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Soil degradation is a major global concern due to its negative impact on soil quality and the sustainability of agricultural resources. The conservation agriculture (CA) approach, which includes three key principles such as zero tillage, retention of crop residue and crop rotation has gained widespread adoption to help mitigate the climate change effects on agricultural soils and meet the growing demand for increased production. Earthworm communities, along with microbial activity and diversity, are highly sensitive to tillage practices. Additionally, microbial activity and diversity quickly respond to different cropping systems, making them effective indicators for detecting short-term changes in soil functioning. We therefore, assess the effects of CA innovative approached after 6-years on biological and microbial diversity within earthworm cast in maize-wheat system (MWS). The treatments consist of PBM-RN 0 /ZTW-RN 0 (permanent beds No-N control-both residues removed and wheat with zero tillage); PBM+RN 0 /ZTW+RN 0 (permanent beds No-N control-both residues retained)-50% of maize stover and 25% of wheat residue retained; PBM-RN 120 /ZTW- RN 120 (permanent beds with 120 kg N ha -1 both residues removed wheat with zero tillage); PBM+RN 120 /ZTW+RN 120 (permanent beds with 120 kg N ha -1 both residues retained and wheat with zero tillage) and FBM-RN 120 /CTW-RN 120 (fresh beds in maize/CT in wheat with 120 kg N ha -1 both residues removed). The result of present study showed that activities of carbon (C) cycle-related enzymes in the cast soils viz ., dehydrogenase (DHA), β-glucosidase (β-glu), cellulase, and xylanase were significantly higher under PBM+RN 120 / ZTW+RN 120 than under PBM-RN 0 /ZTW-RN 0 . Specifically, the activities of these enzymes were 21.5, 26.8, and 76.5% higher under the PBM+RN 120 /ZTW+RN 120 treatment, respectively. Moreover, the Alk-P activity was found to be 1.3 times higher in the PBM+RN 120 /ZTW+RN 120 treatment than in the PBM-RN 0 /ZTW-RN 0 treatment. The bacterial, fungal, and actinomycete counts in the cast soil ranged from 6.87 to 7.47 CFU (colony forming units) x 10 6 g -1 soil, 3.87-3.30 CFU x 10 4 g -1 soil, and 5.09-5.67 CFU x 10 4 g -1 soil, respectively. Total organic carbon (TOC) showed significant increases of 34.6% under PBM+RN 120 /ZTW+RN 120 as compared to PBM-RN 0 /ZTW-RN 0 . The less labile C (Frac. 3), total carbohydrate carbon (TCHO), phenol oxidase (PHE) and peroxidase (PER) were observed as the sensitive indicators under different tillage, rate of nitrogen and residue management practices. This study suggests that permanent beds with crop residue retention with balance fertilization practices can be recommended and popularized to the overall improvement of soil biological pools within earthworm casts in MWS., Competing Interests: None., (© 2024 The Author(s).)

The emergence of bone tissue engineering as a trend in regenerative medicine is forcing scientists to create highly functional materials and scaffold construction techniques. Bone tissue engineering uses 3D bio-printed scaffolds that allow and stimulate the attachment and proliferation of osteoinductive cells on their surfaces. Bone grafting is necessary to expedite the patient's condition because the natural healing process of bones is slow. Fused deposition modeling (FDM) is therefore suggested as a technique for the production process due to its simplicity, ability to create intricate components and movable forms, and low running costs. 3D-printed scaffolds can repair bone defects in vivo and in vitro. For 3D printing, various materials including metals, polymers, and ceramics are often employed but polymeric biofilaments are promising candidates for replacing non-biodegradable materials due to their adaptability and environment friendliness. This review paper majorly focuses on the fused deposition modeling approach for the fabrication of 3D scaffolds. In addition, it also provides information on biofilaments used in FDM 3D printing, applications, and commercial aspects of scaffolds in bone tissue engineering., (© 2024. The Author(s) under exclusive licence to Biomedical Engineering Society.)

Introduction: Biomechanical preparation has gotten easier over time with the development of nickel-titanium (NiTi) rotary instruments. Despite their benefits, research has shown that these files frequently result in microcracks in the root canal dentin, which can fracture the roots. Such mishaps should be prevented, as they compromise the integrity of the root and reduce the long-term survival of endodontically treated teeth., Materials and Methods: This study was conducted at Government Dental College and Hospital, Patiala, Punjab, India. Eighty permanent mandibular premolar teeth were included. All the roots were inspected for any pre-existing cracks or craze lines under a stereomicroscope. The teeth were decoronated and then divided into four groups (n = 20): Group I: TruNatomy, Group II: Neoendo Flex, Group III: ProTaper Gold, and Group IV: 2Shape. The samples were instrumented according to the group to which they belonged. The roots were then sectioned horizontally at 3 mm and 6 mm from the apex and examined under a stereomicroscope at 40x for the presence of microcracks., Results: The data were analyzed using the IBM SPSS Statistics for Windows, version 26 (released 2019; IBM Corp., Armonk, New York, United States). A chi-square test was applied, and the level of significance was set at p < 0.05. The highest incidence of microcracks was associated with ProTaper Gold (65%), followed by Neoendo Flex (45%), TruNatomy (20%), and 2Shape (20%)., Conclusion:  All rotary instruments resulted in dentinal damage. ProTaper Gold exhibited the highest frequency of dentin cracks. TruNatomy and 2Shape exhibited satisfactory results with minimal crack formation., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Mariyam et al.)

The case report describes a multidisciplinary approach using orthodontic forced eruption to facilitate prosthetic restoration of a maxillary permanent lateral incisor and canine with poor restorability for a young patient. Restoration after orthodontic eruption presents a more conservative treatment choice in young patients compared with prosthetic restoration after extraction. On examination, the patient had root stumps in the region of 22 and 23. We decided to treat the patient by orthodontic extrusion followed by endodontic post and core. The case was treated with the help of 19 gauge wire and gold posts., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Inflammatory gingival enlargement, sometimes referred to as gingival hyperplasia or gingival hypertrophy, is an abnormal proliferation of gingival tissues caused by underlying inflammation. It might also be related to long-term periodontitis. Herein, we discuss the case of a young, otherwise healthy male patient wherein the anterior regions of both the upper and lower arches were affected by long-standing gingival growth. The overgrowth was removed, and an excellent aesthetic outcome was achieved, using a surgical procedure termed gingivectomy. After a 15-day follow-up period, the healing process was satisfactory and no negative effects were found., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Sandhu et al.)

A 3-year field experiment was setup to address the threat of underground water depletion and sustainability of agrifood systems. Subsurface drip irrigation (SDI) system combined with nitrogen management under conservation agriculture-based (CA) maize-wheat system (MWS) effects on crop yields, irrigation water productivity (WP i ), nitrogen use efficiency (NUE) and profitability. Grain yields of maize, wheat, and MWS in the SDI with 100% recommended N were significantly higher by 15.8%, 5.2% and 11.2%, respectively, than conventional furrow/flood irrigation (CT-FI) system. System irrigation water savings (~ 55%) and the mean WP i were higher in maize, wheat, and MWS under the SDI than CT-FI system. There was saving of 25% of fertilizer N in maize and MWS whereas no saving of N was observed in wheat. Net returns from MWS were significantly higher (USD 265) under SDI with 100% N (with no subsidy) than CT-FI system despite with higher cost of production. The net returns were increased by 47% when considering a subsidy of 80% on laying SDI system. Our results showed a great potential of complementing CA with SDI and N management to maximize productivity, NUE, and WP i , which may be economically beneficial and environmentally sound in MWS in Trans-IGP of South Asia., (© 2023. The Author(s).)

