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Since electric vehicles (EVs) have definite benefits over gasoline vehicles, the vehicle market could be dominated by EVs in the future. This paper focuses on the new valet charging service to send staffs to replace users for charging their EVs, which can largely reduce charging anxiety. In this study, the location of charging stations and the allocation of charging demands to charging stations are optimized simultaneously due to the interaction of these decisions. The queueing behavior at the charging station is incorporated into the model, and the average charging waiting time is derived. We construct a mixed integer nonlinear optimization model based on the characteristics of valet charge service and an infinite-source queuing model. The objective is to minimize a total cost of the construction of charging facilities and valet charge service launching (i.e., charging staffs' road service, round-trip time, and the charging waiting time). The planning problem for valet charging service in this paper contributes to the existing literature on self-charging way where the users of EVs drive at charging stations to recharge their EVs by themselves. An improved genetic algorithm is developed to obtain deployment and operation plans for large-scale instances constructed based a real case in Shanghai. The improved genetic algorithm shows high performance in convergence and solution quality, which provide the service providers an efficient decision support tool. Meaningful managerial insights are also provided, which can help the service provider make better cost-effective design of charging location and allocation plans. For example, the charging station location decisions are not as much as sensitive to critical variables (such as demand level, charging capacities, and the value of time) than the overall cost to those. This means that partial location decisions remain unchanged when the key parameters vary. [ABSTRACT FROM AUTHOR]

Background: 3D printers have gained prominence in rapid prototyping and viable in creating dimensionally accurate objects that are both safe within a Magnetic Resonance Imaging (MRI) environment and visible in MRI scans. A challenge when making MRI-visible objects using 3D printing is that hard plastics are invisible in standard MRI scans, while fluids are not. So typically, a hollow object will be printed and filled with a liquid that will be visible in MRI scans. This poses an engineering challenge however since objects created using traditional Fused Deposition Modeling (FDM) 3D-printing techniques are prone to leakage. Digital Light Processing (DLP) is a relatively modern and affordable 3D-printing technique using UV-hardened resin, capable of creating objects that are inherently liquid-tight. When printing hollow parts using DLP printers, one typically requires adding drainage holes for uncured liquid resin to escape during the printing process. If this is not done liquid resin will remain inside the object, which in our application is the desired outcome. Purpose: We devised a method to produce an inherently MRI-visible accessory using DLP technology with low dimensional tolerance to facilitate MRI-guided breast biopsies. Methods: By hollowing out the object without adding drainage holes and tuning printing parameters such as z-lift distance to retain as much uncured liquid resin inside as possible through surface tension, objects that are inherently visible in MRI scans can be created without further post-processing treatment. Results: Objects created through our method are simple and inexpensive to recreate, have minimal manufacturing steps, and are shown to be dimensionally exact and inherently MRI visible to be directly used in various applications without further treatment. Conclusion: Our proposed method of manufacturing objects that are inherently both MRI safe, and MRI visible. The proposed process is simple and does not require additional materials and tools beyond a DLP 3D-printer. With only an inexpensive DLP 3D-printer kit and basic cleaning and sanitation materials found in the hospital, we have demonstrated the viability of our process by successfully creating an object containing fine structures with low spatial tolerances used for MRI-guided breast biopsies. [ABSTRACT FROM AUTHOR]

Plasma membranes appear as deformable systems wherein molecules are free to move and diffuse giving rise to condensed microdomains (composed of ordered lipids, transmembrane proteins and cholesterol) surrounded by disordered lipid molecules. Such denser and thicker regions, namely lipid rafts, are important communication hubs for cells. Indeed, recent experiments revealed how the most of active signaling proteins co-localize on such domains, thereby intensifying the biochemical trafficking of substances. From a material standpoint, it is reasonable to assume the bilayer as a visco-elastic body accounting for both in-plane fluidity and elasticity. Consequently, lipid rafts contribute to membrane heterogeneity by typically exhibiting higher stiffness and viscosity and by locally altering the bilayer dynamics and proteins activity. A chemo-mechanical model of lipid bilayer coupled with interspecific dynamics among the resident species (typically transmembrane receptors and trasporters) has been recently formulated to explain and predict how proteins regulate the dynamic heterogeneity of membrane. However, the explicit inclusion of the membrane viscosity in the model was not considered. To this aim, the present work enriches the constitutive description of the bilayer by modeling its visco-elastic behavior. This is done through a strain-level dependent viscosity able to theoretically trace back the alteration of membrane fluidity experimentally observed in lipid phase transitions. This provides new insights into how the quasi-solid and fluid components of lipid membrane response interact with the evolution of resident proteins by affecting the activity of raft domains, with effects on cell mechano-signaling. [ABSTRACT FROM AUTHOR]

Scheduling problems are a fundamental aspect of various industries, wherein the effective allocation of resources and time management play a crucial role in optimizing operational processes. These problems can arise in any industry that requires the scheduling of resources, from manufacturing to healthcare and transportation. Despite the extensive scope of service system scheduling problems in the literature, research has yet to examine the bibliometric variables in this area. Based on bibliometric criteria, this research offers a picture of the structure, evolution, and potential future directions of studies on scheduling in service systems. With the application of the bibliometric analysis software VOSviewer and CiteSpace, 1991 publications related to service scheduling were identified from the Web of Science database between 1982 and 2023 and used in the analysis of this paper. This review used several bibliometric approaches, such as performance analysis and a scientific mapping of service scheduling. Several bibliometric variables, such as h-index, productivity, and citations, were included in the performance evaluation. Science mapping has used co-citations, bibliographic coupling, and the concurrency of keywords. Also, this paper introduces a novel and comprehensive framework for classifying scheduling models in service systems based on their characteristics. The highly cited implementation papers in the literature have demonstrated that scheduling problems in health care have been heavily utilized in the scholarly literature. This review which is the first bibliometric analysis in the service scheduling field provides a summary reference for scholars entering the subject for future research. [ABSTRACT FROM AUTHOR]

