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Mayumi Takeuchi ◽  
Kenji Matsuzaki ◽  
Masafumi Harada

Objectives: Uterine cervical cancer with bladder mucosal invasion is classified as FIGO stage IVA with poor prognosis. MRI can rule out the bladder invasion and skipping cystoscopy may be possible; however, high false-positive rate may be problematic. The purpose of this study is to evaluate the diagnostic performance of reduced field-of-view (FOV) diffusion-weighted imaging (DWI) in evaluating bladder mucosal invasion of cervical cancer. Methods: 3T MRI including T2WI and reduced FOV DWI in 15 women with histologically proven cervical cancer (two stage IIIB, six stage IVA, seven stage IVB) were retrospectively evaluated compared with cystoscopic findings. Results: Cystoscopy revealed mucosal invasion in 13 of 15 cases. The border between the tumor and the bladder wall was unclear on T2WI and clear on reduced FOV DWI in all 15 cases. The diagnosis of mucosal invasion on reduced FOV DWI had a sensitivity of 100%, specificity of 50%, accuracy of 93%, PPV of 93%, and NPV of 100%. Conclusions: Addition of reduced FOV DWI may improve the staging accuracy of MRI for cervical cancer in assessing the bladder mucosal invasion. Advances in knowledge: Reduced FOV DWI may improve the staging accuracy of cervical cancer in assessing bladder mucosal invasion with high NPV and PPV, which may be helpful for avoiding unnecessary cystoscopy.

Geosphere ◽  
2021 ◽  
Andrew V. Zuza ◽  
Christopher D. Henry ◽  
Seth Dee ◽  
Charles H. Thorman ◽  
Matthew T. Heizler

The Ruby Mountains–East Humboldt Range–Wood Hills–Pequop Mountains (REWP) metamorphic core complex, northeast Nevada, exposes a record of Mesozoic contraction and Cenozoic extension in the hinterland of the North American Cordillera. The timing, magnitude, and style of crustal thickening and succeeding crustal thinning have long been debated. The Pequop Mountains, comprising Neoproterozoic through Triassic strata, are the least deformed part of this composite metamorphic core complex, compared to the migmatitic and mylonitized ranges to the west, and provide the clearest field relationships for the Mesozoic–Cenozoic tectonic evolution. New field, structural, geochronologic, and thermochronological observations based on 1:24,000-scale geologic mapping of the northern Pequop Mountains provide insights into the multi-stage tectonic history of the REWP. Polyphase cooling and reheating of the middle-upper crust was tracked over the range of <100 °C to 450 °C via novel 40Ar/39Ar multi-diffusion domain modeling of muscovite and K-feldspar and apatite fission-track dating. Important new observations and interpretations include: (1) crosscutting field relationships show that most of the contractional deformation in this region occurred just prior to, or during, the Middle-Late Jurassic Elko orogeny (ca. 170–157 Ma), with negligible Cretaceous shortening; (2) temperature-depth data rule out deep burial of Paleozoic stratigraphy, thus refuting models that incorporate large cryptic overthrust sheets; (3) Jurassic, Cretaceous, and Eocene intrusions and associated thermal pulses metamorphosed the lower Paleozoic–Proterozoic rocks, and various thermochronometers record conductive cooling near original stratigraphic depths; (4) east-draining paleovalleys with ~1–1.5 km relief incised the region before ca. 41 Ma and were filled by 41–39.5 Ma volcanic rocks; and (5) low-angle normal faulting initiated after the Eocene, possibly as early as the late Oligocene, although basin-generating extension from high-angle normal faulting began in the middle Miocene. Observed Jurassic shortening is coeval with structures in the Luning-Fencemaker thrust belt to the west, and other strain documented across central-east Nevada and Utah, suggesting ~100 km Middle-Late Jurassic shortening across the Sierra Nevada retroarc. This phase of deformation correlates with terrane accretion in the Sierran forearc, increased North American–Farallon convergence rates, and enhanced Jurassic Sierran arc magmatism. Although spatially variable, the Cordilleran hinterland and the high plateau that developed across it (i.e., the hypothesized Nevadaplano) involved a dynamic pulsed evolution with significant phases of both Middle-Late Jurassic and Late Cretaceous contractional deformation. Collapse long postdated all of this contraction. This complex geologic history set the stage for the Carlin-type gold deposit at Long Canyon, located along the eastern flank of the Pequop Mountains, and may provide important clues for future exploration.

