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Background: Pregnancy-related acute kidney injury (Pr-AKI) is a significant factor associated with increased maternal and fetal morbidity and mortality in developing countries. The aim of our study was to investigate the clinical data and associated outcomes in patients diagnosed with postpartum AKI (PP-AKI) at our center. Methods: This prospective study at Zagazig University Hospital, Egypt, from October 1, 2023, to March 1, 2024, included patients with PP-AKI. These women were compared to a matched cohort of healthy pregnant women without pre-existing AKI. Multivariate analysis is used to identify risk factors. Results: Out of 900 pregnant patients who delivered during the study period, 52 patients developed PP-AKI with prevalence of 5.7%. The majority were multiparous (59.6%), and most delivered by cesarean section (67.3%). The most common cause of AKI is preeclampsia (51.9%), followed by antepartum hemorrhage (40.4%) and HELLP syndrome (36.5%). Stage 3 AKI (KDIGO classification) was the most prevalent occurring in 23% of cases. Maternal death occurred in 13.5% of cases, while fetal death was 17.3%. Follow-up showed that 42.3% had complete recovery, 30.7% CKD and 13.4% remained dialysis-dependent. Risk factors for AKI included high WBC, low Hb, low platelets, and high bilirubin levels, with p-values of 0.004, <0.0001, and 0.031, respectively. Additionally, nulliparous women had significantly lower odds of developing AKI (0.248, p = 0.017). However, the significance of these risk factors disappeared in multivariate analysis. Conclusion: PP-AKI is a relatively common pregnancy complication with significant maternal and fetal mortality risks. Preeclampsia and ante-partum hemorrhage are major risk factors. Larger, long-term follow-up studies are recommended to confirm these findings. [ABSTRACT FROM AUTHOR]

Objectives: Hospitals' accreditation process is carried out to enhance the quality of hospitals' care and patient safety practices as well. The current study aimed to investigate the influence of hospitals' accreditation on patient safety culture as perceived by Jordanian hospitals among nurses. Methods: A descriptive cross-sectional correlational survey was used for the current study, where the data were obtained from 395 nurses by convenient sampling technique who were working in 3 accredited hospitals with 254 nurses, and 3 non-accredited hospitals with 141 nurses, with a response rate of 89%. Results: The overall patient safety culture was (71.9%). Moreover, the results of the current study revealed that there were no statistically significant differences between the perceptions of nurses in accredited and non-accredited hospitals in terms of perceptions of patient safety culture. Conclusion: The current study will add new knowledge about nurses' perceptions of patient safety culture in both accredited and non-accredited hospitals in Jordan which in turn will provide valid evidence to healthcare stakeholders if the accreditation status positively affects the nurses' perceptions of patient safety culture or not. Continuous evaluation of the accreditation application needs to be carried out to improve healthcare services as well as quality and patient safety. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To appreciate the importance of patient safety incident reporting practices • To understand that optimal patient safety incident reporting practices require effective leadership behaviours • To be aware of the need for a positive organisational culture to improve incident reporting practices Background: Patient safety is a priority for all healthcare organisations. Enhancing patient safety incident reporting practices requires effective leadership behaviours at all levels in healthcare organisations. Aim: To explore nurses' perceptions of the influence of nurse managers' leadership behaviours and organisational culture on patient safety incident reporting practices. Method: A descriptive, cross-sectional, correlational design was adopted with a convenience sample of 325 nurses from 15 Jordanian hospitals. Results: Respondents had positive perceptions of their nurse managers' leadership behaviours and organisational culture. There was a significant positive relationship between leadership behaviours and organisational culture (r=0.423, P<0.001) and between leadership behaviours and actual incident-reporting practices (r=0.131, P<0.001). Additionally, there was a significant positive relationship between organisational culture and incident-reporting practices (r=0.250, P<0.001). Conclusion: Healthcare organisations must develop leaders who will foster a supportive and just culture that will enhance nurses' practice with regards to reporting patient safety incidents. [ABSTRACT FROM AUTHOR]

Highlights: What are the main findings? A complete series of structures differing from H-DIP to I-DIP. Rationalizing the Cl-DIP structure (Z' = 3) with two distinct conformations. The great wall of bromines at the 2D sheet interfaces in Br-DIP. What is the implication of the main finding? Comparison of organic halogenated materials Br-DIP and the inorganic PbBr2, CuBr2. The unusual synthon formed by the tightly bound hydrate in I-DIP•½(H2O). Simple Summary: Crystal and modelled structures of five N1,N3-di(5-X-pyridin-2-yl)isophthalamides (X = H, F to I) as (X-DIP) are reported. The roles that their molecular conformations and interactions play in solid-state aggregation are assessed. Cl-DIP (Z' = 3) exhibits both syn/anti and anti/anti molecular conformations in 2:1 ratio. The hydrogen bonding hierarchy and sheet formation in Br-DIP induces the formation of a bromine-rich environment manifesting as a 'wall of bromine atoms' at the sheet interfaces. The hydrate in I-DIP•½(H2O) forms a rare synthon. The synthesis and spectroscopic characterisation of six bis(5-X-pyridine-2-yl)isophthalamides (X = H, F, Br, Cl, I, NO2) are reported, together with five crystal structure analyses (for X = H, F to I). The isophthalamides span a range of conformations as syn/anti (H-DIP; I-DIP), anti/anti- (F-DIP; Br-DIP) and with both present in ratio 2:1 in Cl-DIP. The essentially isostructural F-DIP and Br-DIP molecules (using strong amide...amide interactions) aggregate into 2D molecular sheets that align with either F/H or Br atoms at the sheet surfaces (interfaces), respectively. Sheets are linked by weak C-H⋯F contacts in F-DIP and by Br⋯Br halogen bonding interactions as a 'wall of bromines' at the Br atom rich interfaces in Br-DIP. Cl-DIP is an unusual crystal structure incorporating both syn/anti and anti/anti molecular conformations in the asymmetric unit (Z' = 3). The I-DIP•½(H2O) hemihydrate structure has a water molecule residing on a twofold axis between two I-DIPs and has hydrogen and N⋯I (Nc = 0.88) halogen bonding. The hydrate is central to an unusual synthon and involved in six hydrogen bonding interactions/contacts. Contact enrichment analysis on the Hirshfeld surface demonstrates that F-DIP, Cl-DIP and Br-DIP have especially over-represented halogen···halogen interactions. With the F-DIP, Cl-DIP and Br-DIP molecules having an elongated skeleton, the formation of layers of halogen atoms in planes perpendicular to the long unit cell axis occurs in the crystal packings. All six DIPs were analysed by ab initio calculations and conformational analysis; comparisons are made between their minimized structures and the five crystal structures. In addition, physicochemical properties are compared and assessed. [ABSTRACT FROM AUTHOR]

