Cognitive Development in Single-Suture Craniosynostosis - A Systematic Review.

There is conflicting evidence whether single-suture craniosynostosis (SSC), is linked to adversities of cognitive development. To assess the evidence for a link between SSC and cognition, a systematic literature search was conducted and eligible studies assessed for inclusion by two independent readers. Forty-eight studies met inclusion criteria. Small to medium but persistent effects on both general and some specific cognitive functions across age bands were found in higher quality studies for SSC overall. There was limited evidence for effects related to surgical correction. Methodologies varied substantially and there was a lack of longitudinal studies using broad assessment batteries.

Deep learning algorithm performs similarly to radiologists in the assessment of prostate volume on MRI.

OBJECTIVES: Prostate volume (PV) in combination with prostate specific antigen (PSA) yields PSA density which is an increasingly important biomarker. Calculating PV from MRI is a time-consuming, radiologist-dependent task. The aim of this study was to assess whether a deep learning algorithm can replace PI-RADS 2.1 based ellipsoid formula (EF) for calculating PV. METHODS: Eight different measures of PV were retrospectively collected for each of 124 patients who underwent radical prostatectomy and preoperative MRI of the prostate (multicenter and multi-scanner MRI's 1.5 and 3 T). Agreement between volumes obtained from the deep learning algorithm (PVDL) and ellipsoid formula by two radiologists (PVEF1 and PVEF2) was evaluated against the reference standard PV obtained by manual planimetry by an expert radiologist (PVMPE). A sensitivity analysis was performed using a prostatectomy specimen as the reference standard. Inter-reader agreement was evaluated between the radiologists using the ellipsoid formula and between the expert and inexperienced radiologists performing manual planimetry. RESULTS: PVDL showed better agreement and precision than PVEF1 and PVEF2 using the reference standard PVMPE (mean difference [95% limits of agreement] PVDL: -0.33 [-10.80; 10.14], PVEF1: -3.83 [-19.55; 11.89], PVEF2: -3.05 [-18.55; 12.45]) or the PV determined based on specimen weight (PVDL: -4.22 [-22.52; 14.07], PVEF1: -7.89 [-30.50; 14.73], PVEF2: -6.97 [-30.13; 16.18]). Inter-reader agreement was excellent between the two experienced radiologists using the ellipsoid formula and was good between expert and inexperienced radiologists performing manual planimetry. CONCLUSION: Deep learning algorithm performs similarly to radiologists in the assessment of prostate volume on MRI. KEY POINTS: • A commercially available deep learning algorithm performs similarly to radiologists in the assessment of prostate volume on MRI. • The deep-learning algorithm was previously untrained on this heterogenous multicenter day-to-day practice MRI data set.

Efficacy of inferior oblique anterior transposition placement grading for dissociated vertical deviation.

OBJECTIVE: To determine if graded anterior placement of a transposed inferior oblique muscle is beneficial for treating variable amounts of dissociated vertical deviation (DVD). DESIGN: Retrospective, consecutive, comparative case series. PARTICIPANTS: Patients who underwent inferior oblique muscle anterior transposition (IOAT) for DVD at one institution between 1991 and 1999. METHODS: Chart review. All patients had IOAT procedures of graded placement at 1, 2, or 3 mm anterior to the inferior rectus muscle insertion or standard placement at the level of the inferior rectus muscle insertion. MAIN OUTCOME MEASURES: The effect of graded and standard placement was assessed by measuring the difference between preoperative and postoperative DVD and was defined as DVD correction. The success of surgery was judged by the residual DVD at long-term follow-up of 6 months or more. Excellent, fair, and poor outcomes were defined as residual DVD of 0 to 5 prism diopters (PD), 6 to 12 PD, and 13 or more PD, respectively. RESULTS: Fifty-five patients (106 eyes) underwent IOAT for DVD. The comparison of DVD correction for the standard versus graded group yielded significance at long-term follow-up (P = 0.001). This result became nonsignificant after adjusting for preoperative DVD (P = 0.178). The power to detect a 5-PD difference between graded and standard placement was 90%. The surgical success was similar for patients receiving graded and standard IOAT. Patients with 0 to 15 PD of preoperative DVD fared better than those with more than 15 PD of preoperative DVD. CONCLUSIONS: This study does not demonstrate increased correction of DVD with graded IOAT versus standard IOAT. We do not recommend placement of the inferior oblique muscle anterior to the inferior rectus muscle insertion. Inferior oblique muscle anterior transposition for DVD was clinically more effective for smaller amounts of DVD.

