Biological Trace Element Research

Effect of Long-term Administration of Oral Magnesium Sulfate and Insulin to Reduce Streptozotocin-Induced Hyperglycemia in Rats: the Role of Akt2 and IRS1 Gene Expressions Abstract The effects of long-term oral administration of magnesium sulfate and insulin on hyperglycemia were investigated using Akt2 and IRS1 gene expression methods in streptozotocin-induced diabetic rats. Fifty rats were randomly divided into five experimental groups: 1, non-diabetic control (NDC); 2, Mg2+-treated non-diabetic control (Mg-NDC); 3, chronic diabetic (CD); 4, Mg2+-treated chronic diabetic (Mg-CD); and 5, insulin-treated chronic diabetic (Ins-CD). Streptozotocin was used to induce diabetes. The Mg-CD and Mg-NDC groups received 10 g/l of MgSO4 added to drinking water. The Ins-CD group received 2.5 U/kg of insulin twice a day. Blood glucose level and body weight were measured every week. The intraperitoneal glucose tolerance test (IPGTT) was performed after 16 weeks. MgSO4 administration improved the blood glucose level and IPGTT. It also increased Akt2 and IRS1 genes as well as protein expression. Insulin lowered the blood glucose level and increased IRS1 gene and protein expression, but did not affect Akt2 gene and protein expression. Glucose reduction after Mg therapy may be mediated, at least partially, via IRS1 and Akt2 genes and protein stimulation. In insulin-treated rats, insulin resistance was not significant due to the absence of Akt2 gene expression.

Diagnostic Value of Energy Dispersive Hand-Held X-ray Fluorescence Spectrometry in Determining Trace Element Concentrations in Ovine Liver Abstract There are no data available on the use of hand-held X-ray fluorescence (XRF) spectrometry to determine trace element concentrations in veterinary diagnostics. The hand-held XRF spectrometer is easy to use and does not require extensive training for the operator. In Sub-Saharan Africa with few centralised analytical laboratories equipped with expensive apparatus or mass spectrometry capabilities, trace element analysis using the hand-held XRF spectrometer provides an alternative. The objective of this study was to compare ovine hepatic copper (Cu), iron (Fe), manganese (Mn), molybdenum (Mo), selenium (Se) and zinc (Zn) concentrations as obtained with the hand-held XRF spectrometer to those of a reference laboratory using inductively coupled plasma mass spectrometry (ICP-MS). Thirty ovine livers were obtained from an abattoir; prepared as wet blended and oven-dried samples and analysed. Bayesian correlation was used to assess the correspondence between results from the XRF and ICP-MS analyses. The oven-dried preparation procedure for XRF provided the best correlation with the ICP-MS data. The correlations for Cu and Zn were strong and the XRF method may represent a suitable substitute for ICP-MS analysis. For Mn and Fe the correlations were moderately strong and the XRF method may be suitable. For Mo, the correlation was weak and XRF cannot be recommended. Selenium could not be detected in samples prepared by either method. Hand-held XRF spectrometry was a practical method to determine liver concentrations of specific trace elements under African conditions and may significantly reduce the turn-around time of analysis, but unfortunately the apparatus is expensive.

Is There Any Relevance Between Serum Heavy Metal Concentration and BBB Leakage in Multiple Sclerosis Patients? Abstract Sharp increase in multiple sclerosis (MS) incidence rate has been observed in Iranian people. In addition, it has been suggested that increased S100B level may be useful as an indicative factor of blood-brain barrier disruption. The propose of this study was to measuring blood arsenic, lead, and cadmium concentration and serum S100B concentration in a group of healthy and multiple sclerosis patients in Tehran as the most polluted city in Iran. All subjects were interviewed regarding age, medical history, possible chemical exposure, acute or chronic diseases, smoking, and dietary habits. Blood heavy metal level was measured by an atomic absorption spectrometer (Varian model 220-Z) conjugated with a graphite furnace atomizer (GTA-110). Also, a serum S100B protein concentration was determined using a commercial ELISA kit. It was observed that all male subjects had higher blood metal level in comparison with healthy controls. Also, MS patients had higher arsenic and cadmium blood concentration in comparison with healthy individuals. Regarding the S100B concentration, it was observed that it had a significant relationship with smoking habit (P value = 0.0001). In addition, arsenic had a greater correlation (63%) with increased serum S100B biomarker level among other elements. BBB leakage was higher in multiple sclerosis than in healthy subjects due to increased S100B release. In addition with regard to the heavy metal exposure especially arsenic and cadmium, these are associated with an increased BBB disruption and it is possible to play a crucial role as a developing agent of multiple sclerosis.

Role of Pigment Epithelium-Derived Factor in Arsenic-Induced Vascular Endothelial Dysfunction in a Rat Model Abstract Water-borne arsenicosis is caused by the consumption of excess levels of inorganic arsenic from drinking water and is a worldwide public health issue. Arsenic exposure has recently attracted extensive attention due to its damage to the cardiovascular system. Vascular endothelial dysfunction (VED) is recognized as an important cause of cardiovascular diseases. Pigment epithelium-derived factor (PEDF) plays an important role in maintaining endothelial function, and our previous studies suggested that PEDF may have role in arsenic-induced damage. In the present study, we established subchronic arsenic exposure (3 months) rat model from drinking water at doses of 0, 2 mg/L, 10 mg/L, and 50 mg/L, respectively. The results showed that the endothelial cells of the aortic arch were obviously damaged, the apoptosis rate increased, the vWF and iNOS levels increased, and the NO and TNOS levels significantly decreased in the arsenic exposure groups. Regardless of serum or aortic arch endothelium, PEDF levels in the arsenic exposure groups decreased compared to the control group. The oxidative stress level and key proteins associated with apoptosis such as Fas, FasL, P53, and p-p38 were then detected to explore the detailed mechanisms. The results showed that the P53 and p-p38 levels significantly increased in the 10 mg/L and 50 mg/L groups compared to the control group. The MDA content in the arsenic exposure groups increased markedly, whereas the SOD activity decreased significantly with the increased arsenic dose. Taken together, our study is the first to find that PEDF plays a protective role in arsenic-induced endothelial dysfunction through anti-oxidation and anti-apoptosis, and p38 and P53 may be promising target proteins.