Cherry laurel (Laurocerasus officinalis) belongs to the Rosacea family. The main distribution area for edible cherry laurels is the Blacksea shores in Turkey. In the study, it was aimed to reveal the differences among the various cherry laurel genotypes by using the SSR molecular marker technique. Cherry laurel genotypes were selected from the Black Sea Region of Turkey. A total of 15 SSR primer pairs were developed and used for Prunus species, and the phylogenetic relationship and polymorphism rates were also demonstrated. As a result, 13 SSR primers resulted in scorable DNA band profiles. UDAp-401 SSR primer was detected with a minimum of 3 alleles and BBCT001 primer with a maximum of 17 alleles. The average number of alleles was observed at 9 per locus. Whereas, the average number of polymorphic bands per SSR marker was calculated as 8.38. Additionally, 109 polymorphic DNA profiles were obtained from a total of 117, and the polymorphism rate was calculated as 93.5%. The band patterns resulting from SSR analysis showed multiple alleles, suggesting polyploidy in cherry laurel. In conclusion, we determined that the SSR molecular markers could be used to identify the different cherry laurel genotypes. Furthermore, these results depicted that among the different genotypes sampled there is significant genetic variability that can be useful for future research and breeding programs. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to examine the effect of Marketing knowledge on service marketing innovation, to determine the effect of Marketing knowledge on corporate brand image, to identify the effect of service marketing innovation on corporate brand image, and to develop a framework for the impact of marketing knowledge on service marketing innovation, as well as the role of corporate brand image in mediating the link between the variables. To obtain the necessary data, we will conduct quantitative analyses and structural equation models (SEMs) using a questionnaire tool and AMOS software version 25. The study's primary conclusions are that marketing knowledge has a direct effect on corporate brand image, that marketing knowledge has a direct effect on service marketing innovation, and that service marketing innovation has a direct effect on corporate brand image. Our findings indicate that service marketing innovation acts as a mediator in the interaction between marketing knowledge and corporate brand image. [ABSTRACT FROM AUTHOR]

The effect of Aloe vera application (33% and 66% as dipping, AV) on 'Bluecrop' blueberry's (Vaccinium corymbosum) quality properties such as weight loss, respiration rate, fruit color, soluble solids content (SSC), acidity, phytochemical components (vitamin C, total phenolics, and total flavonoids) and antioxidant activity was investigated during the cold storage (at 0 ± 0.5°C and 90 ± 5% RH) for 28 days. During cold storage, significantly lower weight loss was recorded in fruit treated with AV compared to control. At the end of the cold storage, the weight loss was 20% lower in AV treated fruits and AV concentration was not effective in weight loss. On the contrary, the respiration rate (except for the 7th day) and fruit firmness were higher in these fruit. It was observed that color changes were less in AV-treated fruit during storage. In general, AV-treated fruit had significantly lower SSC, while acidity and vitamin C were higher. Moreover, 66% AV application was more effective in delaying the loss of vitamin C at the end of storage. During cold storage, 33% AV-treated fruit had significantly higher total phenolics (except day 28) and total flavonoids content compared to control. In the last two measurements of the cold storage, it was determined that fruit dipped in AV had higher antioxidant activity (both DPPH and FRAP assays) compared to control fruit. As a result, it was revealed that postharvest AV gel applications can be used as an effective postharvest tool to delay the loss of quality, the loss of phytochemical components and antioxidant activity of the blueberry fruit. [ABSTRACT FROM AUTHOR]

Background: Cystic lesions of the kidney are relatively frequent and may represent benign cysts, premalignantlesions, or malignant neoplasms. When asingle layer of cuboidal or flattened cells lines a cystic lesion, they are considered simple renal cortical cysts. Aim Of The Work: Our study aims to determine the frequency and associated risk factors of renal cysts. Patients&Methods: A cross-sectional study including 242 subjects undergoing abdominal CT, aging more than 18 years, and with no history of medical diseases. All involved patients were subjected to Routine investigations, including Random bloodsugar, postprandial bloodglucose., HbA1c, Complete bloodpicture, Serum creatinine, urea, andcholesterol in addition to Complete Urineanalysis. All participants were subjected to Computed tomography (CT)abdomen. Results:18.6% of the studied group had Pyuria, 29.5% had Urate crystal, 14% had microscopic hematuria, 1.2% had gross hematuria, and 29.3% had proteinuria. 20.2% (49 cases) had cyst among the studied population. Cyst cases were significantly associated with older age, male sex, smoking, diabetes mellitus, hypertension, and longer duration of treatment of DM and HTN. RBS, 2PP BS, HbA1C, Cholesterol, Cr, and Urea were significantly higher among cases with the cyst. Also, cases with cysts were significantly associated with Pyuria and Proteinuria. Conclusion: Significant risk factors for the occurrence of renal cysts include older age, male sex, hypertension, diabetes mellitus, smoking, longer DM or HTN TTTduration. Serum Urea, Creatinine, Cholesterol, urinary Pus, and Proteinuria are also significant factors affecting renalcysts. However, BMI, chronic use of NSAIDs, CBC findings, urate crystals, and hematuria are not statistically significant factors affecting renalcysts. [ABSTRACT FROM AUTHOR]