Evaluation of results derived from the analysis of certified reference materials--a user-friendly approach based on simplicity.

Certified reference materials (CRMs) have now been in regular use for several decades. Their production and certification are regulated by international standards. But, even today there are no agreements on procedures for evaluating results obtained by the users. As a consequence, the way CRM results are treated in the literature leaves a lot to be desired. A statistical evaluation is rarely, if ever, described in published reports. The most common approach is to compare the found mean and/or range with the certified range and then state if the mean falls within the certified range, or if the two ranges overlap. If this happens, the analyst is usually satisfied. In addition, usually no regard is paid to the fact that the certified interval is based on a 95% confidence interval (CI) and the found interval on standard deviation and that this evaluation has little, if any, statistical relevance. Long-term evaluation of a CRM often consists in nothing more than producing a control chart, which relates the found results to the certified mean and CI. This paper is an attempt to improve the situation by providing a set of easy-to-use guidelines for evaluating results from CRMs. During the process we have identified different areas in which there is a need for such guidelines: 1. short-term evaluation of a single, or multiple, determination at one or several specific times; 2. identification of systematic and random errors; 3. evaluation of CRMs when used in a collaborative trial of a method; and 4. long-term evaluation for monitoring an analytical process over extended periods of time. It is important that the guidelines do not require expert competence in statistics from the analyst. Such obstacles would probably render most guidelines unused.

Cadmium absorption in mice: effects of broiling on bioavailability of cadmium in foods of animal origin.

The absorption and organ distribution of organic Cd from raw and broiled horse kidney was compared to that of CdCl2 at two dose levels (0.05 and 3 mg Cd/kg feed) in a feeding study in mice. The high Cd concentration in the horse kidney (raw 112 mg/kg; broiled 53 mg/kg) made it possible to mix kidney into mouse feed without marked effects on the composition of the feed. The weight of the mice, feed and water consumption, and Cd levels in the feed were determined once a week. After 9 wk of exposure, the liver and kidneys of the mice were sampled and Cd was analyzed. The Cd concentration in horse kidney was halved by broiling, and the content of soluble Cd decreased from 12% in raw kidney to 5% in broiled kidney. The majority of the soluble Cd was associated with proteins with the same molecular weight as metallothionein (MT) in both raw and broiled kidney. Broiling of the kidney had no marked effect on the fractional accumulation of organic Cd in mice. The fractional accumulation of inorganic CdCl2, on the other hand, was significantly higher than that of organic Cd in the low dose groups but not in the high dose groups. The ratio between Cd accumulation in kidney and that in liver was higher in the group receiving raw kidney compared to the ratio in the group receiving CdCl2 at both the high and low exposure levels. This indicates that the raw kidney contained a Cd form that was more preferentially distributed to the kidneys.

Cadmium and other metals in Swedish wheat and rye flours: longitudinal study, 1983-1997.

Wheat flour (sifted), wheat bran, and rye flour were sampled annually in several different areas in Sweden for 15 consecutive years (1983-1997) for a total of 105, 90, and 30 samples, respectively. These samples were analyzed for their content of Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, and Zn by atomic absorption spectrophotometry with background correction after dry ashing at 450 degrees C. As part of the quality control procedures, an in-house reference material was analyzed in parallel to the samples to ensure reliability of the results. In addition, a certified reference material was analyzed to monitor accuracy of the results. The Cd level in wheat and rye flours (mean 0.029 and 0.017 mg/kg dry wt, respectively) correlated significantly with time (p < 0.05) in 2 phases, tending to increase during the first half of the period and decrease during the latter half. In wheat bran, Cd (mean 0.15 mg/kg) levels did not correlate significantly with time. In wheat flour, Cu, Mn, and Zn (means 1.7, 6.2, and 7.6 mg/kg, respectively) showed a significant linear increase (p < 0.05) in concentration over time. In rye flour, the levels of Cu, Fe, Mn, and Zn (means 3.8, 36, 30, and 28 mg/kg, respectively) all decreased significantly (p < 0.05) over time. Similarly, in wheat bran Cu (mean 14 mg/kg) increased and Pb (mean 0.027 mg/kg) decreased significantly (p < 0.05) over time, whereas Ni and Zn showed a significant curved correlation with time and peaked at about the middle of the measurement period.