Cell membranes, mediator of many biological mechanisms from adhesion and metabolism up to mutation and infection, are highly dynamic and heterogeneous environments exhibiting a strong coupling between biochemical events and structural re-organisation. This involves conformational changes induced, at lower scales, by lipid order transitions and by the micro-mechanical interplay of lipids with transmembrane proteins and molecular diffusion. Particular attention is focused on lipid rafts, ordered lipid microdomains rich of signalling proteins, that co-localise to enhance substance trafficking and activate different intracellular biochemical pathways. In this framework, the theoretical modelling of the dynamic clustering of lipid rafts implies a full multiphysics coupling between the kinetics of phase changes and the mechanical work performed by transmembrane proteins on lipids, involving the bilayer elasticity. This mechanism produces complex interspecific dynamics in which membrane stresses and chemical potentials do compete by determining different morphological arrangements, alteration in diffusive walkways and coalescence phenomena, with a consequent influence on both signalling potential and intracellular processes. Therefore, after identifying the leading chemo-mechanical interactions, the present work investigates from a modelling perspective the spatio-temporal evolution of raft domains to theoretically explain co-localisation and synergy between proteins' activation and raft formation, by coupling diffusive and mechanical phenomena to observe different morphological patterns and clustering of ordered lipids. This could help to gain new insights into the remodelling of cell membranes and could potentially suggest mechanically based strategies to control their selectivity, by orienting intracellular functions and mechanotransduction. [ABSTRACT FROM AUTHOR]

The paper studies a scalar auxiliary variable (SAV) method to solve the Cahn–Hilliard equation with degenerate mobility posed on a smooth closed surface Γ . The SAV formulation is combined with adaptive time stepping and a geometrically unfitted trace finite element method (TraceFEM), which embeds Γ in R 3 . The stability is proven to hold in an appropriate sense for both first- and second-order in time variants of the method. The performance of our SAV method is illustrated through a series of numerical experiments, which include systematic comparison with a stabilized semi-explicit method. [ABSTRACT FROM AUTHOR]

Introduction: Hepatitis E virus (HEV) is one of the leading causes of acute viral hepatitis. There are thought to be 20 million infections per year in poorer nations with inadequate sanitation. In Egypt, awareness about the possible hazards linked to HEV infection is limited due to low socioeconomic and educational levels. Only a small number of sequences have been characterized, making HEV study in Egypt constrained. Numerous factors may have contributed to this neglect. Various extra-hepatic symptoms of HEV infection include neurological problems are recognized. Many European nations have implemented regular HEV monitoring, or targeted screening of blood provided by patients at greater risk to stop the spread of HEV by transfusion. Aim: Assess the prevalence of HEV infection in asymptomatic blood donors. Increasing awareness about HEV testing in patients with some unexplained neurological disorders. Methods: Cross-sectional study involving 550 patients: 500 apparently healthy blood donors and 50 patients with some neurological disorders. All subjects were tested for serological markers (IgG and IgM) for HEV using ELISA technique in addition to HEV RNA PCR testing for seropositive patients. Results: Five hundred asymptomatic blood donors (370 males and 130 females), ages ranging from 20 to 50 years (median 33), 22.6% of them tested positive for HEV (IgG and IgM) of which 2 subjects only had positive HEV RNA PCR testing. In the second group 50 patients (26 males and 24 females) with various unexplained neurological disorders. Liver functions were within normal or showed only a mild increase. Forty-four percent of the patients had positive serology for HEV, with 6 patients testing positive for HEV RNA on PCR. Conclusion: No need for mass screening for HEV serology among blood donors. HEV infection needs to be considered in patients with unexplained neurological disorders even if the liver functions are not markedly elevated. [ABSTRACT FROM AUTHOR]

Railways are the backbone of complex and multimodal transport systems in Europe. To secure a larger share of the transport market and attract existing and future freight customers, further improvement in services is required. To achieve this goal, the use of new technologies in the era of railway automation and digitalization is required. Automatic train operation (ATO) in rail transport is considered a promising solution for providing cost-effective rail products. In this study, we define ATO as autonomous train operation and the feasibility of ATO deployment in rail freight is investigated. For this purpose, a knowledge-based approach is introduced to identify opportunities, problems, and the most appropriate grade of automation in rail freight. In a multi-stage process, Delphi questionnaires were combined with the analytic network process (ANP) method to investigate, define, and weight the determinants for ATO deployment. The final phase of the survey estimated the potential costs and drivers for different grades of automation. The results show that, in addition to the positive impacts of ATO, there are numerous challenges and risks that need to be analysed before ATO is implemented. In addition, the Delphi-ANP approach was used to identify the key determinants for decision-making prior to ATO implementation and the most viable alternative based on them. Investment cost, level of safety, energy saving, and reliability of management system are the most important determinants for the decision to implement ATO. The results of this study can effectively support rail infrastructure managers and operators in strategic planning and decision-making for ATO implementation in rail freight. [ABSTRACT FROM AUTHOR]

Background: Invasive lobular carcinoma (ILC) sometimes presents with unique clinical, pathologic, and radiographic features. In this case report, we describe a patient with ILC, whose initial presentation consisted with symptoms secondary to bone-marrow dissemination. In addition, the breast primary was revealed only by magnetic resonance imaging (MRI) followed by real-time virtual sonography (RVS). Case presentation: A 51-year-old woman presented to our outpatient clinic with dyspnea on exertion. She had severe anemia (hemoglobin, 5.3 g/dL) and thrombocytopenia (platelet count, 31 × 103/mL). Bone-marrow biopsy was performed to evaluate hematopoietic function. The pathologic diagnosis was bone-marrow carcinomatosis due to metastatic breast cancer. Initial mammography followed by ultrasonography (US) failed to detect the primary tumor. On MRI, a non-mass-enhancement lesion was observed. While second-look US also did not detect the lesion, it was clearly visualized with RVS. We were finally able to biopsy the breast lesion. The pathologic diagnosis was ILC positive for both estrogen receptor and progesterone receptor, with 1 + immunohistochemical staining for human epidermal growth factor receptor 2. This case of ILC was characterized by bone-marrow metastasis. Due to decreased cell adhesion, the risk of bone-marrow metastasis is higher in ILC than in invasive ductal carcinoma, the most prevalent type of breast cancer. Biopsy of the primary lesion, which was initially only detected with MRI, was successfully performed with clear visualization during RVS, which is based on the fusion of MRI and US images. Conclusion: In this case report and literature review, we describe the unique clinical characteristics of ILC and a strategy for identifying primary lesions that are initially only visualized with MRI. [ABSTRACT FROM AUTHOR]