Background: There is marked variety in Acute Kidney Injury (AKI) incidence and clinical characteristics as regards independent developmental risk factors and independent risk factors that could affect the outcome especially in critical care setting. Objectives: The aim of the work was to identify incidence and the clinical features of AKI in critical care situation and its impression on outcomes. Patients and Methods: A prospective cohort study in which patients were screened for AKI during the period from October 2018 to September 2019 using the AKIN criteria. Results: Incidence of AKI in critical care setting was 20.3% (63/310). The most independent risk factors for the development of AKI based on multivariate Logistic analysis were sepsis (p value: 0.000, estimated odds ratio: 4.492 and confidence intervals between 2.037 and 9.906) and chronic kidney disease (CKD) (p<0.001, estimated odds ratio: 8,982 and confidence intervals between 3,852 and 20,945). The most independent risk factor for poor AKI outcome was the need for renal replacement therapy (RRT) based on a multivariate logistic analysis (p<0.001, estimated odds Ratio: 3.649 and confidence interval between 1.145 and 4.050). Late nephrologist consultation comes in second place (p=0.002, estimated odds ratio: 4.902 and confidence interval between.463 and 9.316). Mortality in AKI group was 31% (3 patients in stage 2 and 17 patients in stage 3) compared to 42/247 (17%) in patients without AKI. Conclusion: The incidence of AKI in Zagazig University Internal Medicine ICU was 20.3 %. Sepsis was the most independent risk factor for the occurrence of AKI in ICU. The most independent risk factors for poor outcome following AKI development were the need for RRT, Late nephrologist consultation, longer duration of AKI and a high APACHE score. [ABSTRACT FROM AUTHOR]

This study aimed to determine the fatty acid composition and oil oxidation of hazelnuts dried with drying methods (drying machine, concrete and grass ground; DM, CG and GG, respectively) during 18 months of storage (2014-2016) at 20-25°C and 70-90% relative humidity. Palaz cultivar identified a total 13 fatty acids such as myristic (C14:0), palmitic (C16:0), palmitoleic (C16:1), margaric (C17:0), heptadecenoic (C17:1), stearic (C18:0), oleic (C18:1), linoleic (C18:2), linolenic (C18:3), arachidic acid (C20:0), eicosenoic (C20:1), behenic (C22:0), and nervonic acid (C24:0). As expected, monounsaturated fatty acid was the main fatty acid group (83.02%) followed by polyunsaturated (11.47%) and saturated fatty acids (6.91%). The lowest peroxide and iodine value, and the highest oleic/linoleic acidity ratio were found in DM. [ABSTRACT FROM AUTHOR]

This work was carried out to evaluate the effects of sun-dried (concrete ground and grass ground; CG, GG, respectively) and artificial dried (DM) on chemical properties of hazelnut during storage. The following parameters were measured; protein, lipid and moisture content, water activity, aflatoxin, fatty acid composition, total fatty acids, and oil oxidation along 18 months storage (2014 - 2016) at 20-25 °C and 70-90% relative humidity. The results showed that monounsaturated fatty acid (MUFA) was the main fatty acid group (81.36-84.46%) followed by polyunsaturated (9.41-12.18%) and saturated fatty acids (5.74-7.31%). Samples dried in DM had more MUFA (84.46%) than those sun-dried samples. Furthermore, the lowest iodine value and the highest oleic/linoleic acidity ratio were found in DM. Hence, DM could be as the new potential for Tombul (cv) hazelnut drying. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the effects of different drying methods of sun-dried (grass and concrete ground) machine drying on chemical properties of Levant quality hazelnut in coastal region (Ordu, Turkey) during storage. In conventional drying, only solar energy was used and the drying time was about 50-58 h (concrete ground and grass ground, respectively), and in the drying machine it lasted about 30 h. After the drying and storage time, while the highest rancimat value (5.73 h) and the lowest peroxide value (0.27 meqO2kg g-1) were found in the drying machine and the concrete ground gave the lowest free fatty acid (0.04 %). At the end of the storage period, the lowest free fatty acid and peroxide value were determined on concrete ground (0.29 %) and on drying machine (0.00 meqO2kg-1), respectively. In addition, total aflatoksin and aflatoxin B1 were not detected in any drying methods during storage. As a result, the drying machine was more effective than the other two drying methods for nut quality and preservation. In addition, it has been observed that hazelnuts can be stored for 24 months without significant change in nut quality in room conditions. [ABSTRACT FROM AUTHOR]

Cardiac indices estimation is of great importance during identification and diagnosis of cardiac disease in clinical routine. However, estimation of multitype cardiac indices with consistently reliable and high accuracy is still a great challenge due to the high variability of cardiac structures and the complexity of temporal dynamics in cardiac MR sequences. While efforts have been devoted into cardiac volumes estimation through feature engineering followed by a independent regression model, these methods suffer from the vulnerable feature representation and incompatible regression model. In this paper, we propose a semi-automated method for multitype cardiac indices estimation. After the manual labeling of two landmarks for ROI cropping, an integrated deep neural network Indices-Net is designed to jointly learn the representation and regression models. It comprises two tightly-coupled networks, such as a deep convolution autoencoder for cardiac image representation, and a multiple output convolution neural network for indices regression. Joint learning of the two networks effectively enhances the expressiveness of image representation with respect to cardiac indices, and the compatibility between image representation and indices regression, thus leading to accurate and reliable estimations for all the cardiac indices. When applied with five-fold cross validation on MR images of 145 subjects, Indices-Net achieves consistently low estimation error for LV wall thicknesses (1.44 ± 0.71 mm) and areas of cavity and myocardium (204 ± 133 mm2). It outperforms, with significant error reductions, segmentation method (55.1% and 17.4%), and two-phase direct volume-only methods (12.7% and 14.6%) for wall thicknesses and areas, respectively. These advantages endow the proposed method a great potential in clinical cardiac function assessment. [ABSTRACT FROM PUBLISHER]

