Universal quantum operations and ancilla-based read-out for tweezer clocks.

Enhancing the precision of measurements by harnessing entanglement is a long-sought goal in quantum metrology1,2. Yet attaining the best sensitivity allowed by quantum theory in the presence of noise is an outstanding challenge, requiring optimal probe-state generation and read-out strategies3-7. Neutral-atom optical clocks8, which are the leading systems for measuring time, have shown recent progress in terms of entanglement generation9-11 but at present lack the control capabilities for realizing such schemes. Here we show universal quantum operations and ancilla-based read-out for ultranarrow optical transitions of neutral atoms. Our demonstration in a tweezer clock platform9,12-16 enables a circuit-based approach to quantum metrology with neutral-atom optical clocks. To this end, we demonstrate two-qubit entangling gates with 99.62(3)% fidelity-averaged over symmetric input states-through Rydberg interactions15,17,18 and dynamical connectivity19 for optical clock qubits, which we combine with local addressing16 to implement universally programmable quantum circuits. Using this approach, we generate a near-optimal entangled probe state1,4, a cascade of Greenberger-Horne-Zeilinger states of different sizes, and perform a dual-quadrature5 Greenberger-Horne-Zeilinger read-out. We also show repeated fast phase detection with non-destructive conditional reset of clock qubits and minimal dead time between repetitions by implementing ancilla-based quantum logic spectroscopy20 for neutral atoms. Finally, we extend this to multi-qubit parity checks and measurement-based, heralded, Bell-state preparation21-24. Our work lays the foundation for hybrid processor-clock devices with neutral atoms and more generally points to a future of practical applications for quantum processors linked with quantum sensors25.

Erasure conversion in a high-fidelity Rydberg quantum simulator.

Minimizing and understanding errors is critical for quantum science, both in noisy intermediate scale quantum (NISQ) devices1 and for the quest towards fault-tolerant quantum computation2,3. Rydberg arrays have emerged as a prominent platform in this context4 with impressive system sizes5,6 and proposals suggesting how error-correction thresholds could be significantly improved by detecting leakage errors with single-atom resolution7,8, a form of erasure error conversion9-12. However, two-qubit entanglement fidelities in Rydberg atom arrays13,14 have lagged behind competitors15,16 and this type of erasure conversion is yet to be realized for matter-based qubits in general. Here we demonstrate both erasure conversion and high-fidelity Bell state generation using a Rydberg quantum simulator5,6,17,18. When excising data with erasure errors observed via fast imaging of alkaline-earth atoms19-22, we achieve a Bell state fidelity of [Formula: see text], which improves to [Formula: see text] when correcting for remaining state-preparation errors. We further apply erasure conversion in a quantum simulation experiment for quasi-adiabatic preparation of long-range order across a quantum phase transition, and reveal the otherwise hidden impact of these errors on the simulation outcome. Our work demonstrates the capability for Rydberg-based entanglement to reach fidelities in the 0.999 regime, with higher fidelities a question of technical improvements, and shows how erasure conversion can be utilized in NISQ devices. These techniques could be translated directly to quantum-error-correction codes with the addition of long-lived qubits7,22-24.

Surveying biomedical relation extraction: a critical examination of current datasets and the proposal of a new resource.

Natural language processing (NLP) has become an essential technique in various fields, offering a wide range of possibilities for analyzing data and developing diverse NLP tasks. In the biomedical domain, understanding the complex relationships between compounds and proteins is critical, especially in the context of signal transduction and biochemical pathways. Among these relationships, protein-protein interactions (PPIs) are of particular interest, given their potential to trigger a variety of biological reactions. To improve the ability to predict PPI events, we propose the protein event detection dataset (PEDD), which comprises 6823 abstracts, 39 488 sentences and 182 937 gene pairs. Our PEDD dataset has been utilized in the AI CUP Biomedical Paper Analysis competition, where systems are challenged to predict 12 different relation types. In this paper, we review the state-of-the-art relation extraction research and provide an overview of the PEDD's compilation process. Furthermore, we present the results of the PPI extraction competition and evaluate several language models' performances on the PEDD. This paper's outcomes will provide a valuable roadmap for future studies on protein event detection in NLP. By addressing this critical challenge, we hope to enable breakthroughs in drug discovery and enhance our understanding of the molecular mechanisms underlying various diseases.

