Dinuclear Zn-Catalytic System as Brønsted Base and Lewis Acid for Enantioselectivity in Same Chiral Environment.

Zinc (Zn) is a crucial element with remarkable significance in organic transformations. The profusion of harmless zinc salts in the Earth's outer layer qualifies zinc as a noteworthy contender for inexpensive and eco-friendly reagents and catalysts. Recently, widely recognized uses of organo-Zn compounds in the field of organic synthesis have undergone extensive expansion toward asymmetric transformations. The ProPhenol ligand, a member of the chiral nitrogenous-crown family, exhibits the spontaneous formation of a dual-metal complex when reacted with alkyl metal (R-M) reagents, e.g., ZnEt2. The afforded Zn complex possesses two active sites, one Lewis acid and the other Brønsted base, thereby facilitating the activation of nucleophiles and electrophiles simultaneously within the same chiral pocket. In this comprehensive analysis, we provide a thorough account of the advancement and synthetic potential of these diverse catalysts in organic synthesis, while emphasizing the reactivity and selectivities, i.e., dr and ee due to the design/structure of the ligands employed.

Effects of bipolar disorder on maternal and fetal health during pregnancy: a systematic review.

BACKGROUND: Bipolar disorder (BD) is a mental disorder characterized by mood shifts from severe depression to mania. Pregnant women with BD may experience manic or depressive episodes, so they are usually concerned about the effects of BD on their pregnancy. The aim of this systematic review is to determine the effects of BD on maternal health and fetal health, weight, and development. It also addresses how BD affects the probability of incidence of pregnancy complications in women with bipolar compared with healthy controls. METHODS: Seven electronic databases (Ovid MEDLINE, Embase, MIDRIS, APA PsychINFO, Scopus, Web of Science, and ScienceOpen) were searched, and 1728 eligible studies were identified. After deduplication, screening, and manual search processes, we included only 15 studies. Descriptive analysis, and calculation of the probability of incidence for each pregnancy outcome were used to analyze the results. RESULTS: The findings of the included studies suggest that BD during pregnancy may affect both fetal growth and maternal health by increasing the risk of giving birth to an infant with some birth defects such as microcephaly, CNS problems, small for gestational age, and other congenital anomalies, in addition to causing some obstetric complications such as gestational hypertension, preterm labor, need for assisted delivery, hospital readmission, and others. CONCLUSION: Bipolar disorder during pregnancy negatively affects mothers and their fetuses and increases the probability of incidence of obstetrics complications.

Effects of different physiotherapy modalities on insomnia and depression in perimenopausal, menopausal, and post-menopausal women: a systematic review.

BACKGROUND: Menopause is the time that marks passing 12 months after the last menstruation cycle in women between ages 40-50. Menopausal women often experience depression and insomnia that significantly impact their overall well-being and quality of life. This systematic review aims to determine the effects of different therapeutic physiotherapy modalities on insomnia and depression in perimenopausal, menopausal, and post-menopausal women. METHODOLOGY: After identifying our inclusion/exclusion criteria, we conducted a database search in Ovid Embase, MIDRIS, PubMed, Cochrane, and ScienceOpen, where 4007 papers were identified. By using EndNote software, we excluded duplicates, unrelated, and non-full text papers. Adding more studies from manual search, we finally included 31 papers including 7 physiotherapy modalities: exercise, reflexology, footbath, walking, therapeutic and aromatherapy massage, craniofacial message, and yoga. RESULTS: Reflexology, yoga, walking and aromatherapy massage showed an overall significant impact on decreasing insomnia and depression in menopausal women. Most of exercise and stretching interventions also showed improvement in sleep quality but inconsistent findings regarding depression. However, insufficient evidence was found regarding the effect of craniofacial massage, footbath, and acupressure on improving sleep quality and depression in menopausal women. CONCLUSION: Using non-pharmaceutical interventions such as therapeutic and manual physiotherapy have an overall positive impact on reducing insomnia and depression in menopausal women.

