Publications

BACKGROUND. Complete pathologic necrosis (CPN) is associated with improved survival in patients who undergo liver transplant (LT) after locoregional therapy (LRT) for hepatocellular carcinoma (HCC). OBJECTIVE. The purpose of this article was to identify patient, HCC, and transplant center characteristics associated with rates of CPN on explant evaluation using a large national sample of patients undergoing LT after LRT for HCC measuring 3 cm or smaller. METHODS. This retrospective study used data from the United Network for Organ Sharing database. The study included 6265 adults (median age, 62 years; 1505 women, 4760 men) who underwent LT after a single type of LRT (either transarterial chemoembolization [TACE], thermal ablation, or transarterial radioembolization [TARE]) for HCCs measuring 3 cm or smaller at one of 118 U.S. transplant centers from April 12, 2012, to March 31, 2020. Patients were classified as having CPN if explant evaluation showed 100% necrosis of all HCCs. Associations with CPN were explored. Centers were categorized into tertiles on the basis of center-level CPN rates, and tertiles were compared. RESULTS. LRT was performed by TACE in 69.5% (4352/6265), thermal ablation in 19.4% (1217/6265), and TARE in 11.1% (696/6265) of patients. CPN rate was 18.5% (805/4352) after TACE, 35.8% (436/1217) after thermal ablation, 33.6% (234/696) after TARE, and 23.5% (1475/6265) overall. In multivariable analysis incorporating age, sex, model for end-stage liver disease score, α-fetoprotein level before LRT, wait list time, number of HCCs, HCC size, and the transplant center (as a random factor), use of thermal ablation (OR, 2.19; 95% CI, 1.86-2.57; p < .001) or TARE (OR, 1.92; 95% CI, 1.57-2.36; p < .001), with TACE as reference, independently predicted greater likelihood of CPN. Center-level CPN rates ranged from 0.0% to 50.0%. With centers stratified by CPN rates, ablation was performed more frequently than TACE in 5.0% of centers in the first, 15.4% in the second, and 23.1% in the third tertiles (p = .07). CONCLUSION. CPN rate on explant evaluation was low. Thermal ablation or TARE, rather than TACE, was associated with higher likelihood of CPN in patient-level and center-level analyses. CLINICAL IMPACT. Findings from this large national sample support a potential role of thermal ablation or TARE for achieving CPN of HCC measuring 3 cm or smaller.

The ACR Intersociety Committee meeting of 2022 (ISC-2022) was convened around the theme of "Recovering From The Great Resignation, Moral Injury and Other Stressors: Rebuilding Radiology for a Robust Future." Representatives from 29 radiology organizations, including all radiology subspecialties, radiation oncology, and medical physics, as well as academic and private practice radiologists, met for 3 days in early August in Park City, Utah, to search for solutions to the most pressing problems facing the specialty of radiology in 2022. Of these, the mismatch between the clinical workload and the available radiologist workforce was foremost-as many other identifiable problems flowed downstream from this, including high job turnover, lack of time for teaching and research, radiologist burnout, and moral injury.

PURPOSE: To evaluate the ability of hand motion analysis using conventional and new motion metrics to differentiate between operators of varying levels of experience for central venous access (CVA) and liver biopsy (LB).

MATERIALS AND METHODS: In the CVA task, 7 interventional radiologists (experts), 10 senior trainees, and 5 junior trainees performed ultrasound-guided CVA on a standardized manikin; 5 trainees were retested after 1 year. In the LB task, 4 radiologists (experts) and 7 trainees biopsied a lesion on a manikin. Conventional motion metrics (path length and task time), a refined metric (translational movements), and new metrics (rotational sum and rotational movements) were calculated.

RESULTS: In the CVA task, experts outperformed trainees on all metrics (P < .02). Senior trainees required fewer rotational movements (P = .02), translational movements (P = .045), and time (P = .001) than junior trainees. Similarly, on 1-year follow-up, trainees had fewer translational (P = .02) and rotational (P = .003) movements with less task time (P = .003). The path length and rotational sum were not different between junior and senior trainees or for trainees on follow-up. Rotational and translational movements had greater area under the curve values (0.91 and 0.86, respectively) than the rotational sum (0.73) and path length (0.61). In the LB task, experts performed the task with a shorter path length (P = .04), fewer translational (P = .04) and rotational (P = .02) movements, and less time (P < .001) relative to the trainees.

CONCLUSIONS: Hand motion analysis using translational and rotational movements was better at differentiating levels of experience and improvement with training than the conventional metric of path length.