Case 329.

HISTORY: A 45-year-old female patient who was previously healthy presented after several weeks of fullness in the right upper quadrant of the abdomen. The patient did not experience pain, nausea, vomiting, or jaundice, and had no contributory past medical or surgical history, including no history of malignancy. Upon examination, vital signs were within normal limits and the patient was appeared well with soft palpable fullness in the right upper quadrant. The abdomen was nontender and nondistended. Laboratory investigation revealed no abnormalities, with a normal complete blood cell count and normal serum tumor markers that included α-fetoprotein (<2.0 ng/mL; reference, <8.3 ng/mL), cancer antigen 19-9 (21.6 U/mL; reference, <35 U/mL), and carcinoembryonic antigen (1.3 ng/mL; reference, <5 ng/mL). CT of the abdomen and pelvis was performed with intravenous contrast material in the emergency department (Fig 1). Subsequently, combined MRI and MR cholangiopancreatography of the abdomen was performed with and without intravenous contrast material for further evaluation (Fig 2). CT of the chest performed during the same encounter was unremarkable.

Case 329: Intracholecystic Papillary Neoplasm of the Gallbladder.

HISTORY: A 45-year-old female patient who was previously healthy presented after several weeks of fullness in the right upper quadrant of the abdomen. The patient did not experience pain, nausea, vomiting, or jaundice, and had no contributory past medical or surgical history, including no history of malignancy. Upon examination, vital signs were within normal limits and the patient appeared well, with soft palpable fullness in the right upper quadrant. The abdomen was nontender and nondistended. Laboratory investigation revealed no abnormalities, with a normal complete blood cell count and normal serum tumor markers that included α-fetoprotein (<2.0 ng/mL; reference, <8.3 ng/mL), cancer antigen 19-9 (21.6 U/mL; reference, <35 U/mL), and carcinoembryonic antigen (1.3 ng/mL; reference, <5 ng/mL). CT of the abdomen and pelvis was performed with intravenous contrast material in the emergency department. Subsequently, combined MRI and MR cholangiopancreatography of the abdomen was performed with and without intravenous contrast material for further evaluation. CT of the chest performed during the same encounter was unremarkable.

CT and MR Enterography in the Evaluation of Celiac Disease.

Celiac disease is a common inflammatory disease of the small bowel that induces mucosal intestinal lesions. The disease is mediated by an immune response and triggered by the ingestion of gluten in genetically predisposed individuals. Gluten contains gliadin, a component found mostly in wheat, barley, and rye. This process leads to gastrointestinal malabsorption with symptoms such as diarrhea, constipation, abdominal pain, and distention. It has a prevalence of 1%-2% in the general adult population, who present with symptoms at any age, but is more frequently found in adult women in the 3rd or 4th decade of life. Recognition of the disease has increased, but it remains a challenge to diagnose. CT and MR enterography are noninvasive studies used for evaluation of small bowel neoplasms and inflammatory small bowel pathologic conditions such as celiac disease. The authors review the spectrum of intestinal and extraintestinal findings of celiac disease at CT and MR enterography, as well as its complications, and the importance of recognizing certain imaging features that help in the diagnosis of celiac disease. More common and specific findings of celiac disease such as inversion of the jejunoileal fold pattern and mesenteric lymphadenopathy are reviewed. More uncommon entities that are more frequently associated with refractory or untreated celiac disease, such as ulcerative jejunoileitis, cavitary mesenteric lymph node syndrome, and malignancies including small bowel adenocarcinoma and lymphoma, are described. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material. The slide presentation from the RSNA Annual Meeting is available for this article.