2021 ◽  
Vol 11 (3-4) ◽  
pp. 1-22
Qiang Yang

With the rapid advances of Artificial Intelligence (AI) technologies and applications, an increasing concern is on the development and application of responsible AI technologies. Building AI technologies or machine-learning models often requires massive amounts of data, which may include sensitive, user private information to be collected from different sites or countries. Privacy, security, and data governance constraints rule out a brute force process in the acquisition and integration of these data. It is thus a serious challenge to protect user privacy while achieving high-performance models. This article reviews recent progress of federated learning in addressing this challenge in the context of privacy-preserving computing. Federated learning allows global AI models to be trained and used among multiple decentralized data sources with high security and privacy guarantees, as well as sound incentive mechanisms. This article presents the background, motivations, definitions, architectures, and applications of federated learning as a new paradigm for building privacy-preserving, responsible AI ecosystems.

2021 ◽  
Alejandro Lazo-Langner ◽  
Benjamin Chin-Yee ◽  
Jaryd Tong ◽  
Lori Lowes ◽  
Benjamin D. Hedley ◽  

Background. Detection of viral RNA by nucleic acid amplification testing (NAAT) remains the gold standard for diagnosis of SARS-CoV-2 infection but is limited by high cost and other factors. Whether serology-based assays can be effectively incorporated into a diagnostic algorithm remains to be determined. Herein we describe the development of a serology-based testing algorithm for SARS-CoV-2 infection. Patients and Methods. Between July 2020 and February 2021, we included symptomatic unvaccinated patients evaluated in the Emergency Department of our institution for suspected SARS-CoV-2. All patients had testing by real-time Reverse Transcription Polymerase Chain Reaction. The performance characteristics of five commercial enzymatic serology assays testing for different antibody isotypes were evaluated in a derivation cohort and the assay with the best performance was further tested on a validation cohort. Optimal cut-off points were determined using receiver operating characteristic (ROC) curves and further tested using logistic regression. Results. The derivation and validations cohorts included 72 and 319 patients, respectively. Based on its initial performance, the Elecsys Anti-SARS-CoV-2 assay (Roche Diagnostics) was further tested in the validation cohort. Using ROC curve analysis, we estimated the diagnostic performance for different cut-off points assuming a prevalence of positive tests of 5%. At any given cut-off point the NPV was over 97%. Discussion. This study suggests that an initial diagnostic strategy using the Elecsys Anti-SARS-CoV-2 serology test in symptomatic unvaccinated patients could help to rule out an acute SARS-CoV2 infection and potentially lead to appropriately tailored infection control measures or rational guidance for further testing with a potential cost reduction and increased availability

Arun P. Ajith ◽  
Aishwarya Ullal ◽  
Sanjeev Mishra

<p><strong>Background:</strong> Virtual bronchoscopy (VB) is a software based, three-dimensional visualization format created from non-invasive medical imaging methods such as CT and magnetic resonance imaging, with the goal of creating views similar to minimally invasive bronchoscopy procedure. The aim of the study was to find the usefulness of VB in diagnosing vegetative and non-vegetative longstanding intra bronchial foreign bodies (FB).</p><p><strong>Methods</strong>: This was a retrospective and prospective cross-sectional study conducted in the department of otorhinolaryngology M. G. M. M. C and M. Y. hospital Indore for a period of 5 years. The medical records of patients with FB aspiration from august 2006 to September 2015 were reviewed. Data was collected regarding their clinical presentation examination and chest x-ray findings. Patients with suspected FB aspiration were subjected to VB and rigid bronchoscopy was performed.<strong></strong></p><p><strong>Results: </strong>In the subjects, we observed that chest radiograph were normal in as many as 40% cases. Hence negative chest radiographs do not rule out FB.  In 48 patients with FB aspiration, which was detected by VB, 46 patients were diagnosed to have FB on rigid bronchoscopy. This amounts to a positive predictive value of 98%, which was similar to the gold standard, which is rigid bronchoscopy which had a positive predictive value of 99%.</p><p><strong>Conclusions: </strong>VB is the only imaging modality which gives 99.9% reassurance about the presence or absence of a FB, because of its high sensitivity and specificity, hence proves to be a lifesaving tool.</p>