Expression Profiles of Selenium-Related Genes in Human Chondrocytes Exposed to T-2 Toxin and Deoxynivalenol Abstract The combination of excess mycotoxin exposure and selenium deficiency has been widely considered as a cause of Kashin-Beck disease (KBD). The present study aimed to investigate the expression profiles of selenium-related genes in human chondrocytes after exposure to T-2 toxin and deoxynivalenol (DON) and to preliminarily identify the potential biological functions of the identified genes. Gene expression profiling was performed on human chondrocytes treated with 0.01 μg/ml T-2 toxin and 1.0 μg/ml DON by using Affymetrix Human Gene Arrays. The 1660 selenium-related genes were derived from the Comparative Toxicogenomics Database. Gene-term enrichment analysis was conducted by the DAVID gene annotation tool. Our results showed that 69 and 191 selenium-related genes were differentially expressed after T-2 toxin and DON treatment, respectively. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that these identified genes were involved in various biological functions, such as the GO terms in response to oxidative stress, cell cycle arrest, and apoptotic process and the KEGG metabolic, FoxO signaling, and p53 signaling pathways. Our results may help explain the mechanisms of interaction between mycotoxins and selenium following human chondrocyte damage and reveal the potential roles of environmental risk factors in cartilage lesions during KBD development.

The Study on Polymorphism of TrxR and Nrf2/HO-1 Signaling Pathway in Kaschin-Beck Disease Abstract Kaschin-Beck disease (KBD) is an endemic, chronic, and degenerative osteoarthropathy, which seriously impairs the quality of patients' life. We detected the expression of TrxR by ELISA and found that TrxR was lower in KBD than in normal control group significantly (P < 0.001); this result indicated that TrxR must be related to KBD. We retrieved cSNPs in NCBI SNP database and used three bioinformatics programmers, including SIFT, PolyPhen, and SNP3d, to help select the researched nsSNP. Then, we used PCR-RFLP to analyze the relationship between the SNP site rs5746841 in TrxR2 gene and susceptibility of KBD and detected the expression of Nrf2 and HO-1 by western blot. The results showed that the genotype of rs5746841 in 93 normal controls and 103 KBD subjects were C/C totally, but A/A and A/C were not found, which indicated preliminarily that there was no correlation between rs5746841 in TrxR2 gene and susceptibility of KBD. The expression of TrxR was lower in KBD than in normal control group significantly, while the expressions of Nrf2 and HO-1 were higher in KBD than in normal control group. These results indicated that the low expression of selenoprotein TrxR may be a candidate factor of KBD, which related to Nrf2/HO-1 signaling pathway.

Total Bioavailable Organic Selenium in Fishmeal-Based Diet Influences Growth and Physiology of Juvenile Cobia Rachycentron canadum (Linnaeus, 1766) Abstract The study examined the effects of supplemental organic selenium (Se) extracted from selenoyeast on the growth performance, glutathione peroxidase (GPx) activity, biochemical status and liver histochemistry of juvenile cobia Rachycentron canadum. Six experimental diets were prepared supplemented with Se with total concentration of 1.52 (Se-1.52), 1.93 (Se-1.93), 2.29 (Se-2.29), 2.71 (Se-2.71) and 3.14 (Se-3.14) mg/kg of total Se in the diets and a fishmeal-based control diet without Se supplementation containing 1.15 (Se-1.15) mg/kg of Se was used as control. Experimental diets were fed to the fish of six treatment groups in triplicate twice daily for 8 weeks. Juvenile cobia fed dietary Se of 1.93, 2.29 and 2.71 mg/kg showed increased final body weight (FBW), specific growth rate (SGR) and feed intake (FI) than the fish fed the control diet. Se accumulations in the muscle and liver tissue displayed a positive linear relationship with dietary Se levels. Se deficiency was apparent in fish fed the control diet and displayed reduced growth and feed efficiency. Red blood cell (RBC) counts were significantly (P < 0.05) higher in cobia fed dietary Se between 1.52 to 2.71 mg/kg than the fish fed 3.14-mg/kg Se diet. Glutathione peroxidase activity significantly (P < 0.05) declined in the group fed with control diet compared to fish fed Se-supplemental diet. Juvenile cobia fed the highest Se level (Se-3.14 mg/kg) showed toxic effects in the liver, including histopathological lesions in the liver. Based on the results obtained for FBW, SGR, tissue Se retention and haematological parameters, we conclude that optimal dietary Se requirement for juvenile cobia fed commercial diets is 2.32 mg/kg.

Ascorbic Acid Supplementation Prevents the Detrimental Effects of Prenatal and Postnatal Lead Exposure on the Purkinje Cell and Related Proteins in the Cerebellum of Developing Rats Abstract We investigated the effects of lead (Pb) and ascorbic acid co-administration on rat cerebellar development. Prior to mating, rats were randomly divided into control, Pb, and Pb plus ascorbic acid (PA) groups. Pregnant rats were administered Pb in drinking water (0.3% Pb acetate), and ascorbic acid (100 mg/kg) via oral intubation until the end of the experiment. Offspring were sacrificed at postnatal day 21, the age at which the morphology of the cerebellar cortex in developing pups is similar to that of the adult brain. In the cerebellum, Pb exposure significantly reduced Purkinje cells and ascorbic acid prevented their reduction. Along with the change of the Purkinje cells, long-term Pb exposure significantly reduced the expression of the synaptic marker (synaptophysin), γ-aminobutyric acid (GABA)–synthesizing enzyme (glutamic acid decarboxylase 67), and axonal myelin basic protein while ascorbic acid co-treatment attenuated Pb-mediated reduction of these proteins in the cerebellum of pups. However, glutamatergic N-methyl-d-aspartate receptor subtype 1 (NMDAR1), anchoring postsynaptic density protein 95 (PSD95), and antioxidant superoxide dismutases (SODs) were adversely changed; Pb exposure increased the expression of NMDAR1, PSD95, and SODs while ascorbic acid co-administration attenuated Pb-mediated induction. Although further studies are required about the neurotoxicity of the Pb exposure, the results presented here suggest that developmental Pb exposure disrupted normal development of Purkinje cells by increasing glutamatergic and oxidative stress in the cerebellum. Additionally, ascorbic acid co-treatment is beneficial in attenuating prenatal and postnatal Pb exposure–induced maldevelopment of Purkinje cells in the developing cerebellum.

The Variable Regulatory Effect of Arsenic on Nrf2 Signaling Pathway in Mouse: a Systematic Review and Meta-analysis Abstract Arsenic is known to cause oxidative damage. Nuclear factor E2-relate factor-2 (Nrf2) can resist this toxicity. Scholars demonstrated that Nrf2 pathway was activated by arsenic. In contrast, other articles established arsenic-induced inhibition of Nrf2 pathway. To resolve the contradiction and elucidate the mechanism of Nrf2 induced by arsenic, 39 publications involving mouse models were identified through exhaustive database retrieval and were analyzed. The pooled results suggested that arsenic obviously elevated transcription and translation levels of Nrf2 and its downstream genes, NAD(P)H dehydrogenase 1 (NQO1), heme oxygenase-1 (HO-1), glutamate-cysteine ligase catalytic subunit (GCLC), and GST-glutathione-S-transferase1/2 (GSTO1/2). Arsenic increased the level of reactive oxygen species (ROS), but reduced the level of glutathione (GSH). Subgroup analysis between arsenic and control groups showed that the levels of Nrf2 and its downstream genes are greater in high dose than that in the low dose, higher in short-term exposure than long term, female subjects tolerated better than males, higher in mice than the rats, and greater in other organs than the liver. However, the contents of genes of Nrf2 pathway between the arsenic and control groups were lower in rats than in mice and were less for long-term exposure than the short term (P < 0.05). Conclusively, a variable regulation of arsenic on Nrf2 pathway is noted. Higher dose and short-term exposure of female mice organs except for liver promoted Nrf2 pathway. On the other hand, arsenic inhibited Nrf2 pathway for long-term exposure on rats.