ApoE4 markedly exacerbates tau-mediated neurodegeneration in a mouse model of tauopathy.

APOE4 is the strongest genetic risk factor for late-onset Alzheimer disease. ApoE4 increases brain amyloid-ß pathology relative to other ApoE isoforms. However, whether APOE independently influences tau pathology, the other major proteinopathy of Alzheimer disease and other tauopathies, or tau-mediated neurodegeneration, is not clear. By generating P301S tau transgenic mice on either a human ApoE knock-in (KI) or ApoE knockout (KO) background, here we show that P301S/E4 mice have significantly higher tau levels in the brain and a greater extent of somatodendritic tau redistribution by three months of age compared with P301S/E2, P301S/E3, and P301S/EKO mice. By nine months of age, P301S mice with different ApoE genotypes display distinct phosphorylated tau protein (p-tau) staining patterns. P301S/E4 mice develop markedly more brain atrophy and neuroinflammation than P301S/E2 and P301S/E3 mice, whereas P301S/EKO mice are largely protected from these changes. In vitro, E4-expressing microglia exhibit higher innate immune reactivity after lipopolysaccharide treatment. Co-culturing P301S tau-expressing neurons with E4-expressing mixed glia results in a significantly higher level of tumour-necrosis factor-α (TNF-α) secretion and markedly reduced neuronal viability compared with neuron/E2 and neuron/E3 co-cultures. Neurons co-cultured with EKO glia showed the greatest viability with the lowest level of secreted TNF-α. Treatment of P301S neurons with recombinant ApoE (E2, E3, E4) also leads to some neuronal damage and death compared with the absence of ApoE, with ApoE4 exacerbating the effect. In individuals with a sporadic primary tauopathy, the presence of an ε4 allele is associated with more severe regional neurodegeneration. In individuals who are positive for amyloid-ß pathology with symptomatic Alzheimer disease who usually have tau pathology, ε4-carriers demonstrate greater rates of disease progression. Our results demonstrate that ApoE affects tau pathogenesis, neuroinflammation, and tau-mediated neurodegeneration independently of amyloid-ß pathology. ApoE4 exerts a 'toxic' gain of function whereas the absence of ApoE is protective.

Macrophages show higher levels of engulfment after disruption of cis interactions between CD47 and the checkpoint receptor SIRPα.

The macrophage checkpoint receptor SIRPα signals against phagocytosis by binding CD47 expressed on all cells - including macrophages. Here, we found that inhibiting cis interactions between SIRPα and CD47 on the same macrophage increased engulfment ('eating') by approximately the same level as inhibiting trans interactions. Antibody blockade of CD47, as pursued in clinical trials against cancer, was applied separately to human-derived macrophages and to red blood cell (RBC) targets for phagocytosis, and both scenarios produced surprisingly similar increases in RBC engulfment. Blockade of both macrophages and targets resulted in hyper-phagocytosis, and knockdown of macrophage-CD47 likewise increased engulfment of 'foreign' cells and particles, decreased the baseline inhibitory signaling of SIRPα, and linearly increased binding of soluble CD47 in trans, consistent with cis-trans competition. Many cell types express both SIRPα and CD47, including mouse melanoma B16 cells, and CRISPR-mediated deletions modulate B16 phagocytosis, consistent with cis-trans competition. Additionally, soluble SIRPα binding to human CD47 displayed on Chinese hamster ovary (CHO) cells was suppressed by SIRPα co-display, and atomistic computations confirm SIRPα bends and binds CD47 in cis Safety and efficacy profiles for CD47-SIRPα blockade might therefore reflect a disruption of both cis and trans interactions.

Biomedical named entity recognition and linking datasets: survey and our recent development.