PROBLEM: Emotional intelligence (EI) is an ability to recognize our and others' emotions, and manage emotions in ourselves and in relationships with other people. A large body of research evidence outside nursing shows that measured (EI) abilities correlated with employee performance, motivation, and job satisfaction; and preliminary nursing research evidence shows the correlation between EI ability and nurses' clinical performance. There is less research on the EI ability of Jordanian nurses, and the present study was undertaken to address this gap. METHODS: A descriptive, cross‐sectional, correlation comparative design (nonexperimental) was employed. Six Jordanian hospitals were included in the study. Two hundred fifty questionnaires were distributed to prospective participants. One hundred ninety‐four questionnaires were returned, giving a response rate of 78%. EI was measured using the Genos Instrument. Clinical performance was measured using a self‐report measure. FINDINGS: Findings demonstrated significant positive relationships between all subscales of EI and job performance, ranging from r =.250, p =.000 to r =.193, p =.007. Regression analysis indicated working in medical–surgical wards, recognizing and expressing emotions scores (β = 0.186, p =.048), and controlling emotions (β = 0.255, p =.027) explained 19.1% of variance in nurses’ job performance. CONCLUSIONS: The study findings confirm the correlation between nurse EI ability and clinical performance. [ABSTRACT FROM AUTHOR]

The diagnosis, comparative and population study of cardiac radiology data require heart segmentation on increasingly large amount of images from different modalities/chambers/patients under various imaging views. Most existing automatic cardiac segmentation methods are often limited to single image segmentation with regulated modality/region settings or well-cropped ROI areas, which is impossible for large datasets due to enormous device protocols and institutional differences. A pure data-driven unsupervised segmentation without regulated setting requirements is crucial in this scenario, and will significantly automate the manual work and adopt the various changes of modality, subject or view. In this paper, we propose a general unsupervised groupwise segmentation: a direct simultaneous segmentation for a group of multi-modality, multi-chamber, multi-subject ( M^3) cardiac images from a freely chosen imaging view. The segmentation can directly perform not only on regulated two/four-chamber images, but also on non-regulated uncropped raw MR/CT scans. A new Synchronized Spectral Network (SSN) is developed for the simultaneous decomposing, synchronizing, and clustering the spectral features of free-view M^3 cardiac images. The SSN-based groupwise analysis of image spectral bases immediately leads to groupwise segmentation of M^3 freeview images. The segmentation is quantitatively evaluated by three datasets (MR and CT mixed) with more than 200 subjects. High dice metric ( > 85\%) is consistently achieved in validation. Our method provides a powerful tool for medical images under general imaging environment. [ABSTRACT FROM AUTHOR]

• During cold storage, weight loss and respiration rate were delayed with MAP. • Firmness and acidity of fruit stored in MAP were higher at the end of storage. • Vitamin C and bioactive compounds of jujube in AV and MAP were higher than control. • AV and MAP treatments could be an effective tool for retarding the losses. This study assessed Aloe vera gel (AV) and modified atmosphere packaging (MAP) treatments on weight loss, respiration rate, color, firmness, soluble solids content (SSC), titratable acidity, vitamin C, phenol, flavonoids and antioxidant activity of jujube (Ziziphus jujuba Mill. cv. 'Li') fruit during cold storage and shelf life. Fruit were stored at 0 ± 0.5 °C and 90 ± 5 % relative humidity (RH) for 35 d followed by 21 ± 1.0 °C and 65 ± 5 % to simulate shelf life for 4 d. During cold storage, weight loss and respiration rate were delayed by MAP. At the end of cold storage, higher firmness and acidity were measured in fruit treated with MAP compared to control. Also, L*, hue angle, vitamin C, total phenolics, and the antioxidant activity of jujube fruit treated with both AV and MAP were higher than control. However, lower chroma and SSC in fruit treated with MAP were determined. During shelf life storage, higher firmness, L*, hue angle and acidity in fruit treated with MAP were obtained compared to control and AV treatments, whereas lower chroma and SSC were observed. On the last day of shelf life measurement (35 + 4 d), vitamin C, total phenolics, total flavonoids and antioxidant activity (DPPH and FRAP assays) of fruit treated with both AV and MAP was higher than control. In conclusion, it was revealed that AV and MAP treatments could be an effective tool for retarding the losses that occurred in the fruit quality of jujube during cold storage and shelf life. The effect of MAP treatment in maintaining fruit quality was more pronounced. [ABSTRACT FROM AUTHOR]

Intrathoracic rib (IR) is a very rare anomaly in which a normal, an accessory, or a bifid rib lies within the chest cavity and may originate from a vertebra or a rib. It is more commonly present on the right side, and sometimes it may be associated with vertebral anomalies. Only 50 cases have been reported to date in the literature. In most cases, the IR is an isolated finding; it is incidentally detected and is asymptomatic. The IR can be easily missed on a chest radiograph and can be mistaken initially for a pleural lesion, lung consolidation, other peripheral lung parenchymal lesions, or a bony lesion. It is, therefore, essential for physicians and radiologists to know about this entity and consider it in the differential diagnosis, to avoid further evaluation and unnecessary investigations. We present a unique case of three intrathoracic ribs, a left second supernumerary rib, left third depressed normonumerary rib, and bifid arm of the left third rib, with block vertebrae and hypoplastic left lung. To our knowledge, this is the first such case presentation in the published literature. [ABSTRACT FROM AUTHOR]

A 51-year-old man presented with a 5-day history of progressive facial swelling, sensation of head fullness, increasing shortness of breath and paroxysmal nocturnal dyspnea. He denied chest pain, syncope or presyncope. Past medical history included mechanical aortic valve replacement 7 years prior and atrial fibrillation treated with warfarin. A clinical diagnosis of acute superior vena cava (SVC) syndrome was made. Portable chest radiograph showed a widened superior mediastinum. Computed tomography scan of the thorax demonstrated a large type A aortic dissection almost completely effacing the SVC. Acute type A aortic dissection (AD) is an emergency requiring prompt diagnosis and treatment. Patients typically present with acute onset of chest and/or back pain, classically described as "ripping" or "tearing." SVC syndrome is rarely, if ever, mentioned as a presentation, as it is usually due to more chronic conditions. This case illustrates a rare incidence of type A AD actually presenting as SVC syndrome. [ABSTRACT FROM AUTHOR]