GM1 Ameliorates Lead-Induced Cognitive Deficits and Brain Damage Through Activating the SIRT1/CREB/BDNF Pathway in the Developing Male Rat Hippocampus Abstract Developmental lead (Pb) exposure involves various serious consequences, especially leading to neurotoxicity. In this study, we examined the possible role of monosialoganglioside (GM1) in lead-induced nervous impairment in the developing rat. Newborn male Sprague-Dawley rat pups were exposed to lead from birth for 30 days and then subjected to GM1 administration (0.4, 2, or 10 mg/kg; i.p.) or 0.9% saline. The results showed that developmental lead exposure significantly impaired spatial learning and memory in the Morris water maze test, reduced GM1 content, induced oxidative stress, and weakened the antioxidative systems in the hippocampus. However, co-treatment with GM1 reversed these effects. Moreover, GM1 counteracted lead-induced apoptosis by decreasing the expression of Bax, cleaved caspase-3, and by increasing the level of Bcl-2 in a dose-dependent manner. Furthermore, we found that GM1 upregulated the expression of SIRT1, CREB phosphorylation, and BDNF, which underlie learning and memory in the lead-treated developing rat hippocampus. In conclusion, our study demonstrated that GM1 exerts a protective effect on lead-induced cognitive deficits via antioxidant activity, preventing apoptosis, and activating SIRT1/CREB/BDNF in the developing rat hippocampus, implying a novel potential assistant therapy for lead poisoning.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Mindfulness

Are We Forgetting Sati? Memory and the Benefits of Mindfulness from a Non-Buddhist Viewpoint

Item Response Theory Analysis of the Five Facet Mindfulness Questionnaire and Its Short Forms Abstract Objectives The Five Facet Mindfulness Questionnaire (FFMQ) is a self-report measure of mindfulness with forms of several different lengths, including the FFMQ-39, FFMQ-24, and FFMQ-15. We use item response theory analysis to directly compare the functioning of these three forms. Methods Data were drawn from a non-clinical Amazon Mechanical Turk study (N = 522) and studies of aftercare treatment of individuals with substance use disorders (combined N = 454). The item and test functioning of the three FFMQ forms were studied and compared. Results All 39 items were strongly related to the facet latent variables, and the items discriminated over a similar range of the latent mindfulness constructs. Items provided more information in the low-to-medium range of latent mindfulness than in the high range. Scores in three of the five FFMQ-39 facets were unreliable when measuring individuals in the high range of latent mindfulness, resulting from ceiling effects in item responses. Reliability in the high range of mindfulness was further reduced in the FFMQ-24 and FFMQ-15, such that short forms may be ill-suited for applications that require reliable measurement in the high range. Conclusions Results suggest the existing FFMQ item pool cannot be reduced without negatively affecting either overall reliability or the span of mindfulness over which reliability is assessed. Conditional test reliability curves and item functioning parameters can aid investigators in tailoring their choice of FFMQ form to the reliability they hope to achieve and to the range of latent mindfulness over which they must reliably measure.

Individual Gender and Group Gender Composition as Predictors of Differential Benefit from Mindfulness-Based Relapse Prevention for Substance Use Disorders Abstract Objectives Mindfulness-based relapse prevention (MBRP) is an effective group-based aftercare treatment for substance use disorders (SUDs), yet few studies have examined moderators of MBRP efficacy. This secondary data analysis evaluated individual gender and group gender composition (e.g., proportion of women relative to men in each therapy group) as treatment moderators of MBRP. Methods The analysis sample included 186 individuals with SUDs randomized to MBRP or relapse prevention (RP) as an aftercare treatment. Outcomes included number of heavy drinking days and drug use days at the 12-month follow-up. Results There were no treatment moderation effects for models with heavy drinking days as the outcome (all ps > .05). Group gender composition, but not individual gender, moderated the effect of treatment condition on drug use days (p < .01). Individuals who received MBRP had significantly fewer drug use days at 12 months than those who received RP, but only among individuals in therapy groups comprising one-third or more women (p < 0.0001). Specifically, all women and men who received MBRP in groups with one third or more women were abstinent from drugs at month 12, whereas those in RP groups with one third or more women had an average of about eight drug use days at month 12 (corresponding to a large between-treatment condition effect size). Conclusions Group-based MBRP may be more efficacious than group-based RP, particularly when women compose at least one third of the therapy group. Further research is warranted on gender and group gender composition as moderators of MBRP.

Exploring Gender Differences in the Relationship Between Dispositional Mindfulness and Compulsive Sexual Behavior Among Adults in Residential Substance Use Treatment Abstract Objectives Compulsive sexual behavior (CSB) is overrepresented among adults with substance use disorders (SUD), yet there is no empirically supported CSB treatment for this population. Cross-sectional and single case designs supported dispositional mindfulness as a potential CSB intervention target. However, the relations between CSB and each of the five dispositional mindfulness facets remain unknown. Methods Extending prior research to inform intervention efforts, we reviewed medical records for 1993 adults (77.6% male) in residential treatment for SUD to examine gender differences in the relations between dispositional mindfulness facets (acting with awareness, observation of experience, describing with words, nonjudging of inner experience, and nonreactivity to inner experience) and five CSB indicators (loss of control, relationship disturbance, preoccupation, affect disturbance, and internet problems). Results For men, path analyses revealed that acting with awareness, nonjudging of inner experience, describing with words, nonreactivity to inner experience, alcohol/drug use and problems, and depression and anxiety symptoms related to CSB (p range .00–.04). For women, acting with awareness, nonjudging of inner experience, alcohol/drug use and problems, and depression symptoms related to several CSB indicators (p range .00–.04). Conclusions Mindfulness-based CSB interventions should evaluate the benefit of increasing intentional responses towards present-moment experiences among adults with SUD. Targeting alcohol/drug misuse, negative affect, and judgment towards thoughts and emotions may be beneficial.