Natural language processing (NLP) is widely applied in biological domains to retrieve information from publications. Systems to address numerous applications exist, such as biomedical named entity recognition (BNER), named entity normalization (NEN) and protein-protein interaction extraction (PPIE). High-quality datasets can assist the development of robust and reliable systems; however, due to the endless applications and evolving techniques, the annotations of benchmark datasets may become outdated and inappropriate. In this study, we first review commonlyused BNER datasets and their potential annotation problems such as inconsistency and low portability. Then, we introduce a revised version of the JNLPBA dataset that solves potential problems in the original and use state-of-the-art named entity recognition systems to evaluate its portability to different kinds of biomedical literature, including protein-protein interaction and biology events. Lastly, we introduce an ensembled biomedical entity dataset (EBED) by extending the revised JNLPBA dataset with PubMed Central full-text paragraphs, figure captions and patent abstracts. This EBED is a multi-task dataset that covers annotations including gene, disease and chemical entities. In total, it contains 85000 entity mentions, 25000 entity mentions with database identifiers and 5000 attribute tags. To demonstrate the usage of the EBED, we review the BNER track from the AI CUP Biomedical Paper Analysis challenge. Availability: The revised JNLPBA dataset is available at https://iasl-btm.iis.sinica.edu.tw/BNER/Content/Re vised_JNLPBA.zip. The EBED dataset is available at https://iasl-btm.iis.sinica.edu.tw/BNER/Content/AICUP _EBED_dataset.rar. Contact: Email: thtsai@g.ncu.edu.tw, Tel. 886-3-4227151 ext. 35203, Fax: 886-3-422-2681 Email: hsu@iis.sinica.edu.tw, Tel. 886-2-2788-3799 ext. 2211, Fax: 886-2-2782-4814 Supplementary information: Supplementary data are available at Briefings in Bioinformatics online.

Increased Online Aggression During COVID-19 Lockdowns: Two-Stage Study of Deep Text Mining and Difference-in-Differences Analysis.

BACKGROUND: The COVID-19 pandemic caused a critical public health crisis worldwide, and policymakers are using lockdowns to control the virus. However, there has been a noticeable increase in aggressive social behaviors that threaten social stability. Lockdown measures might negatively affect mental health and lead to an increase in aggressive emotions. Discovering the relationship between lockdown and increased aggression is crucial for formulating appropriate policies that address these adverse societal effects. We applied natural language processing (NLP) technology to internet data, so as to investigate the social and emotional impacts of lockdowns. OBJECTIVE: This research aimed to understand the relationship between lockdown and increased aggression using NLP technology to analyze the following 3 kinds of aggressive emotions: anger, offensive language, and hate speech, in spatiotemporal ranges of tweets in the United States. METHODS: We conducted a longitudinal internet study of 11,455 Twitter users by analyzing aggressive emotions in 1,281,362 tweets they posted from 2019 to 2020. We selected 3 common aggressive emotions (anger, offensive language, and hate speech) on the internet as the subject of analysis. To detect the emotions in the tweets, we trained a Bidirectional Encoder Representations from Transformers (BERT) model to analyze the percentage of aggressive tweets in every state and every week. Then, we used the difference-in-differences estimation to measure the impact of lockdown status on increasing aggressive tweets. Since most other independent factors that might affect the results, such as seasonal and regional factors, have been ruled out by time and state fixed effects, a significant result in this difference-in-differences analysis can not only indicate a concrete positive correlation but also point to a causal relationship. RESULTS: In the first 6 months of lockdown in 2020, aggression levels in all users increased compared to the same period in 2019. Notably, users under lockdown demonstrated greater levels of aggression than those not under lockdown. Our difference-in-differences estimation discovered a statistically significant positive correlation between lockdown and increased aggression (anger: P=.002, offensive language: P<.001, hate speech: P=.005). It can be inferred from such results that there exist causal relations. CONCLUSIONS: Understanding the relationship between lockdown and aggression can help policymakers address the personal and societal impacts of lockdown. Applying NLP technology and using big data on social media can provide crucial and timely information for this effort.