In recent years the concern with emerging pollutants in water has become more prominent, especially pharmaceutical residues, such as antibiotics due to the influence to increase antibacterial resistance. Further, conventional wastewater treatment methods have not demonstrated efficiency for the complete degradation of these compounds, or they have limitations to treat a large volume of waste. In this sense, this study aims to investigate the degradation of amoxicillin, one of the most prescribed antibiotics, in wastewater via supercritical water gasification (SCWG) using a continuous flow reactor. For this purpose, the process operating conditions of temperature, feed flow rate, and concentration of H2O2 was evaluated using Experimental Design and Response Surface Methodology techniques and optimized by Differential Evolution methodology. Total organic carbon (TOC) removal, chemical oxygen demand (COD) degradability, reaction time, amoxicillin degradation rate, toxicity of degradation by-products, and gaseous products were evaluated. The use of SCWG for treatment achieved 78.4% of the TOC removal for the industrial wastewater. In the gaseous products, hydrogen was the majority component. Furthermore, high-performance liquid chromatography analyses demonstrated that the antibiotic amoxicillin was degraded. For a mass flow rate of 15 mg/min of amoxicillin fed into the reaction system, 14.4 mg/min was degraded. Toxicity tests with microcrustacean Artemia salina showed slight toxicity to treated wastewater. Despite that, the outcomes reveal the SCWG has great potential to degrade amoxicillin and may be applied to treat several pharmaceutical pollutants. Aside from this, carbon-rich effluents may lead to a significant energy gaseous product, especially, hydrogen and syngas.

PURPOSE: To investigate the role of microRNA-21 (miR21) in radiofrequency (RF) ablation-induced tumor growth and whether miR21 inhibition suppresses tumorigenesis.

MATERIAL AND METHODS: Standardized liver RF ablation was applied to 35 C57/BL6 mice. miR21 and target proteins pSTAT3, PDCD4, and PTEN were assayed 3 hours, 24 hours, and 3 days after ablation. Next, 53 Balb/c and 44 C57BL/6 mice received Antago-miR21 or scrambled Antago-nc control, followed by intrasplenic injection of 10,000 CT26 or MC38 colorectal tumor cells, respectively. Hepatic RF ablation or sham ablation was performed 24 hours later. Metastases were quantified and tumor microvascular density (MVD) and cellular proliferation were assessed at 14 or 21 days after the procedures, respectively.

RESULTS: RF ablation significantly increased miR21 levels in plasma and hepatic tissue at 3 and 24 hours as well as target proteins at 3 days after ablation (P < .05, all comparisons). RF ablation nearly doubled tumor growth (CT26, 2.0 SD ± 1.0 fold change [fc]; MC38, 1.9 SD ± 0.9 fc) and increased MVD (CT26, 1.9 SD ± 1.0 fc; MC38, 1.5 ± 0.5 fc) and cellular proliferation (CT26, 1.7 SD ± 0.7 fc; MC38, 1.4 SD ± 0.5 fc) compared with sham ablation (P < .05, all comparisons). RF ablation-induced tumor growth was suppressed when Antago-miR21 was administered (CT26, 1.0 SD ± 0.7 fc; MC38, 0.9 SD ± 0.4 fc) (P < .01, both comparisons). Likewise, Antago-miR21 decreased MVD (CT26, 1.0 SD ± 0.3 fc; MC38, 1.0 SD ± 0.2 fc) and cellular proliferation (CT26, 0.9 SD ± 0.3 fc; MC38, 0.8 SD ± 0.3 fc) compared with baseline (P < .05, all comparisons).

CONCLUSIONS: RF ablation upregulates protumorigenic miR21, which subsequently influences downstream tumor-promoting protein pathways. This effect can potentially be suppressed by specific inhibition of miR21, rendering this microRNA a pivotal and targetable driver of tumorigenesis after hepatic thermal ablation.

Tomato leafminer (Tuta absoluta), an important quarantine pest in China, was first detected in China in Yili, Xinjiang Uygur Autonomous Region, in 2017. Its damage has grown in recent years, severely harming Solanaceae plants in China and causing enormous economic losses. The study and prediction of the current and future suitable habitats for tomato leafminer in China can provide an important reference for the monitoring, early warning, and prevention and control of the pest. Here, tomato leafminer's potential distributions in China under the current climate and four future climate models (SSP1-26, SSP2-45, SSP3-70, and SSP5-85) were predicted using the maximum entropy (MaxEnt) model with ArcGIS software, and the accuracy of the prediction results was tested. The areas under the receiver operating characteristic curves of the models were all greater than 0.8, and the test omission rate of the model simulation results basically agreed with the theoretical omission rate, suggesting that the prediction results had satisfactory accuracy and reliability. Under the current climatic conditions, the highly suitable habitats for tomato leafminer in China are mainly distributed in most of North China, most of East China, most of South China, most of Central China, most of Southwest China, some parts of Northeast China, and only a few parts of Northwest China. Annual mean temperature is the main environmental factor limiting the distribution. The suitable habitats for tomato leafminer will shift under different future climate models: Under SSP1-26, the highly suitable habitats will spread to the north and northeast and to the southeast coastal areas; under SSP2-45, the size of highly suitable habitats will grow from the present to 2080 and shrink from 2081 to 2100; under SSP3-70, the highly suitable habitats will spread northeastwards, but the highly suitable habitats in southeast coastal areas will shrink from 2081 to 2100 and turn into moderately suitable habitats. Under SSP5-85, the highly suitable habitats will spread northeastwards and northwestwards, with the size of highly suitable habitats gradually decreasing and the size of moderately suitable habitats increasing. Different climates will lead to different distributions of suitable habitats for tomato leafminer, with annual mean temperature, isothermality, and mean diurnal range as the main environmental influences.