In this study, the effect of storage periods (0, 2, 3 and 4 months) on physico-chemical and colour properties of organic and conventional kiwifruits were investigated. The fruit mass, geometric mean diameter, volume of organic and conventional kiwifruits decreased with increasing storage period. The skin and flesh firmnesses were higher in organic kiwifruits than that of conventional kiwifruits. The organic acid contents was higher in conventional kiwifruits than that of organic kiwifruits; the sugar contents was higher in organic kiwifruits than that of conventional kiwifruits. Colour characteristics (L*, a*, b*) for skin fruit and fruit juice in organic and conventional kiwifruits were higher in conventional kiwifruits than that of organic kiwifruits. Results from this study showed that the physico-chemical properties and colour characteristics of organic and conventional kiwifruits were affected by storage periods. [ABSTRACT FROM AUTHOR]

Adipocytes isolated from cachectic mice bearing the MAC 16 tumour showed over a 3-fold increase in lipolytic response to both low concentrations of isoprenaline and a tumour-derived lipid mobilizing factor (LMF). This was reflected by an enhanced stimulation of adenylate cyclase in plasma membrane fractions of adipocytes in the presence of both factors. There was no up-regulation of adenylate cyclase in response to forskolin, suggesting that the effect arose from a change in receptor number or G-protein expression. Immunoblotting of adipocyte membranes from mice bearing the MAC16 tumour showed an increased expression of Gαs up to 10% weight loss and a reciprocal decrease in Gα. There was also an increased expression of Gαs and a decrease in Gα in adipose tissue from a patient with cancer-associated weight loss compared with a non-cachectic cancer patient. The changes in G-protein expression were also seen in adipose tissue of normal mice administered pure LMF as well as in 3T3L1 adipocytes in vitro. The changes in G-protein expression induced by LMF were attenuated by the polyunsaturated fatty acid, eicosapentaenoic acid (EPA). This suggests that this tumour-derived lipolytic factor acts to sensitize adipose tissue to lipolytic stimuli, and that this effect is attenuated by EPA, which is known to preserve adipose tissue in cancer cachexia. [ABSTRACT FROM AUTHOR]

Treatment of murine myoblasts, myotubes and tumour cells with a tumour-produced lipid mobilizing factor (LMF), caused a concentration-dependent stimulation of protein synthesis, within a 24 h period. There was no effect on cell number or [[SUP3]H] thymidine incorporation, but a similar concentration-dependent stimulation of 2-deoxyglucose uptake. LMF produced an increase in intracellular cyclic AMP levels, which was linearly (r[SUP2] = 0.973) related to the increase in protein synthesis. The effect of LMF was attenuated by the adenylate cyclase inhibitor MDL[SUP12330A'] and was additive with the stimulation produced by forskolin. Both propranolol (10 μM) and the specific β[SUB3]-adrenergic receptor antagonist SR 59230A (10[SUP-5]M), significantly reduced the stimulation of protein synthesis induced by LMF. Protein synthesis was also increased by 69% (P = 0.006) in soleus muscles of mice administered LMF, while there was a 26% decrease in protein degradation (P = 0.03). While LMF had no effect on the lysosomal enzymes, cathepsins B and L, there was a decrease in proteasome activity, as determined both by the 'chymotrypsin-like' enzyme activity, as well as expression of proteasome α-type subunits, determined by Western blotting. These results show that in addition to its lipid-mobilizing activity LMF also increases protein accumulation in skeletal muscle both by an increase in protein synthesis and a decrease in protein catabolism. [ABSTRACT FROM AUTHOR]

A 61‐year‐old male presented with symptoms of decompensated heart failure and cardiogenic shock. Transthoracic and transesophageal echocardiography showed severely impaired left ventricular (LV) systolic function (LVEF of 20–25%), bicuspid aortic valve with moderate aortic insufficiency and no significant stenosis, dilated coronary sinus and a tortuous vascular structure in the left‐sided atrioventricular groove. Cardiac computed tomography confirmed the diagnosis of persistent left superior vena cava and a giant coronary artery fistula to the coronary sinus. Cardiac magnetic resonance illustrated non‐specific late gadolinium enhancement in the mid‐wall of the septum. The patient was treated medically and with cardiac re‐synchronization therapy. [ABSTRACT FROM AUTHOR]

Cardiac four-chamber volume estimation serves as a fundamental and crucial role in clinical quantitative analysis of whole heart functions. It is a challenging task due to the huge complexity of the four chambers including great appearance variations, huge shape deformation and interference between chambers. Direct estimation has recently emerged as an effective and convenient tool for cardiac ventricular volume estimation. However, existing direct estimation methods were specifically developed for one single ventricle, i.e., left ventricle (LV), or bi-ventricles; they can not be directly used for four chamber volume estimation due to the great combinatorial variability and highly complex anatomical interdependency of the four chambers. In this paper, we propose a new, general framework for direct and simultaneous four chamber volume estimation. We have addressed two key issues, i.e., cardiac image representation and simultaneous four chamber volume estimation, which enables accurate and efficient four-chamber volume estimation. We generate compact and discriminative image representations by supervised descriptor learning (SDL) which can remove irrelevant information and extract discriminative features. We propose direct and simultaneous four-chamber volume estimation by the multioutput sparse latent regression (MSLR), which enables jointly modeling nonlinear input-output relationships and capturing four-chamber interdependence. The proposed method is highly generalized, independent of imaging modalities, which provides a general regression framework that can be extensively used for clinical data prediction to achieve automated diagnosis. Experiments on both MR and CT images show that our method achieves high performance with a correlation coefficient of up to 0.921 with ground truth obtained manually by human experts, which is clinically significant and enables more accurate, convenient and comprehensive assessment of cardiac functions. [ABSTRACT FROM AUTHOR]