American Society of Emergency Radiology Multicenter Blunt Splenic Trauma Study: CT and Clinical Findings.

Background Treatment of blunt splenic trauma (BST) continues to evolve with improved imaging for detection of splenic vascular injuries. Purpose To report on treatments for BST from 11 trauma centers, the frequency and clinical impact of splenic vascular injuries, and factors influencing treatment. Materials and Methods Patients were retrospectively identified as having BST between January 2011 and December 2018, and clinical, imaging, and outcome data were recorded. Patient data were summarized descriptively, both overall and stratified by initial treatment received (nonoperative management [NOM], angiography, or surgery). Regression analyses were used to examine the primary outcomes of interest, which were initial treatment received and length of stay (LOS). Results This study evaluated 1373 patients (mean age, 42 years ± 18; 845 men). Initial treatments included NOM in 849 patients, interventional radiology (IR) in 240 patients, and surgery in 284 patients. Rates from CT reporting were 22% (304 of 1373) for active splenic hemorrhage (ASH) and 20% (276 of 1373) for contained vascular injury (CVI). IR management of high-grade injuries increased 15.6%, from 28.6% (eight of 28) to 44.2% (57 of 129) (2011-2012 vs 2017-2018). Patients who were treated invasively had a higher injury severity score (odds ratio [OR], 1.04; 95% CI: 1.02, 1.05; P < .001), lower temperature (OR, 0.97; 95% CI: 0.97, 1.00; P = .03), and a lower hematocrit (OR, 0.96; 95% CI: 0.93, 0.99; P = .003) and were more likely to show ASH (OR, 8.05; 95% CI: 5.35, 12.26; P < .001) or CVI (OR, 2.70; 95% CI: 1.64, 4.44; P < .001) on CT images, have spleen-only injures (OR, 2.35; 95% CI: 1.45, 3.8; P < .001), and have been administered blood product for fewer than 24 hours (OR, 2.35; 95% CI: 1.58, 3.51; P < .001) compared with those chosen for NOM, after adjusting for key demographic and clinical variables. After adjustment, factors associated with a shorter LOS were female sex (OR, 0.84; 95% CI: 0.73, 0.96; P = .009), spleen-only injury (OR, 0.72; 95% CI: 0.6, 0.86; P < .001), higher admission hematocrit (OR, 0.98; 95% CI: 0.6, 0.86; P < .001), and presence of ASH at CT (OR, 0.74; 95% CI: 0.62, 0.88; P < .001). Conclusion Contained vascular injury and active splenic hemorrhage (ASH) were frequently reported, and rates of interventional radiologic management increased during the study period. ASH was associated with a shorter length of stay, and patients with ASH had eight times the odds of undergoing invasive treatment compared with undergoing nonoperative management. © RSNA, 2021 See also the editorial by Patlas in this issue.

Cultural competence of Australian dental students.

BACKGROUND: Australia possesses a highly multicultural demographic, and thus dental practitioners are likely to regularly encounter culturally and linguistically diverse individuals. It is important for dental practitioners to be culturally competent, however, cultural competency education is highly variable in the curricula of dentistry and oral health courses in Australia, and research is largely limited to dentistry students. This study aims to investigate and compare perceived attitudes, beliefs and practices of cultural competence amongst first and final year Doctor of Dental Surgery (DDS) and Bachelor of Oral Health (BOH) students at the University of Melbourne Dental School. METHODS: Following ethics approval, anonymous questionnaires were completed by 213 participants. The questionnaire was adapted from Schwarz's Healthcare Provider Cultural Competence Instrument and consisted of five scales. Data was analysed using SPSS V 24.0 software. RESULTS: A total of 213 students participated in this study (response rate = 88%) The majority of participants were female (n = 114, 53.5%) and the mean age of 23.5 years (range 18-40). The majority of participants were Australian born (n = 110) with 74.6% (n = 159) first generation Australians. Participants who identified as Australian represented 35.7% (n = 76) with 66.1% (n = 141) identified as partly Australian. Multivariate analysis indicated that, after controlling for other independent variables in the model, those who had the highest cultural competence score were female, who self-identify as "Australian", who were in the final year. Furthermore, those who were in the final BOH year scored significatively higher than final year DDS students. CONCLUSION: The findings of this study suggest that there is a significant difference in students self-reported cultural competence at different stages of their education. This may be attributed to differences in cultural competence education, scope of practice and the type of patient encounters and role modelling that students may experience. Future research should involve follow up to create longitudinal data, as well as research at other dental schools in Australia and overseas.