Diffusion MRI characteristics assessed by apparent diffusion coefficient (ADC) histogram analysis in head and neck squamous cell carcinoma (HNSCC) have been reported as helpful in classifying tumours based on diffusion characteristics. There is little reported on HNSCC lymph nodes classification by diffusion characteristics. The aim of this study was to determine whether pretreatment nodal microstructural diffusion MRI characteristics can classify diseased nodes of patients with HNSCC from normal nodes of healthy volunteers. Seventy-nine patients with histologically confirmed HNSCC prior to chemoradiotherapy, and eight healthy volunteers, underwent diffusion-weighted (DW) MRI at a 1.5-T MR scanner. Two radiologists contoured lymph nodes on DW (b = 300 s/m 2 ) images. ADC, distributed diffusion coefficient (DDC) and alpha (α) values were calculated by monoexponential and stretched exponential models. Histogram analysis metrics of drawn volume were compared between patients and volunteers using a Mann-Whitney test. The classification performance of each metric between the normal and diseased nodes was determined by receiver operating characteristic (ROC) analysis. Intraclass correlation coefficients determined interobserver reproducibility of each metric based on differently drawn ROIs by two radiologists. Sixty cancerous and 40 normal nodes were analysed. ADC histogram analysis revealed significant differences between patients and volunteers (p ≤0.0001 to 0.0046), presenting ADC distributions that were more skewed (1.49 for patients, 1.03 for volunteers; p = 0.0114) and 'peaked' (6.82 for patients, 4.20 for volunteers; p = 0.0021) in patients. Maximum ADC values exhibited the highest area under the curve ([AUC] 0.892). Significant differences were revealed between patients and volunteers for DDC and α value histogram metrics (p ≤0.0001 to 0.0044); the highest AUC were exhibited by maximum DDC (0.772) and the 25th percentile α value (0.761). Interobserver repeatability was excellent for mean ADC (ICC = 0.88) and the 25th percentile α value (ICC = 0.78), but poor for all other metrics. These results suggest that pretreatment microstructural diffusion MRI characteristics in lymph nodes, assessed by ADC and α value histogram analysis, can identify nodal disease., (© 2021 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.)

Context: Problematic eating behavior pattern prevalent in children can be a potential risk factor for Early Childhood Caries (ECC). Pediatric dentist must be vigilant to enquire about eating behavior pattern and guide parents comprehensively., Aim: The aim of this study is to find the association between problematic ECC among 36-71-month-old children., Setting and Design: A cross-sectional study was conducted in 2000 children from both the sex and various socioeconomic backgrounds., Methods: A questionnaire was made to assess the personal information and problematic eating behavior of the child using Children's Eating Behavior Questionnaire (CEBQ) which was filled by parents. Clinical examinations were performed on the date of questionnaire collection and caries diagnosis was done in the dentition status part of "WHO oral health assessment form 2013.", Statistical Analysis Used: The software used for the statistical analysis was SPSS (Statistical Package for the Social Sciences) software version 16.0., Results: The prevalence of ECC in the study sample was 42.6%. Out of eight domains into which problematic eating behavior was divided, domains Emotional Overeating (EOE), Satiety Responsiveness (SR), Slowness of Eating (SE), Desire to Drink, Food Fussiness, and Emotional Under eating were significantly associated with ECC., Conclusion: There is a positive correlation between problematic eating behavior and ECC; such behavior should be recognized at early stages and interrupted so that the risk of developing caries in permanent dentition could be prevented., Competing Interests: None

In water scarce regions of South Asia, diversification of rice with maize is being advocated towards sustainability of cereal-based cropping systems. Adoption of innovative agronomic management practices, i.e., conservation agriculture (CA) and sub-surface drip irrigation (SSDI) are considered as key strategies for much needed interventions to address the challenges of water scarcity under projected climate change. Benefits from CA and SSDI concerning water economy are well-established, however, information about their complementarity and water budgeting in cereal-based systems are lacking. A field study was conducted with process-based model (HYDRUS-2D) to understand water transport, root water uptake and components of soil water balance in maize grown in rotation with wheat after five years of continuous adoption of conservation agriculture. In this study, altogether eight treatments comprising of 6 CA+ treatments (CA coupled with SSDI); permanent beds using sub-surface drip (PB-SSD) with (WR) and without (WOR) crop residue at different N rates, 0, 120 and 150 kg N ha -1 were compared with CA (PB using furrow irrigation-FI with crop residue-120 kg N ha -1 ) and conventional tillage practices (CT) (CT using FI without crop residue-120 kg N ha -1 ). Results showed that the model could simulate the daily changes in profile soil water content with reasonable accuracy in all the treatments. Simulated soil water balance indicated higher cumulative root water uptake (CRWU), lower cumulative evaporation (CE) and higher soil water retention in CA+ (PB-SSD+ crop residue at 150 and 120 kg N ha -1 ) than CA and CT plots. Hydrus-2D model efficiency > 0, RMSE between 0.009-0.026 and R 2 value between 0.80-0.92 at P < 0.01 indicates that the model is performing efficiently. The mean evaporation from CA+ treatments was 10 and 36% less than CA and CT treatments, respectively. On average, CRWU under CA+ treatments were 14-48% higher than FI treatments. The mean cumulative deep drainage in CA+ plots was 80-100 mm less than CA and CT plots. In CA+ based plots significantly higher biomass production and radiation use efficiency were observed with reduced water use than CA and CT. Therefore, the study justifies the water-saving nature of CA+, while maintaining higher productivity and meeting the transpiration demand of crops and halting unnecessary evaporation and deep drainage losses., (© 2021. The Author(s).)

Pleuropulmonary blastoma is a rare and highly aggressive pulmonary malignancy in children. Clinically, the malignancy is often mistaken for symptoms of respiratory tract infection or pneumothorax. The neoplasm is histologically characterized by primitive blastema and a malignant mesenchymal stroma that demonstrates multidirectional differentiation. The patients with PPB are managed by multimodal therapy. We present a report of 3 cases of histopathologically diagnosed pleuropulmonary blastoma. The patients presented with chief complaints of difficulty in breathing, cough, fever and chest pain. Radiographs of the patients showed partial to complete opacification of hemithorax. Contrast enhanced computed tomography scans revealed large well defined heterogenously enhancing solid mass lesions in the hemithorax. Knowledge of types, imaging findings, staging and association with other tumors is crucial for correct diagnosis of pleuropulmonary blastoma and subsequent adequate management., (© 2021 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Compatibility of Fictor composticola and Pasteuria penetrans was evaluated through two experiments against Meloidogyne incognita. In vitro assay conducted in 5 cm diameter Petri plates containing 1% water agar. Two males and two females of F. composticola were released alongwith 200 P. penetrans encumbered or healthy J 2 of M. incognita. Observations on prey consumed were taken after 24 and 48 h of release. P. penetrans-encumbered J 2 were consumed more by the predator than healthy J 2 . In a pot assay, cucumber plants grown in one kg pots were inoculated with 2000 P. penetrans encumbered or healthy J 2 of M. incognita and 400 individuals of F. composticola. After 45 days; numbers of galls, egg masses and final J 2 population in soil were significantly less in the treatment with F. composticola + P. penetrans-encumbered J 2 than F. composticola with healthy J 2 . The root galls and the number of Pasteuria-infected females were more in the absence of predatory nematode.

Plasticizers, due to the widespread use of plastics, occur ubiquitously in the environment. The reuse of waste resources (e.g., treated wastewater, biosolids, animal waste) and other practices (e.g., plastic mulching) introduce phthalates into agroecosystems. As a detoxification mechanism, plants are known to convert phthalates to polar monophthalates after uptake, which are followed by further transformations, including conjugation with endogenous biomolecules. The objective of this study was 2-fold: to obtain a complete metabolic picture of the widely used di- n -butyl phthalate (DnBP) by using a suite of complementary techniques, including stable isotope labeling, 14 C tracing, and high-resolution mass spectrometry, and to determine if conjugates are deconjugated in human microsomes to release bioactive metabolites. In Arabidopsis thaliana cells, the primary initial metabolite of DnBP was mono- n -butyl phthalate (MnBP), and MnBP was rapidly metabolized via hydroxylation, carboxylation, glycosylation, and malonylation to seven transformation products. One of the conjugates, MnBP-acyl-β-d-glucoside (MnBP-Glu), was incubated in human liver (HLM) and intestinal (HIM) microsomes and was found to undergo rapid transformations. Approximately 15% and 10% of MnBP-Glu were deconjugated to the free form MnBP in HIM and HLM, respectively. These findings highlight that phthalates, as diesters, are susceptible to hydrolysis to form monoesters that can be readily conjugated via a phase II metabolism in plants. Conjugates may be deconjugated to release bioactive compounds after human ingestion. Therefore, an accurate assessment of the dietary exposure of phthalates and other contaminants must consider plant metabolites, especially including conjugates, to better predict their potential environmental and human health risks.