Vaccines are one of the most powerful tools for preventing infectious diseases. To effectively fight pathogens, vaccines should induce potent and long-lasting immune responses that are specific to the pathogens. However, not all vaccines can induce effective immune responses, and the responses vary greatly among individuals and populations. Although several factors, such as age, host genetics, nutritional status, and region, affect the effectiveness of vaccines, increasing data have suggested that the gut microbiota is critically associated with vaccine-induced immune responses. In this review, I discuss how gut microbiota affects vaccine effectiveness based on the clinical and preclinical data, and summarize possible underlying mechanisms related to the adjuvant effects of microbiota. A better understanding of the link between vaccine-induced immune responses and the gut microbiota using high-throughput technology and sophisticated system vaccinology approaches could provide crucial insights for designing effective personalized preventive and therapeutic vaccination strategies. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the feasibility of contrast-enhanced mammography (CEM)-guided biopsy at Hospital del Mar, a Spanish university hospital. Methods: We retrospectively reviewed all consecutive women with a suspicious enhancing finding eligible for CEM-guided biopsy, who were prospectively enrolled in a pre-marketing clinical validation and feasibility study (October 2019 to September 2021). CEM-guided biopsy is a stereotactic-based procedure that, by using intravenous iodinated contrast media administration and dual-energy acquisition, provides localisation of enhancing lesions. All the biopsies were performed using a vacuum-assisted device. We collected procedural characteristics (patient position and type of approach), and histopathological results. Feasibility endpoints included success (visualisation of the enhancing lesion, post-procedural biopsy changes and clip placement), procedural time, number of scout acquisitions and complications. Results: A total of 66 suspicious enhancing lesions (18.0% foci, 44.0% mass, 38.0% non-mass enhancement; median size 8.5 mm) in 64 patients (median age 59 years, mostly minimal [48.4%] or mild [32.8%] background parenchymal enhancement) were referred for CEM-guided biopsy in the study period. The success rate was 63/66 (95.4%). Amongst successful procedures, patients were most frequently seated (52/63, 82.5%) and the preferred approach was horizontal (48/63, 76.2%). Median total time per procedure was 15 min. Median number of acquisitions needed before targeting was 2 (range 1–4). Complications consisted of hematoma (17/63, 27%) and vasovagal reaction (2/63, 3.2%). At histology, the malignancy rate was 25/63 (39.7%). Conclusion: In this first patient series, CEM-guided breast biopsy was feasible, with success and complication rates similar to those previously reported for magnetic resonance guidance. Key points: • CEM may be used to guide biopsy of enhancing lesions through a stereotactic-based procedure combined with intravenous iodinated contrast media administration and dual-energy acquisition. • In this first patient series (n = 64), the success rate of CEM-guided biopsy was above 95%, the only complications were hematoma (22.2%) and vasovagal reaction (3.2%), and median total time per procedure was 15 min. • CEM-guided biopsy is feasible and could potentially be a widely available biopsy technique for enhancing-only lesions. [ABSTRACT FROM AUTHOR]

This paper describes the development of a mechanism to deal with time windows constraints. To the best of our knowledge, the time windows constraints are difficult to be fulfilled even for state-of-the-art methods. Therefore, the main contribution of this paper is to propose a new computational technique to deal with such constraints. Such technique was tested combined with two metaheuristics to solve the discrete and dynamic Berth Allocation Problem. The technique ensures obtaining feasible solutions in terms of vessels time windows constraints, which are treated as hard constraints. A data set generator was created, resulting in a diversity of problems in terms of time windows constraints. A detailed computational analysis was carried out to compare the performance of both metaheuristics considering the technique. [ABSTRACT FROM AUTHOR]

Introduction: Sodium-glucose co-transporter-2 (SGLT-2) inhibitors have been shown to have beneficial effects on various cardiovascular (CV) outcomes in patients with type 2 diabetes (T2D) in primary prevention and in those with a high CV risk profile. However, the mechanism(s) responsible for these CV benefits remain elusive and unexplained. The aim of the DAPAHEART study will be to demonstrate that treatment with SGLT-2 inhibitors is associated with greater myocardial insulin sensitivity in patients with T2D, and to determine whether this improvement can be attributed to a decrease in whole-body (and tissue-specific) insulin resistance and to increased myocardial perfusion and/or glucose uptake. We will also determine whether there is an appreciable degree of improvement in myocardial-wall conditions subtended by affected and non-affected coronary vessels, and if this relates to changes in left ventricular function. Methods: The DAPAHEART trial will be a phase III, single-center, randomized, two-arm, parallel-group, double-blind, placebo-controlled study. A cohort of 52 T2D patients with stable coronary artery disease (without any previous history of myocardial infarction, with or without previous percutaneous coronary intervention), with suboptimal glycemic control (glycated hemoglobin [HbA1c] 7–8.5%) on their current standard of care anti-hyperglycemic regimen, will be randomized in a 1:1 ratio to dapagliflozin or placebo. The primary outcome is to detect changes in myocardial glucose uptake from baseline to 4 weeks after treatment initiation. The main secondary outcome will be changes in myocardial blood flow, as measured by 13N-ammonia positron emission tomography/computed tomography (PET/CT). Other outcomes include cardiac function, glucose uptake in skeletal muscle, adipose tissue, liver, brain and kidney, as assessed by fluorodeoxyglucose (FDG) PET-CT imaging during hyperinsulinemic-euglycemic clamp; pericardial, subcutaneous and visceral fat, and browning as observed on CT images during FDG PET-CT studies; systemic insulin sensitivity, as assessed by hyperinsulinemic-euglycemic clamp, glycemic control, urinary glucose output; and microbiota modification. Discussion: SGLT-2 inhibitors, in addition to their insulin-independent plasma glucose-lowering effect, are able to directly (substrate availability, fuel utilization, insulin sensitivity) as well as indirectly (cardiac after-load reduction, decreased risk factors for heart failure) affect myocardial functions. Our study will provide novel insights into how these drugs exert CV protection in a diabetic population. Trial registration: EudraCT No. 2016-003614-27; ClinicalTrials.gov Identifier: NCT03313752. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study is to report on the performance of the MRI-guided VABB in our center and to look at the long-term outcome of biopsies with benign histology over a period of 19 years.Methods: In a single-center retrospective review study, data of 600 VABB procedures performed between September 1999 and March 2017 were evaluated. We collected patient demographics, histopathological diagnosis at MRI-VABB, and basic lesion characteristics (size, location). Data from the Belgian Cancer Registry was cross-referenced with our database to find out which patients with benign MRI-VABB results developed a malignant lesion over time.Results: These 600 VABB procedures were performed in 558 women with a mean patient age of 51.8 years (range 18-82 years). Our technical success rate was 99.3%. We found 27.67% B5 lesions, 9.82% B3 lesions, and 0.17% B4 lesions. Of 362 benign MRI-guided VABBs, follow-up data was available for a mean follow-up period of 7.6 years (0.8-18.3). Only one (0.3%) biopsy was a false negative lesion after MRI-guided VABB during follow-up. Short-term FU-MRI provided no increase in detection rate.Conclusion: The accuracy of MRI-guided VABB is high with a very low false negative rate of 0.3% on long-term follow-up. The value of short-term FU-MRI for every case after MRI-guided VABB may be questioned.Key Points: • MRI-guided vacuum-assisted breast biopsies yield a large portion of clinically relevant lesions (9.82% B3, 0.17% B4, and 27.67% B5 lesions). • The false negative biopsy rate of MRI-guided VABB in this study with a mean follow-up time of 7.6 years was only 0.3%. • Performing a short-term follow-up MRI after a benign MRI-guided VABB concordant to the MRI appearance may be questioned. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zeitschrift für Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zeitschrift für Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zeitschrift für Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zeitschrift für Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zeitschrift Für Neurologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Nowadays, most shipping companies are aware of the importance of analysing seafarers' work performance. Thus, improving seafarers' work performance or finding out the ways by which seafarers' work performance can be enhanced is becoming one of the decisive factors for the success of any shipping company. Any organization aims to have employees who can accomplish corporate goals and objectives using available resources efficiently and effectively. Manpower performance can be enhanced by putting more emphasis on factors that can stimulate employees' motivational level, creativity and job satisfaction. In this study, we use literature review and experts' opinions to identify determinants of workplace performance for seafarers working with Marine Services Company Limited (MSCL), a shipping company owned by the government of Tanzania. The data is collected from a random sample of 30 seafarers working for the MSCL and a Fuzzy Electre Model (FEM) is developed and applied to determine the significance of the factors and sub-factors for the work performance of seafarers. The fuzzy terms are adopted in order to integrate the uncertainty of subjective judgment when evaluating alternatives. The computational results validate the effectiveness of the developed evaluation model. This study is resourceful for the top management of MSCL, as it points out those factors that can directly affect the performance of her seafarers. Seafarers are important assets of any shipping company and thus, this study helps shipping enterprises devise efficient human resource strategies to get maximum benefit from this kind of assets. More importantly, enhanced seafarers' work performance leads to improved company's productivity and higher service quality and therefore make the shipping company competitive in the trading markets. [ABSTRACT FROM AUTHOR]

