Cerebral Microstructure Analysis by Diffusion-Based MRI in Systemic Lupus Erythematosus: Lessons Learned and Research Directions

Diffusion-based magnetic resonance imaging (MRI) studies, namely diffusion-weighted imaging (DWI) and diffusion-tensor imaging (DTI), have been performed in the context of systemic lupus erythematosus (SLE), either with or without neuropsychiatric (NP) involvement, to deepen cerebral microstructure alterations. These techniques permit the measurement of the variations in random movement of water molecules in tissues, enabling their microarchitecture analysis. While DWI is recommended as part of the initial MRI assessment of SLE patients suspected for NP involvement, DTI is not routinely part of the instrumental evaluation for clinical purposes, and it has been mainly used for research. DWI and DTI studies revealed less restricted movement of water molecules inside cerebral white matter (WM), expression of a global loss of WM density, occurring in the context of SLE, prevalently, but not exclusively, in case of NP involvement. More advanced studies have combined DTI with other quantitative MRI techniques, to further characterize disease pathogenesis, while brain connectomes analysis revealed structural WM network disruption. In this narrative review, the authors provide a summary of the evidence regarding cerebral microstructure analysis by DWI and DTI studies in SLE, focusing on lessons learned and future research perspectives.

Optimization of Alkali-Activated Municipal Slag Composite Performance by Substituting Varying Ratios of Fly Ash for Fine Aggregate

This study investigates the effect of varying ratios of fly ash as a partial replacement for fine aggregate on the performance of alkali-activated municipal slag composites. The strength and other properties of alkali-activated cementitious material (AACM) composites can be optimized by selecting the appropriate mix proportion. In this study, we used fly ash as a substitute for fine aggregate (FA/S) at varying ratios of 0.0, 5.0, 10.0, 15.0, 20.0, 25.0, and 30.0%, mixed with 50% water (W/SL), and 20% alkali activator (AL/SL) content instead of municipal slag (SL) as a core binder, cured in steam conditions. The effects of these substitutions on the initial mixing temperature, slump flow, compressive and splitting tensile strengths, and microstructure analysis of composites cured in steam conditions were investigated at 1, 7, 28, and 91 days. The evaluation of the experimental results revealed that increasing the ratio of fly ash substitution to fine aggregate by up to 20.0% led to a higher strength attributable to the composites, whereas when the extra substitution ratio of FA/S ranged from 25.0–30.0%, significant decreases in strength were observed. The composites’ strengths were estimated using the ACI 209 and ACI 318 design equations and compared to the measured strengths.