Reduction of excess nutrient application and balanced fertilizer use are the key mitigation options in agriculture. We evaluated Nutrient Expert (NE) tool-based site-specific nutrient management (SSNM) in rice and wheat crops by establishing 1594 side-by-side comparison trials with farmers' fertilization practices (FFP) across the Indo-Gangetic Plains (IGP) of India. We found that NE-based fertilizer management can lower global warming potential (GWP) by about 2.5% in rice, and between 12 and 20% in wheat over FFP. More than 80% of the participating farmers increased their crop yield and farm income by applying the NE-based fertilizer recommendation. We also observed that increased crop yield and reduced fertilizer consumption and associated greenhouse gas (GHG) emissions by using NE was significantly influenced by the crop type, agro-ecology, soil properties and farmers' current level of fertilization. Adoption of NE-based fertilizer recommendation practice in all rice and wheat acreage in India would translate into 13.92 million tonnes (Mt) more rice and wheat production with 1.44 Mt less N fertilizer use, and a reduction in GHG of 5.34 Mt CO 2 e per year over farmers' current practice. Our study establishes the utility of NE to help implement SSNM in smallholder production systems for increasing crop yields and farmers' income while reducing GHG emissions.

Background: Spinal arthrodesis is a commonly performed spinal operation. Spinal arthrodesis can be complicated by pseudoarthrosis and resultant hardware failure. Static magnetic fields (SMF) have the ability to improve bone fusion. We seek to assess the feasibility of the construction and implantation of a lumbar interbody cage equipped with a SMF in a caprine model., Methods: Six skeletally mature female Boer goats underwent a lateral approach for placement of an interbody graft at lumbar (L) 1-2 and 3-4. The goats were divided into 2 groups of 3 animals. The interbody graft contained a neodymium iron boron magnet in the experimental group and a nonmagnetic titanium sham in the control group. Both groups contained a synthetic bone graft. Blinded radiographic and histologic evaluation was performed at predetermined timepoints to assess degree of bony fusion and osseointegration., Results: All 6 goats underwent successful placement of lumbar interbody grafts. At the 1-month postoperative computed tomography, 1 goat in the experimental group and 1 goat in the control group were noted to have dislodged their intervertebral cage. Qualitative radiographic and histologic evaluation identified enhanced bone formation, bone density, and osteointegration of the graft in the experimental group., Conclusions: A spinal interbody cage containing a neodymium iron boron magnet for the production of a local SMF is feasible. Preliminary data suggests enhanced bone formation, bone density, and osseointegration of the graft., (Copyright © 2020 Elsevier Inc. All rights reserved.)

To contain the COVID-19 pandemic, India imposed a national lockdown at the end of March 2020, a decision that resulted in a massive reverse migration as many workers across economic sectors returned to their home regions. Migrants provide the foundations of the agricultural workforce in the 'breadbasket' states of Punjab and Haryana in Northwest India.There are mounting concerns that near and potentially longer-term reductions in labor availability may jeopardize agricultural production and consequently national food security. The timing of rice transplanting at the beginning of the summer monsoon season has a cascading influence on productivity of the entire rice-wheat cropping system. To assess the potential for COVID-related reductions in the agriculture workforce to disrupt production of the dominant rice-wheat cropping pattern in these states, we use a spatial ex ante modelling framework to evaluate four scenarios representing a range of plausible labor constraints on the timing of rice transplanting. Averaged over both states, results suggest that rice productivity losses under all delay scenarios would be low as compare to those for wheat, with total system productivity loss estimates ranging from 9%, to 21%, equivalent to economic losses of USD $674 m to $1.48 billion. Late rice transplanting and harvesting can also aggravate winter air pollution with concomitant health risks. Technological options such as direct seeded rice, staggered nursery transplanting, and crop diversification away from rice can help address these challenges but require new approaches to policy and incentives for change., Competing Interests: None., (© 2020 The Author(s).)

Emerging evidence supports the intuitive link between chronic health conditions associated with air pollution and the vulnerability of individuals and communities to COVID-19. Poor air quality already imposes a highly significant public health burden in Northwest India, with pollution levels spiking to hazardous levels in November and early December when rice crop residues are burned. The urgency of curtailing the COVID-19 pandemic and mitigating a potential resurgence later in the year provides even more justification for accelerating efforts to dramatically reduce open agricultural burning in India., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2020 Elsevier Ltd. All rights reserved.)

Herlyn-Werner-Wunderlich syndrome is a rare complex congenital anomaly of the urogenital tract involving Mullerian ducts and mesonephric ducts. It is also called OHVIRA syndrome (Obstructed Hemivagina and Ipsilateral Renal agenesis). It is characterized by a triad of uterus didelphys, obstructed hemivagina and ipsilateral renal agenesis. Patients usually present after menarche with pelvic pain, dysmenorrhea, mass, and rarely with primary infertility in later years. We report a case of a multiparous female who presented to the hospital with pain in lower abdomen for the past 2 months and acute retention of urine for 1 day. This is an atypical presentation in a multiparous female that has been described in a single case report so far. 1 Intravenous pyelogram and MRI of the patient revealed uterine didelphys, obstructed right hemivagina causing hematohemicolpos and right renal agenesis. Thorough knowledge of imaging features can enable a radiologist to make a correct diagnosis even in an atypical presentation., (© 2021 The Authors. Published by the British Institute of Radiology.)

A criss-cross heart is an uncommon congenital rotational anomaly. It accounts for less than 0.1% of all congenital heart defects. The anomaly is characterized by crossing of the atrioventricular connections caused by rotation of the heart about its long axis. It is commonly associated with diverse cardiac defects. Cardiac CT imaging of criss-cross heart is sparse. We present a case of 1-year-old child with chief complaints of bluish discoloration of the body and fast breathing. Cardiac CT revealed atrial situs solitus, criss-cross-atrioventricular connections, atrioventricular discordance, double outlet right ventricle and dextro-malposed great arteries (Van Praagh S,D,D)., (© 2021 The Authors. Published by the British Institute of Radiology.)

Mono-(2-ethylhexyl) phthalate (MEHP) is the primary monoester transformation product of the commonly used plasticizer, di-2-ethylhexyl phthalate (DEHP), and has been frequently detected in various environmental compartments (e.g., soil, biosolids, plants). Plants growing in contaminated soils can take up MEHP, and consumption of the contaminated plants may result in unintended exposure for humans and other organisms. The metabolism of MEHP in plants is poorly understood, but critical for evaluating the potential human and environmental health risks. The present study represents the first attempt to explore the metabolic fate of MEHP in plants. We used Arabidopsis thaliana cells as a plant model and explored metabolic pathways of MEHP using deuterium stable isotope labelling (SIL) coupled with time-of-flight high resolution mass spectrometer (TOF-HRMS). A. thaliana rapidly took up MEHP from the culture medium and mediated extensive metabolism of MEHP. Combining SIL with TOF-HRMS analysis was proved as a powerful method for identification of unknown MEHP metabolites. Four phase Ⅰ and three phase Ⅱ metabolites were confirmed or tentatively identified. Based on the detected transformation products, hydroxylation, oxidation, and malonylation are proposed as the potential MEHP metabolism pathways. In cells, the maximum fraction of each transformation product accounted for 2.8-56.5% of the total amount of metabolites during the incubation. For individual metabolites, up to 2.9-100% was found in the culture medium, suggesting plant excretion. The results in the cell culture experiments were further confirmed in cabbage and A. thaliana seedlings. The findings suggest active metabolism of MEHP in plants and highlight the need to include metabolites in refining environmental risk assessment of plasticizers in the agro-food systems., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020. Published by Elsevier Ltd.)

Mediastinal tumours are not uncommon in paediatric population and often pose a diagnostic challenge. They include a variety of entities including developmental, inflammatory, infectious and neoplastic; most are malignant. These lesions can be classified based on imaging according to the specific compartment (anterior, middle and posterior), generating a focused differential diagnosis. This combined with a rational, clinically oriented approach based on patient's history, focused physical examination, age, gender, symptoms, signs, anatomic localization, imaging characteristics and laboratory investigations including tumor markers paves way to a presumptive diagnosis guiding additional and prudent investigations. For example, a suspicion of lymphoma should be kept in a child presenting with a neck mass and superior vena cava syndrome. Neuroblastoma should be suspected among children younger than 5 years old with a posterior mediastinal mass. Such a structured approach along with histopathology will lead to an exact diagnosis. Surgery remains the mainstay of treatment of most benign and malignant non-lymphoid tumours. For optimal management, a combined modality of treatment incorporating chemotherapy and radiotherapy is often required in malignant tumours and is associated with high survival rates in these patients. In the present article, we review the approach to evaluation of mediastinal masses in childhood from a clinical perspective., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/med-19-82). The series “Pediatric Mediastinal Tumors” was commissioned by the editorial office without any funding or sponsorship. The authors have no other conflicts of interest to declare., (2020 Mediastinum. All rights reserved.)