Nowadays, most shipping companies are aware of the importance of analysing seafarers' work performance. Thus, improving seafarers' work performance or finding out the ways by which seafarers' work performance can be enhanced is becoming one of the decisive factors for the success of any shipping company. Any organization aims to have employees who can accomplish corporate goals and objectives using available resources efficiently and effectively. Manpower performance can be enhanced by putting more emphasis on factors that can stimulate employees' motivational level, creativity and job satisfaction. In this study, we use literature review and experts' opinions to identify determinants of workplace performance for seafarers working with Marine Services Company Limited (MSCL), a shipping company owned by the government of Tanzania. The data is collected from a random sample of 30 seafarers working for the MSCL and a Fuzzy Electre Model (FEM) is developed and applied to determine the significance of the factors and sub-factors for the work performance of seafarers. The fuzzy terms are adopted in order to integrate the uncertainty of subjective judgment when evaluating alternatives. The computational results validate the effectiveness of the developed evaluation model. This study is resourceful for the top management of MSCL, as it points out those factors that can directly affect the performance of her seafarers. Seafarers are important assets of any shipping company and thus, this study helps shipping enterprises devise efficient human resource strategies to get maximum benefit from this kind of assets. More importantly, enhanced seafarers' work performance leads to improved company's productivity and higher service quality and therefore make the shipping company competitive in the trading markets. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluated the feasibility of DWI for lesion targeting in MRI-guided breast biopsies. Furthermore, it assessed device positioning on DWI during biopsy procedures.Methods: A total of 87 biopsy procedures (5/87 bilateral) consecutively performed between March 2019 and June 2020 were retrospectively reviewed: in these procedures, a preliminary DWI sequence (b = 1300 s/mm2) was acquired to assess lesion detectability. We included 64/87 procedures on lesions detectable at DWI; DWI sequences were added to the standard protocol to localize lesion and biopsy device and to assess the site marker correct positioning.Results: Mass lesions ranged from 5 to 48 mm, with a mean size of 10.7 mm and a median size of 8 mm. Non-mass lesions ranged from 7 to 90 mm, with a mean size of 33.9 mm and a median size of 31 mm. Positioning of the coaxial system was confirmed on both T1-weighted and DWI sequences. At DWI, the biopsy needle was detectable in 62/64 (96.9%) cases; it was not visible in 2/64 (3.1%) cases. The site marker was always identified using T1-weighted imaging; a final DWI sequence was acquired in 44/64 cases (68.8%). In 42/44 cases (95.5%), the marker was recognizable at DWI.Conclusions: DWI can be used as a cost-effective, highly reliable technique for targeting both mass and non-mass lesions, with a minimum size of 5 mm, detectable at pre-procedural DWI. DWI is also a feasible technique to localize the biopsy device and to confirm the deployment of the site marker.Key Points: • MRI-guided breast biopsy is performed in referral centers by an expert dedicated staff, based on prior MR imaging; contrast agent administration is usually needed for lesion targeting. • DWI represents a feasible, highly reliable technique for lesion targeting, avoiding contrast agent administration. • DWI allows a precise localization of both biopsy needle device and site marker. [ABSTRACT FROM AUTHOR]

Purpose of Review: Tuberculosis is the number one infectious killer of people with HIV worldwide, but it can be both prevented and treated. Prevention of tuberculosis by screening for and treating latent tuberculosis infection (LTBI), along with the initiation of antiretroviral therapy (ART), is the key component of HIV care. Recent Findings: While access to ART has increased worldwide, uptake and completion of LTBI treatment regimens among people living with HIV (PWH) are very poor. Concomitant TB-preventive therapy and ART are complex because of drug–drug interactions, but these can be managed. Recent clinical trials of shorter preventive regimens have demonstrated safety and efficacy in PWH with higher completion rates. More research is needed to guide TB-preventive therapy in children and in pregnant women, and for drug-resistant TB (DR-TB). Summary: Antiretroviral therapy and tuberculosis-preventive treatment regimens can be optimized to avoid drug–drug interactions, decrease pill burden and duration, and minimize side effects in order to increase adherence and treatment completion rates among PWH and LTBI. [ABSTRACT FROM AUTHOR]

