normalised to 13C. The thin agarose standard sections were used for LA-ICP-MS Zn analyses in the muscle of melanised and non-melanised sand flathead collected from a polluted estuary and assigned with different melanisation scores. Zn levels in melanised regions of fish muscle were determined to be significantly higher than non-melanised regions across all melanisation scores, though Zn levels in the melanised regions of muscle were not significantly different between sand flathead with different melanisation scores. In non-melanised regions of muscle from fish with melanisation and fish unaffected by melanisation, Zn levels were around baseline levels. Overall, this study has successfully developed matrix-specific standards for LA-ICP-MS analysis of soft tissues, thus allowing broader application of this analytical technique in future environmental pollution studies.

Gender-Based Survey Analysis of Research and Mentoring in Interventional Radiology.

PURPOSE: This study sought to define gender-related differences in attitudes, perceptions, and aspirations among trainees interested in interventional radiology (IR) and to analyze their experiences in research and mentorship. MATERIALS AND METHODS: A cross-sectional survey study was conducted among the members of the Society of Interventional Radiology Resident, Fellow, and Student section and Medical Student section in the summer of 2020. The anonymous, internally validated 27-item survey assessed demographics, research attitudes and experiences, mentorship, and career aspirations. Descriptive statistics were calculated using Fisher exact analyses and Student t-tests. The institutional review board approved the protocols for this study. RESULTS: Of 105 respondents who indicated their gender, 30% were women and 70% were men. Although both genders reported similar levels of research experience, female trainees were less likely to feel valued and encouraged by their institution to engage in research (2.79 out of 4 vs 3.16 out of 4, P = .02) and were less likely to indicate that their program required them to participate in research (2.47 vs 3.06, P = .01). Female residents and fellows reported more difficulty in finding a mentor (2.88 vs 3.28, P = .04) and received less mentorship relating to IR education (29% vs 64%, P = .002). CONCLUSIONS: This work provides a perspective on the perceived obstacles faced by female trainees in pursuing research and finding effective mentorship in the field of IR. These data may guide future interventions to boost interest and engagement in IR research and residency programs in a way that promotes gender diversity and equity in the field.

The use of image analysis techniques for the study of muscle melanisation in sand flathead (Platycephalus bassensis).

Muscle melanisation in sand flathead is visible as black spots in the normally white flesh of fish. It is widespread in Tasmania, including at the Tamar Estuary, with increasing frequency of reporting by recreational fishers. The phenomenon is more prevalent in areas impacted by heavy metal pollution and has been linked to heavy metal accumulation. In this study, image processing software ImageJ was employed to study the phenomenon and to establish an objective rating system. A longitudinal profile plot was used to study the greying of the fillet. The degree of melanisation was rated based on the percentage surface area melanised on the surface and in transverse sections of fillets. A muscle melanisation scoring system for sand flathead was established based on visual interpretation using the macroscopic melanisation scoring criteria: melanisation scores 0 = <0.5%, 1 = 0.5-5%, 2 = 5-20%, and 3 = >20% (% = melanised surface area in proportion to the whole fillet). A refined image analysis technique was developed to quantify the percentage of melanised muscle surface area and the muscle melanisation scoring system was statistically validated. Sand flathead fillet with higher melanisation score was shown to be linked to increased intensity of greyness and greater numbers and size of black spots on the surface of fillets and within the flesh. The greying and black spots were primarily concentrated at the anterior region of fillet and around the dorsal vertebrae zone on transverse section of fillets. Overall, findings from this study established the use of image analysis techniques to validate visual inspection and to give a standardised and objective method to determine the degree of melanisation in sand flathead. As muscle melanisation appears to be linked to heavy metal pollution, the standardised scoring system would facilitate future research for environmental pollution and monitoring purposes.

ICON 2020-International Scientific Tendinopathy Symposium Consensus: A Systematic Review of Outcome Measures Reported in Clinical Trials of Achilles Tendinopathy.