Azole and 5-nitroimidazole based nanoformulations are potential antiamoebic drug candidates against brain-eating amoebae.

AIM: Herein, the anti-parasitic activity of azoles (fluconazole and itraconazole) and 5-nitroimdazole (metronidazole) against the brain-eating amoebae: Naegleria fowleri and Balamuthia mandrillaris was elucidated. METHODS AND RESULTS: Azoles and 5-nitroimidazole based nanoformulations were synthesized and characterized using a UV-visible spectrophotometer, atomic force microscopy, and fourier transform infrared spectroscopy. H1-NMR, EI-MS, and ESI-MS were performed to determine their molecular mass and elucidate their structures. Their size, zeta potential, size distribution, and polydispersity index (PDI) were assessed. Amoebicidal assays revealed that all the drugs and their nanoformulations, (except itraconazole) presented significant anti-amoebic effects against B. mandrillaris, while all the treatments indicated notable amoebicidal properties against N. fowleri. Amoebicidal effects were radically enhanced upon conjugating the drugs with nanoparticles. The IC50 values for KM-38-AgNPs-F, KM-20-AgNPs-M, and KM-IF were 65.09, 91.27, and 72.19 µg.mL-1, respectively, against B. mandrillaris. Whereas against N. fowleri, the IC50 values were: 71.85, 73.95, and 63.01 µg.mL-1, respectively. Additionally, nanoformulations significantly reduced N. fowleri-mediated host cell death, while nanoformulations along with fluconazole and metronidazole considerably reduced Balamuthia-mediated human cell damage. Finally, all the tested drugs and their nanoformulations revealed limited cytotoxic activity against human cerebral microvascular endothelial cell (HBEC-5i) cells. CONCLUSION: These compounds should be developed into novel chemotherapeutic options for use against these distressing infections due to free-living amoebae, as currently there are no effective treatments.

Certified high-efficiency "large-area" perovskite solar module for Fresnel lens-based concentrated photovoltaics.

The future of energy generation is well in tune with the critical needs of the global economy, leading to more green innovations and emissions-abatement technologies. Introducing concentrated photovoltaics (CPVs) is one of the most promising technologies owing to its high photo-conversion efficiency. Although most researchers use silicon and cadmium telluride for CPV, we investigate the potential in nascent technologies, such as perovskite solar cell (PSC). This work constitutes a preliminary investigation into a "large-area" PSC module under a Fresnel lens (FL) with a "refractive optical concentrator-silicon-on-glass" base to minimize the PV performance and scalability trade-off concerning the PSCs. The FL-PSC system measured the solar current-voltage characteristics in variable lens-to-cell distances and illuminations. The PSC module temperature was systematically studied using the COMSOL transient heat transfer mechanism. The FL-based technique for "large-area" PSC architectures is a promising technology that further facilitates the potential for commercialization.

Parental Genetics Communicate with Intrauterine Environment to Reprogram Newborn Telomeres and Immunity.

Telomeres, markers for cellular senescence, have been found substantially influenced by parental inheritance. It is well known that genomic stability is preserved by the DNA repair mechanism through telomerase. This study aimed to determine the association between parents−newborn telomere length (TL) and telomerase gene (TERT), highlighting DNA repair combined with TL/TERT polymorphism and immunosenescence of the triad. The mother−father−newborn triad blood samples (n = 312) were collected from Ziauddin Hospitals, Pakistan, between September 2021 and June 2022. The telomere length (T/S ratio) was quantified by qPCR, polymorphism was identified by Sanger sequencing, and immunosenescence by flow cytometry. The linear regression was applied to TL and gene association. The newborns had longest TL (2.51 ± 2.87) and strong positive association (R = 0.25, p ≤ 0.0001) (transgenerational health effects) with mothers' TL (1.6 ± 2.00). Maternal demographics­socioeconomic status, education, and occupation­showed significant effects on TL of newborns (p < 0.015, 0.034, 0.04, respectively). The TERT risk genotype CC (rs2736100) was predominant in the triad (0.6, 0.5, 0.65, respectively) with a strong positive association with newborn TL (ß = 2.91, <0.0011). Further analysis highlighted the expression of KLRG 1+ in T-cells with shorter TL but less frequent among newborns. The study concludes that TERT, parental TL, antenatal maternal health, and immunity have a significantly positive effect on the repair of newborn TL.