A bovine colostrum fraction (BCF) was recently shown to enhance the adherence of several commensal organisms to intestinal epithelial cells through modulating the epithelial cell surface. In this study, the main components of the BCF were examined to investigate the active component/s responsible for driving the changes in the intestinal cells. The adherence of various bifidobacteria to HT-29 cells was increased when the intestinal cells were pre-incubated with immunoglobulin G (IgG). Modulation of the intestinal cells by IgG was concentration dependent with 16 mg/mL IgG resulting in a 43-fold increase in the adhesion of Bifidobacterium longum NCIMB 8809 to HT-29 cells. Periodate treatment of colostral IgG prior to performing the colonization studies resulted in a reduction in the adhesion of the strain to the intestinal cells demonstrating that the glycans of IgG may be important in modulating the intestinal cells for enhanced commensal adhesion. IgG isolated from mature milk also resulted in significant increases in adhesion of the Bifidobacterium strains tested albeit at reduced levels (3.9-fold). The impact of IgG on the HT-29 cells was also visualised via scanning electron microscopy. This study builds a strong case for the inclusion of IgG ingredients sourced from cow's milk in functional foods aimed at increasing numbers of health promoting bacteria in the human gut. [ABSTRACT FROM AUTHOR]

MRI-guided vacuum-assisted breast biopsy (VABB) is used for suspicious breast cancer (BC) lesions which are detectable only with MRI: because the high sensitivity but limited specificity of breast MRI it is a fundamental tool in breast imaging divisions. We analyse our experience of MRI-guided VABB and critically discuss the potentialities of diffusion-weighted imaging (DWI) and artificial intelligence (AI) in this matter. We retrospectively analysed a population of consecutive women underwent VABB at our tertiary referral BC centre from 01/2011 to 01/2019. Reference standard was histological diagnosis or at least 1-year negative follow-up. McNemar, Mann-Whitney and χ2 tests at 95% level of significance were used as statistical exams. 217 women (mean age = 52, 18-72 years) underwent MRI-guided VABB; 11 were excluded and 208 MRI-guided VABB lesions were performed: 34/208 invasive carcinomas, 32/208 DCIS, 8/208 LCIS, 3/208 high-risk lesions and 131/208 benign lesions were reported. Accuracy of MRI-guided VABB was 97%. The predictive features for malignancy were mass with irregular shape (OR 8.4; 95% CI 0.59-31.6), size of the lesion (OR 4.4; 95% CI 1.69-9.7) and mass with irregular/spiculated margins (OR 5.4; 95% CI 6.8-31.1). Six-month follow-up showed 4 false-negative cases (1.9%). Invasive BC showed a statistically significant higher hyperintense signal at DWI compared to benign lesions (p = 0.03). No major complications occurred. MR-guided VABB showed high accuracy. Benign-concordant lesions should be followed up with breast MRI in 6-12 months due to the risk of false-negative results. DWI and AI applications showed potential benefit as support tools for radiologists. [ABSTRACT FROM AUTHOR]

From the first half of the twentieth century to the present day, injuries and fatalities from captive-bolt livestock stunners are a major topic in forensic medicine. The vast majority of cases account for suicides with the frontal, temporal, parietal, and occipital regions being the most common sites of entrance (in descending order of frequency). Due to the limited length of the bolt, the corresponding wound channel within the braincase is only several centimeters long. It has been a controversial subject for a long time, whether the skin-bone complex punched out by the conically grooved end of the steel rod may act as a "secondary projectile" being propelled beyond the actual path of the bolt. To answer this question, experimental shots from various types of captive bolt-guns were fired to simulants. Video-documentation employing a high-speed motion camera showed that the punched-out pieces of skin and bone did not move further than the bolt. Thus, a secondary extension of the total wound channel could not be observed. However, the suction effect caused by the bolt's rearward movement may induce a slight retrograde displacement of the skin-bone complex. [ABSTRACT FROM AUTHOR]

Effective liner shipping is important for the global seaborne trade. The volume of cargoes transported by liner shipping has been increasing over the past decades. Liner shipping companies face three levels of decision problems, including strategic, tactical, and operational problems. The tactical-level decisions are commonly made every three to 6 months. These decisions include: (1) port service frequency determination; (2) fleet deployment; (3) sailing speed optimization; and (4) vessel schedule design. Most of the concurrent liner shipping studies have addressed the tactical-level decision problems separately. Even though a few studies have proposed joint planning models that capture multiple decision problems at the same time, none of the conducted studies has integrated all the four tactical-level decision problems. To address this gap in the state-of-the-art, this study presents a holistic optimization model that addresses all the tactical-level liner shipping decision problems, aiming to maximize the total profit obtained from liner shipping services. The key route service cost components, found in the liner shipping literature, are considered in this study, which include: (1) vessel operational cost; (2) vessel chartering cost; (3) port handling cost; (4) port late arrival cost; (5) fuel consumption cost; (6) container inventory costs in sea and at ports of call; and (7) emission costs in sea and at ports of call. An exact optimization approach is adopted for the developed mathematical model. The computational experiments, conducted for a set of Asia-North America liner shipping routes, showcase the efficiency of the proposed approach and offer some important managerial insights. [ABSTRACT FROM AUTHOR]

The diagnosis of breast cancer currently relies on radiological and clinical evaluation, confirmed by histopathological examination. However, such approach has some limitations as the suboptimal sensitivity, the long turnaround time for recall tests, the invasiveness of the procedure and the risk that some features of target lesions may remain undetected, making re-biopsy a necessity. Recent technological advances in the field of artificial intelligence hold promise in addressing such medical challenges not only in cancer diagnosis, but also in treatment assessment, and monitoring of disease progression. In the perspective of a truly personalised medicine, based on the early diagnosis and individually tailored treatments, two new technologies, namely radiomics and liquid biopsy, are rising as means to obtain information from diagnosis to molecular profiling and response assessment, without the need of a biopsied tissue sample. Radiomics works through the extraction of quantitative peculiar features of cancer from radiological data, while liquid biopsy gets the whole of the malignancy's biology from something as easy as a blood sample. Both techniques hopefully will identify diagnostic and prognostic information of breast cancer potentially reducing the need for invasive (and often difficult to perform) biopsies and favouring an approach that is as personalised as possible for each patient. Nevertheless, such techniques will not substitute tissue biopsy in the near future, and even in further times they will require the aid of other parameters to be correctly interpreted and acted upon. [ABSTRACT FROM AUTHOR]