We consider a red-versus-blue coupled synchronization and spatial swarming (i.e., swarmalator) model that incorporates attraction and repulsion terms and an adversarial game of phases. The model exhibits behaviors such as spontaneous emergence of tactical manoeuvres of envelopment (e.g., flanking, pincer, and envelopment) that are often proposed in military theory or observed in nature. We classify these states based on a large set of features such as spatial densities, synchronization between clusters, and measures of cluster distances. These features are used to study the influence of coupling parameters on the expected presence of these states and the-sometimes sharp-transitions between them.

A study was conducted to design productive, profitable, irrigation water¸ nitrogen and energy use efficient intensive cereal systems (rice-wheat; RW and maize-wheat; MW) in North-West India. Bundling of conservation agriculture (CA) with sub-surface drip irrigation termed as CA + were compared with CA alone and conventional tillage based and flood irrigated RW rotation (farmer's practice; ScI). In contrast to conventional till RW rotation which consumed 1889 mm ha -1 irrigation water (2-yr mean), CA + system saved 58.4 and 95.5% irrigation water in RW and MW rotations, respectively. CA + practices saved 45.8 and 22.7% of irrigation water in rice and maize, respectively compared to CA with flood irrigation. On a system basis, CA + practices saved 46.7 and 44.7% irrigation water under RW (ScV) and MW (ScVI) systems compared to their respective CA-based systems with flood irrigation (ScIII and ScIV). CA + in RW system recorded 11.2% higher crop productivity and improved irrigation water productivity by 145% and profitability by 29.2% compared to farmers' practice. Substitution of rice with maize (MW system; ScVI) recorded 19.7% higher productivity, saved 84.5% of irrigation water and increased net returns by 48.9% compared to farmer's practice. CA + RW and MW system improved energy productivity by 75 and 169% and partial factor productivity of N by 44.6 and 49.6%, respectively compared to ScI. The sub-surface drip irrigation system saved the fertilizer N by 20% under CA systems. CA + in RW and MW systems recorded ~13 and 5% (2-yr mean) higher profitability with 80% subsidy on installing sub-surface drip irrigation system and similar profitability without subsidy scenario compared with their respective flood irrigated CA-based systems.

Background: Luminal water imaging (LWI) suffers less from imaging artifacts than the diffusion-weighted imaging used in multiparametric MRI of the prostate. LWI obtains multicompartment tissue information from a multiecho T 2 dataset., Purpose: To compare a simplified LWI technique with apparent diffusion coefficient (ADC) in classifying lesions based on groupings of PI-RADS v2 scores. Secondary aims were to investigate whether LWI differentiates between histologically confirmed tumor and normal tissue as effectively as ADC, and whether LWI is correlated with the multicompartment parameters of the vascular, extracellular, and restricted diffusion for cytometry in tumors (VERDICT) diffusion model., Study Type: A subset of a larger prospective study., Population: In all, 65 male patients aged 49-79 were scanned., Field Strength/sequence: A 32-echo T 2 and a six b-value diffusion sequence (0, 90, 500, 1500, 2000, 3000 s/mm 2 ) at 3T., Assessment: Regions of interest were placed by a board-certified radiologist in areas of lesion and benign tissue and given PI-RADS v2 scores., Statistical Tests: Receiver operating characteristic and logistic regression analyses were performed., Results: LWI classifies tissue as PI-RADS 1,2 or PI-RADS 3,4,5 with an area under curve (AUC) value of 0.779, compared with 0.764 for ADC. LWI differentiated histologically confirmed malignant from nonmalignant tissue with AUC, sensitivity, and specificity values of 0.81, 75%, and 87%, compared with 0.75, 83%, and 67% for ADC. The microstructural basis of the LWI technique is further suggested by the correspondence with the VERDICT diffusion-based microstructural imaging technique, with α, A 1 , A 2 , and LWF showing significant correlations., Data Conclusion: LWI alone can predict PI-RADS v2 score groupings and detect histologically confirmed tumors with an ability similar to ADC alone without the limitations of diffusion-weighted MRI. This is important, given that ADC has an advantage in these tests as it already informs PI-RADS v2 scoring. LWI also provides multicompartment information that has an explicit biophysical interpretation, unlike ADC., Level of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:910-917., (© 2018 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Objective: The purpose of this study was: To test whether machine learning classifiers for transition zone (TZ) and peripheral zone (PZ) can correctly classify prostate tumors into those with/without a Gleason 4 component, and to compare the performance of the best performing classifiers against the opinion of three board-certified radiologists., Methods: A retrospective analysis of prospectively acquired data was performed at a single center between 2012 and 2015. Inclusion criteria were (i) 3-T mp-MRI compliant with international guidelines, (ii) Likert ≥ 3/5 lesion, (iii) transperineal template ± targeted index lesion biopsy confirming cancer ≥ Gleason 3 + 3. Index lesions from 164 men were analyzed (119 PZ, 45 TZ). Quantitative MRI and clinical features were used and zone-specific machine learning classifiers were constructed. Models were validated using a fivefold cross-validation and a temporally separated patient cohort. Classifier performance was compared against the opinion of three board-certified radiologists., Results: The best PZ classifier trained with prostate-specific antigen density, apparent diffusion coefficient (ADC), and maximum enhancement (ME) on DCE-MRI obtained a ROC area under the curve (AUC) of 0.83 following fivefold cross-validation. Diagnostic sensitivity at 50% threshold of specificity was higher for the best PZ model (0.93) when compared with the mean sensitivity of the three radiologists (0.72). The best TZ model used ADC and ME to obtain an AUC of 0.75 following fivefold cross-validation. This achieved higher diagnostic sensitivity at 50% threshold of specificity (0.88) than the mean sensitivity of the three radiologists (0.82)., Conclusions: Machine learning classifiers predict Gleason pattern 4 in prostate tumors better than radiologists., Key Points: • Predictive models developed from quantitative multiparametric magnetic resonance imaging regarding the characterization of prostate cancer grade should be zone-specific. • Classifiers trained differently for peripheral and transition zone can predict a Gleason 4 component with a higher performance than the subjective opinion of experienced radiologists. • Classifiers would be particularly useful in the context of active surveillance, whereby decisions regarding whether to biopsy are necessitated.

Key Message: Genome-wide association on winter survival was conducted using data from image-based phenotyping method. Nine QTL were observed and three of them with candidate gene identified. Winter survival is an essential trait of winter wheat (Triticum aestivum L.) grown in regions with high risk of winterkill. We characterized a diversity panel of 450 Canadian wheat varieties that included mostly winter-growth habit wheats to identify key genetic factors that contribute to higher winter survival under field conditions. To more accurately quantify winter survival differences among varieties, image-based phenotyping methods, captured by unmanned aerial vehicle (UAV) and on ground level, were used to estimate the winter survival of each varieties. Winter survival index was developed to correct for emergence when evaluating winter survival. Winter survival measurement estimated by visual estimation, UAV imagery and ground imagery showed strong correlation with each other and had comparable broad-sense heritability. Genome-wide association studies resulted in the identification of seven quantitative trait loci (QTL) for winter survival including Vrn-A1. By using the recently released annotated sequence of the wheat genome and the available RNA-Seq data, two putative candidate genes underlying the QTL for winter survival were identified. However, our study showed that certain QTL was unique to specific winter survival measurement. Collectively, our study demonstrated the feasibility of using UAV-based imagery for the identification of loci associated with winter survival in wheat. The complexity of in-field condition make our result a valuable complement to indoor frost-tolerance studies in the identification of genetic factors not directly linked to freezing tolerance.

Objectives: Compare the performance of zone-specific multi-parametric-MRI (mp-MRI) diagnostic models in prostate cancer detection with experienced radiologists., Methods: A single-centre, IRB approved, prospective STARD compliant 3 T MRI test dataset of 203 patients was generated to test validity and generalisability of previously reported 1.5 T mp-MRI diagnostic models. All patients included within the test dataset underwent 3 T mp-MRI, comprising T2, diffusion-weighted and dynamic contrast-enhanced imaging followed by transperineal template ± targeted index lesion biopsy. Separate diagnostic models (transition zone (TZ) and peripheral zone (PZ)) were applied to respective zones. Sensitivity/specificity and the area under the receiver operating characteristic curve (ROC-AUC) were calculated for the two zone-specific models. Two radiologists (A and B) independently Likert scored test 3 T mp-MRI dataset, allowing ROC analysis for each radiologist for each prostate zone., Results: Diagnostic models applied to the test dataset demonstrated a ROC-AUC = 0.74 (95% CI 0.67-0.81) in the PZ and 0.68 (95% CI 0.61-0.75) in the TZ. Radiologist A/B had a ROC-AUC = 0.78/0.74 in the PZ and 0.69/0.69 in the TZ. Radiologists A and B each scored 51 patients in the PZ and 41 and 45 patients respectively in the TZ as Likert 3. The PZ model demonstrated a ROC-AUC = 0.65/0.67 for the patients Likert scored as indeterminate by radiologist A/B respectively, whereas the TZ model demonstrated a ROC-AUC = 0.74/0.69., Conclusion: Zone-specific mp-MRI diagnostic models demonstrate generalisability between 1.5 and 3 T mp-MRI protocols and show similar classification performance to experienced radiologists for prostate cancer detection. Results also indicate the ability of diagnostic models to classify cases with an indeterminate radiologist score., Key Points: • MRI diagnostic models had similar performance to experienced radiologists for classification of prostate cancer. • MRI diagnostic models may help radiologists classify tumour in patients with indeterminate Likert 3 scores.