Assessment of functional ability by anthropometric and physiological parameters during six-minute walk test in healthy children.

OBJECTIVE: To assess the functional ability and vitals of young children using six-minute walk test. METHODS: The analytical cross-sectional study was conducted from October 2019 to January 2020 at public and private schools of Rawalpindi and Islamabad after approval from the ethics review committee of Riphah College of Rehabilitation Sciences, Westridge Campus Rawalpindi, Pakistan, and comprised healthy children aged 7-12 years who were subjected to the six-minute walk test according to standardised guidelines. Data was collected using a semi-structured questionnaire. Anthropometric measurements, distance walked in six minutes, heart rate, respiratory rate, oxygen saturation, and rate of perceived exertion were the outcome variables. Data was analysed using SPSS 26. RESULTS: Of the 376 subjects, 225(59.8%) were boys and 151(40.2%) were girls. The mean age of the sample was 9.25±1.64 years. Mean distance covered by the children was 482.63±119.76 metres. Public school students performed better than those studying in private schools (p=0.001). The difference in gender terms was non-significant (p=0.926). Significant difference was observed in mean heart rate and respiratory rate post-walk (p<0.05). There was a weak positive correlation of the test with age and height (p<0.001), but not with weight, gender and body mass index (p>0.05). Conclusion: The level of functional ability of the young students improved with age and was better among those studying at public schools. Besides, anthropometric and physiological parameters influenced the text performance.

Delirium in COVID-19: An Atypical Case Managed With Quetiapine.

Coronavirus disease 2019 (COVID-19) can present without the typical symptoms of respiratory tract infection. Delirium has been reported as a prominent feature leading to an atypical presentation in older adults infected with COVID-19. Here, we present the case of a 65-year-old female who came to our hospital with confusion and altered mental status. The patient maintained an asymptomatic course of illness after testing positive for COVID-19 two weeks prior to the hospital visit. An appropriate workup was done to rule out other causes of the patient's symptoms. During the next couple of days, the patient developed classic symptoms suggestive of delirium. The patient was eventually treated based on the general guidelines for delirium management due to the absence of adequate medical literature specifying the management of delirium in the population of interest. Thus, the patient was given a trial of an atypical antipsychotic, quetiapine, to which she responded well and was subsequently discharged one week later.

SNP-Based Genome-Wide Association Mapping of Pollen Viability Under Heat Stress in Tropical Zea mays L. Inbred Lines.

Global environmental changes with more extreme episodes of heat waves are major threats to agricultural productivity. Heat stress in spring affects the reproductive stage of maize, resulting in tassel blast, pollen abortion, poor pollination, reduced seed set, barren ears and ultimately yield loss. As an aneamophelous crop, maize has a propensity for pollen abortion under heat stress conditions. To overcome the existing challenges of heat stress and pollen abortion, this study utilized a broad genetic base of maize germplasm to identify superior alleles to be utilized in breeding programs. A panel of 375 inbred lines was morpho-physiologically screened under normal and heat stress conditions in two locations across two consecutive planting seasons, 2017 and 2018. The exposure of pollen to high temperature showed drastic decline in pollen germination percentage. The average pollen germination percentage (PGP) at 35 and 45°C was 40.3% and 9.7%, respectively, an average decline of 30.6%. A subset of 275 inbred lines were sequenced using tunable genotyping by sequencing, resulting in 170,098 single nucleotide polymorphisms (SNPs) after filtration. Genome wide association of PGP in a subset of 122 inbred lines resulted in ten SNPs associated with PGP35°C (p ≤ 10-5), nine with PGP45°C (p ≤ 10-6-10-8) and ten SNPs associated with PGP ratio (p ≤ 10-5). No SNPs were found to be in common across PGP traits. The number of favorable alleles possessed by each inbred line for PGP35°C, PGP45°C, and the PGP ratio ranged between 4 and 10, 3-13 and 5-13, respectively. In contrast, the number of negative alleles for these traits ranged between 2 and 8, 3-13 and 3-13, respectively. Genetic mapping of yield (adjusted weight per plant, AWP-1) and flowering time (anthesis-silking interval, ASI) in 275 lines revealed five common SNPs: three shared for AWP-1 between normal and heat stress conditions, one for ASI between conditions, and one SNP, CM007648.1-86615409, was associated with both ASI and AWP-1. Variety selection can be performed based on these favorable alleles for various traits. These marker trait associations identified in the diversity panel can be utilized in breeding programs to improve heat stress tolerance in maize.