We summarise here the information to be provided to women and referring physicians about percutaneous breast biopsy and lesion localisation under imaging guidance. After explaining why a preoperative diagnosis with a percutaneous biopsy is preferred to surgical biopsy, we illustrate the criteria used by radiologists for choosing the most appropriate combination of device type for sampling and imaging technique for guidance. Then, we describe the commonly used devices, from fine-needle sampling to tissue biopsy with larger needles, namely core needle biopsy and vacuum-assisted biopsy, and how mammography, digital breast tomosynthesis, ultrasound, or magnetic resonance imaging work for targeting the lesion for sampling or localisation. The differences among the techniques available for localisation (carbon marking, metallic wire, radiotracer injection, radioactive seed, and magnetic seed localisation) are illustrated. Type and rate of possible complications are described and the issue of concomitant antiplatelet or anticoagulant therapy is also addressed. The importance of pathological-radiological correlation is highlighted: when evaluating the results of any needle sampling, the radiologist must check the concordance between the cytology/pathology report of the sample and the radiological appearance of the biopsied lesion. We recommend that special attention is paid to a proper and tactful approach when communicating to the woman the need for tissue sampling as well as the possibility of cancer diagnosis, repeat tissue sampling, and or even surgery when tissue sampling shows a lesion with uncertain malignant potential (also referred to as "high-risk" or B3 lesions). Finally, seven frequently asked questions are answered. [ABSTRACT FROM AUTHOR]

Objective: Non-mass enhancement (NME) in breast MRI is the most common feature of ductal carcinoma in situ (DCIS). We sought to evaluate the interobserver variability and positive predictive value (PPV) for malignancy of NME descriptors using the fifth edition BI-RADS lexicon focusing on the newly introduced "clustered ring enhancement" pattern.Materials and Methods: Breast MRIs of 129 patients who had undergone MRI-guided vacuum-assisted biopsy (VAB) in our institution were reviewed. Studies assessed as NME were classified according to the fifth edition BI-RADS lexicon by two breast radiologists. Consensus was reached by involving a third radiologist. Interobserver variability and PPV for malignancy were assessed.Results: Seventy-two of 129 studies were assessed as NME. The disagreement rate in the first assessment step (mass vs. NME) was low at 9.3% (ĸ = 0.81, 95% confidence interval [CI] 0.71-0.91). The disagreement rate for distribution patterns was 23.6% (ĸ = 0.67, 95% CI 0.54-0.80) and 22.2% (ĸ = 0.69, 95% CI 0.56-0.81) for internal enhancement patterns. Clustered ring enhancement (PPV 53.85, p = 0.038) and segmental distribution (PPV 62.5%, p = 0.028) had the highest malignancy rates among internal enhancement and distribution patterns with a significant result; the combination of clustered ring enhancement and segmental distribution raised the malignancy rate by approximately 4% (PPV 66.67%, p = 0.049).Conclusion: There was a high agreement rate among readers when differentiating NME from mass lesions. The agreement rate was lower when assessing the distribution and internal enhancement pattern descriptors, but still substantial. The descriptors clustered ring enhancement and segmental distribution were significant predictors of malignancy.Key Points: • Non-mass enhancement is a common morphological feature of non-invasive breast cancer (DCIS) in MRI. Differentiation between potentially malignant and benign changes may be very challenging. • Since clustered ring enhancement and segmental distribution are both significant predictors of malignancy, the awareness of this important finding, combined with high-quality image interpretation skills, may improve the tumor detection rate. • The combination of clustered ring enhancement and segmental distribution increases the positive predictive value for malignancy, which may be relevant for clinical practice. [ABSTRACT FROM AUTHOR]

The superconducting La1.85Sr0.15CuO4 ceramics has been studied by small angle neutron scattering, magnetization measurements, and scanning electron microscopy. Experiments have shown that the intensity of the magnetic scattering is 2–3 times higher in the field cooled regime than in the zero-field cooled regime. Additional magnetic heterogeneities due to closure of the trapped magnetic flux cause the excess scattering in the field cooled regime. The isotropic nature of the scattering is associated with the absence of a preferred direction of the Abrikosov vortices, which is caused by the random orientation of the ab planes of the anisotropic superconductor granules. [ABSTRACT FROM AUTHOR]

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Background: In breast tissue, pre-malignant lesions are classified as BIRADS 3. The treatment of this heterogeneous group varies with expertise and tools available.Materials and Methods: With the example of two case reports, the literature is reviewed on current treatment options for BIRADS 3 breast lesions.Results: About 7% of all B-type breast biopsies fall into the B3 category. Approximately 35% of these B3 lesions are due to FEA, 20% to PLs and another 20% to ADH. Due to improvement in diagnostics, the incidence is increasing, while their value as a predictive factor for malignancy has steadily been fallen.Conclusion: Depending on the histology of the needle biopsy, a complete resection with vacuum-assisted biopsy may be a treatment alternative to open biopsy. [ABSTRACT FROM AUTHOR]

Purpose of the Review: Breast lesions of uncertain malignant potential (B3) are a heterogeneous group of diagnostic entities that can be associated with atypia. These are associated with in situ or invasive malignancy in 20–30% of cases. The management of those lesions has been both controversial and challenging for the multidisciplinary teams. Recent Findings: This is an up-to-date review of the current International Consensus on the management of B3 lesions with emphasis on the practical considerations. Summary: Through multidisciplinary management pathways, the vast majority of B3 lesions should be managed by vacuum-assisted excision, rather than surgical excision. Exceptions to this pathway and the rationale for surgical excision are discussed. [ABSTRACT FROM AUTHOR]