The present paper studies a predator-prey fishery model which incorporates the independent harvesting strategies and nonlinear impact of an anthropogenic toxicant. Both fish populations are harvested with different harvesting efforts, and the cases for the presence and non-presence of harvesting effort are discussed. The prey fish population is assumed to be infected by the toxicant directly which causes indirect infection to predator fish population through the feeding process. Each equilibrium of the proposed system is examined by analyzing the respective local stability properties. Dynamical behavior and bifurcations are studied with the assistance of threshold conditions influencing the persistence and extinction of both predator and prey. Bionomic equilibrium solutions for three possible cases are investigated with certain restrictions. Optimal harvesting policy is explored by utilizing the Pontryagin's Maximum Principle to optimize the profit while maintaining the sustainability of the marine ecosystem. Bifurcation analysis showed that the harvesting parameters are the key elements causing fishery extinction. Numerical simulations of bionomic and optimal equilibrium solutions showed that the presence of toxicant has a detrimental effect on the fish populations.

Background: Whole-body MRI (WB-MRI) could be an alternative to multimodality staging of colorectal cancer, but its diagnostic accuracy, effect on staging times, number of tests needed, cost, and effect on treatment decisions are unknown. We aimed to prospectively compare the diagnostic accuracy and efficiency of WB-MRI-based staging pathways with standard pathways in colorectal cancer., Methods: The Streamline C trial was a prospective, multicentre trial done in 16 hospitals in England. Eligible patients were 18 years or older, with newly diagnosed colorectal cancer. Exclusion criteria were severe systemic disease, pregnancy, contraindications to MRI, or polyp cancer. Patients underwent WB-MRI, the result of which was withheld until standard staging investigations were complete and the first treatment decision made. The multidisciplinary team recorded its treatment decision based on standard investigations, then on the WB-MRI staging pathway (WB-MRI plus additional tests generated), and finally on all tests. The primary outcome was difference in per-patient sensitivity for metastases between standard and WB-MRI staging pathways against a consensus reference standard at 12 months, in the per-protocol population. Secondary outcomes were difference in per-patient specificity for metastatic disease detection between standard and WB-MRI staging pathways, differences in treatment decisions, staging efficiency (time taken, test number, and costs), and per-organ sensitivity and specificity for metastases and per-patient agreement for local T and N stage. This trial is registered with the International Standard Randomised Controlled Trial registry, number ISRCTN43958015, and is complete., Findings: Between March 26, 2013, and Aug 19, 2016, 1020 patients were screened for eligibility. 370 patients were recruited, 299 of whom completed the trial; 68 (23%) had metastasis at baseline. Pathway sensitivity was 67% (95% CI 56 to 78) for WB-MRI and 63% (51 to 74) for standard pathways, a difference in sensitivity of 4% (-5 to 13, p=0·51). No adverse events related to imaging were reported. Specificity did not differ between WB-MRI (95% [95% CI 92-97]) and standard pathways (93% [90-96], p=0·48). Agreement with the multidisciplinary team's final treatment decision was 96% for WB-MRI and 95% for the standard pathway. Time to complete staging was shorter for WB-MRI (median, 8 days [IQR 6-9]) than for the standard pathway (13 days [11-15]); a 5-day (3-7) difference. WB-MRI required fewer tests (median, one [95% CI 1 to 1]) than did standard pathways (two [2 to 2]), a difference of one (1 to 1). Mean per-patient staging costs were £216 (95% CI 211-221) for WB-MRI and £285 (260-310) for standard pathways., Interpretation: WB-MRI staging pathways have similar accuracy to standard pathways and reduce the number of tests needed, staging time, and cost., Funding: UK National Institute for Health Research., (Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Objectives: To determine the diagnostic accuracy and interobserver concordance of whole-body (WB)-MRI, vs. 99m Tc bone scintigraphy (BS) and 18 fluoro-ethyl-choline ( 18 F-choline) PET/CT for the primary staging of intermediate/high-risk prostate cancer., Methods: An institutional review board approved prospective cohort study carried out between July 2012 and November 2015, whereby 56 men prospectively underwent 3.0-T multiparametric (mp)-WB-MRI in addition to BS (all patients) ± 18 F-choline PET/CT (33 patients). MRI comprised pre- and post-contrast modified Dixon (mDixon), T2-weighted (T2W) imaging, and diffusion-weighted imaging (DWI). Patients underwent follow-up mp-WB-MRI at 1 year to derive the reference standard. WB-MRIs were reviewed by two radiologists applying a 6-point scale and a locked sequential read (LSR) paradigm for the suspicion of nodal (N) and metastatic disease (M1a and M1b)., Results: The mean sensitivity/specificity of WB-MRI for N1 disease was 1.00/0.96 respectively, compared with 1.00/0.82 for 18 F-choline PET/CT. The mean sensitivity and specificity of WB-MRI, 18 F-choline PET/CT, and BS were 0.90/0.88, 0.80/0.92, and 0.60/1.00 for M1b disease. ROC-AUC did not show statistically significant improvement for each component of the LSR; mean ROC-AUC 0.92, 0.94, and 0.93 (p < 0.05) for mDixon + DWI, + T2WI, and + contrast respectively. WB-MRI had an interobserver concordance (κ) of 0.79, 0.68, and 0.58 for N1, M1a, and M1b diseases respectively., Conclusions: WB-MRI provides high levels of diagnostic accuracy for both nodal and metastatic bone disease, with higher levels of sensitivity than BS for metastatic disease, and similar performance to 18 F-choline PET/CT. T2 and post-contrast mDixon had no significant additive value above a protocol comprising mDixon and DWI alone., Key Points: • A whole-body MRI protocol comprising unenhanced mDixon and diffusion-weighted imaging provides high levels of diagnostic accuracy for the primary staging of intermediate- and high-risk prostate cancer. • The diagnostic accuracy of whole-body MRI is much higher than that of bone scintigraphy, as currently recommended for clinical use. • Staging using WB-MRI, rather than bone scintigraphy, could result in better patient stratification and treatment delivery than is currently provided to patients worldwide.