BACKGROUND: Nine core domains for tendinopathy have been identified. For Achilles tendinopathy there is large variation in outcome measures used, and how these fit into the core domains has not been investigated. OBJECTIVE: To identify all available outcome measures outcome measures used to assess the clinical phenotype of Achilles tendinopathy in prospective studies and to map the outcomes measures into predefined health-related core domains. DESIGN: Systematic review. DATA SOURCES: Embase, MEDLINE (Ovid), Web of Science, CINAHL, The Cochrane Library, SPORTDiscus and Google Scholar. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Clinical diagnosis of Achilles tendinopathy, sample size ≥ ten participants, age ≥ 16 years, and the study design was a randomized or non-randomized clinical trial, observational cohort, single-arm intervention, or case series. RESULTS: 9376 studies were initially screened and 307 studies were finally included, totaling 13,248 participants. There were 233 (177 core domain) different outcome measures identified across all domains. For each core domain outcome measures were identified, with a range between 8 and 35 unique outcome measures utilized for each domain. The proportion of studies that included outcomes for predefined core domains ranged from 4% for the psychological factors domain to 72% for the disability domain. CONCLUSION: 233 unique outcome measures for Achilles tendinopathy were identified. Most frequently, outcome measures were used within the disability domain. Outcome measures assessing psychological factors were scarcely used. The next step in developing a core outcome set for Achilles tendinopathy is to engage patients, clinicians and researchers to reach consensus on key outcomes measures. PROSPERO REGISTRATION: CRD42020156763.

Mentorship in Interventional Radiology: Addressing Obstacles to Pursuing Research and Innovation Among IR Trainees.

RATIONALE AND OBJECTIVES: To ascertain the perceived obstacles that medical students and Interventional Radiology (IR) residents face performing IR research during training and incorporating research into their future careers. MATERIALS AND METHODS: The study was reviewed and exempt from Institutional Review Board review. Participants' attitudes and perceived barriers toward performing IR research, and experience with mentorship in IR were assessed using a 27-item survey sent to all members of the Society of Interventional Radiology Resident, Fellow and Student (SIR-RFS, n = 445), and Medical Student Council (SIR-MSC, n = 267) sections between July and September 2020. Descriptive statistics were computed for all assessed categorical variables. Fisher's exact tests were performed to measure the significance of association between categorical variables. RESULTS: Of the 712 students and residents surveyed, 151 (∼21%) responded. Of respondents, 100% reported that conducting research is important to advancing the field of IR. The highest ranked factors and obstacles to performing IR research were increased clinical demands (67.9%), lack of time (46.2%), lack of institutional support (41.5%), and lack of research experience (35.8%). Interestingly, those with a mentor were more likely to report an interest in pursuing a career in IR compared to those without a mentor (98.6% vs 41.0%, p < 0.0001). Furthermore, those with a mentor were more likely to report an interest in pursuing IR research compared to those without a mentor (32.5% vs 14.4%, p < 0.0001). CONCLUSION: There are many obstacles to performing IR research. Strong mentorship is an avenue to address these deterrents. The deployment of mentorship programs in IR is needed to ensure trainees can overcome the barriers outlined in this study and successfully pursue research careers in IR.

Interrelation between sulphur and conductive materials and its impact on ammonium and organic pollutants removal in electroactive wetlands.

This investigation is the first of its kind to evaluate the interrelation of sulphate (SO42-) with conductive materials as well as their individual and synergetic effects on the removal of ammonium and organic pollutants in electroactive wetlands, also known as constructed wetland (CW) - microbial fuel cell (MFC). The role of MFC components in CW was investigated to treat the sulphate containing wastewater under a long-term operation without any toxicity build-up in the system. A comparative study was also performed between CW-MFC and CW, where sulphate containing wastewater (S-replete) and without sulphate wastewater (S-deplete) was assessed. The S-replete showed high NH4+ removal than the S-deplete, and the requesnce of removal was: CW-MFC-replete>CW-MFC-deplete>CW-replete>CW-deplete. The chemical oxygen demand (COD) removal was high in the case of CW-MFC-replete, and the sequence of removal was CW-MFC-replete>CW-MFC-deplete>CW-deplete>CW-replete. X-ray photon spectroscopic study indicates 0.84% sulphur accumulation in CW-MFC-replete and 2.49% in CW-replete, indicating high sulphur precipitation in CW without the MFC component. The high relative abundance of class Deltaproteobacteria (7.3%) in CW-MFC-replete along with increased microbial diversity (Shannon index=3.5) rationalise the symbiosis of sulphate reducing/oxidising microbes and its impact on the treatment performance and electrochemical activity.

Influence of applied potential on treatment performance and clogging behaviour of hybrid constructed wetland-microbial electrochemical technologies.