Scoping Review of Mindfulness Research: a Topic Modelling Approach Abstract Objectives As the volume of mindfulness research continues amassing exponentially, there have been attempts to review works in various aspects of mindfulness research systematically. The present study provides a scoping review via a topic modelling approach to supplement the overall research synthesis effort. Specifically, the objective is to scope the mindfulness research by identifying topics relevant to mindfulness research using the probabilistic topic modelling approach. Methods A literature search based on "mindfulness" returned 5947 bibliographical records from the Web of Science Core Collection platform (for records up to 20 October 2017). The combined field of titles and abstracts was subjected to probabilistic topic modelling based on latent Dirichlet allocation (LDA). Results The optimal number of topics suggested was 106. Further interpretation by the research team resulted in a total of 231 Suggested Terms. The terms were further categorised into Condition/Issue, Construct/Philosophy, Modality, Population/Setting and Research Methodology. Conclusions The topic modelling process obtained a panoptic view of mindfulness research, providing mindfulness researchers with some indicators regarding the range of topics researched. The outcome of this topic modelling effort has been made available at https://hdl.handle.net/10497/20862.

The Role of Dispositional Mindfulness and Self-compassion in Educator Stress Abstract Objectives Compromised educator well-being creates educational, social, and economic problems, which are not resolved by knowledge of risk factors alone. The present study explored the protective role of dispositional mindfulness and self-compassion within the context of educator stress. Methods A total of 231 educators from 21 Australian schools completed online surveys including measures of perceived stress, mindfulness, self-compassion, student-teacher relationships, experiences in close relationships, and eating and sleeping patterns, which were used for correlation, regression, and path analysis. Results The present study identified multiple predictors of perceived stress, with self-compassion as the strongest significant predictor. Findings of path analyses also demonstrated that lower levels of dispositional mindfulness and higher levels of anxiety in close relationships were associated with poor sleep quality, and this association was mediated by higher levels of perceived stress. The same potential pathways were suggested with self-compassion replacing dispositional mindfulness. Conclusions The role of dispositional mindfulness and self-compassion is discussed as protective resources that could be utilized in times of stress.

Meditation on the Breath: Mindfulness and Focused Attention Abstract This article explores to what degree meditation on the breath in early Buddhist thought involved focused attention. Closer inspection of instructions on this mode of meditation in the form of sixteen steps shows focused attention to be only a secondary aspect of the practice, which for the most part rather involves cultivating breadth of mind. This differs from later tradition. As the apparent result of a gradual reduction of the sixteen-step scheme to just the touch experience of the breath, a stronger focus naturally came to be required, eventually leading to the necessity of devising additional meditation techniques such as counting the breaths, a modality of practice only found in later texts. The findings from the present article suggest the need to consider "focus" on the breath and "mindfulness" of the process of breathing as related but distinct mental qualities.

Appreciative Joy Meditation Enhances Acceptance of Unfair Offer in Ultimatum Game Abstract Objectives Empirical studies have shown that the Four Immeasurables Meditations (FIM) can enhance compassionate decisions towards others, such as helping victims being treated unfairly in economic games. However, research investigating how FIM affects individuals' decisions when they themselves are victims is sparse. Thus, the current study utilized a randomized trial to scrutinize the causal influence of practicing FIM on people's reactions towards unfairness that is directed at them. Methods Meditation novices (N = 135) were randomly assigned to practice either a brief Appreciative Joy Meditation (AJM) or a matched neutral visualization. They then took part in the Ultimatum Game where they first acted as a proposer to propose an offer to another person, then acted as a responder to decide whether to accept a set of offers. Results The AJM group accepted significantly more unfair offers, but neither proposed a higher offer to others nor changed the perception of fairness, as compared with the neutral visualization control group. Furthermore, self-reported emotional changes during meditation practice could not predict behavior in the Ultimatum Game, but the Self-Transcendence dimension of the Appreciative Joy Scale, which reflects one's ability to feel happy for others when one is in an inferior situation, predicted higher acceptance rate of unfair offers. Conclusions This study provided a piece of causal evidence that a brief practice of AJM can make people more tolerable to unfairness directed against them. Broadly, this study also inspired more investigations on attitudes towards people in superior situations in future studies on FIM.

The Mutual Support Model of Mindfulness and Character Strengths Abstract Objectives Numerous studies have confirmed robust relationships between general well-being and mindfulness or character strengths, respectively, but few have examined associations between mindfulness and character strengths. Two studies were carried out to explore these relationships comprehensively in the framework of the Values in Action (VIA) classification of character strengths. Methods In study 1, participants (N = 1335) completed validated assessments of mindfulness and character strengths, and the relationship between the two was investigated in a broad online sample. In study 2, the effect of a mindfulness training on specific character strengths was investigated using a randomized-control design (N = 42). Results The results of study 1 confirmed positive relationships between mindfulness and character strengths and further identified a list of character strengths that might overlap with mindfulness—i.e., creativity, curiosity, open-mindedness, love of learning, perspective, bravery, perseverance, zest, love, social intelligence, forgiveness, self-regulation, appreciation of beauty, gratitude, hope, and spirituality. The findings of study 2 provided further support for the hypothesis that mindfulness training could help cultivate certain character strengths. Compared with participants in the waitlist control condition, those who attended an 8-week mindfulness-based training program showed significant increases in the strengths of love, appreciation of beauty, gratitude, and spirituality, and a trend toward significant increases in the strengths of zest and bravery. Conclusions The results provide initial evidence for a mutual support model of mindfulness and character strengths.

Mindful Parenting Assessed in Mainland China: Psychometric Properties of the Chinese Version of the Interpersonal Mindfulness in Parenting Scale Abstract Objectives The Interpersonal Mindfulness in Parenting Scale is a 31-item self-report measure to assess mindful parenting, and has been revised into a Dutch, Portuguese, and Hong Kong version. The aim of this research was to explore the factor structure and psychometric properties of the Chinese version of the Interpersonal Mindfulness in Parenting scale (IM-P-C) in Mainland China. Methods The Chinese version was translated from the original English version in the preliminary study. Exploratory factor analysis, confirmatory factor analysis, and measurement invariance analysis across gender, test-retest reliability were examined consecutively in study 1 (n = 183), 2 (n = 294), and 3 (n = 48). In study 4, its factor structure was examined in a clinical sample (n = 288). Results A four-factor structure was found in study 1 and the scale scores showed adequate internal consistency. The four-factor structure was confirmed with a new sample in study 2. Measurement invariance analysis across gender suggested that both fathers and mothers interpreted the IM-P-C in a similar manner. Significant correlations were found between the IM-P-C and measures of over-reactivity, parental warmth, anxiety, depression, life satisfaction, and dispositional mindfulness. In study 3, results exhibited temporal stability over a period of 2 weeks. In study 4, the IM-P-C was validated in parents of children with autism. Conclusions The present research demonstrated that mindful parenting in a Chinese population can be measured through the assessment of four dimensions (Interacting with Full Attention, Compassion and Acceptance, Self-regulation in Parenting, Emotional Awareness of Child) and confirmed that the Chinese version is an adequate measure for the studies of mindful parenting in Mainland China.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Abnormal Child Psychology