Background: Whole-body magnetic resonance imaging (WB-MRI) could be an alternative to multi-modality staging of non-small-cell lung cancer (NSCLC), but its diagnostic accuracy, effect on staging times, number of tests needed, cost, and effect on treatment decisions are unknown. We aimed to prospectively compare the diagnostic accuracy and efficiency of WB-MRI-based staging pathways with standard pathways in NSCLC., Methods: The Streamline L trial was a prospective, multicentre trial done in 16 hospitals in England. Eligible patients were 18 years or older, with newly diagnosed NSCLC that was potentially radically treatable on diagnostic chest CT (defined as stage IIIb or less). Exclusion criteria were severe systemic disease, pregnancy, contraindications to MRI, or histologies other than NSCLC. Patients underwent WB-MRI, the result of which was withheld until standard staging investigations were complete and the first treatment decision made. The multidisciplinary team recorded its treatment decision based on standard investigations, then on the WB-MRI staging pathway (WB-MRI plus additional tests generated), and finally on all tests. The primary outcome was difference in per-patient sensitivity for metastases between standard and WB-MRI staging pathways against a consensus reference standard at 12 months, in the per-protocol population. Secondary outcomes were difference in per-patient specificity for metastatic disease detection between standard and WB-MRI staging pathways, differences in treatment decisions, staging efficiency (time taken, test number, and costs) and per-organ sensitivity and specificity for metastases and per-patient agreement for local T and N stage. This trial is registered with the International Standard Randomised Controlled Trial registry, number ISRCTN50436483, and is complete., Findings: Between Feb 26, 2013, and Sept 5, 2016, 976 patients were screened for eligibility. 353 patients were recruited, 187 of whom completed the trial; 52 (28%) had metastasis at baseline. Pathway sensitivity was 50% (95% CI 37-63) for WB-MRI and 54% (41-67) for standard pathways, a difference of 4% (-7 to 15, p=0·73). No adverse events related to imaging were reported. Specificity did not differ between WB-MRI (93% [88-96]) and standard pathways (95% [91-98], p=0·45). Agreement with the multidisciplinary team's final treatment decision was 98% for WB-MRI and 99% for the standard pathway. Time to complete staging was shorter for WB-MRI (13 days [12-14]) than for the standard pathway (19 days [17-21]); a 6-day (4-8) difference. The number of tests required was similar WB-MRI (one [1-1]) and standard pathways (one [1-2]). Mean per-patient costs were £317 (273-361) for WBI-MRI and £620 (574-666) for standard pathways., Interpretation: WB-MRI staging pathways have similar accuracy to standard pathways, and reduce the staging time and costs., Funding: UK National Institute for Health Research., (Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Background: Multiparametric magnetic resonance imaging (mpMRI)-targeted prostate biopsies can improve detection of clinically significant prostate cancer and decrease the overdetection of insignificant cancers. It is unknown whether visual-registration targeting is sufficient or augmentation with image-fusion software is needed., Objective: To assess concordance between the two methods., Design, Setting, and Participants: We conducted a blinded, within-person randomised, paired validating clinical trial. From 2014 to 2016, 141 men who had undergone a prior (positive or negative) transrectal ultrasound biopsy and had a discrete lesion on mpMRI (score 3-5) requiring targeted transperineal biopsy were enrolled at a UK academic hospital; 129 underwent both biopsy strategies and completed the study., Intervention: The order of performing biopsies using visual registration and a computer-assisted MRI/ultrasound image-fusion system (SmartTarget) on each patient was randomised. The equipment was reset between biopsy strategies to mitigate incorporation bias., Outcome Measurements and Statistical Analysis: The proportion of clinically significant prostate cancer (primary outcome: Gleason pattern ≥3+4=7, maximum cancer core length ≥4mm; secondary outcome: Gleason pattern ≥4+3=7, maximum cancer core length ≥6mm) detected by each method was compared using McNemar's test of paired proportions., Results and Limitations: The two strategies combined detected 93 clinically significant prostate cancers (72% of the cohort). Each strategy detected 80/93 (86%) of these cancers; each strategy identified 13 cases missed by the other. Three patients experienced adverse events related to biopsy (urinary retention, urinary tract infection, nausea, and vomiting). No difference in urinary symptoms, erectile function, or quality of life between baseline and follow-up (median 10.5 wk) was observed. The key limitations were lack of parallel-group randomisation and a limit on the number of targeted cores., Conclusions: Visual-registration and image-fusion targeting strategies combined had the highest detection rate for clinically significant cancers. Targeted prostate biopsy should be performed using both strategies together., Patient Summary: We compared two prostate cancer biopsy strategies: visual registration and image fusion. A combination of the two strategies found the most clinically important cancers and should be used together whenever targeted biopsy is being performed., (Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.)

Background Biologic specificity of diffusion MRI in relation to prostate cancer aggressiveness may improve by examining separate components of the diffusion MRI signal. The Vascular, Extracellular, and Restricted Diffusion for Cytometry in Tumors (VERDICT) model estimates three distinct signal components and associates them to (a) intracellular water, (b) water in the extracellular extravascular space, and (c) water in the microvasculature. Purpose To evaluate the repeatability, image quality, and diagnostic utility of intracellular volume fraction (FIC) maps obtained with VERDICT prostate MRI and to compare those maps with apparent diffusion coefficient (ADC) maps for Gleason grade differentiation. Materials and Methods Seventy men (median age, 62.2 years; range, 49.5-82.0 years) suspected of having prostate cancer or undergoing active surveillance were recruited to a prospective study between April 2016 and October 2017. All men underwent multiparametric prostate and VERDICT MRI. Forty-two of the 70 men (median age, 67.7 years; range, 50.0-82.0 years) underwent two VERDICT MRI acquisitions to assess repeatability of FIC measurements obtained with VERDICT MRI. Repeatability was measured with use of intraclass correlation coefficients (ICCs). The image quality of FIC and ADC maps was independently evaluated by two board-certified radiologists. Forty-two men (median age, 64.8 years; range, 49.5-79.6 years) underwent targeted biopsy, which enabled comparison of FIC and ADC metrics in the differentiation between Gleason grades. Results VERDICT MRI FIC demonstrated ICCs of 0.87-0.95. There was no significant difference between image quality of ADC and FIC maps (score, 3.1 vs 3.3, respectively; P = .90). FIC was higher in lesions with a Gleason grade of at least 3+4 compared with benign and/or Gleason grade 3+3 lesions (mean, 0.49 ± 0.17 vs 0.31 ± 0.12, respectively; P = .002). The difference in ADC between these groups did not reach statistical significance (mean, 1.42 vs 1.16 × 10 -3 mm 2 /sec; P = .26). Conclusion Fractional intracellular volume demonstrates high repeatability and image quality and enables better differentiation of a Gleason 4 component cancer from benign and/or Gleason 3+3 histology than apparent diffusion coefficient. Published under a CC BY 4.0 license. Online supplemental material is available for this article. See also the editorial by Sigmund and Rosenkrantz in this issue.

With growing work-time restrictions and public expectations, the Halstedian educational model of 'see one, do one, teach one' is unfit for the modern training of thoracic residents. With the cardiothoracic surgical workforce set to decline by 50% over the next 10 years, new models are desperately needed to help trainees bypass the early error-prone phase of the lobectomy learning curve. In this review, we detail the development and validation of numerous simulators designed to teach trainees an array of skills ranging from basic technical skills to more complex non-technical skills. Given the recent increases in minimally invasive lobectomies, we critique both open and thoracoscopic simulators. We elucidate that whilst there are a growing number of thoracic simulators of varying fidelity available, fundamentally, there is currently a significant lack of well-designed trials validating various simulators for teaching lobectomy despite an awareness of their potential to improve surgical education. Furthermore, there is a void in the simulation training of non-technical skills within thoracic surgery. Encouragingly, there is a definite awareness of the ability of simulation to aid with the training of future thoracic surgical trainees., (© The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Aims: The aim of this study is to determine the prevalence of traumatic dental injuries (TDIs) to anterior teeth in 8-12-year-old schoolchildren of Patiala city in North India and to study the risk factors related to dental trauma., Materials and Methods: An epidemiological cross-sectional survey was conducted. The study consisted of 3,000 schoolchildren from various schools of Patiala city in North India. The body mass index was calculated. Lip competency, anterioposterior molar relationship, overjet, and overbite were examined. Dental injuries to anterior teeth were recorded according to the Ellis classification. Data were collected on a proforma., Results: The prevalence was found to be 11.4%. Maximum injuries occurred in the 11-year age group and the boys:girls ratio was 1.7:1. The home was the most common place with fall being the most common reason. The relationship between obesity and dental trauma was found to be statistically insignificant, whereas a statistically significant relationship was found between TDIs and incompetent lips, incisal overjet ≥5 mm, and Angle's class II div I molar relation. The Ellis class I fracture was the most predominant type., Conclusion: The high prevalence of dental trauma stresses the need for the development of preventive strategies. There is a need for increased awareness among parents and children regarding dental trauma., How to Cite This Article: Dharmani CKK, Pathak A, et al. Prevalence of Traumatic Dental Injuries to Anterior Teeth in 8-12-year-old Schoolchildren of Patiala City, Punjab, India: An Epidemiological Study. Int J Clin Pediatr Dent 2019;12(1):25-29., Competing Interests: Source of support: Nil Conflict of interest: None

The value of exotic wheat genetic resources for accelerating grain yield gains is largely unproven and unrealized. We used next-generation sequencing, together with multi-environment phenotyping, to study the contribution of exotic genomes to 984 three-way-cross-derived (exotic/elite1//elite2) pre-breeding lines (PBLs). Genomic characterization of these lines with haplotype map-based and SNP marker approaches revealed exotic specific imprints of 16.1 to 25.1%, which compares to theoretical expectation of 25%. A rare and favorable haplotype (GT) with 0.4% frequency in gene bank identified on chromosome 6D minimized grain yield (GY) loss under heat stress without GY penalty under irrigated conditions. More specifically, the 'T' allele of the haplotype GT originated in Aegilops tauschii and was absent in all elite lines used in study. In silico analysis of the SNP showed hits with a candidate gene coding for isoflavone reductase IRL-like protein in Ae. tauschii. Rare haplotypes were also identified on chromosomes 1A, 6A and 2B effective against abiotic/biotic stresses. Results demonstrate positive contributions of exotic germplasm to PBLs derived from crosses of exotics with CIMMYT's best elite lines. This is a major impact-oriented pre-breeding effort at CIMMYT, resulting in large-scale development of PBLs for deployment in breeding programs addressing food security under climate change scenarios.