A two-stage hybrid Constructed Wetland (CW) integrated with a microbial fuel cell (MFC), and microbial electrolysis cell (MEC) has been assessed for treatment performance and clogging assessment and further compared with CW. The CW-MEC was operated with applied potential to the working electrode and compared with the performance of naturally adapted redox potential of the CW-MFC system. A complex synthetic municipal wastewater was used during the study, which was composed of trace metals, organics, inorganics, and dye. The study demonstrated that providing a constant potential to the working electrode in CW-MEC has resulted in high treatment performance and reduced sludge generation. The maximum chemical oxygen demand (COD), ammonium (NH4+), and phosphate (PO43-) removal achieved during treatment by CW-MEC at 24 h hydraulic retention time was 89 ± 6%, 72 ± 6% and 93 ± 2%, respectively. ICP-MS results indicated that trace metal removals were also higher in CW-MEC than in CW alone (p < 0.05). At the end of the experiment, significant volumetric change (total volume of the microcosm) occurred in CW (1.3 L), which indicates high sludge generation, whereas it was lesser in CW-MEC (0.3 L) and in CW-MFC (0.5 L). Further, Energy Dispersive X-ray (EDX) spectroscopy results indicated low levels of metal precipitation in the CW-MEC system. Based on the Shannon diversity index, the CW-MEC was assessed to be characterised by high species richness and diversity. The observations from this study indicate that the applied potential at the working electrode has a significant impact on treatment performance and clogging behaviour of the system.

Recent advances in stir-bar sorptive extraction: Coatings, technical improvements, and applications.

Stir-bar sorptive extraction (SBSE) is a popular solvent-less sample preparation method, which is widely applied for the sampling and preconcentration of a wide range of non-polar solutes. A typical stir-bar for SBSE is composed of a polydimethylsiloxane (PDMS) film, coated onto a glass jacket with an incorporated magnet core. Sampling is carried out by direct immersion or by exposing the stir-bar to the headspace of the sample. To-date the majority of reported SBSE devices have used PDMS as the sorbent, with a few alternative commercially SBSE coatings available (such as polyethylene glycol and polyacrylate), which limits the applicability of SBSE to more polar and hydrophilic solutes. The interest in more selective extraction has been the driving force behind the recent development of novel SBSE coatings, particularly those exhibiting selectivity towards more polar solutes. During the last decade, a significant number of novel SBSE coatings were introduced utilising different fabrication approaches, including surface adhesion, molecular imprinting, sol-gel technology, immobilised monoliths, and solvent exchange processes. A range of nano- and micro-carbon-based materials, functional polymers, metal organic frameworks (MOFs), and inorganic nanoparticles have been employed for this purpose. Some of these SBSE coatings have exhibited higher thermal and chemical stability and delivered wider selectivity profiles. This review aims to summarise these significant developments, reported over the past six years, with specific attention to novel materials and selectivity for extending the potential applications of SBSE.

Type a botulinum toxin in the management of spontaneous salivary otorrhea: a case report.

BACKGROUND: Spontaneous salivary otorrhea is a rare presentation only previously documented twice in literature where parotid salivary secretions are found in the external auditory canal. Conventional treatment of spontaneous parotid salivary fistulas includes surgical management with interposed grafts, fistula tract ablation, and possible superficial parotidectomy. Associated risks include facial nerve injury, Frey syndrome and facial scarring. Here we report the first case of spontaneous salivary otorrhea conservatively managed with a type A botulinum toxin (BTA) injection. CASE PRESENTATION: A 17-year-old female presented with a 5-month history of left sided otorrhea and transient left facial swelling associated with gustatory stimulation. The otorrhea fluid tested positive for salivary amylase and negative for beta 2 transferrin. Fifty units of BTA were injected into the left parotid gland under ultrasound guidance. Cessation of symptoms was achieved 3 weeks after intervention. The patient remains symptom-free at the 2 year follow up. CONCLUSION: BTA injection was well tolerated under ultrasound guidance and has led to long-term resolution of the patient's symptoms. BTA injection appears to be a safe and effective way to conservatively manage this rare presentation of spontaneous salivary otorrhea.

Patient with rheumatoid arthritis with deep vein thrombosis presenting as a calf strain: a case report.