Direct estimation of cardiac ventricular volumes has become increasingly popular and important in cardiac function analysis due to its effectiveness and efficiency by avoiding an intermediate segmentation step. However, existing methods rely on either intensive user inputs or problematic assumptions. To realize the full capacities of direct estimation, this paper presents a general, fully learning-based framework for direct bi-ventricular volume estimation, which removes user inputs and unreliable assumptions. We formulate bi-ventricular volume estimation as a general regression framework which consists of two main full learning stages: unsupervised cardiac image representation learning by multi-scale deep networks and direct bi-ventricular volume estimation by random forests. By leveraging strengths of generative and discriminant learning, the proposed method produces high correlations of around 0.92 with ground truth by human experts for both the left and right ventricles using a leave-one-subject-out cross validation, and largely outperforms existing direct methods on a larger dataset of 100 subjects including both healthy and diseased cases with twice the number of subjects used in previous methods. More importantly, the proposed method can not only be practically used in clinical cardiac function analysis but also be easily extended to other organ volume estimation tasks. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the effect of Cherry laurel marmalade (0%, 5%, 10%, 15%, and 20%) on the physico-chemical and sensorial characteristics of yogurts during the storage time. Increasing marmalade concentrations into the yogurts affected titratable acidity, a* values and overall acceptability positively, and viscosity, syneresis and L* values negatively. During storage time pH. viscosity, syneresis, 11 values, flavour and overall acceptability scores (P<0.05) decreased significantly compared to control, while titratable acidity and a* values (P<0.05) increased significantly, When compared to L* values at the end of storage time with the first day L* values, at the marmalade added samples were observed an increasing but, at the control samples a decreasing were observed. 15% cherry laurel marmalade would be recommended in the production of fruit yogurts. [ABSTRACT FROM AUTHOR]

There are very few reported cases of regression of large cervical disc herniation without any intervention-the so-called spontaneous regression, demonstrated using MRI. We report a rare and interesting case of MRI that demonstrated near complete regression of a large herniated cervical intervertebral disc, without any surgical treatment. [ABSTRACT FROM AUTHOR]

In an asymptomatic 19-year-old who regularly underwent cardiopulmonary fitness testing for national lifeguard-accreditation, 129Xe MRI unexpectedly revealed an abnormally augmented RBC signal and RBC-to-alveolar-capillary-tissue ratio with spatially homogeneous ventilation, tissue barrier, and RBC images. Pulmonary function was normal, but cardiopulmonary follow-up including transthoracic and transesophageal echocardiogram, heart catheterization, and contrast-enhanced cardiac CT imaging led to the diagnosis of a large (20 × 27 mm) secundum atrial septal defect (ASD) with a net right-to-left shunt (Qp:Qs = 0.5) and normal pulmonary pressures. This novel, unexpected case revealed that 129Xe RBC signal intensity likely reflected erythrocytosis, compensatory to the abnormal cardiovascular hemodynamics that resulted from a large congenital ASD. Unlike ASD cases that present with dyspnea and exercise limitation, this 129Xe MRI abnormality was detected in an asymptomatic teenager. This is the first report of asymptomatic adult congenital heart disease diagnosed subsequent to novel 129Xe MRI that led to early intervention, avoiding long-term complications of cyanosis, including ventricular fibrosis and thromboembolic and bleeding risks. [ABSTRACT FROM AUTHOR]

Abstract: Tracking regional heart motion and detecting the corresponding abnormalities play an essential role in the diagnosis of cardiovascular diseases. Based on functional images, which are subject to noise and segmentation/registration inaccuracies, regional heart motion analysis is acknowledged as a difficult problem and, therefore, incorporation of prior knowledge is desirable to enhance accuracy. Given noisy data and a nonlinear dynamic model to describe myocardial motion, an unscented Kalman smoother is proposed in this study to estimate the myocardial points. Due to the similarity between the statistical information of normal and abnormal heart motions, detecting and classifying abnormality is a challenging problem. We use the Shannon’s differential entropy of the distributions of potential classifier features to detect and locate regional heart motion abnormality. A naive Bayes classifier algorithm is constructed from the Shannon’s differential entropy of different features to automatically detect abnormal functional regions of the myocardium. Using 174 segmented short-axis magnetic resonance cines obtained from 58 subjects (21 normal and 37 abnormal), the proposed method is quantitatively evaluated by comparison with ground truth classifications by radiologists over 928 myocardial segments. The proposed method performed significantly better than other recent methods, and yielded an accuracy of 86.5% (base), 89.4% (mid-cavity) and 84.5% (apex). The overall classification accuracy was 87.1%. Furthermore, standard kappa statistic comparisons between the proposed method and visual wall motion scoring by radiologists showed that the proposed algorithm can yield a kappa measure of 0.73. [Copyright &y& Elsevier]

Lipomas constitute less than 5% of primary brain tumors. Pericallosal lipomas (PCLp) constitute almost half of all intracranial lipomas. Corpus callosal anomalies commonly occur in cases with PCLps. Although PCLp is often described as corpus callosal lipoma, it is most often pericallosal in location. PCLps may have calcification in the periphery and may continue into lateral ventricles, which is a very rare presentation. We observed a case of PCLp with peripheral calcifications associated with PCLp continuing as bilaterally symmetrical lateral ventricular choroid plexus lipomas (CPLp) without any corpus callosal or other central nervous system anomalies, and as this is not been previously reported, we are presenting it. The appearance of PCLp in this case does not correspond to the descriptions of any of the existing morphological types (anterior and posterior) of classification of PCLps; it is rather mixed, where PCLp occupies both anterior and posterior locations around the corpus callosum. [ABSTRACT FROM AUTHOR]

