Optimization and impact of sensitivity mode on abbreviated scan protocols with population-based input function for parametric imaging of [18F]-FDG for a long axial FOV PET scanner.

BACKGROUND: The long axial field of view, combined with the high sensitivity of the Biograph Vision Quadra PET/CT scanner enables the precise deviation of an image derived input function (IDIF) required for parametric imaging. Traditionally, this requires an hour-long dynamic PET scan for [18F]-FDG, which can be significantly reduced by using a population-based input function (PBIF). In this study, we expand these examinations and include the scanner's ultra-high sensitivity (UHS) mode in comparison to the high sensitivity (HS) mode and evaluate the potential for further shortening of the scan time. METHODS: Patlak Ki and DV estimates were determined by the indirect and direct Patlak methods using dynamic [18F]-FDG data of 6 oncological patients with 26 lesions (0-65 min p.i.). Both sensitivity modes for different number/duration of PET data frames were compared, together with the potential of using abbreviated scan durations of 20, 15 and 10 min by using a PBIF. The differences in parametric images and tumour-to-background ratio (TBR) due to the shorter scans using the PBIF method and between the sensitivity modes were assessed. RESULTS: A difference of 3.4 ± 7.0% (Ki) and 1.2 ± 2.6% (DV) was found between both sensitivity modes using indirect Patlak and the full IDIF (0-65 min). For the abbreviated protocols and indirect Patlak, the UHS mode resulted in a lower bias and higher precision, e.g., 45-65 min p.i. 3.8 ± 4.4% (UHS) and 6.4 ± 8.9% (HS), allowing shorter scan protocols, e.g. 50-65 min p.i. 4.4 ± 11.2% (UHS) instead of 7.3 ± 20.0% (HS). The variation of Ki and DV estimates for both Patlak methods was comparable, e.g., UHS mode 3.8 ± 4.4% and 2.7 ± 3.4% (Ki) and 14.4 ± 2.7% and 18.1 ± 7.5% (DV) for indirect and direct Patlak, respectively. Only a minor impact of the number of Patlak frames was observed for both sensitivity modes and Patlak methods. The TBR obtained with direct Patlak and PBIF was not affected by the sensitivity mode, was higher than that derived from the SUV image (6.2 ± 3.1) and degraded from 20.2 ± 12.0 (20 min) to 10.6 ± 5.4 (15 min). Ki and DV estimate images showed good agreement (UHS mode, RC: 6.9 ± 2.3% (Ki), 0.1 ± 3.1% (DV), peak signal-to-noise ratio (PSNR): 64.5 ± 3.3 dB (Ki), 61.2 ± 10.6 dB (DV)) even for abbreviated scan protocols of 50-65 min p.i. CONCLUSIONS: Both sensitivity modes provide comparable results for the full 65 min dynamic scans and abbreviated scans using the direct Patlak reconstruction method, with good Ki and DV estimates for 15 min short scans. For the indirect Patlak approach the UHS mode improved the Ki estimates for the abbreviated scans.

Treatment of canine perineal hernia with a fascia lata graft is noninferior to the elevation of the internal obturator muscle: a prospective randomized trial of 66 dogs.

OBJECTIVE: To compare the recurrence rate after herniorrhaphy of canine perineal hernia (PH) using elevation of the internal obturator muscle (EIOM) or fascia lata graft (FLG) and assess how clinical signs related to defecation evolve during 12 months postoperatively. ANIMALS: 66 client-owned male dogs undergoing PH surgery between March 1, 2017, and December 31, 2020. METHODS: Dogs were randomized into 2 groups (EIOM = 36; FLG = 30) applying 2 stratification factors: preoperative bladder location and the defecation signs score (DSS). Follow-up visits were at 2 weeks and 3, 6, and 12 months postoperatively. The main outcome, the recurrence of PH was evaluated by rectal examination. We evaluated the noninferiority of FLG to EIOM from the difference in recurrence proportions between the techniques (95% CI), comparing the CI with a pre-defined noninferiority margin (15%). To evaluate defecation signs, the DSS was calculated from the owner questionnaire and assessed with a linear mixed model (P < .05 significant). RESULTS: In 63 dogs attending the 12-month follow-up, the recurrence rate was 8.8% (3/34) in the EIOM and 10.3% (3/29) in the FLG group. The CI (-11.94% to 14.99%) was below the pre-defined margin, indicating the noninferiority of FLG. After surgery, the DSS decreased (P < .001), remaining low during the follow-up. CLINICAL RELEVANCE: FLG was non-inferior to EIOM when considering recurrence. The DSS decreased postoperatively and complications were uncommon. FLG is a useful alternative for the treatment of canine PH.

Dimensional and spatial computed tomographic abnormalities of the rectum and prostate are only partly reversible after surgical repair of perineal hernia in dogs.

Caudal protrusion of pelvic organs and dilatation and deviation of the rectum with perineal hernia (PH) have not previously been studied using CT, and it is not known how completely the changes normalize after PH repair. Objectives of this prospective experimental case series were to evaluate the dimensions and shape of the rectum and the volume, location, and other features (enhancement pattern, presence of cysts, and mineralizations) of the prostate of 66 dogs on CT before and 3 months after PH repair. The rectal cross-sectional areas were measured at intrapelvic and caudal locations, and the shape was categorized as straight, deviated, flexure, or caudal fold on dorsal images. According to paired samples t-tests, the caudal rectal dimensions were significantly larger (P < .001) than the intrapelvic dimensions both before and 3 months after PH repair, and according to linear mixed models, the intrapelvic dimensions increased significantly (P < .001) after repair. Before PH repair, the most common rectal shape was flexure (69.2%); after repair, the number of dogs having a straight rectum increased significantly (P < .001) according to the McNemar paired-samples proportion test. We were also able to show that rectal dimensions increased after PH repair despite straightening in most dogs. According to the linear mixed model, prostate ratio volume, and according to Wilcoxon signed ranks test, the number of prostates with intraprostatic cysts decreased significantly (both P < .001) after PH repair, but the proportion of prostates located in the caudal or perineal area did not. Small mineralizations remained in some dogs.