BACKGROUND: Patients with rheumatoid arthritis experience various comorbidities, including cardiovascular disease. More data and awareness exist regarding the adverse effects of rheumatoid arthritis affecting the arterial side of the cardiovascular system, such as stroke or myocardial infarction, than regarding adverse venous complications, such as deep vein thrombosis and pulmonary embolism. Rheumatoid arthritis affects more women than men, and the risk of venous thromboembolism in rheumatoid arthritis tends to increase with age; therefore, the presentation in this case report of deep vein thrombosis in a nonsmoking, young, fit man with rheumatoid arthritis is rare. This patient was sent away from a minor injuries unit with a diagnosis of a calf strain. Further assessment at an accident and emergency department later in the day confirmed deep vein thrombosis via ultrasonography. This case report underlines the need for vigilance because deep vein thrombosis is a risk factor in rheumatoid arthritis, even in young, male, and physically fit individuals. CASE PRESENTATION: A nonsmoking 39-year-old Caucasian man with a 2-year history of rheumatoid arthritis presented for assessment at a private physiotherapy clinic with a 4-week history of right-sided posterior calf pain that had developed following exercise at a gym. The patient therefore believed his symptoms were due to a calf strain. Findings at physiotherapy assessment suggested that the actual cause of the patient's symptoms were as a result of deep vein thrombosis. The patient was directed to a local minor injuries unit with a referral letter from the author outlining this diagnosis. Following clinical assessment at the minor injuries unit, the patient was told that there was no likelihood of deep vein thrombosis, and his diagnosis was a calf strain. The patient harbored concerns at this point and decided to seek further medical opinion at a nearby accident and emergency department, where deep vein thrombosis was diagnosed using ultrasonography, and the patient was commenced on anticoagulants. CONCLUSIONS: Venous thromboembolism risk in rheumatoid arthritis is stated as being less recognized as an arterial complication. This is borne out by this patient's clinical journey, wherein his youth, fitness, athletic appearance, and onset of symptoms during exercise were said to suggest a diagnosis of a calf strain at a minor injuries unit. Ultrasonography at a different accident and emergency unit later that day ultimately was used to diagnose deep vein thrombosis.

Transitioning the IR Clinic to Telehealth: A Single-Center Experience during the COVID-19 Pandemic.

Telehealth has not previously been widely implemented as a result of regulatory and reimbursement concerns; however, in the current national emergency of the COVID-19 pandemic, the Centers for Medicare and Medicaid Services has relaxed many of its rules, allowing increased adoption of telehealth services, improving the safety and access of outpatient health care. A complete understanding of the regulatory requirements, technologic options, and billing processes of telehealth is required to initiate a successful clinic. A model is presented here based on a single institution's experience with implementing telehealth in the outpatient interventional radiology clinic.

Does glucocorticoid exposure explain the association between metabolic dysfunction and tendinopathy?

BACKGROUND: While metabolic health is acknowledged to affect connective tissue structure and function, the mechanisms are unclear. Glucocorticoids are present in almost every cell type throughout the body and control key physiological processes such as energy homeostasis, stress response, inflammatory and immune processes, and cardiovascular function. Glucocorticoid excess manifests as visceral adiposity, dyslipidaemia, insulin resistance, and type 2 diabetes. As these metabolic states are also associated with tendinopathy and tendon rupture, it may be that glucocorticoids excess is the link between metabolic health and tendinopathy. OBJECTIVE: To synthesise current knowledge linking glucocorticoids exposure to tendon structure and function. METHODS: Narrative literature review. RESULTS: We provide an overview of endogenous glucocorticoid production, regulation, and signalling. Next we review the impact that oral glucocorticoid has on risk of tendon rupture and the effect that injected glucocorticoid has on resolution of symptoms. Then we highlight the clinical and mechanistic overlap between tendinopathy and glucocorticoid excess in the areas of visceral adiposity, dyslipidaemia, insulin resistance and type 2 diabetes. In these areas, we highlight the role of glucocorticoids and how these hormones might underpin the connection between metabolic health and tendon dysfunction. CONCLUSIONS: There are several plausible pathways through which glucocorticoids might mediate the connection between metabolic health and tendinopathy.

Electrode dependent anaerobic ammonium oxidation in microbial fuel cell integrated hybrid constructed wetlands: A new process.