Tracking heart motion plays an essential role in the diagnosis of cardiovascular diseases. As such, accurate characterization of dynamic behavior of the left ventricle (LV) is essential in order to enhance the performance of motion estimation. However, a single Markovian model is not sufficient due to the substantial variability in typical heart motion. Moreover, dynamics of an abnormal heart could be very different from that of a normal heart. This study introduces a tracking approach based on multiple models, each matched to a different phase of the LV motion. First, the algorithm adopts a graph cut distribution matching method to tackle the problem of segmenting LV cavity from cardiac MR images, which is acknowledged as a difficult problem because of low contrast and photometric similarities between the heart wall and papillary muscles within the LV cavity. Second, interacting multiple model (IMM), an effective estimation algorithm for Markovian switching system, is devised subsequent to the segmentations to yield state estimates of the endocardial boundary points. The IMM also yields the model probability indicating the model that most closely matches the LV motion. The proposed method is evaluated quantitatively by comparison with independent manual segmentations over 2280 images acquired from 20 subjects, which demonstrated competitive results in comparisons with related recent methods. [ABSTRACT FROM AUTHOR]

Purpose In a pig model of acute myocardial infarction (AMI), we validated a functional computed tomography (CT) technique for concomitant assessment of myocardial edema and ischemia through extravscualar contrast distribution volume (ECDV) and myocardial perfusion (MP) measurements from a single dynamic imaging session using a single contrast bolus injection. Methods In seven pigs, balloon catheter was used to occlude the distal left anterior descending artery for one hour followed by reperfusion. CT and cardiac magnetic resonance (CMR) imaging studies were acquired on 3 days and 12 ± 3 day post ischemic insult. In each CT study, 0.7 ml/kg of iodinated contrast was intravenously injected at 3–4 ml/s before dynamic contrast-enhanced (DCE) cardiac images were acquired with breath-hold using a 64-row CT scanner. DCE cardiac images were analyzed with a model-based deconvolution to generate ECDV and MP maps. ECDV as an imaging marker of edema was validated against CMR T2 weighted imaging in normal and infarcted myocardium delineated from ex-vivo histological staining. Results ECDV in infarcted myocardium was significantly higher (p < 0.05) than that in normal myocardium on both days post AMI and was in agreement with the findings of CMR T2 weighted imaging. MP was significantly lower (p < 0.05) in the infarcted region compared to normal on both days post AMI. Conclusion This imaging technique can rapidly and simultaneously assess myocardial edema and ischemia through ECDV and MP measurements, and may be useful for delineation of salvageable tissue within at-risk myocardium to guide reperfusion therapy. [ABSTRACT FROM AUTHOR]

Purpose We implemented and validated a compressed sensing (CS) based algorithm for reconstructing dynamic contrast-enhanced (DCE) CT images of the heart from sparsely sampled X-ray projections. Methods DCE CT imaging of the heart was performed on five normal and ischemic pigs after contrast injection. DCE images were reconstructed with filtered backprojection (FBP) and CS from all projections (984-view) and 1/3 of all projections (328-view), and with CS from 1/4 of all projections (246-view). Myocardial perfusion (MP) measurements with each protocol were compared to those with the reference 984-view FBP protocol. Results Both the 984-view CS and 328-view CS protocols were in good agreements with the reference protocol. The Pearson correlation coefficients of 984-view CS and 328-view CS determined from linear regression analyses were 0.98 and 0.99 respectively. The corresponding mean biases of MP measurement determined from Bland-Altman analyses were 2.7 and 1.2 ml/min/100 g. When only 328 projections were used for image reconstruction, CS was more accurate than FBP for MP measurement with respect to 984-view FBP. However, CS failed to generate MP maps comparable to those with 984-view FBP when only 246 projections were used for image reconstruction. Conclusion DCE heart images reconstructed from one-third of a full projection set with CS were minimally affected by aliasing artifacts, leading to accurate MP measurements with the effective dose reduced to just 33% of conventional full-view FBP method. The proposed CS sparse-view image reconstruction method could facilitate the implementation of sparse-view dynamic acquisition for ultra-low dose CT MP imaging. [ABSTRACT FROM AUTHOR]

Purpose: The authors investigated the performance of a recently introduced 160-mm/256-row CT system for low dose quantitative myocardial perfusion (MP) imaging of the whole heart. This platform is equipped with a gantry capable of rotating at 280 ms per full cycle, a second generation of adaptive statistical iterative reconstruction (ASiR-V) to correct for image noise arising from low tube voltage potential/tube current dynamic scanning, and image reconstruction algorithms to tackle beam-hardening, cone-beam, and partial-scan effects. Methods: Phantom studies were performed to investigate the effectiveness of image noise and artifact reduction with a GE Healthcare Revolution CT system for three acquisition protocols used in quantitative CT MP imaging: 100, 120, and 140 kVp/25 mAs. The heart chambers of an anthropomorphic chest phantom were filled with iodinated contrast solution at different concentrations (contrast levels) to simulate the circulation of contrast through the heart in quantitative CT MP imaging. To evaluate beam-hardening correction, the phantom was scanned at each contrast level to measure the changes in CT number (in Hounsfield unit or HU) in the water-filled region surrounding the heart chambers with respect to baseline. To evaluate cone-beam artifact correction, differences in mean water HU between the central and peripheral slices were compared. Partial-scan artifact correction was evaluated from the fluctuation of mean water HU in successive partial scans. To evaluate image noise reduction, a small hollow region adjacent to the heart chambers was filled with diluted contrast, and contrast-to-noise ratio in the region before and after noise correction with ASiR-V was compared. The quality of MP maps acquired with the CT system was also evaluated in porcine CT MP studies. Myocardial infarct was induced in a farm pig from a transient occlusion of the distal left anterior descending (LAD) artery with a catheter-based interventional procedure. MP maps were generated from the dynamic contrast-enhanced (DCE) heart images taken at baseline and three weeks after the ischemic insult. Results: Their results showed that the phantom and animal images acquired with the CT platform were minimally affected by image noise and artifacts. For the beam-hardening phantom study, changes in water HU in the wall surrounding the heart chambers greatly reduced from >±30 to ≤±5 HU at all kVp settings except one region at 100 kVp (7 HU). For the cone-beam phantom study, differences in mean water HU from the central slice were less than 5 HU at two peripheral slices with each 4 cm away from the central slice. These findings were reproducible in the pig DCE images at two peripheral slices that were 6 cm away from the central slice. For the partial-scan phantom study, standard deviations of the mean water HU in 10 successive partial scans were less than 5 HU at the central slice. Similar observations were made in the pig DCE images at two peripheral slices with each 6 cm away from the central slice. For the image noise phantom study, CNRs in the ASiR-V images were statistically higher (p < 0.05) than the non-ASiR-V images at all kVp settings. MP maps generated from the porcine DCE images were in excellent quality, with the ischemia in the LAD territory clearly seen in the three orthogonal views. Conclusions: The study demonstrates that this CT system can provide accurate and reproducible CT numbers during cardiac gated acquisitions across a wide axial field of view. This CT number fidelity will enable this imaging tool to assess contrast enhancement, potentially providing valuable added information beyond anatomic evaluation of coronary stenoses. Furthermore, their results collectively suggested that the 100 kVp/25 mAs protocol run on this CT system provides sufficient image accuracy at a low radiation dose (<3 mSv) for whole-heart quantitative CT MP imaging. [ABSTRACT FROM AUTHOR]