Depression and ADHD-Related Risk for Substance Use in Adolescence and Early Adulthood: Concurrent and Prospective Associations in the MTA Abstract Childhood attention-deficit/hyperactivity disorder (ADHD) is prospectively linked to substance use and disorder. Depression emerging in adolescence is an understudied risk factor that may explain some of this risk. In the present study, we considered mediating and moderating roles of adolescent depression in explaining this association by using longitudinal data from the prospective 16-year follow-up of the Multimodal Treatment Study of ADHD (MTA). Participants were 547 children diagnosed with DSM-IV ADHD Combined Type, and 258 age- and sex-matched comparison children. In adolescence, depressive symptoms did not exacerbate effects of childhood ADHD on any substance use. For both groups, time-varying and average depressive symptoms were associated with more frequent use of all substances. Prospectively, we found no evidence of depression mediation to adult substance use. However, adolescent depression moderated the association between childhood ADHD and adult marijuana use. Although adults without ADHD histories used marijuana more frequently if they had elevated depressive symptoms in adolescence, marijuana use by adults with ADHD histories was independent of their adolescent depression. In adulthood, depression diagnoses and ADHD persistence continued to operate as independent, additive correlates of substance use risk. Our findings suggest a circumscribed role for depression in substance use risk that adds to, but does not alter or explain, ADHD-related risk.

Frontal Brain Asymmetry and the Trajectory of Shyness Across the Early School Years Abstract Although resting right frontal electroencephalogram (EEG) asymmetry has been linked to avoidance and withdrawal-related behaviors such as shyness in previous cross-sectional studies, relatively little research has examined the influence of frontal brain electrical activity on the development of shyness in children using a prospective, longitudinal study design. Here, we tested whether resting frontal EEG asymmetry predicted the trajectory of children's shyness across five assessments. Children were enrolled in the study during the summer prior to grade 1 (N = 37; Mage = 6.39 years, S.D. = 0.15 years), at which time resting frontal EEG activity and maternal report of children's shyness were collected. Mothers then reported on their child's shyness over another four follow-up assessments, spanning 2 years (winter of grade 1, summer prior to grade 2 entry, winter of grade 2, and summer prior to grade 3). Growth curve analysis revealed that children displaying greater relative right frontal EEG activity had lower levels of shyness relative to children exhibiting greater relative left frontal EEG activity at study enrollment (i.e., age 6), but displayed statistically significant linear increases in shyness across time, with the highest levels of shyness by the summer prior to grade 3 (i.e., age 8). There was, however, no relation between left frontal EEG asymmetry and change in shyness across time. These preliminary findings suggest that right frontal EEG asymmetry may reflect a biological diathesis for the growth of shyness during the early school years.

A Dynamic Examination of the Associations between Shyness, Psychological Difficulties, and Stressful Life Events during Early Adolescence Abstract Although numerous studies have established linkages between shyness and later psychological difficulties, most extant research did not examine variation in shyness over time in relation to variation in psychological difficulties over time or possible environmental factors of influence outside of the school context. The current study used multi-level modelling to simultaneously examine time-invariant and time-variant associations between shyness, the psychological difficulties of depressive symptoms and loneliness, and stressful life events at four waves across 1 year in a community sample of 271 young adolescents (51% boys; Mage = 11.83 years at W1). Results revealed significant time-variant and time-invariant effects when loneliness was examined as a predictor of shyness. In addition, a significant interaction effect indicated that shyness decreased over time for those young adolescents who experienced few stressful life events, highlighting an understudied moderator of risk. Overall, findings have important implications for understanding the psychological concomitants of shyness as well as etiological models of shyness.

Parenting Interacts with Oxytocin Polymorphisms to Predict Adolescent Social Anxiety Symptom Development: A Novel Polygenic Approach Abstract Guided by a developmental psychopathology framework, research has increasingly focused on the interplay of genetics and environment as a predictor of different forms of psychopathology, including social anxiety. In these efforts, the polygenic nature of complex phenotypes such as social anxiety is increasingly recognized, but studies applying polygenic approaches are still scarce. In this study, we applied Principal Covariates Regression as a novel approach to creating polygenic components for the oxytocin system, which has recently been put forward as particularly relevant to social anxiety. Participants were 978 adolescents (49.4% girls; Mage T1 = 13.8 years). Across 3 years, questionnaires were used to assess adolescent social anxiety symptoms and multi-informant reports of parental psychological control and autonomy support. All adolescents were genotyped for 223 oxytocin single nucleotide polymorphisms (SNPs) in 14 genes. Using Principal Covariates Regression, these SNPs could be reduced to five polygenic components. Four components reflected the underlying linkage disequilibrium and ancestry structure, whereas the fifth component, which consisted of small contributions of many SNPs across multiple genes, was strongly positively associated with adolescent social anxiety symptoms, pointing to an index of genetic risk. Moreover, significant interactions were found with this polygenic component and the environmental variables of interest. Specifically, adolescents who scored high on this polygenic component and experienced less adequate parenting (i.e., high psychological control or low autonomy support) showed the highest levels of social anxiety. Implications of these findings are discussed in the context of individual-by-environment models.

Sad, Scared, or Rejected? A Short-Term Longitudinal Study of the Predictors of Social Avoidance in Chinese Children Abstract The goal of the present study was to empirically examine different conceptual mechanisms previously postulated to underlie the development of social avoidance in childhood. Participants were N = 601 children (321 boys, 280 girls) attending elementary schools (Mage = 10.21 years) and middle schools (Mage = 12.77 years) in Shanghai, P.R. China. Measures of motivations for social withdrawal (shyness, unsociability, social avoidance) and socio-emotional adjustment were collected using self-reports and peer nominations at two time-points separated by 9 months. Results from cross-lagged panel analyses indicated that: (1) social avoidance and symptoms of social anxiety were not reciprocally related over time; (2) Time 1 social avoidance predicted incremental change in Time 2 peer problems (whereas Time 1 peer problems did not predict incremental change in Time 2 social avoidance); and (3) Time 1 symptoms of depression significantly predicted incremental change in Time 2 social avoidance (whereas Time 1 social avoidance did not predict incremental change in Time 2 symptoms of depression). These results provide evidence in support of depressive symptoms (but not symptoms of social anxiety or peer problems) as a salient predictor of social avoidance. Results are discussed in terms of the development and implications of social avoidance in Chinese culture.