Peripheral Artery Disease as a Risk Factor for Myocardial Infarction.

INTRODUCTION:  Atherosclerosis contributes to the underlying pathophysiology for peripheral arterial disease (PAD), coronary artery disease (CAD), and cerebrovascular disease. Several studies have been conducted to demonstrate PAD as a major risk factor for cardiovascular (CV) events, however, the regional data are limited. This study aims to highlight PAD as a major risk factor in CV events in a local setting. METHODS:  In this longitudinal study, 400 hypertensive patients with a confirmed diagnosis of PAD were enrolled from the outpatient department of the cardiology unit. Diagnosis of PAD was made using the ankle brachial index (ABI). ABI less than 0.9 was labeled as participants with PAD. Another group of 400 without PAD was also enrolled as the control group from the outpatient department of cardiology unit. Patients were followed up for 12 months or for the development of myocardial infarction (MI). RESULT:  Participants with PAD had a significant increased risk of total MI events with a relative risk (RR) of 1.67 (confidence interval, CI 95%: 1.05-2.66; p-value: 0.02). The RR for fatal MI was 2.62 (CI 95%: 0.94-7.29; p-value: 0.06) compared to the participants without PAD, however, it was not significant. CONCLUSION:  This study has focused on the risk factors of PAD and has suggested that the patients who have any of the mentioned risk factors should be treated with caution under strict instructions given by doctors. A variety of treatment options is available, but the initial changes should be made in the lifestyle of these patients, making sure the risk factors are being treated.

NDSP 09: Risk Assessment of Pakistani Individual for Diabetes (RAPID) - Findings from Second National Diabetes Survey of Pakistan (NDSP) 2016-2017.

OBJECTIVE: To elucidate the effectiveness of Risk Assessment of Pakistani individuals with diabetes (RAPID) tool in epidemiological and population-based second National Diabetes Survey of Pakistan (NDSP) 2016-2017 for identifying risk of developing type 2 diabetes. METHODOLOGY: This observational study was a sub-analysis of the second National Diabetes Survey of Pakistan (NDSP) 2016-2017 conducted from February 2016 to August 2017 in all four provinces of Pakistan. Ethical approval was obtained from National Bioethics Committee Pakistan. RAPID score, a validated and published scoring scale to assess risk of diabetes, originally developed from community-based surveys was used. The risk score is assessed by parameters namely: age, waist circumference, and positive family history of diabetes. Subjects with score greater ≥4 were considered at risk of diabetes. RESULTS: A total of 4904 individuals were assessed (2205 males and 2699 females). Mean age of participants was 41.8±14.2 years. Positive family history of diabetes was seen in 1379 (28.1%) people. According to RAPID score 1268 (25.9%) individuals scored ≥4 and were at risk of diabetes. OGTT status of people at risk of diabetes according to RAPID score showed that 18.1% people with diabetes and 29.2% were prediabetic. Whereas, OGTT status of people not at risk of diabetes showed that only 7.6% people with diabetes, 20% were prediabetic. CONCLUSION: A simple diabetes risk score can be used for identification of high-risk individuals for diabetes so that timely intervention can be implemented. Community-based awareness programs are needed to educate people regarding healthy lifestyle in order to reduce risk of diabetes.