Determination of lead, cadmium, zinc, copper, and iron in foods by atomic absorption spectrometry after microwave digestion: NMKL Collaborative Study.

A method for determination of lead, cadmium, zinc, copper, and iron by atomic absorption spectrometry (AAS) after microwave digestion was subjected to a collaborative study in which 16 laboratories participated [including users of inductively coupled plasma (ICP) and ICP-mass spectrometry (MS)]. The types of samples included in the study were minced fish, wheat bran, milk powder, bovine and pig liver, mushroom, 2 simulated diets, and bovine muscle; the last 4 were certified reference materials. These were analyzed as single (4 samples), double blind (1 sample), or split level (2 samples) samples. Before the collaborative study, a pretrial was conducted in which 4 ready-made solutions and one fish tissue sample were analyzed for Pb and Cu. The reproducibility relative standard deviation (RSDR) values, for results above the detection limit, ranged from 59% at 0.155 mg/kg to 16% at 1.62 mg/kg for Pb, from 28% at 0.0124 mg/kg to 11% at 0.482 mg/kg for Cd, from 9.3% at 35.3 mg/kg to 1.7% at 147 mg/kg for Zn, from 39% at 0.241 mg/kg to 3.0% at 63.4 mg/kg for Cu, and from 17% at 7.4 mg/kg to 5.9% at 303 mg/kg for Fe. The RSDR values agreed well with the norms described by the International Union of Pure and Applied Chemistry. As a complement to the AAS determinations, a number of laboratories analyzed the samples either by ICP or by ICP-MS. The results of these analyses agreed well with the AAS results. On the basis of the results of the collaborative study, the method was adopted Official First Action by AOAC INTERNATIONAL.

Accumulation of cadmium from wheat bran, sugar-beet fibre, carrots and cadmium chloride in the liver and kidneys of mice.

The gastrointestinal absorption and organ distribution of Cd after exposure for 9 weeks to three fibre-rich foodstuffs (wheat bran, sugar-beet fibre and carrots) were determined in mice. Groups of eight mice were given a diet containing 0.05 mg Cd/kg from wheat bran, sugar-beet fibre, carrots or CdCl2 mixed in a semi-synthetic, low-Cd (< 0.007 mg/kg) feed. A control group was fed on the low-Cd semi-synthetic feed. The water consumption, food consumption and the weight of the animals were monitored throughout the study. The feed was changed once weekly and Cd was analysed in the feed at each change. myo-Inositol phosphates (hexa-, penta-, tetra- and tri-) and Zn, Cu, Fe and Ca were also analysed in the diets. After 9 weeks, the mice were killed and liver and kidneys were sampled and analysed for Cd. The group receiving the wheat-bran diet had significantly lower fractional Cd accumulation (% total Cd intake) in the liver and kidneys than the other groups, indicating a lower fractional absorption of Cd. The wheat-bran diet had markedly higher levels of inositol hexa- and pentaphosphates (phytates) and a Zn level that was twice as high as those in the other diets. The higher levels of myo-inositol hexa- and pentaphosphates in the wheat-bran diet most probably contributed more to the lower fractional absorption of Cd than the elevated Zn level, due to the formation of insoluble Cd-phytate complexes. Compared with the wheat-bran diet, the sugar-beet-fibre and carrot diets contained very low levels of myo-inositol penta- and hexaphosphates, and consequently the fractional Cd absorption from these diets was higher.

Toxic and essential elements in fish from Nordic waters, with the results seen from the perspective of analytical quality assurance.

Fish from fresh, brackish and marine waters were analysed for their levels of Pb, Cd, Cr, Ni, Co, Zn, Cu, Mn, As and Se in muscle tissue. Various quality control procedures were implemented during the survey and the results were compared with those from several other surveys, most of which were carried out during the 1990s. It was noted that several elements varied widely both within and between studies. A systematic examination of a large number of surveys and ranking of their quality level indicated that a lack of quality control procedures often results in high or varying results. This may have serious consequences when results are used as a basis for for example, legislation or intake recommendations.

Cadmium accumulation in liver and kidney of mice exposed to the same weekly cadmium dose continuously or once a week.