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With a view to occupational effects of climate change, we performed a simulation study on the influence of different heat stress assessment metrics on estimated workability (WA) of labour in warm outdoor environments. Whole-day shifts with varying workloads were simulated using as input meteorological records for the hottest month from four cities with prevailing hot (Dallas, New Delhi) or warm-humid conditions (Managua, Osaka), respectively. In addition, we considered the effects of adaptive strategies like shielding against solar radiation and different work-rest schedules assuming an acclimated person wearing light work clothes (0.6 clo). We assessed WA according to Wet Bulb Globe Temperature (WBGT) by means of an empirical relation of worker performance from field studies (Hothaps), and as allowed work hours using safety threshold limits proposed by the corresponding standards. Using the physiological models Predicted Heat Strain (PHS) and Universal Thermal Climate Index (UTCI)-Fiala, we calculated WA as the percentage of working hours with body core temperature and cumulated sweat loss below standard limits (38 °C and 7.5% of body weight, respectively) recommended by ISO 7933 and below conservative (38 °C; 3%) and liberal (38.2 °C; 7.5%) limits in comparison. ANOVA results showed that the different metrics, workload, time of day and climate type determined the largest part of WA variance. WBGT-based metrics were highly correlated and indicated slightly more constrained WA for moderate workload, but were less restrictive with high workload and for afternoon work hours compared to PHS and UTCI-Fiala. Though PHS showed unrealistic dynamic responses to rest from work compared to UTCI-Fiala, differences in WA assessed by the physiological models largely depended on the applied limit criteria. In conclusion, our study showed that the choice of the heat stress assessment metric impacts notably on the estimated WA. Whereas PHS and UTCI-Fiala can account for cumulative physiological strain imposed by extended work hours when working heavily under high heat stress, the current WBGT standards do not include this. Advanced thermophysiological models might help developing alternatives, where not only modelling details but also the choice of physiological limit criteria will require attention. There is also an urgent need for suitable empirical data relating workplace heat exposure to workability. [ABSTRACT FROM AUTHOR]

The aim of the study was to compare the patterns of development of macrophytes and macroinvertebrates in different types of reference mountain rivers. The study is based on reference river sites surveyed throughout the mountains in Poland and Slovakia in two European ecoregions (9—Central Highlands, 10—The Carpathians). A wide range of environmental variables were estimated, including water chemistry, hydromorphology, geology, and the spatial factor. Based on the Jaccard index, macrophyte and macroinvertebrate variation was confirmed between four mountain and upland river types. It was found that the biological diversification is mainly influenced by geological and associated chemical factors. In the case of macroinvertebrates, additionally, the importance of the spatial factor was revealed (difference between ecoregions). Finally, the habitat preferences of various taxa were identified. It was found that extreme mountain conditions can sometimes distort bioindicative response, as was detected in the case of macroinvertebrates in the highest mountain sites. We concluded that consideration of two groups of organisms enables more comprehensive and reliable monitoring than assessment based on a single group, especially when standard bioindicative methods can be distorted by extreme local conditions. [ABSTRACT FROM AUTHOR]

In humans, most fatalities from slaughterer's guns are suicides committed by persons familiar with stunning devices. The great majority of cases accounts for shots to the head, especially the frontal region. Only a small number of two subsequent cranial shots from captive-bolt humane killers have been reported up to now. In the case presented by the authors, a suicide by simultaneous shots to the head fired from two different makes of captive-bolt guns (one of them having two separate outlets for the combustion gases in the muzzle plane, the other type having no additional openings) is described for the first time. One of the shooting devices remained in firm contact with the left hand and produced patterned staining from rust corresponding to the surface relief of the gun. The medicolegal and criminalistic aspects of this unique case are discussed with reference to the pertinent literature. [ABSTRACT FROM AUTHOR]

Objectives: To assess whether using the Tree flowchart obviates unnecessary magnetic resonance imaging (MRI)-guided biopsies in breast lesions only visible on MRI.Methods: This retrospective IRB-approved study evaluated consecutive suspicious (BI-RADS 4) breast lesions only visible on MRI that were referred to our institution for MRI-guided biopsy. All lesions were evaluated according to the Tree flowchart for breast MRI by experienced readers. The Tree flowchart is a decision rule that assigns levels of suspicion to specific combinations of diagnostic criteria. Receiver operating characteristic (ROC) curve analysis was used to evaluate diagnostic accuracy. To assess reproducibility by kappa statistics, a second reader rated a subset of 82 patients.Results: There were 454 patients with 469 histopathologically verified lesions included (98 malignant, 371 benign lesions). The area under the curve (AUC) of the Tree flowchart was 0.873 (95% CI: 0.839-0.901). The inter-reader agreement was almost perfect (kappa: 0.944; 95% CI 0.889-0.998). ROC analysis revealed exclusively benign lesions if the Tree node was ≤2, potentially avoiding unnecessary biopsies in 103 cases (27.8%).Conclusions: Using the Tree flowchart in breast lesions only visible on MRI, more than 25% of biopsies could be avoided without missing any breast cancer.Key Points: • The Tree flowchart may obviate >25% of unnecessary MRI-guided breast biopsies. • This decrease in MRI-guided biopsies does not cause any false-negative cases. • The Tree flowchart predicts 30.6% of malignancies with >98% specificity. • The Tree's high specificity aids in decision-making after benign biopsy results. [ABSTRACT FROM AUTHOR]

Background: Cardiac dysfunction is a severe complication of diabetes, with no effective treatment. Currently, bariatric surgery is more and more widely used to attenuate diabetes-associated diseases. The mechanism is not clear. Endoplasmic reticulum (ER) stress-dependent apoptosis has been observed in the progression of diabetic myocardium damage. Therefore, this research was designed to investigate the effects of different bariatric procedures on cardiac dysfunction via ER stress-induced cardiomyocyte apoptosis pathway in a diabetic rat model. Methods: Duodenal-jejunal bypass (DJB), sleeve gastrectomy (SG), and sham surgery were performed in diabetic rats. Echocardiographic examination, H&E staining, Masson staining, and TUNEL staining were performed to measure the diabetes-caused heart damages. ER stress-associated signaling molecules like glucose-regulated protein 78 (GRP78), protein kinase RNA (PKR)-like ER protein kinase (PERK), p-PERK, inositol-requiring enzyme 1ɑ (IRE1ɑ), p-IRE1ɑ, activating transcription factor 6 (ATF6), C/EBP homologous protein (CHOP), and caspase 12 were measured and compared among DJB group, SG group, and sham group. Results: Compared with sham group, DJB and SG groups both had significantly lower GRP78, PERK, p-PERK, CHOP, and caspase 12, though there was no statistical change on IRE1ɑ, p-IRE1ɑ, and ATF6. DJB and SG groups also showed improved heart function and lower cardiomyocyte apoptosis in diabetic rats. Conclusion: DJB and SG ameliorated cardiac dysfunction by inhibiting PERK-mediated pathway. And no difference was observed on the effects of DJB and SG on ER stress-dependent myocardium damage in diabetic rats. [ABSTRACT FROM AUTHOR]