Anatomical cine cardiovascular magnetic resonance (CMR) imaging is widely used to assess the systolic cardiac function because of its high soft tissue contrast. Assessment of diastolic LV function has not regularly been performed due the complex and time consuming procedures. This study presents a semi-automated assessment of the left ventricular (LV) diastolic function using anatomical short-axis cine CMR images. The proposed method is based on three main steps: (1) non-rigid registration, which yields a sequence of endocardial boundary points over the cardiac cycle based on a user-provided contour on the first frame; (2) LV volume and filling rate computations over the cardiac cycle; and (3) automated detection of the peak values of early ( E ) and late ventricular ( A ) filling waves. In 47 patients cine CMR imaging and Doppler-echocardiographic imaging were performed. CMR measurements of peak values of the E and A waves as well as the deceleration time were compared with the corresponding values obtained in Doppler-Echocardiography. For the E / A ratio the proposed algorithm for CMR yielded a Cohen's kappa measure of 0.70 and a Gwet's AC1 coefficient of 0.70. Conclusion: Semi-automated assessment of the left ventricular (LV) diastolic function using anatomical short-axis cine CMR images provides mitral inflow measurements comparable to Doppler-Echocardiography. [ABSTRACT FROM AUTHOR]

Accurate estimation of the ventricular volumes is essential to the assessment of global cardiac functions. The existing estimation methods are mostly restricted to the left ventricle (LV), and often require segmentation which is challenging and computationally expensive. This paper proposes to estimate the volumes of both LV and right ventricle (RV) jointly with an efficient segmentation-free method. The proposed method employs an adapted Bayesian formulation. It introduces a novel likelihood function to exploit multiple appearance features, and a novel prior probability model to incorporate the area correlation between LV and RV cavities. The method is validated on a comprehensive dataset containing 56 clinical subjects (3360 images in total). The experimental results demonstrate that the estimated biventricular volumes are highly correlated to their independent ground truth. As a result, the proposed method enables a direct, efficient, and accurate assessment of global cardiac functions. [ABSTRACT FROM PUBLISHER]

Automating the detection and localization of segmental (regional) left ventricle (LV) abnormalities in magnetic resonance imaging (MRI) has recently sparked an impressive research effort, with promising performances and a breadth of techniques. However, despite such an effort, the problem is still acknowledged to be challenging, with much room for improvements in regard to accuracy. Furthermore, most of the existing techniques are labor intensive, requiring delineations of the endo- and/or epi-cardial boundaries in all frames of a cardiac sequence. The purpose of this study is to investigate a real-time machine-learning approach which uses some image features that can be easily computed, but that nevertheless correlate well with the segmental cardiac function. Starting from a minimum user input in only one frame in a subject dataset, we build for all the regional segments and all subsequent frames a set of statistical MRI features based on a measure of similarity between distributions. We demonstrate that, over a cardiac cycle, the statistical features are related to the proportion of blood within each segment. Therefore, they can characterize segmental contraction without the need for delineating the LV boundaries in all the frames. We first seek the optimal direction along which the proposed image features are most descriptive via a linear discriminant analysis. Then, using the results as inputs to a linear support vector machine classifier, we obtain an abnormality assessment of each of the standard cardiac segments in real-time. We report a comprehensive experimental evaluation of the proposed algorithm over 928 cardiac segments obtained from 58 subjects. Compared against ground-truth evaluations by experienced radiologists, the proposed algorithm performed competitively, with an overall classification accuracy of 86.09% and a kappa measure of 0.73. [ABSTRACT FROM AUTHOR]

Objectives: We developed a quantitative Dynamic Contrast-Enhanced CT (DCE-CT) technique for measuring Myocardial Perfusion Reserve (MPR) and Volume Reserve (MVR) and studied their relationship with coronary stenosis.Methods: Twenty-six patients with Coronary Artery Disease (CAD) were recruited. Degree of stenosis in each coronary artery was classified from catheter-based angiograms as Non-Stenosed (NS, angiographically normal or mildly irregular), Moderately Stenosed (MS, 50-80% reduction in luminal diameter), Severely Stenosed (SS, >80%) and SS with Collaterals (SSC). DCE-CT at rest and after dipyridamole infusion was performed using 64-slice CT. Mid-diastolic heart images were corrected for beam hardening and analyzed using proprietary software to calculate Myocardial Blood Flow (MBF, in mL∙min(-1)∙100 g(-1)) and Blood Volume (MBV, in mL∙100 g(-1)) parametric maps. MPR and MVR in each coronary territory were calculated by dividing MBF and MBV after pharmacological stress by their respective baseline values.Results: MPR and MVR in MS and SS territories were significantly lower than those of NS territories (p < 0.05 for all). Logistic regression analysis identified MPR∙MVR as the best predictor of ≥50% coronary lesion than MPR or MVR alone.Conclusions: DCE-CT imaging with quantitative CT perfusion analysis could be useful for detecting coronary stenoses that are functionally significant. [ABSTRACT FROM AUTHOR]