This study provides a new approach of electrode dependent anaerobic ammonium oxidation (electroanammox) in microbial fuel cell (MFC) integrated hybrid constructed wetlands (CWs). The study was carried out in three CWs, each with a horizontal flow (HF) followed by a vertical upflow (VUF). Two of the CWs were integrated with MFC, one was operated in closed circuit (CL) mode and the other in open circuit (OP) mode to determine the influence of electron transfer through an external electrical circuit. The initial nitrogen and carbon concentration were 40 mg/l and 880 mg/l respectively. The total nitrogen (TN), NH4+-N, TOC and COD removal achieved in CW-MFC-CL were 90.0 ±â€¯1.15%, 94.4 ±â€¯0.75%, 64.8 ±â€¯3.0% and up to 99.5 ±â€¯3.4%, respectively. The TN and NH4+-N removal in CW-MFC-CL was 20.0% and 13.6% higher than normal CW. Maximum current density achieved in CW-MFC-HF was of 75 mA/m3 and in CW-MFC-VUF was 156 mA/m3. Furthermore, the study revealed that even at low microbiological biomass, an MFC integrated CW operating in closed circuit gave higher removal of NH4+-N and COD than the normal CW and open circuit CW-MFC. Microbiological analysis shows the presence of already known nitrifier and denitrifer which indicates their role in electrode dependent nitrogen removal.

Enhanced chromium(VI) treatment in electroactive constructed wetlands: Influence of conductive material.

A constructed wetland (CW) microcosm based on conductive graphite gravel was investigated for hexavalent chromium (Cr(VI)) treatment from synthetic wastewater. Its performance was evaluated and compared with a traditional gravel-based CW microcosm. The microcosms were operated at varying initial Cr(VI) concentrations (5-20 mg/L) and hydraulic retention times (HRT) (3-7.5 h). Near complete treatment (99.9 ±â€¯0.06 %) was achieved in the graphite-based microcosm throughout the experiment. The performance was consistently high throughout with 42.9 % improvement in Cr (VI) treatment compared to a traditional gravel microcosm. Scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM-EDX) analysis indicated that chromium was adsorbed to microbial biofilms. Moreover, microbial diversity profiling suggested that the microbial population in both microcosms differed in diversity and communities. The results suggest that the use of conductive materials in CW significantly enhances the treatment of Cr(VI) and more importantly, allows microbial activity even at high levels of Cr(VI) in the CW.

Development of polydimethylsiloxane-microdiamond composite materials for application as sorptive devices.

The development and application of non-porous and porous sorptive rods, comprised of polydimethylsiloxane-microdiamond (PDMS-MD) composites, is reported. The PDMS-MD composites were made porous using inorganic salt (NaCl and NaHCO3) particles as dissolvable templates. Materials with pore size of ~40 µm down to ~5 µm were produced. The advantages of incorporating up to ~60%microdiamond (2-4 µm) into PDMS included: (1) significant increase in the density, which saw the rods sink within the aqueous sample without addition of secondary metal or glass materials, (2) significant improvement in mechanical stability (the porous composite rods could be thermally treated multiple times before application, unlike porous PDMS), (3) increased thermal stability up to 450-500 °C with only 6% weight loss of volatile components, and (4) higher thermal conductivity, estimated to be 108% higher than for PDMS. The PDMS-MD investigated as a sorbent for extraction, followed by liquid desorption and GC-FID analysis. Recovery of the sorbent for test solutes, isoamyl acetate, ethyl hexanoate, ethyl octanoate, ethyl decanoate, and phenethyl acetate, was found to range from ~87% to >100, with RSD of 2.10-12.50% in synthetic wine samples. Non-porous composite rods provided similar % recoveries to a commercial sorptive device (PDMS Twister), whereas porous rods showed improved % recovery for most of the test solutes (>10-20%) when applied under similar conditions. The limits of detection (LOD) for the above solutes within the developed method ranged from 0.60 to 27.30 µg L-1). Application of the PDMS-MD-LD-GC-FID method to white wine samples demonstrated how the PDMS-MD composite material can be applied as a robust and an efficient sorptive phase for trace chemical analysis.

Muscle melanisation in sand flathead (Platycephalus bassensis) and links to elevated zinc levels.

Melanisation of muscle, observed as black pigmentation of the normally white flesh, has been reported in sand flathead from Tasmania and investigated in this study. There was a significant difference in the presence of melanised muscle in sand flathead from two sites within the Tamar Estuary (northern Tasmania), with higher proportion of sand flathead from Deceitful Cove with this condition. Presence of melanisation was not related to length or weight of the fish. No parasitic infections were detected in the muscles of the affected sand flathead. However, concentration of zinc in melanised regions of muscle in the affected fish was significantly higher, about 1.7 to 1.8 times, than non-melanised regions of muscle in the same fish. Furthermore, the concentration of zinc in melanised regions of affected fish was on average about 2.0 times higher when compared to muscle of unaffected fish that had no melanised spots.