Assessment of primary liver carcinomas other than hepatocellular carcinoma (HCC) with LI-RADS v2018: comparison of the LI-RADS target population to patients without LI-RADS-defined HCC risk factors.

OBJECTIVES: To determine whether the LI-RADS imaging features of primary liver carcinomas (PLCs) other than hepatocellular carcinoma (non-HCC PLCs) differ between patients considered high risk (RF+) versus not high risk (RF-) for HCC and to compare rates of miscategorization as probable or definite HCC between the RF+ and RF- populations. METHODS: This retrospective study included all pathology-proven non-HCC PLCs imaged with liver-protocol CT or MRI from 2007 to 2017 at two liver transplant centers. Patients were defined per LI-RADS v2018 criteria as RF+ or RF-. Two independent, blinded readers (R1, R2) categorized 265 lesions using LI-RADS v2018. Logistic regression was utilized to assess for differences in imaging feature frequencies between RF+ and RF- patients. Fisher's exact test was used to assess for differences in miscategorization rates. RESULTS: Non-HCC PLCs were significantly more likely to exhibit nonrim arterial phase hyperenhancement (R1: OR = 2.94; R2: OR = 7.09) and nonperipheral "washout" (R1: OR = 3.65; R2: OR = 7.69) but significantly less likely to exhibit peripheral "washout" (R1: OR = 0.30; R2: OR = 0.10) and delayed central enhancement (R1: OR = 0.18; R2: OR = 0.25) in RF+ patients relative to RF- patients. Consequently, non-HCC PLCs were more often miscategorized as probable or definite HCC in RF+ versus RF- patients (R1: 23.3% vs. 3.6%, p < 0.001; R2: 11.0% vs. 2.6%, p = 0.009). CONCLUSIONS: Non-HCC PLCs are more likely to mimic HCCs on CT and MRI in the LI-RADS target population than in patients without LI-RADS-defined HCC risk factors. KEY POINTS: • The presence of LI-RADS-defined risk factors for HCC tends to alter the imaging appearances of non-HCC PLCs, resulting in higher frequencies of major features and lower frequencies of LR-M features. • Non-HCC PLCs are more likely to be miscategorized as probable or definite HCC in the LI-RADS target population than in patients without LI-RADS-defined HCC risk factors.

Outcomes of Yttrium-90 Radioembolization for Unresectable Combined Biphenotypic Hepatocellular-Cholangiocarcinoma.

PURPOSE: To evaluate outcomes of yttrium-90 radioembolization in patients with combined biphenotypic hepatocellular-cholangiocarcinoma (cHCC-CC). MATERIALS AND METHODS: A retrospective review of patients with biopsy-confirmed cHCC-CC treated with yttrium-90 radioembolization between 2012 and 2018 was performed. Twenty-two patients with cHCC-CC (mean age 65.6 y, 17 men, 5 women) underwent 29 radioembolization treatments (5 resin, 24 glass microspheres). Survival data were available in 21 patients, and hepatic imaging response data were available in 20 patients. Hepatic imaging response to radioembolization was assessed on follow-up CT or MR imaging using modified Response Evaluation Criteria In Solid Tumours criteria. Univariate stepwise Cox regression analysis was used to evaluate the association between demographic and clinical factors and survival. Logistic regression evaluated associations between clinical factors and response to treatment, overall response, and disease control. RESULTS: Hepatic imaging response was as follows: 15% complete response, 40% partial response, 10% stable disease, and 35% progressive disease (55% response rate, 65% disease control rate). Two patients were downstaged or bridged to transplant, and 1 patient was downstaged to resection. Median overall survival was 9.3 mo (range, 2.5-31.0 mo) from time of radioembolization. Nonreponse to treatment, bilobar disease, presence of multiple tumors, and elevated carbohydrate antigen 19-9 before treatment were associated with reduced survival after radioembolization. CONCLUSIONS: Radioembolization is a viable option for locoregional control of cHCC-CC with good response and disease control rates.