Molecular Characterization of 87 Functional Genes in Wheat Diversity Panel and Their Association With Phenotypes Under Well-Watered and Water-Limited Conditions.

Modern breeding imposed selection for improved productivity that largely influenced the frequency of superior alleles underpinning traits of breeding interest. Therefore, molecular diagnosis for the allelic variations of such genes is important to manipulate beneficial alleles in wheat molecular breeding. We analyzed a diversity panel largely consisted of advanced lines derived from synthetic hexaploid wheats for allelic variation at 87 functional genes or loci of breeding importance using 124 high-throughput KASP markers. We also developed two KASP markers for water-soluble carbohydrate genes (TaSST-D1 and TaSST-A1) associated with plant height and thousand grain weight (TGW) in the diversity panel. KASP genotyping results indicated that beneficial alleles for genes underpinning flowering time (Ppd-D1 and Vrn-D3), thousand grain weight (TaCKX-D1, TaTGW6-A1, TaSus1-7B, and TaCwi-D1), water-soluble carbohydrates (TaSST-A1), yellow-pigment content (Psy-B1 and Zds-D1), and root lesion nematodes (Rlnn1) were fixed in diversity panel with frequency ranged from 96.4 to 100%. The association analysis of functional genes with agronomic and biochemical traits under well-watered (WW) and water-limited (WL) conditions revealed that 21 marker-trait associations (MTAs) were consistently detected in both moisture conditions. The major developmental genes such as Vrn-A1, Rht-D1, and Ppd-B1 had the confounding effect on several agronomic traits including plant height, grain size and weight, and grain yield in both WW and WL conditions. The accumulation of favorable alleles for grain size and weight genes additively enhanced grain weight in the diversity panel. Graphical genotyping approach was used to identify accessions with maximum number of favorable alleles, thus likely to have high breeding value. These results improved our knowledge on the selection of favorable and unfavorable alleles through unconscious selection breeding and identified the opportunities to deploy alleles with effects in wheat breeding.

Frequency, Awareness, and Symptoms of Chikungunya Among Patients in a Tertiary Care Hospital of Karachi: A Cross-Sectional Study.

Background  Chikungunya fever (CHIKF) is an infectious illness spread by the bite of mosquitoes and caused by an arbovirus known as Chikungunya virus (CHIKV). This disease has become an epidemic in Karachi and various other cities of Pakistan, affecting a large population, especially those from poor, socioeconomically underdeveloped areas. It is proving to be a severe and alarming cause of debility due to its prolonged detrimental effects on the joints. A significant number of cases are reported daily in different hospitals of Karachi, with Civil Hospital being one of the major tertiary care hospitals. The aim of this study is to determine the frequency and symptoms of chikungunya as well as to assess the participants' awareness about the spread and preventive measures of this disease. Methods This is a cross-sectional study that was carried out in Civil Hospital Karachi by approaching patients in the out-patient department (OPD) and the emergency department with complaints of fever and joint pain. All the data was collected via a pre-coded questionnaire during May-June 2017 by taking prior informed verbal consent and were analyzed through Statistical Package for the Social Sciences (SPSS) version 22 software. Results The age group most affected by this disease was the 21-30 years range, which represented almost a quarter of the cases (n=83, 32.17%). Majority of the respondents (n=214, 82.95%) had heard of the disease, mainly due to their own prior experience with it (n=100, 38.76%). Lethargy (n=219, 84.88%), difficulty in walking (n=213, 82.56%), and headache (n=209, 81.01%) were the major symptoms reported apart from fever (n=258, 100.00%) and arthralgia (n=258, 100.00%). Conclusion CHIKF is proving to be a great threat to people as it impairs their quality of life to a great extent. The recent outbreak of chikungunya has victimized a considerable population of Karachi. This study mainly assessed the severity of the disease and its symptoms as well as the lack of awareness among patients. Proper and effective preventive measures can further help to eradicate this disease on a large scale and prevent future epidemics.