Early Childhood Predictors of Anxiety in Early Adolescence Abstract This longitudinal study examined a multitude of early childhood predictors of anxiety symptoms and disorders over an 8-year period. The purpose of the study was to identify early life predictors of anxiety across childhood and early adolescence in a sample of at-risk children. The sample included 202 preschool children initially identified as behaviorally inhibited or uninhibited between the ages of 3 years 2 months and 4 years 5 months. Temperament and familial environment variables were assessed using observation and parent report at baseline. Anxiety symptoms and disorders were assessed using questionnaires and diagnostic interviews at baseline (age 4), and at age 6, 9 and 12 years. In line with our hypotheses, the findings showed that preschool children were more likely to experience anxiety symptoms and disorders over time i) when the child was inhibited, ii) when there was a history of maternal anxiety disorders or iii) when mothers displayed high levels of overinvolvement. Further, the study identified a significant interaction effect between temperament and maternal overvinvolvement such that behaviorally inhibited preschoolers had higher anxiety symptoms at age 12, only in the presence of maternal overinvolvement at age 4. The increased risk of anxiety in inhibited children was mitigated when mothers demonstrated low levels of overinvolvement at age 4. This study provides evidence of both additive and interactive effects of temperament and family environment on the development of anxiety and provides important information for the identification of families who will most likely benefit from targeted early intervention.

Predicting Temperamentally Inhibited Young Children's Clinical-Level Anxiety and Internalizing Problems from Parenting and Parent Wellbeing: a Population Study Abstract The aim of this study was to explore how some temperamentally inhibited young children and not others in the general population develop anxiety disorders and broader clinical-level internalizing (anxious/depressive) problems, with a focus on the family. A brief screening tool for inhibition was universally distributed to parents of children in their year before starting school across eight socioeconomically diverse government areas in Melbourne, Australia (307 preschool services). Screening identified 11% of all children as inhibited. We invited all parents of inhibited children to participate in a longitudinal prevention study. Participants were 545 parents of inhibited pre-schoolers (78% uptake) of whom 498 (91%) completed assessment one year later and 469 (86%) two years later. Parents completed questionnaires to assess parenting practices, parent wellbeing, and child internalizing problems. Parents also engaged in structured diagnostic interviews to assess child anxiety disorders. During the follow up period close to half of the inhibited young children had anxiety disorders and one in seven had clinical-level internalizing problems, with girls perhaps at higher risk. The family variables significantly predicted inhibited children's anxiety disorders and broader internalizing problems. For child anxiety disorders, overinvolved/protective parenting was particularly important for girls and boys, and poorer parent wellbeing contributed. For child anxious/depressive problems, harsh discipline was a consistent predictor for girls and boys, and poorer parent wellbeing again contributed. These etiological findings support early intervention for temperamentally inhibited young children that focuses on the family environment to prevent the development of mental health problems.

Multiple Trajectories in Anxious Solitary Youths: the Middle School Transition as a Turning Point in Development Abstract This study aimed to identify divergent patterns of individual continuity and change in anxious solitude (AS) in the last half of elementary school (3rd – 5th grade) and the first two years of middle school (6th – 7th grade), and test predictors and outcomes of these pathways. Participants were 688 youths (girls n = 354, 51.5%; M age at outset = 8.66 years, SD = 0.50). Latent class growth analyses identified two AS trajectory classes in elementary school (moderate-decreasing, high-increasing) and three in middle school (low-stable, low-increasing, high-decreasing). The elementary school moderate-decreasing class was two-and-a-half times more likely than others to end in the middle school low-stable class. In contrast, the elementary school high-increasing class was twice as likely as others to end in the middle school low-increasing class, and four times as likely to end in the middle school high-decreasing class. Peer exclusion predicted membership in increasing AS trajectory classes in both elementary and middle school, whereas the middle school high-decreasing AS trajectory class demonstrated decreasing peer exclusion during middle school. Likewise, inability to defend oneself predicted membership in increasing AS trajectory classes in both elementary and middle school, whereas membership in the middle school high-decreasing AS trajectory class was predicted by inability to defend oneself in elementary but not middle school. High-decreasing AS youths' improved ability to defend themselves in middle school appeared to be related to a cascade of improvements in related domains. In contrast, membership in increasing AS classes in elementary and middle school predicted symptoms of social anxiety and depression.

Multidimensional Emotion Regulation Moderates the Relation Between Behavioral Inhibition at Age 2 and Social Reticence with Unfamiliar Peers at Age 4 Abstract Behavioral inhibition (BI), a temperament trait characterized by fear and wariness in novel situations, has been identified as a risk factor for later social reticence and avoidance of peer interactions. However, the ability to regulate fearful responses to novelty may disrupt the link between BI and socially reticent behavior. The present study examined how and whether both behaviorally-manifested and physiological indices of emotion regulation moderate the relation between BI and later social reticence. Participants in this study included 88 children followed longitudinally from ages 2 to 4. At age 2, children completed the BI Paradigm in which children's responses to novel objects and adults were observed. At age 4, children's baseline respiratory sinus arrhythmia (RSA) was assessed and mothers reported on children's negative emotionality and soothability. Social reticence at age 4 was observed during a free play session with 3 unfamiliar peers. Results from saturated path models revealed a significant two-way interaction between BI and baseline RSA and a three-way interaction between BI, negative emotionality, and baseline RSA when predicting socially reticent behavior at age 4. At high levels of baseline RSA and high levels of negative emotionality, the association between BI and social reticence was negative. The relation between BI and later social reticence was only positive and significant at low levels of baseline RSA combined with high levels of negative emotionality. The results suggest that either strong physiological regulation or low negative emotionality seems sufficient to buffer inhibited young children against later social reticence.

Developmental Trajectories of Shyness-Sensitivity from Middle Childhood to Early Adolescence in China: Contributions of Peer Preference and Mutual Friendship Abstract This study examined trajectories of shyness-sensitivity and the contributions of peer relationships to these trajectories in Chinese children. Participants were 1061 school-age children (537 boys), initially in fifth grade (Mage = 11 years), in China. Longitudinal data on shyness-sensitivity were collected from peer assessments once a year for four years. In addition, peer nomination data on peer acceptance-rejection and mutual friendship were collected in the initial study. Four distinct shyness-sensitivity trajectories were identified: Low-Stable, Low-Increasing, Moderate-Decreasing, and High-Stable. Children with high peer acceptance scores were more likely to be in the High-Stable and Moderate-Decreasing trajectories than in the Low-Stable and Low-Increasing trajectories. The analysis of predictors of the within-trajectory growth rate indicated that children who were more liked by peers increased their shyness-sensitivity more slowly within the Low-Increasing trajectory and that children with mutual friendship involvement decreased their shyness-sensitivity more slowly within the Moderate-Decreasing trajectory. The results suggested that positive relationships might serve to attenuate developmental changes of shyness-sensitivity within these trajectories. The results were discussed in the Chinese context.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Clinical Infectious Diseases