Cd levels in blood, liver and kidney of female mice were measured after exposure to Cd as CdCl2 in the food, either continuously (CE group) throughout the week (300 microg Cd/kg feed) or for 24 hr/wk (2100 microg Cd/kg) for 5 wk (occasionally exposed, OE group). In a control group that received feed with Cd levels below the detection limit (< 7 microg/kg), Cd levels in blood, liver and kidneys were below the detection limit after the 5 wk of exposure. The weekly dose of Cd administered to the exposed CE and OE groups was similar (approx. 400 microg Cd/kg mice/wk). The OE group had a higher Cd level in blood and a higher fractional accumulation (% of dose) of Cd in the liver and kidneys compared with the CE group. This indicates that the fractional Cd absorption in the gastrointestinal tract is higher when high Cd doses are ingested occasionally than when low doses are ingested continuously, even if weekly doses are the same. It is hypothesized that this difference in absorption could be due to Cd-induced unspecific damage to the intestinal mucosa, changes in tight-junction permeability caused by Cd, or to a saturation of the Cd-binding capacity of the intestinal mucosa in mice exposed to high Cd levels occasionally.

Levels of certain trace elements in beef and pork imported to Sweden.

The levels of Pb, Cd, Ni, Cr, Co, Zn, Cu, Mn, As and Se were determined in beef and pork imported to Sweden from six different countries. Samples of Swedish beef and pork were included for comparison. The results of this survey showed in most cases little difference in levels of these elements between the countries and agreed well with the results from our previous studies. All results for Pb, Cd, Ni and As were below the detection limits of 0.007, 0.001, 0.016 and 0.030 mg/kg fresh weight, respectively. Chromium and cobalt were, in both beef and pork, close to, or below, the detection limits of 0.004 and 0.003 mg/kg fresh wt, respectively. The level of selenium in beef varied considerably between countries, from < 0.030 to 0.18 mg/kg fresh wt. The levels of lead and cadmium from this study differed strongly in some cases from what have been reported in surveys from several countries, among them some countries exporting to Sweden. The importance of a rigorous quality control programme is emphasized.

Bioavailability of cadmium from crab hepatopancreas and mushroom in relation to inorganic cadmium: a 9-week feeding study in mice.

The bioavailability of Cd from boiled crab hepatopancreas and dried mushroom was studied in relation to that of inorganic Cd (CdCl2). Female Balb/c mice were fed with diets containing 0.4 ppm Cd from either boiled crab (Cancer pagurus) hepatopancreas or dried mushroom (Agaricus augustus), or as inorganic Cd (CdCl2). A control group received low Cd (< 0.007 ppm) feed, and did not accumulate detectable levels of Cd during 9 wk of exposure. Using Cd accumulation in the liver and kidney as a measure of Cd absorption, it was indicated that the bioavailability of Cd from boiled crab hepatopancreas is slightly lower than that of Cd from mushroom and inorganic Cd. Fractionation of Cd in boiled crab hepatopancreas and mushroom indicated that Cd in crab hepatopancreas mainly is associated with denaturated proteins with low solubility, whereas a large fraction of Cd in dried mushroom is associated with soluble ligands. This difference in speciation of Cd may be a reason for the lower bioavailability of crab Cd than that of mushroom Cd. The difference in bioavailability is, however, low and as a safety measure it is recommended that human consumption of both crab hepatopancreas and wild mushrooms with high Cd levels should be restricted.

Trace elements in crayfish: regional differences and changes induced by cooking.

The concentrations of Pb, Cd, Zn, Cu, Ni, Cr, Mn, Co, As, and Se were determined in the abdominal muscle and hepatopancreas from raw and cooked crayfish of Astacus astacus (L.) and Pacifastacus leniusculus (Dana), both of Swedish origin. After cooking, the concentrations of Cd, Ni, and Co in the hepatopancreas showed a decrease and the concentrations of Pb, Cu, and Mn in the abdominal muscle showed an increase. Metal and metalloid concentrations were also determined in the abdominal muscle and hepatopancreas of commercially caught and cooked crayfish, including Astacus leptodactylus (Esch.) and Procambarus clarkii (Girard), from China, Spain, Sweden, Turkey, and USA. Most of the elements showed little variation except for cadmium in the abdominal muscle of P. leniusculus from California, which was markedly higher (mean = 0.082 mg/kg) than the others (mean = 0.004 mg/kg). Metal and metalloid concentrations in hepatopancreas varied greatly within as well as between countries. In the hepatopancreas from P. leniusculus from a Swedish lake the manganese concentrations were markedly higher than in any other crayfish. The intake of cadmium from crayfish inhabiting uncontaminated waters will be low if the hepatopancreas is not consumed.