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Shinya Ishizuka ◽  
Akinori Kobayakawa ◽  
Hideki Hiraiwa ◽  
Hiroki Oba ◽  
Takefumi Sakaguchi ◽  

The most common cause of medial scapular winging is long thoracic nerve palsy (LTN) and subsequent serratus anterior muscle dysfunction. A 16-year-old right-handed male high-school rugby player developed severe right-sided neck and shoulder pain after tackling an opponent while playing rugby. Six weeks after initial injury, the patient observed shoulder muscle weakness when performing his daily activities. On physical examination, limited active elevation of the right shoulder in the scapular plane and scapular winging was observed. Magnetic resonance imaging revealed atrophy of both the SA and subclavius muscles on the right side, and we initially suspected an LTN injury sustained. However, while detailing his history, the patient explained that he also had noted difficulty sucking high viscosity drinks such as shakes and smoothies since childhood. In addition, physical examination showed weakness of the orbicularis oculi muscle. Considering the facial muscle weakness, facioscapulohumeral dystrophy (FSHD) was also suspected, and genetic testing showed chromosome 4q35 deletion with restriction fragments 17 kb and 3 tandem repeated DNA confirming the diagnosis of FSHD. Clinicians should be aware that FSHD could be one of the differential diagnoses of scapular winging after sports injury, and surgeons should rule out the diagnosis of FSHD before performing any surgical treatment for SA palsy.

Sanjay Patidar ◽  
Kritika Kamal ◽  
Jaydip Sinh Kathota ◽  
Sudhanshu Tiwari ◽  
Prashant Nakrani

Background: In clinical practice, biopsies are generally performed only when the results ofprostate specific antigen (PSA) test or digital rectal examination (DRE) are abnormal. This leads to misdiagnosis of most small prostatic cancers present in many older men. Patients with lower urinary tract infection (LUTS) who have serum PSA levels higher than 4ng/ml are primarily advised to undergo prostate biopsy to rule out cancer. However, PSA is organ specific not disease specific, so the presence of other prostate diseases such as benign prostatic hyperplasia (BPH) and prostatitis may influence its effectiveness for cancer detection. Hence, the PSA based prostate cancer detection is fraught with high false positive rate. Aim:To evaluate the utility of PSA assay as a method of investigation in diagnosis of prostatic lesion. Objectives: The use of Serum PSA levels for the early detection of prostate cancer and evaluate its role with other modalities for diagnosis of prostate cancer and to diagnose different diseases of prostate, i.e. prostatitis, BPH in prostatomegaly, and its correlation with Serum PSA levels. Materials and Methods: This prospective descriptive study was conducted in Index Medical College, Hospital & Research Centre, Indore, M.P,India in the period of August 2019 to July 2021. The patients were selected from the outdoor Department of General Surgery. Results: A total of 80 male patients presenting with LUTS were included. Their mean age was 68.66 years. The majority i.e. 41 of the study group were in the age group of 61-70 years. 42 of patients had Serum PSA < 4ng/ml. Biopsy proven adenocarcinoma cases 34% of the cases are in the age group of 61-70 years. Out of the biopsy proven adenocarcinoma cases, DRE was suspicious of malignancy in 89%. Conclusion: Serum PSA levels have a significant correlation with the age group, with the increase in age there is rise in Serum PSA levels. Transabdominal ultrasound, DRE and Serum PSA has high sensitivity in diagnosis of prostatomegaly but it was found that none of the screening tool has got much efficacy in differentiating carcinoma prostate from benign hypertrophy, but the combination of DRE and Serum total PSA or DRE, Serum total PSA and ultrasound abdomen showed higher efficacy in diagnosis of carcinoma prostate. Increase in Serum PSA is directly related to carcinoma, but there is no absolute cut-off for Serum PSAfor diagnosis of carcinoma. Key-Words: Prostate specific antigen, Prostatomegaly, Benign Prostatic Hypertrophy, Digital Rectal Examination, International Prostate Severity Score, Carcinoma Prostate.