Advance articles alert   30 June 2019 - 01 July 2019         Penicillin as a Potential Agent for Dual Beta-lactam Therapy for Enterococcal Endocarditis     B J Tritle; T T Timbrook; M A Fisher; E S Spivak     Sources of Airborne Norovirus in Hospital Outbreaks     Malin Alsved; Carl-Johan Fraenkel; Mats Bohgard; Anders Widell ; Anna Söderlund-Strand ...     Asymptomatic infection and transmission of pertussis in households: a systematic review     Rodger Craig, MPH; Elizabeth Kunkel, MScPH; Natasha S Crowcroft, MD(Cantab); Meagan C Fitzpatrick, PhD ; Hester de Melker, PhD ...     Assessing the Incidence of Symptomatic Respiratory Syncytial Virus (RSV) Illness within a Prospective Birth Cohort in Managua, Nicaragua     John Kubale ; Guillermina Kuan; Lionel Gresh; Sergio Ojeda; Eduardo Azziz-Baumgartner ...     If Influenza Vaccines Wane Can We Delay Vaccination Without Compromising Coverage?     Nicola P Klein, M.D. Ph.D; Bruce Fireman     Waning of influenza vaccine protection: Exploring the trade-offs of changes in vaccination timing among older adults     J M Ferdinands; E Alyanak; C Reed; A M Fry

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Academic Radiology

Ultrasound-guided Therapeutic Injection and Cryoablation of the Medial Plantar Proper Digital Nerve (Joplin's Nerve): Sonographic Findings, Technique, and Clinical Outcomes Publication date: Available online 3 July 2019 Source: Academic Radiology Author(s): Christopher J. Burke, Julien Sanchez, William R. Walter, Luis Beltran, Ronald Adler Rationale and Objectives The medial plantar proper digital nerve, also called Joplin's nerve, arises from the medial plantar nerve, courses along the medial hallux metatarsophalangeal joint, and can be a source of neuropathic pain due to various etiologies, following acute injury including bunion surgery and repetitive microtrauma. We describe our clinical experience with diagnostic ultrasound assessment of Joplin's neuropathy and technique for ultrasound-guided therapeutic intervention including both injection and cryoablation over a 6-year period. Materials and Methods Retrospective review of all diagnostic studies performed for Joplin's neuropathy and therapeutic Joplin's nerve ultrasound-guided injections and cryoablations between 2012 and 2018 was performed. Indications for therapeutic injection and cryoablation, were recorded. Studies were assessed for sonographic abnormalities related to the nerve and perineural soft tissues. Post-treatment outcomes including immediate pain scores, clinical follow-up, and periprocedural complications were documented. Results Twenty-four ultrasound-guided procedures were performed, including 15 perineural injections and nine cryoablations. With respect to sonographic abnormalities, nerve thickening (33%) and perineural hypoechoic scar tissue (27%) were the most common findings. The mean pain severity score prior to the therapeutic injection was 6.4/10 (range 4–10) and 0.25/10 (range 0–2) following the procedure; mean follow-up was 26.2 months (range 3–63 months). All of the cryoablation patients experienced sustained pain relief with a mean length follow-up of 3.75 months (range 0.2–10 months). Conclusion Therapeutic injection of Joplin's nerve is a safe and easily performed procedure under ultrasound guidance, with high rates of immediate symptom improvement. For those experiencing a relapse or recurrent symptoms, cryoablation offers an effective secondary potential treatment option.

To Score or Not to Score—The USMLE Debate Continues Publication date: Available online 2 July 2019 Source: Academic Radiology Author(s): Priscilla J. Slanetz

Discrepancy in Practices Related to the Use of Oral Contrast in Abdominal CT Scan Publication date: July 2019 Source: Academic Radiology, Volume 26, Issue 7 Author(s): Shahmeer Khan, Muhammad Awais, Anwar Ahmed

Counterpoint: Why Some Imposed Structure is a Necessity in Radiology Reporting Publication date: July 2019 Source: Academic Radiology, Volume 26, Issue 7 Author(s): Adam E. Flanders

In Opposition to Standardized Templated Reporting Publication date: July 2019 Source: Academic Radiology, Volume 26, Issue 7 Author(s): David Mark Yousem

Institutional Implementation of a Structured Reporting System: Our Experience with the Brain Tumor Reporting and Data System Publication date: July 2019 Source: Academic Radiology, Volume 26, Issue 7 Author(s): Ashwani Gore, Michael J. Hoch, Hui-Kuo G. Shu, Jeffrey J. Olson, Alfredo D. Voloschin, Brent D. Weinberg Rationale and Objectives Analyze the impact of implementing a structured reporting system for primary brain tumors, the Brain Tumor Reporting and Data System, on attitudes toward radiology reports at a single institution. Materials and Methods Following Institutional Review Board approval, an initial 22 question, 5 point (1—worst to 5—best), survey was sent to faculty members, house staff members, and nonphysician providers at our institution who participate in the direct care of brain tumor patients. Results were used to develop a structured reporting strategy for brain tumors which was implemented across an entire neuroradiology section in a staged approach. Nine months following structured reporting implementation, a follow-up 27 question survey was sent to the same group of providers. Keyword search of radiology reports was used to assess usage of Brain Tumor Reporting and Data System over time. Results Fifty-three brain tumor care providers responded to the initial survey and 38 to the follow-up survey. After implementing BT-RADS, respondents reported improved attitudes across multiple areas including: report consistency (4.3 vs. 3.4; p < 0.001), report ambiguity (4.2 vs. 3.2, p < 0.001), radiologist/physician communication (4.5 vs. 3.8; p < 0.001), facilitation of patient management (4.2 vs. 3.6; p = 0.003), and confidence in reports (4.3 vs. 3.5; p < 0.001). Providers were more satisfied with the BT-RADS structured reporting system (4.3 vs. 3.7; p = 0.04). Use of the reporting template progressively increased with 81% of brain tumor reports dictated using the new template by 9 months. Conclusion Implementing a structured template for brain tumor imaging improves perception of radiology reports among radiologists and referring providers involved in the care of brain tumor patients.

Reliability of MRI-Derived Depth of Invasion of Oral Tongue Cancer Publication date: July 2019 Source: Academic Radiology, Volume 26, Issue 7 Author(s): Ryuji Murakami, Shinya Shiraishi, Ryoji Yoshida, Junki Sakata, Keisuke Yamana, Akiyuki Hirosue, Yoshikazu Uchiyama, Hideki Nakayama, Yasuyuki Yamashita Rationale and Objective To evaluate the inter-rater reliability of the magnetic resonance imaging (MRI)-derived depth of invasion (DOI) and the agreement between MRI and pathological measurements of oral tongue cancer. Materials and Methods The institutional review board approved this retrospective study. The study population consisted of 29 patients with clinical T2N0 oral tongue cancer treated by surgery. Routine pretreatment MRI was performed on a 3T superconducting imager. Two raters with 23 and 18 years of head-and-neck MRI experience, respectively, independently chosen MRI sequences for each patient, then delineate the tumor, and then used three protocols to measure the MRI-derived DOI: the axial reconstructed thickness (method 1), the axial invasive portion (method 2), and the coronal invasive portion (method 3). Then they consensually selected the optimal among the three methods for each patient; it was designated method 4. The Bland-Altman plots, intraclass correlation coefficients (ICCs), and the paired samples test were used. According to the median follow-up of 41 months, the relationship between the MRI-derived DOI and nodal recurrence was also investigated. Results The inter-rater reliability of methods 2 and 4 was excellent (ICC of 0.829 and 0.807, respectively). The correlation between MRI and pathological measurements was good for method 4 (ICC of 0.611), however, all measurements recorded on MRI were 2–3 mm larger than on pathology. No patients whose MRI-derived DOI was less than 5 mm suffered nodal recurrence. Conclusion The MRI-derived DOI was valuable for the preoperative staging. The optimal measurement method should be selected on a case-by-case basis.