Incidence of microvascular complications of type 2 diabetes: A 12 year longitudinal study from Karachi-Pakistan.

OBJECTIVES: To estimate the incidence of microvascular complications among subjects with type 2 diabetes at a tertiary care hospital. METHODS: This retrospective longitudinal follow-up study assessed the data records of type 2 diabetic subjects who visited the outpatient department of Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, from January 2005 to April 2016. Subjects with gestational diabetes, type 1 diabetes and with history of any microvascular complication were excluded. Medical records were obtained through electronic database (Health Management System). Statistical analyses were conducted using STATA version 14 and SPSS version 20. RESULTS: The incidence of microvascular complications was 92.8, 106.2, and 130.2 per 1000 person per years for retinopathy, neuropathy and nephropathy respectively. Retinopathy, neuropathy and nephropathy were significantly high among diabetic patients with duration of diabetes >10 years followed by 5-10 years. Incidence of retinopathy and nephropathy was significantly higher in patients who had HbA1c>7% than patients with HbA1c≤7% (p-value<0.05). Higher incidence rate of all three microvascular complications were seen in subjects with hypertension than subjects without hypertension. CONCLUSION: A high incidence of microvascular complications is found in subjects with type 2 diabetes. Poor glycaemic control, longer duration of diabetes and hypertension was found to be associated with the occurrence of these complications.

Association of serum liver enzyme Alanine Aminotransferase (ALT) in patients with type 2 diabetes.

OBJECTIVES: To assess the association of raised serum liver enzyme (ALT) with type 2 diabetic subjects. METHODS: This retrospective data was accessed at Baqai Institute of Diabetology and Endocrinology (BIDE) from January 2005 to May 2016. A total of 1966 subjects with type 2 diabetes were included in the study. Subjects were divided into two groups; in group A 1284 subjects had ALT within the normal range (ALT≤35iu/l) and in Group-B 682 subjects had elevated ALT (ALT>35iu/l). Details of demographics, anthropometric measurements and biochemical results at baseline were extracted from the health management system of BIDE. Data analysis was conducted on Statistical Package for Social Sciences (SPSS) version 20. RESULTS: Out of 1966 type 2 diabetic subjects 1284(65.4%) were observed with normal value of ALT (≤35) and 682(34.6%) with elevated ALT (>35). Overall mean age of subjects was 54.66±10.98 years and mean BMI was 27.34±5.99 kg/m2. Significant difference was observed between the groups in age (if ALT>35), gender (more likely to be male) and triglyceride (higher if ALT>35).Whereas no significant difference was found between the groups in HbA1c, cholesterol, HDL and LDL. CONCLUSION: High frequency of elevated ALT suggests the association of liver disease with type 2 diabetes. The type 2 diabetic subjects need to be routinely screened and further studies to assess the possible associations with NAFLD and insulin resistance are required to further clarify the disease process.

Neutrophil-to-lymphocyte ratio and microvascular complications in subjects with type 2 diabetes: Pakistan's perspective

Background/aim: The aim of this study is to find the association between diabetic microvascular complications and the neutrophil-to-lymphocyte ratio (NLR) in subjects with type 2 diabetes. Materials and methods: This was a retrospective study based on hospital data records from January 2005 to May 2016 at the Baqai Institute of Diabetology and Endocrinology. The eligibility criteria included subjects with type 2 diabetes with their latest complete blood count while subjects with conditions such as chronic inflammation, cancer, heart failure, and end-stage renal disease were not eligible for inclusion. Subjects were divided into two groups: one with any microvascular complications and the other with no microvascular complications. Body mass index, anthropometric measurements, and blood pressure were measured. Results: Out of 5620 type 2 diabetic subjects, 3202 (57%) were male and (2418) 43% were female. Among these, 3374 diabetic subjects had one or more microvascular complications and 2246 had no microvascular complications. The NLR was found to be 1.14 times higher in diabetic subjects with at least one microvascular complication as compared to diabetic subjects without any complications (4.34 ± 3.32 vs. 3.36 ± 2.67; P < 0.0001). Factors likely associated with microvascular complications were high levels of NLR, HbA1c, serum creatinine, and systolic blood pressure and longer duration of diabetes. Conclusion: According to the results, the NLR is an efficient, cheaper, and readily available marker of inflammation and it is known as an important predictor for the existence of microvascular complications in subjects with type 2 diabetes.