Medical internal radiation dosimetry constitutes a fundamental aspect of diagnosis, treatment, optimization, and safety in nuclear medicine. The MIRD committee of the Society of Nuclear Medicine and Medical Imaging developed a new computational tool to support organ-level and suborgan tissue dosimetry (MIRDcalc, version 1). Based on a standard Excel spreadsheet platform, MIRDcalc provides enhanced capabilities to facilitate radiopharmaceutical internal dosimetry. This new computational tool implements the well-established MIRD schema for internal dosimetry. The spreadsheet incorporates a significantly enhanced database comprising details for 333 radionuclides, 12 phantom reference models (International Commission on Radiological Protection), 81 source regions, and 48 target regions, along with the ability to interpolate between models for patient-specific dosimetry. The software also includes sphere models of various composition for tumor dosimetry. MIRDcalc offers several noteworthy features for organ-level dosimetry, including modeling of blood source regions and dynamic source regions defined by user input, integration of tumor tissues, error propagation, quality control checks, batch processing, and report-preparation capabilities. MIRDcalc implements an immediate, easy-to-use single-screen interface. The MIRDcalc software is available for free download (www.mirdsoft.org) and has been approved by the Society of Nuclear Medicine and Molecular Imaging.

OBJECTIVES: The aim of the study was to clarify the reliability and quality of English videos about Coronary artery bypass grafting on YouTubeTM.

METHODS: The study was performed between July 16 and July 30. A cardiovascular surgeon searched for terms including "coronary artery disease," "coronary artery treatment," "coronary artery bypass" and "coronary artery bypass surgery," in YouTubeTM. All videos were classified into two groups according to the source who uploaded the video as professional videos and non-professional videos. Video characteristics including duration of video on YouTube™, length of video, and view numbers for each video were recorded. Moreover, the numbers of "comments," "likes," and "dislikes" were noted. Furthermore, the target audience of the videos (professional health care worker and patients) was analyzed, DISCERN score and Global quality score (GQS) were calculated for each video.

RESULTS: Totally, 812 videos were divided into two groups according to upload sources; 448 videos were categorized as professional videos and 364 videos were categorized as non-professional videos. The mean number of views was 3220.5 for professional videos and 2216.5 for non-professional videos (p=0.001). In addition, the mean "like" numbers and mean comment numbers were significantly higher for professional videos (p=0.001 and p=0.001). The mean DISCERN score was 2.6 for professional videos and 1.5 for non-professional videos (p=0.001). Similarly, the mean GSQ was significantly higher for professional videos (3.5 vs. 2.5, p=0.001).

CONCLUSION: YouTube™ videos which are shared by professional healthcare workers have better quality and reliability with significantly higher DISCERN score and GQS.

Radiopharmaceutical dosimetry is usually estimated via organ-level MIRD schema-style formalisms, which form the computational basis for commonly used clinical and research dosimetry software. Recently, MIRDcalc internal dosimetry software was developed to provide a freely available organ-level dosimetry solution that incorporates up-to-date models of human anatomy, addresses uncertainty in radiopharmaceutical biokinetics and patient organ masses, and offers a 1-screen user interface as well as quality assurance tools. The present work describes the validation of MIRDcalc and, secondarily, provides a compendium of radiopharmaceutical dose coefficients obtained with MIRDcalc. Biokinetic data for about 70 currently and historically used radiopharmaceuticals were obtained from the International Commission on Radiological Protection (ICRP) publication 128 radiopharmaceutical data compendium. Absorbed dose and effective dose coefficients were derived from the biokinetic datasets using MIRDcalc, IDAC-Dose, and OLINDA software. The dose coefficients obtained with MIRDcalc were systematically compared against the other software-derived dose coefficients and those originally presented in ICRP publication 128. Dose coefficients computed with MIRDcalc and IDAC-Dose showed excellent overall agreement. The dose coefficients derived from other software and the dose coefficients promulgated in ICRP publication 128 both were in reasonable agreement with the dose coefficients computed with MIRDcalc. Future work should expand the scope of the validation to include personalized dosimetry calculations.

Mitogenomes are essential due to their contribution to cell respiration. Recently they have also been implicated in fungal pathogenicity mechanisms. Members of the basidiomycetous yeast genus Malassezia are an important fungal component of the human skin microbiome, linked to various skin diseases, bloodstream infections, and they are increasingly implicated in gut diseases and certain cancers. In this study, the comparative analysis of Malassezia mitogenomes contributed to phylogenetic tree construction for all species. The mitogenomes presented significant size and gene order diversity which correlates to their phylogeny. Most importantly, they showed the inclusion of large inverted repeats (LIRs) and G-quadruplex (G4) DNA elements, rendering Malassezia mitogenomes a valuable test case for elucidating the evolutionary mechanisms responsible for this genome diversity. Both LIRs and G4s coexist and convergently evolved to provide genome stability through recombination. This mechanism is common in chloroplasts but, hitherto, rarely found in mitogenomes.