Influence of Monoenergetic Images at Different Energy Levels in Dual-Energy Spectral CT on the Accuracy of Computer-Aided Detection for Pulmonary Embolism Publication date: July 2019 Source: Academic Radiology, Volume 26, Issue 7 Author(s): Guangming Ma, Yuequn Dou, Shan Dang, Nan Yu, Yanbing Guo, Chuangbo Yang, Shuanhong Lu, Dong Han, Chenwang Jin Purpose To investigate the influence of monoenergetic images of different energy levels in spectral computed tomography (CT) on the accuracy of computer aided detection (CAD) for pulmonary embolism (PE). Materials and Methods CT images of 20 PE patients who underwent spectral CT pulmonary angiography were retrospectively analyzed. Nine sets of monochromatic images from 40 to 80 keV at 5 keV interval were reconstructed and then independently analyzed for detecting PE using a commercially available CAD software. Two experienced radiologists reviewed all images and recorded the number of emboli manually, which was used as the reference standard. The CAD findings for the number of PE at different energies were compared with the reference standard to determine the number of true positives and false positives with CAD and to calculate the sensitivity and false positive rate at different energies. Result There were 120 true emboli. The total numbers of CAD-detected PE at 40–80 keV were 48, 67, 63, 87, 106, 115, 138, 157, and 226. Images at low energies had low sensitivities and low false positive rates; images at high energies had high sensitivities and high false positive rates. At 60 keV and 65 keV, CAD achieved sensitivity at 81.67% and 84.17%, respectively and false positive rate at 7.55% and 12.17%, respectively to provide the optimum combination of high sensitivity and low false positive rate. Conclusion Monochromatic images of different energies in dual-energy spectral CT affect the accuracy of CAD for PE. The combination of CAD with images at 60–65 keV provides the optimum combination of high sensitivity and low false positive rate in detecting PE.

The Association Between Bronchial Wall CT Attenuation and Spirometry in Patients with Bronchial Asthma Publication date: July 2019 Source: Academic Radiology, Volume 26, Issue 7 Author(s): Shoichiro Matsushita, Tsuneo Yamashiro, Shin Matsuoka, Kunihiro Yagihashi, Yasuo Nakajima Rationale and Objective The purpose of this study was to evaluate the correlation between generation-based bronchial wall attenuation on thin-section computed tomography (CT) scans and airflow limitation in patients with bronchial asthma. Materials and Methods This study included 28 bronchial asthma patients (13 men, 15 women; age range, 23–89 years) who underwent both chest CT and spirometry. On CT, the mean values of peak wall attenuation, wall area percentage, and luminal area were measured in the segmental, subsegmental, and sub-subsegmental bronchi of the right B1 and B10 bronchi. Correlations of the CT measurements with forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC), percent predicted forced expiratory flow at 25%–75% of the FVC (%pred forced expiratory flow25–75), and percent predicted peak flow rate were evaluated with Spearman's rank correlation test. Results The peak wall attenuation of each generation of segmental bronchi significantly correlated with the forced expiratory volume in 1 second/FVC (B1 segmental, ρ = −0.683, p < 0.0001; B1 subsegmental, ρ = −0.875, p < 0.0001; B1 sub-subsegmental, ρ = −0.926, p < 0.0001; B10 segmental, ρ = −0.811, p < 0.0001; B10 subsegmental, ρ = −0.903, p < 0.0001; B10 sub-subsegmental ρ = −0.950, p < 0.0001). Similar correlations were found between the peak wall attenuation and %pred forced expiratory flow 25–75 or percent predicted peak flow rate. Overall, the correlation coefficients were relatively high in the more peripheral bronchial generations. In all measurements, the coefficients of the peak wall attenuations were higher than those of the wall area percentage and luminal area. Conclusion Peak attenuation of the bronchial wall, particularly in the peripheral bronchi, measured on CT is a good biomarker for the severity of bronchial asthma.

A Comparison of Two Hyperpolarized 129Xe MRI Ventilation Quantification Pipelines: The Effect of Signal to Noise Ratio Publication date: July 2019 Source: Academic Radiology, Volume 26, Issue 7 Author(s): Mu He, Wei Zha, Fei Tan, Leith Rankine, Sean Fain, Bastiaan Driehuys Rationale Hyperpolarized 129Xe MRI enables quantitative evaluation of regional ventilation. To this end, multiple classifiers have been proposed to determine ventilation defect percentage (VDP) as well as other cluster populations. However, consensus has not yet been reached regarding which of these methods to deploy for multicenter clinical trials. Here, we compare two published classification techniques–linear-binning and adaptive K-means–to establish their limits of agreement and their robustness against reduced signal-to-noise ratio (SNR). Methods A total of 29 subjects (age: 38.4 ± 19.0 years) were retrospectively identified for inter-method comparison. For each 129Xe ventilation image, 7 images with reduced SNR were generated with equal decrements relative to the native SNR. All 8 sets of images were then analyzed using both methods independently to classify all lung voxels into four clusters: VDP, low-, medium-, and high-ventilation-percentage (LVP, MVP and HVP). For each cluster, the percentage of the lung it comprised was compared between the two methods, as well as how these values persisted as SNR was degraded. Results The limits of agreement for calculating VDP were [+0.2%, +4.0%] with a +1.5% bias for binning relative to K-means. However, the inter-method agreement for the other clusters was moderate, with biases of −5.7%, 8.1%, and −4.0% for LVP, MVP, and HVP, respectively. As SNR decreased below ∼4, both methods began reporting values that deviated substantially from the native image. By requiring VDP to remain within ≤1.8% of that calculated from the native image, the minimum tolerable SNR values were 2.4 ± 1.0 for the linear-binning, and 3.5 ± 1.5 for the K-means. Conclusions Both methods agree well in quantifying VDP, but agreement for LVP and MVP remains variable. We suggest a required SNR threshold be two standard deviations above the minimum value of 3.5 ± 1.5 for robust determination of VDP, suggesting a minimum SNR of 6.6. However, robust quantification of the ventilated clusters required an SNR of 13.4.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com