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Background: Ingrown toenail is a nail disorder that commonly affects great toenails. Surgical modalities are commonly used as first-line treatment. A conservative approach is preferable as surgical procedures lead to pain and affect routine activities. Our aim is to study the efficacy of a new conservative technique using steri-strip[sup.TM] for the treatment of mild to moderate ingrown toenails as an outpatient procedure. Methods: Fifty patients presenting with stage 1-2 ingrown toenails were treated with the ‘steri-strip sling technique'. Steri-strip[sup.TM] is inserted between the disto-lateral edge of the nail plate and nail fold and secured with an elastic bandage. The dressing is kept till the nail edge grows over the nail fold and stops penetrating the skin. Patients were reviewed every week for a month after the treatment and monthly thereafter. The final result was assessed at 6 months. The success of treatment was assessed clinically and by patient satisfaction levels. Results: Fifty patients were treated and followed up. Immediately after the procedure, all patients reported significant relief in pain. After 6 months, 46 out of 50 patients were satisfied with the treatment and showed no recurrence. No complications were reported. Conclusion: The ‘Steri-strip[sup.TM] sling technique' is a simple and effective outpatient procedure for the management of mild to moderate ingrown toenails. Keywords: Ingrown toenails, onychocryptosis, steri-strip, Author(s): Eeshaan Ranjan (corresponding author) [1]; Sandeep Arora [2]; Neha Sharma [3]; Durga M. Tripathy [4]; Shekhar Neema [5]; Shailendra Srivastava [1]; Reetu Agarwal [1] Introduction Onychocryptosis or ingrown toenails [...]

US and MRI-guided therapeutic US (TUS) can aid in the treatment of prostate, liver, and pancreatic cancer, as well as uterine fibroids and osseous metastases, and understanding the selection and optimization of treatment strategies is essential to furthering TUS advances and innovations.

Background Prostate MRI is used widely in clinical care for guiding tissue sampling, active surveillance, and staging. The Prostate Imaging Reporting and Data System (PI-RADS) helps provide a standardized probabilistic approach for identifying clinically significant prostate cancer. Despite widespread use, the variability in performance of prostate MRI across practices remains unknown. Purpose To estimate the positive predictive value (PPV) of PI-RADS for the detection of high-grade prostate cancer across imaging centers. Materials and Methods This retrospective cross-sectional study was compliant with the HIPAA. Twenty-six centers with members in the Society of Abdominal Radiology Prostate Cancer Disease-focused Panel submitted data from men with suspected or biopsy-proven untreated prostate cancer. MRI scans were obtained between January 2015 and April 2018. This was followed with targeted biopsy. Only men with at least one MRI lesion assigned a PI-RADS score of 2-5 were included. Outcome was prostate cancer with Gleason score (GS) greater than or equal to 3+4 (International Society of Urological Pathology grade group ≥2). A mixed-model logistic regression with institution and individuals as random effects was used to estimate overall PPVs. The variability of observed PPV of PI-RADS across imaging centers was described by using the median and interquartile range. Results The authors evaluated 3449 men (mean age, 65 years ± 8 [standard deviation]) with 5082 lesions. Biopsy results showed 1698 cancers with GS greater than or equal to 3+4 (International Society of Urological Pathology grade group ≥2) in 2082 men. Across all centers, the estimated PPV was 35% (95% confidence interval [CI]: 27%, 43%) for a PI-RADS score greater than or equal to 3 and 49% (95% CI: 40%, 58%) for a PI-RADS score greater than or equal to 4. The interquartile ranges of PPV at these same PI-RADS score thresholds were 27%-44% and 27%-48%, respectively. Conclusion The positive predictive value of the Prostate Imaging and Reporting Data System was low and varied widely across centers. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Milot in this issue.

In order to solve the problems of data acquisition, quantitative analysis and model solving in the field of construction schedule optimization, a construction schedule optimization system based on genetic algorithm was constructed. On this basis, the construction schedule two-stage multi-objective optimization models of “duration-cost” and “fixed duration-resource equilibrium” are established, which aim at the lowest cost and resource equilibrium. Through the investigation and analysis of the project contract documents, the energy consumption and cost of the normal construction and emergency construction state of the contract plan of the basic project part (from the beginning of precipitation activities to the end of +0) are obtained. This section was optimized for the analysis. The genetic algorithm is used to solve the model, and the optimal duration of each process and the optimal start time of non-critical process are determined. The feasibility and effectiveness of the system and model are verified by practical application in the actual project, which provides support for determining the construction schedule scientifically and reasonably and helps to improve the construction schedule technical application effect and construction schedule management level.

The Liver Imaging and Reporting Data System (LI-RADS) is a comprehensive system for standardizing the terminology, technique, interpretation, reporting, and data collection of liver imaging with the overarching goal of improving communication, clinical care, education, and research relating to patients at risk for or diagnosed with hepatocellular carcinoma (HCC). In 2018, the American Association for the Study of Liver Diseases (AASLD) integrated LI-RADS into its clinical practice guidance for the imaging-based diagnosis of HCC. The harmonization between the AASLD and LI-RADS diagnostic imaging criteria required minor modifications to the recently released LI-RADS v2017 guidelines, necessitating a LI-RADS v2018 update. This article provides an overview of the key changes included in LI-RADS v2018 as well as a look at the LI-RADS v2018 diagnostic algorithm and criteria, technical recommendations, and management suggestions. Substantive changes in LI-RADS v2018 are the removal of the requirement for visibility on antecedent surveillance ultrasound for LI-RADS 5 (LR-5) categorization of 10-19 mm observations with nonrim arterial phase hyper-enhancement and nonperipheral "washout", and adoption of the Organ Procurement and Transplantation Network definition of threshold growth (≥ 50% size increase of a mass in ≤ 6 months). Nomenclatural changes in LI-RADS v2018 are the removal of -us and -g as LR-5 qualifiers.