2021 ◽  
Vol 2 (5) ◽  
pp. 7040-7052
Paula Andrea Benito Benito ◽  
Manuel Yecid Fernandez Torres ◽  
Jhonny Orlando Tolosa Cetina

En este trabajo se analizan los efectos biológicos de las radiaciones electromagnéticas a partir de la recopilación y comparación de fuentes bibliográficas que evidencian el estudio de dicho fenómeno físico, analizado mediante una metodología cualitativa basada en la revisión bibliográfica de trabajos que reportan aspectos fundamentales del tema en cuestión y examinados por medio de una matriz de análisis que recoge los puntos de vista más importantes de cada investigación. Dentro de los resultados obtenidos no hay coincidencia, ya que algunos autores apoyan la idea de que estas radiaciones son perjudiciales para la salud humana, mientras que otros no descartan la posibilidad de que estas puedan ser inofensivas para el ser humano, pero sin desechar el riesgo de que a largo plazo puedan generar problemas de salud. Después de realizar las evaluaciones correspondientes y utilizar los métodos ya mencionados con anterioridad, se concluye que las radiaciones electromagnéticas pueden llegar a ser perjudiciales para la salud humana a exposiciones prolongadas, por esto se advierte sobre posibles enfermedades y se dan recomendaciones al respecto.   This work analyzes the biological effects of electromagnetic radiation based on the compilation and comparison of bibliographic sources that evidence the study of this physical phenomenon, analyzed by means of a qualitative methodology based on the bibliographic review of works that report fundamental aspects of the subject in question and examined by means of an analysis matrix that gathers the most important points of view of each research. Within the results obtained there is no coincidence, since some authors support the idea that these radiations are harmful to human health, while others do not rule out the possibility that they may be harmless to humans, but without discarding the risk that in the long term they may generate health problems. After performing the corresponding evaluations and using the methods mentioned above, it is concluded that electromagnetic radiations may be harmful to human health with prolonged exposure, and for this reason a warning is given about possible diseases and recommendations are given in this regard.

2021 ◽  
Vol 13 (4) ◽  
pp. 583-588
Paola Feraco ◽  
Francesca Incandela ◽  
Roberto Franceschi ◽  
Cesare Gagliardo ◽  
Maria Bellizzi

Vitamin B12 (Vit-B12) deficiency is a rare and treatable cause of failure to thrive and delayed development in infants who are exclusively breastfed. Apart from genetic causes, it can be related to a malabsorption syndrome or when the mother follows a strict vegetarian or vegan diet, causing a low hepatic storage of Vit-B12 in the infant at birth. As the neurological symptoms are nonspecific, a brain magnetic resonance imaging (MRI) exam is usually performed to rule out primary causes of neurodevelopmental delay. Findings related to brain atrophy are usually observed. A favorable response is achieved with Vit-B12 therapy, and neurological symptoms dramatically improve within a few days after the treatment. We present the case of an infant with severe Vit-B12 deficiency, exclusively breastfed by his young vegan mother, and whose clinical symptoms together with MRI findings improved after treatment. Brain atrophy recovery after Vit-B12 therapy has been seldom documented.

2021 ◽  
Vol 233 (5) ◽  
pp. e111
Aman Kumar ◽  
Alex Zendel ◽  
Pablo Serrano Rodriguez ◽  
Michael Batres ◽  
Jennifer S. Vonderau ◽  

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