Diagnostic Approach to Benign and Malignant Calcifications in the Abdomen and Pelvis.

Intra-abdominal calcifications are common. Multiple pathologic processes manifest within the abdomen and pelvis in association with calcifications, which can be benign, premalignant, or malignant. Although calcium deposition in the abdomen can occur secondary to various mechanisms, the most common cau se is cellular injury that leads to dystrophic calcifications. The authors provide a summary of various common and uncommon calcifications in the abdomen and pelvis, primarily using location to illuminate diagnostic significance. Six broad categories of calcifications in the abdomen and pelvis are recognized: mesenteric, peritoneal, retroperitoneal, organ-based, vascular, and musculoskeletal. In addition to site, the various patterns and morphology of calcifications encountered in various conditions can be helpful for diagnosis, especially those depicted on radiographs. For example, some patterns diagnostic for various conditions include round or oval stones in the biliary or urothelial tracts, curvilinear calcifications associated with cysts or neoplasms, and sheetlike calcifications along peritoneal surfaces in the setting of chronic peritoneal dialysis or metastatic disease. Organ encrustation with calcium may be a premalignant finding (eg, porcelain gallbladder). In addition, the development of calcium after initiation of treatment can be used as an indicator of response in conditions such as tuberculosis, lymphoma, and hydatid disease. As calcifications are almost invariably detected at imaging, it is imperative for radiologists to be aware of their diagnostic implications and use the presence of calcification in an organ, mass, or other anatomic location for problem solving. ©RSNA, 2020.

Computed Tomography Identifies Clinically Unsuspected Acute Necrotizing Pancreatitis Complicating Abdominal Aortic Repair.

BACKGROUND: Pancreatitis rarely complicates aortic repair. The aim of the study was to examine the role of imaging in identifying this complication and to characterize pancreatitis occuring in this setting. METHODS: The radiology information system queried reports for terms pancreatitis, fluid collection, peripancreatic fluid, and aortic/aneurysm/endovascular/open repair from January 2010 through May 2018 and yielded 243 unique patients. Aortic repair and pancreatitis did not occur in temporal proximity (within 30 days) in 227 patients, and three patients had invalid medical record numbers. The final population was 13 patients. Surgical data included indication for repair and surgical approach. Clinical/imaging data points included method of diagnosis, type of pancreatitis, location, management of collections, and patient outcome. RESULTS: Thirteen patients (n = 9 male, age 58-76 years) met inclusion criteria. All patients underwent open repair, 9 electively. Acute pancreatitis was first identified by computed tomography in 10 (77%) patients and by serum lipase levels in 3 patients (23%). Necrotizing pancreatitis was present in 10 patients (77%), eight with infected collections (one not sampled). Four patients (31%) had collections fistulizing to the aortic sac, and there was one case of aortic anastomotic pseudoaneurysm. There were 7 deaths (4 septic shock, 1 hemorrhagic pancreatitis, 1 pulmonary embolism, and 1 multiorgan failure) despite 5 of these patients undergoing drainage of collections. In surviving patients, 4 underwent drainage of collections, 1 necrosectomy, and 1 no intervention. CONCLUSIONS: Pancreatitis complicating aortic repair occurs after open repair and is often necrotizing. Pancreatitis is more often first detected by imaging rather than serum lipase levels. High mortality is more attributable to complications of pancreatitis rather than failure of the aortic repair.