Objective: To determine whether indeterminate (Likert-score 3/5) peripheral zone (PZ) multiparametric MRI (mpMRI) studies are classifiable by prostate-specific antigen (PSA), PSA density (PSAD), Prostate Imaging Reporting And Data System version 2 (PI-RADS&#95;v2) rescoring and morphological MRI features., Methods: Men with maximum Likert-score 3/5 within their PZ were retrospectively selected from 330 patients who prospectively underwent prostate mpMRI (3 T) without an endorectal coil, followed by 20-zone transperineal template prostate mapping biopsies ＋/- focal lesion-targeted biopsy. PSAD was calculated using pre-biopsy PSA and MRI-derived volume. Two readers A and B independently assessed included men with both Likert-assessment and PI-RADS&#95;v2. Both readers then classified mpMRI morphological features in consensus. Men were divided into two groups: significant cancer (≥ Gleason 3 ＋ 4) or insignificant cancer (≤ Gleason 3 ＋ 3)/no cancer. Comparisons between groups were made separately for PSA & PSAD using Mann-Whitney test and morphological descriptors with Fisher's exact test. PI-RADS&#95;v2 and Likert-assessment were descriptively compared and percentage inter-reader agreement calculated., Results: 76 males were eligible for PSA & PSAD analyses, 71 for PI-RADS scoring, and 67 for morphological assessment (excluding significant image artefacts). Unlike PSA (p = 0.915), PSAD was statistically different (p = 0.004) between the significant [median: 0.19 ng ml - 2 (interquartile range: 0.13-0.29)] and non-significant/no cancer [median: 0.13 ng ml - 2 (interquartile range: 0.10-0.17)] groups. Presence of mpMRI morphological features was not significantly different between groups. Subjective Likert-assessment discriminated patients with significant cancer better than PI-RADS&#95;v2. Inter-reader percentage agreement was 83% for subjective Likert-assessment and 56% for PI-RADS&#95;v2., Conclusion: PSAD may categorize presence of significant cancer in patients with Likert-scored 3/5 PZ mpMRI findings. Advances in knowledge: PSAD may be used in indeterminate PZ mpMRI to guide decisions between biopsy vs monitoring.

Objective: To investigate the development of reproductive endocrine changes in Indian women with epilepsy initiating on either Valproate (VPA) or Lamotrigine (LTG) monotherapy., Methods: Reproductive hormonal profiles, hirsutism, ovarian morphology by ultrasonography and menstrual cycle data in newly diagnosed women with epilepsy taking VPA (n=34) or LTG (n=32) monotherapy were compared. None of the women were receiving hormonal contraception. Patients gave details of seizure type and frequency, medical and drug history. Body weight and fasting insulin, glucose, testosterone, dihyroepiandrosterone sulfate (DHEAS), androstenedione, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), follicle-stimulating hormone (FSH) were measured. Body mass index, free androgen index and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. Longitudinal evaluations were done at 6th month and at 12th month. After 12th month some VPA-treated women were replaced with LTG and further followed-up twice in next six months., Results: The mean testosterone level was significant increased in VPA-treated women at 6th month (p=0.03), then at 12th month (p=0.01). More women in the valproate group than the lamotrigine group developed hirsutism (p=0.06), menstrual disturbances (p=0.02) and PCOS (p=0.001). Before valproate therapy, 32% of the patients were obese, this percentage rose to 47% after treatment (p=0.03). A significant positive correlation was existed between obesity (BMI >25) and the development of menstrual disturbances (p=0.006), serum testosterone levels (p=0.02) and PCOS (p=0.03). Insulin resistance (HOMA-IR >2.5) was significant correlated with menstrual disturbances (p=0.03) and serum testosterone levels (p=0.02). Substitution of VPA with LTG results in significant reduction in mean testosterone levels (p=0.005) and means body weight at 6th month (p=0.01)., Conclusion: Long-term valproate therapy in Indian women with epilepsy was associated with development of menstrual disturbances, alterations in reproductive hormonal function and increased the risk to developed PCOS., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Objectives: To evaluate multiparametric-MRI (mpMRI) derived histogram textural-analysis parameters for detection of transition zone (TZ) prostatic tumour., Methods: Sixty-seven consecutive men with suspected prostate cancer underwent 1.5T mpMRI prior to template-mapping-biopsy (TPM). Twenty-six men had 'significant' TZ tumour. Two radiologists in consensus matched TPM to the single axial slice best depicting tumour, or largest TZ diameter for those with benign histology, to define single-slice whole TZ-regions-of-interest (ROIs). Textural-parameter differences between single-slice whole TZ-ROI containing significant tumour versus benign/insignificant tumour were analysed using Mann Whitney U test. Diagnostic accuracy was assessed by receiver operating characteristic area under curve (ROC-AUC) analysis cross-validated with leave-one-out (LOO) analysis., Results: ADC kurtosis was significantly lower (p < 0.001) in TZ containing significant tumour with ROC-AUC 0.80 (LOO-AUC 0.78); the difference became non-significant following exclusion of significant tumour from single-slice whole TZ-ROI (p = 0.23). T1-entropy was significantly lower (p = 0.004) in TZ containing significant tumour with ROC-AUC 0.70 (LOO-AUC 0.66) and was unaffected by excluding significant tumour from TZ-ROI (p = 0.004). Combining these parameters yielded ROC-AUC 0.86 (LOO-AUC 0.83)., Conclusion: Textural features of the whole prostate TZ can discriminate significant prostatic cancer through reduced kurtosis of the ADC-histogram where significant tumour is included in TZ-ROI and reduced T1 entropy independent of tumour inclusion., Key Points: • MR textural features of prostate transition zone may discriminate significant prostatic cancer. • Transition zone (TZ) containing significant tumour demonstrates a less peaked ADC histogram. • TZ containing significant tumour reveals higher post-contrast T1-weighted homogeneity. • The utility of MR texture analysis in prostate cancer merits further investigation.

Sclerosing Mediastinitis (SM) is a rare condition which is characterized by the presence of dense fibrosis which infiltrates and encroaches upon various structures in the mediastinal cavity. Depending on the extent and the predominant organ of involvement, the patient presents with symptomatology of dysphagia, superior vena cava compression syndrome or dyspnoea. However, the involvement of the heart is rarely seen. Aetiologies of SM are several, with infections being the most common. We discuss a case of SM involving the oesophagus, descending aorta, hilum of lungs and the heart secondary to mucormycosis in an immunocompetent male.

Purpose: Excessive weight gain associated with sodium valproate (VPA) may predispose patients with epilepsy to other health problems such as insulin resistance. We prospectively evaluated the long-term impact of VPA monotherapy compared with lamotrigine (LTG) monotherapy on anthropometric and metabolic parameters in women with epilepsy. Our primary objective is to understand the underlying mechanism responsible for VPA-induced obesity., Methods: Sixty-six female patients with newly diagnosed or untreated epilepsy were included in the study. Thirty-four patients with VPA and thirty-two patients with LTG were treated for a period of one year in our center. Anthropometric and clinical data were collected at 5 time points: before, at 6th week, 3rd month, 6th month, 9th month and 12th month (last visit). Biochemical and hormonal data were collected 2 time points: before and last visit., Results: Subjects in the VPA group had significantly higher body weight than LTG-treated subjects (64.88±3.25 vs. 58.28±2.43, P<0.001). HOMA-IR level was significantly increased (2.76 vs. 1.35, P<0.05), and adiponectin levels were significantly lower in the VPA group (3.46 vs. 6.22, P<0.05). Triglycerides levels were significantly increased (118 vs. 96, P<0.05), and HDL-C levels were significantly lower in the VPA group. Both the VPA-treated group and the LTG-treated group showed no significant difference in term of total cholesterol, LDL-C, fasting blood glucose and serum leptin levels., Conclusions: Based on the findings of this study, we proposed that VPA induced hypoadiponectinemia which correlates significantly with insulin resistance. These two factors may be responsible for weight gain, possible by stimulating appetite. Valproic acid appears to be use cautionally in obese females with epilepsy., (Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)