The distribution of 14 rare earth elements, Th and U was studied in streams of the study area at 21 sites. Aquatic mosses are known to accumulate even metabolically nonessential or toxic metals in concentrations much higher than their aqueous environment due to their unique morphology and physiology. Thus, the capacity of metal amplification in four aquatic mosses ( Fontinalis squamosa, Brachythecium rivulare, Platyhypnidium riparioides and Thamnobryum alopecurum) was also evaluated as a potential bioindicator/biomonitoring tool. Thirteen REEs (0.001-2.81 μg L) and U were detected in the stream water. Mean content of lighter rare earth elements (LREEs) was higher than that of heavier rare earth elements (HREEs). Fourteen REEs and two actinides were detected in moss samples, including Yb and Th which were below detection level in water samples. LREE uptake (0.17-12.2 mg kg) was greater than HREE uptake (0.02-0.78 mg kg) in all mosses. Uptake of LREEs was observed in the order: B. rivulare > T. alopecurum > F. squamosa > P. riparioides and that of HREEs in the order: T. alopecurum > B. rivulare > F. squamosa > P. riparioides. Mean U content (0.68-1.62 mg kg) in the mosses was found in the order: B. rivulare > F. squamosa > T. alopecurum > P. riparioides. Th content ranged from 0.4 to 2.36 mg kg in the order: B. rivulare > T. alopecurum > P. riparioides > F. squamosa. One-way ANOVA indicated a statistically significant difference ( P ≤ 0.01) in mean concentrations of all elements (individually) in moss samples except for U. Highest bioconcentration factors of six REEs each were observed in B. rivulare (La, Ce, Sm, Eu, Tb and Dy) and T. alopecurum (Nd, Gd, Ho, Er, Tm and Lu). The highest BCFs for Pr and U were obtained in F. squamosa and P. riparioides, respectively. These species hold promise for biomonitoring studies in the future. [ABSTRACT FROM AUTHOR]

Background: Amikacin is an aminoglycoside commonly used in intensive care units for the treatment of patients with life-threatening Gram-negative infections. Although aminoglycosides are extensively used, the accurate determination of their optimal dosage is complicated by marked intra- and interindividual variability in intensive care unit patients. Amikacin pharmacokinetics have been described in numerous studies over the past 25 years.Objective: This review presents a synthesis of the population pharmacokinetic models for amikacin described in critically ill patients. The objective was to determine whether there was a consensus on a structural model and which covariates had been identified.Methods: A literature search was conducted from the PubMed database, from its inception up until December 2015, using the following terms: 'amikacin', 'pharmacokinetic(s)', 'population', 'model(ling)' and 'nonlinear mixed effect'. Articles were excluded if they were not pertinent. The reference lists of all selected articles were also evaluated.Results: Ten articles were included in this review: pharmacokinetics of amikacin were described by a one-compartment or a two-compartment model. Various covariates were tested, but only two (creatinine clearance and total body weight) were included in almost all of the described models. After inclusion of these covariates, the interindividual variability (range) in clearance and the volume of distribution were 44.4 % (28.2-69.4 %) and 31.3 % (8.1-44.7 %), respectively. The residual variability (range) was around 21.0 % (9.0-31.0 %), using a proportional model, and for a combined model (proportional/additive), the median (range) values were 0.615 mg/L (0.2-1.03 mg/L) and 29.2 % (26.8-31.6 %).Conclusion: This review highlights the different population pharmacokinetic models for amikacin developed in critically ill patients over the past decades and proposes relevant information for clinicians and researchers. To optimize amikacin dosage, this review points out the relevant covariates according to the target population. In a population of critically ill patients, dose optimization mainly depends on creatinine clearance and total body weight. New pharmacokinetic population studies could be considered, with new covariates of interest to be tested in model building and to further explain variability. Another future perspective could be external evaluation of previously published models. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare three different biopsy devices on false-negative and underestimation rates in MR-guided, vacuum-assisted breast biopsy (VABB) of MRI-only lesions.Methods: This retrospective, single-center study was IRB-approved. Informed consent was waived. 467 consecutive patients underwent 487 MR-guided VABB using three different 8-10-gauge-VABB devices (Atec-9-gauge,A; Mammotome-8-gauge,M; Vacora-10-gauge,V). VABB data (lesion-type, size, biopsy device, histopathology) were compared to final diagnosis (surgery, n = 210 and follow-up, n = 277). Chi-square, and Kruskal-Wallis tests were applied. P values < 0.05 were considered significant.Results: Final diagnosis was malignant in 104 (21.4 %), high risk in 64 (13.1 %) and benign in 319 (65.5 %) cases. Eleven of 328 (3.4 %) benign-rated lesions were false-negative (1/95, 1.1 %, A; 2/73, 2.7 %, M; 8/160 5.0 % V; P = 0.095). Eleven high-risk (11/77, 14.3 %) lesions proved to be malignant (3/26, 11.5 % A; 4/12, 33.3 % M; 4/39, 10.3 % V; P = 0.228). Five of 34 (14.7 %) DCIS were upgraded to invasive cancer (2/15, 13.3 %, A; 1/6, 16.6 % M; 2/13, 15.3 %, V; P = 0.977). Lesion size (P = 0.05) and type (mass vs. non-mass, P = 0.107) did not differ significantly.Conclusion: MR-guided VABB is an accurate method for diagnosis of MRI-only lesions. No significant differences on false-negative and underestimation rates were observed between three different biopsy devices.Key Points: • MR-guided VABB is an accurate procedure for the diagnosis of MRI-only lesions. • Similar false-negative and underestimation rates allow all three different MR-guided VABB devices for clinical application. • High-risk lesions should undergo surgery due to a substantial underestimation rate. • Agreement between MR-guided VABB and final diagnosis (benign/malignant) was 95.5% (465/487). [ABSTRACT FROM AUTHOR]

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The purpose of this study is to obtain a consensus for the therapy of B3 lesions. The first International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions) including atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), classical lobular neoplasia (LN), papillary lesions (PL), benign phyllodes tumors (PT), and radial scars (RS) took place in January 2016 in Zurich, Switzerland organized by the International Breast Ultrasound School and the Swiss Minimally Invasive Breast Biopsy group-a subgroup of the Swiss Society of Senology. Consensus recommendations for the management and follow-up surveillance of these B3 lesions were developed and areas of research priorities were identified. The consensus recommendation for FEA, LN, PL, and RS diagnosed on core needle biopsy or vacuum-assisted biopsy (VAB) is to therapeutically excise the lesion seen on imaging by VAB and no longer by open surgery, with follow-up surveillance imaging for 5 years. The consensus recommendation for ADH and PT is, with some exceptions, therapeutic first-line open surgical excision. Minimally invasive management of selected B3 lesions with therapeutic VAB is acceptable as an alternative to first-line surgical excision. [ABSTRACT FROM AUTHOR]