Distinct tau PET patterns in atrophy-defined subtypes of Alzheimer's disease.

INTRODUCTION: Differential patterns of brain atrophy on structural magnetic resonance imaging (MRI) revealed four reproducible subtypes of Alzheimer's disease (AD): (1) "typical", (2) "limbic-predominant", (3) "hippocampal-sparing", and (4) "mild atrophy". We examined the neurobiological characteristics and clinical progression of these atrophy-defined subtypes. METHODS: The four subtypes were replicated using a clustering method on MRI data in 260 amyloid-ß-positive patients with mild cognitive impairment or AD dementia, and we subsequently tested whether the subtypes differed on [18 F]flortaucipir (tau) positron emission tomography, white matter hyperintensity burden, and rate of global cognitive decline. RESULTS: Voxel-wise and region-of-interest analyses revealed the greatest neocortical tau load in hippocampal-sparing (frontoparietal-predominant) and typical (temporal-predominant) patients, while limbic-predominant patients showed particularly high entorhinal tau. Typical patients with AD had the most pronounced white matter hyperintensity load, and hippocampal-sparing patients showed the most rapid global cognitive decline. DISCUSSION: Our data suggest that structural MRI can be used to identify biologically and clinically meaningful subtypes of AD.

Crohn's Disease Is Associated With an Increased Prevalence of Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study Using Magnetic Resonance Proton Density Fat Fraction Mapping.

Nonalcoholic fatty liver disease (NAFLD) commonly coexists with Crohn's disease (CD); however, it remains unclear if it is more prevalent than would be expected as ultrasound surveys of CD patients report a very wide range of prevalence (9%-40%).1-3 To address this uncertainty, we performed a prospective, cross-sectional survey of NAFLD in CD patients by generating magnetic resonance proton density fat fraction (MR-PDFF) maps as compared with 2 control populations. MR-PDFF provides a quantitative, sensitive and specific (97% and 100%, respectively) radiographic surrogate for liver fat.4.

In-Phase and Opposed-Phase Imaging: Applications of Chemical Shift and Magnetic Susceptibility in the Chest and Abdomen.

An earlier incorrect version appeared online. This article was corrected on December 17, 2018.

Expanding the Liver Imaging Reporting and Data System (LI-RADS) v2018 diagnostic population: performance and reliability of LI-RADS for distinguishing hepatocellular carcinoma (HCC) from non-HCC primary liver carcinoma in patients who do not meet strict LI-RADS high-risk criteria.

BACKGROUND: Hepatocellular carcinoma (HCC) can be diagnosed using imaging criteria in patients at high-risk for HCC, according to Liver Imaging Reporting and Data System (LI-RADS) guidelines. The aim of this study was to determine the diagnostic performance and inter-rater reliability (IRR) of LI-RADS v2018 for differentiating HCC from non-HCC primary liver carcinoma (PLC), in patients who are at increased risk for HCC but not included in the LI-RADS 'high-risk' population. METHODS: This retrospective HIPAA-compliant study included a 10-year experience of pathologically-proven PLC at two liver transplant centers, and included patients with non-cirrhotic hepatitis C infection, non-cirrhotic non-alcoholic fatty liver disease, and fibrosis. Two readers evaluated each lesion and assigned an overall LI-RADS diagnostic category, additionally scoring all major, LR-M, and ancillary features. RESULTS: The final study cohort consisted of 27 HCCs and 104 non-HCC PLC in 131 patients. The specificity of a 'definite HCC' designation was 97% for reader 1 and 100% for reader 2. The IRR was fair for overall LI-RADS category and substantial for most major features. CONCLUSION: In a population at increased risk for HCC but not currently included in the LI-RADS 'high-risk' population, LI-RADS v2018 demonstrated very high specificity for distinguishing pathologically-proven HCC from non-HCC PLC.