Stereotactic core needle breast biopsy marker migration: An analysis of factors contributing to immediate marker migration.

OBJECTIVES: To evaluate breast biopsy marker migration in stereotactic core needle biopsy procedures and identify contributing factors. METHODS: This retrospective study analyzed 268 stereotactic biopsy markers placed in 263 consecutive patients undergoing stereotactic biopsies using 9G vacuum-assisted devices from August 2010-July 2013. Mammograms were reviewed and factors contributing to marker migration were evaluated. Basic descriptive statistics were calculated and comparisons were performed based on radiographically-confirmed marker migration. RESULTS: Of the 268 placed stereotactic biopsy markers, 35 (13.1%) migrated ≥1 cm from their biopsy cavity. Range: 1-6 cm; mean (± SD): 2.35 ± 1.22 cm. Of the 35 migrated biopsy markers, 9 (25.7%) migrated ≥3.5 cm. Patient age, biopsy pathology, number of cores, and left versus right breast were not associated with migration status (P> 0.10). Global fatty breast density (P= 0.025) and biopsy in the inner region of breast (P = 0.031) were associated with marker migration. Superior biopsy approach (P= 0.025), locally heterogeneous breast density, and t-shaped biopsy markers (P= 0.035) were significant for no marker migration. CONCLUSIONS: Multiple factors were found to influence marker migration. An overall migration rate of 13% supports endeavors of research groups actively developing new biopsy marker designs for improved resistance to migration. KEY POINTS: • Breast biopsy marker migration is documented in 13% of 268 procedures. • Marker migration is affected by physical, biological, and pathological factors. • Breast density, marker shape, needle approach etc. affect migration. • Study demonstrates marker migration prevalence; marker design improvements are needed.

Texture analysis as a radiomic marker for differentiating renal tumors.

PURPOSE: To evaluate the utility of texture analysis for the differentiation of renal tumors, including the various renal cell carcinoma subtypes and oncocytoma. MATERIALS AND METHODS: Following IRB approval, a retrospective analysis was performed, including all patients with pathology-proven renal tumors and an abdominal computed tomography (CT) examination. CT images of the tumors were manually segmented, and texture analysis of the segmented tumors was performed. A support vector machine (SVM) method was also applied to classify tumor types. Texture analysis results were compared to the various tumors and areas under the curve (AUC) were calculated. Similar calculations were performed with the SVM data. RESULTS: One hundred nineteen patients were included. Excellent discriminators of tumors were identified among the histogram-based features noting features skewness and kurtosis, which demonstrated AUCs of 0.91 and 0.93 (p < 0.0001), respectively, for differentiating clear cell subtype from oncocytoma. Histogram feature median demonstrated an AUC of 0.99 (p < 0.0001) for differentiating papillary subtype from oncocytoma and an AUC of 0.92 for differentiating oncocytoma from other tumors. Machine learning further improved the results achieving very good to excellent discrimination of tumor subtypes. The ability of machine learning to distinguish clear cell subtype from other tumors and papillary subtype from other tumors was excellent with AUCs of 0.91 and 0.92, respectively. CONCLUSION: Texture analysis is a promising non-invasive tool for distinguishing renal tumors on CT images. These results were further improved upon application of machine learning, and support the further development of texture analysis as a quantitative biomarker for distinguishing various renal tumors.