Antiepileptic drugs (AEDs) are extensively used worldwide to treat a wide range of disorders other than epilepsy, such as neuropathic pain, migraine, and bipolar disorder. Due to this situation more than 20 new third-generation AEDs have been introduced in the market recently. The future design of new AEDs must also have potential to help in the non-epileptic disorders. The wide acceptance of second generation AEDs for the management of various non-epileptic disorders has caused the emergence of generics in the market. The wide use of approved AEDs outside epilepsy is based on both economic and scientific reasons. Bipolar disorders, migraine prophylaxis, fibromyalgia, and neuropathic pain represent the most attractive indication expansion opportunities for anticonvulsant developers, providing blockbuster revenues. Strong growth in non-epilepsy conditions will see Pfizer's Lyrica become the market leading brand by 2018. In this review, we mainly focus on the current status of new AEDs in the treatment of chronic pain and migraine prophylaxis. AEDs have a strong analgesic potential and this is demonstrated by the wide use of carbamazepine in trigeminal neuralgia and sodium valproate in migraine prophylaxis. At present, data on the new AEDs for non-epileptic conditions are inconclusive. Not all AEDs are effective in the management of neuropathic pain and migraine. Only those AEDs whose mechanisms of action are match with pathophysiology of the disease, have potential to show efficacy in non-epileptic disorder. For this better understanding of the pathophysiology of the disease and mechanisms of action of new AEDs are essential requirement before initiating pre-clinical and clinical trials. Many new AEDs show good results in the animal model and open-label studies but fail to provide strong evidence at randomized, placebo-controlled trials. The final decision regarding the clinical efficacy of the particular AEDs in a specific non-epileptic disorder should be withdrawal from randomized placebo trials rather than open-label studies; otherwise this may lead to off-label uses of drug. The purpose of the present review is to relate the various mechanisms of action of new AEDs to pathophysiological mechanisms and clinical efficacy in neuropathic pain and migraine.

Waterborne parasites that infect both humans and animals are common causes of diarrhoeal illness, but the relative importance of transmission between humans and animals and vice versa remains poorly understood. Transmission of infection from animals to humans via environmental reservoirs, such as water sources, has attracted attention as a potential source of endemic and epidemic infections, but existing mathematical models of waterborne disease transmission have limitations for studying this phenomenon, as they only consider contamination of environmental reservoirs by humans. This paper develops a mathematical model that represents the transmission of waterborne parasites within and between both animal and human populations. It also improves upon existing models by including animal contamination of water sources explicitly. Linear stability analysis and simulation results, using realistic parameter values to describe Giardia transmission in rural Australia, show that endemic infection of an animal host with zoonotic protozoa can result in endemic infection in human hosts, even in the absence of person-to-person transmission. These results imply that zoonotic transmission via environmental reservoirs is important.

Objectives: To assess the interchangeability of zone-specific (peripheral-zone (PZ) and transition-zone (TZ)) multiparametric-MRI (mp-MRI) logistic-regression (LR) models for classification of prostate cancer., Methods: Two hundred and thirty-one patients (70 TZ training-cohort; 76 PZ training-cohort; 85 TZ temporal validation-cohort) underwent mp-MRI and transperineal-template-prostate-mapping biopsy. PZ and TZ uni/multi-variate mp-MRI LR-models for classification of significant cancer (any cancer-core-length (CCL) with Gleason > 3 + 3 or any grade with CCL ≥ 4 mm) were derived from the respective cohorts and validated within the same zone by leave-one-out analysis. Inter-zonal performance was tested by applying TZ models to the PZ training-cohort and vice-versa. Classification performance of TZ models for TZ cancer was further assessed in the TZ validation-cohort. ROC area-under-curve (ROC-AUC) analysis was used to compare models., Results: The univariate parameters with the best classification performance were the normalised T2 signal (T2nSI) within the TZ (ROC-AUC = 0.77) and normalized early contrast-enhanced T1 signal (DCE-nSI) within the PZ (ROC-AUC = 0.79). Performance was not significantly improved by bi-variate/tri-variate modelling. PZ models that contained DCE-nSI performed poorly in classification of TZ cancer. The TZ model based solely on maximum-enhancement poorly classified PZ cancer., Conclusion: LR-models dependent on DCE-MRI parameters alone are not interchangable between prostatic zones; however, models based exclusively on T2 and/or ADC are more robust for inter-zonal application., Key Points: • The ADC and T2-nSI of benign/cancer PZ are higher than benign/cancer TZ. • DCE parameters are significantly different between benign PZ and TZ, but not between cancerous PZ and TZ. • Diagnostic models containing contrast enhancement parameters have reduced performance when applied across zones.

Endocrine-disrupting chemicals (EDCs) occur in reclaimed water (RW), which may serve as an exposure source for humans. The presence of EDCs in RW used to irrigate turf and in nearby water-retention ponds was determined. In addition, the total dislodgeable mass of each EDC was determined after irrigation (using RW) to simulate exposure of a 3-year-child playing in turf grass recently irrigated with RW. Five EDCs (estrone, 17β-estradiol, 17α-ethynylestradiol, bisphenol A, and 4-n-nonylphenol) were quantified in 28 samples of RWs (wastewater-treatment plant effluents) and 88 samples from residential surface water-retention ponds. St. Augustine variety of turf grass was irrigated with spiked RW to study dislodgement of the five EDCs overtime using a drag-sled method. Grass clippings were analyzed to relate masses of EDC on grass with masses dislodged. EDCs were detected in both RW and ponds at ng/L concentrations. Maximum EDC masses were dislodged immediately after irrigation. Dislodged masses of estrone and 17β-estradiol are two separate EDCs, 17β-estradiol and 17α-ethynylestradiol decreased rapidly and were lower than detection limits 4 h after application. Dislodged bisphenol-A and nonylphenol decreased more slowly but were not detected 6 h after application. Avoiding contact with recently irrigated turf grass should decrease the risks of exposure to these EDCs.

Objectives: We aimed to develop logistic regression (LR) models for classifying prostate cancer within the transition zone on multi-parametric magnetic resonance imaging (mp-MRI)., Methods: One hundred and fifty-five patients (training cohort, 70 patients; temporal validation cohort, 85 patients) underwent mp-MRI and transperineal-template-prostate-mapping (TPM) biopsy. Positive cores were classified by cancer definitions: (1) any-cancer; (2) definition-1 [≥Gleason 4 + 3 or ≥ 6 mm cancer core length (CCL)] [high risk significant]; and (3) definition-2 (≥Gleason 3 + 4 or ≥ 4 mm CCL) cancer [intermediate-high risk significant]. For each, logistic-regression mp-MRI models were derived from the training cohort and validated internally and with the temporal cohort. Sensitivity/specificity and the area under the receiver operating characteristic (ROC-AUC) curve were calculated. LR model performance was compared to radiologists' performance., Results: Twenty-eight of 70 patients from the training cohort, and 25/85 patients from the temporal validation cohort had significant cancer on TPM. The ROC-AUC of the LR model for classification of cancer was 0.73/0.67 at internal/temporal validation. The radiologist A/B ROC-AUC was 0.65/0.74 (temporal cohort). For patients scored by radiologists as Prostate Imaging Reporting and Data System (Pi-RADS) score 3, sensitivity/specificity of radiologist A 'best guess' and LR model was 0.14/0.54 and 0.71/0.61, respectively; and radiologist B 'best guess' and LR model was 0.40/0.34 and 0.50/0.76, respectively., Conclusions: LR models can improve classification of Pi-RADS score 3 lesions similar to experienced radiologists., Key Points: • MRI helps find prostate cancer in the anterior of the gland • Logistic regression models based on mp-MRI can classify prostate cancer • Computers can help confirm cancer in areas doctors are uncertain about.

Objective: To measure fluoride release and recharge ability of restorative materials in deionised water, artificial saliva and lactic acid., Materials and Methods: Pellets were prepared from GC2, Ketac N100 and Beautifil II. Each pellets were individually immersed in 10 ml deionised water, artificial saliva or lactic acid as per respective subgroup for 24 h and then elutes were collected. Specimens were reimmersed in respective container. Fluoride released was analysed after 24 h, 7(th) and 15(th) day. On 15(th) day all specimens were exposed to 1.23% APF gel and fluoride release in respective solution was measured on 16(th), 22(nd), 30(th) day., Result: Fluoride release was more after 24 h for all materials in all media then decrease gradually. GC2 shows more fluoride release than Ketac N100 at 24 hours and on 7(th) day but onwards Ketac N100 released significantly more fluoride. Beautifil II showed least fluoride release at all measured intervals in all media. Order of fluoride release in media was lactic acid > deionised water > artificial saliva for all materials., Conclusion: GICs are smart material which release more fluoride when environment become more acidic and also show tendency to recharge which helps clinically in caries risk children.