Long COVID-associated symptoms prevalent in both SARS-CoV-2 positive and negative individuals: A prospective follow-up study.

Background: Research into persistent symptoms among SARS-CoV-2-positive i.e. CoV(+) patients mostly focuses on hospitalized individuals. Our prospective follow-up study compares long COVID-associated symptoms among laboratory-confirmed CoV(+) and SARS-CoV-2 negative [CoV(-)] individuals. Methods: SARS-CoV-2 RT-PCR-tested volunteers were recruited into four cohorts: 1) CoV(+) outpatients, 2) CoV(-) outpatients, 3) CoV(+) intensive care unit (ICU) inpatients, and 4) CoV(+) non-ICU inpatients. Neutralizing antibodies were assessed and questionnaires filled in at enrolment and days 90-120, 121-180, 181-270, 271-365, and 365-533. Results: Of the 1326 participants, 1191 were CoV(+): 46 ICU, 123 non-ICU, and 1022 outpatients; 135 were CoV(-) outpatient controls. Both CoV(+) outpatients and CoV(-) controls showed high overall symptom rates at all time points. More prevalent among CoV(+) than CoV(-) outpatients were only impaired olfaction and taste; many others proved more frequent for CoV(-) participants. At ≥181 days, fatigue, dyspnoea, various neuropsychological symptoms and several others were recorded more often for CoV(+) inpatients than outpatients. Conclusions: Long COVID-associated symptoms were more frequent among hospitalized than non-hospitalized CoV(+) participants. As for outpatients, only impaired olfaction and taste showed higher rates in the CoV(+) group; some symptoms proved even more common among those CoV(-). Besides suggesting low long COVID prevalences for outpatients, our results highlight the weight of negative controls.

Applied surgical methods and outcomes in crooked nose rhinoplasty.

OBJECTIVE: In this retrospective and multicentric study, we investigated applied surgical methods in rhinoplasty for crooked nose deformity. PATIENTS AND METHODS: The retrospective data for 300 crooked nose deformity cases (191 males and 109 females) were used in our study. Classification of the initial deformities was performed as (1) I-shaped crooked nose deformity, (2) C-shaped crooked nose deformity, (3) Reverse C-shaped crooked nose deformity, and (4) S-shaped crooked nose deformity. As an operation technique, L-strut septoplasty was performed. The applied surgical methods in rhinoplasty to correct the crooked nose are evaluated and classified. RESULTS: Our results showed that initial deformities in crooked nose patients were I-shaped crooked nose deformity (34%), C-shaped crooked nose deformity (28%), Reverse C-shaped crooked nose deformity (21.3%), and S-shaped crooked nose deformity (16.7%). L-strut septoplasty was performed, and the results of the applied methods to correct the crooked nose were evaluated and classified. It was noticed that more than one procedure was applied to each case: (1) double-side lateral osteotomy (86.6%), (2) wedge bone resection on one side of the osteotomy (7.3%), (3) single-side lateral osteotomy (6%), (4) symmetric spreader grafts (56%), (5) asymmetric spreader grafts (10.6%), (6) shaving of the transverse wing of dorsal septum (8%), (7) correction of deviated dorsal septum (16.3%), (8) displaced anterior nasal spine (12.6%), (9) clocking suture (dorsal septal rotation suture) (9%), (10) dorsal septal scoring and splinting graft (8.3%), and equalizing lateral cruses (12.6%). CONCLUSIONS: I-shaped and C-shaped crooked nose deformities were mainly detected in crooked nose deformity patients. Correcting the crooked nose, double-side lateral osteotomy, and symmetric spreader grafts were the most applied techniques to correct the crooked nose. Other rhinoplasty techniques were also applied to these patients; more than one technique was needed.

Coadministered pneumococcal conjugate vaccine decreases immune response to hepatitis A vaccine: a randomized controlled trial.

OBJECTIVES: We explored the influence of coadministration on safety and immunogenicity of the most common travellers' vaccine hepatitis A (HepA) and the pneumococcal conjugate vaccine (PCV) increasingly used both at home and before travel. METHODS: Volunteers aged ≥18 years (n = 305) were randomly assigned 1:1:1 into three groups receiving: 13-valent PCV (PCV13) + HepA, PCV13, or HepA. Anti-pneumococcal IgG concentrations, opsonophagocytic activity (OPA) titres, and total hepatitis A antibody (anti-HAV) concentrations were measured before and 28 ± 3 days after vaccination. Adverse events (AEs) were recorded over 4 weeks. RESULTS: After vaccination, the anti-HAV geometric mean concentration was significantly lower in the PCV13+HepA than the HepA group: 34.47 mIU/mL (95% CI: 26.42-44.97 mIU/mL) versus 72.94 mIU/mL (95% CI: 55.01-96.72 mIU/mL), p < 0.001. Anti-HAV ≥10 mIU/mL considered protective was reached by 71 of 85 (83.5%) in the PCV13+HepA group versus 76 of 79 (96.2%) in the HepA group, p 0.008. The increases in anti-pneumococcal IgG and OPA levels were comparable in the PCV13+HepA and PCV13 groups, apart from a bigger rise in the PCV13+HepA group for serotype 3 (one-way ANOVA: serotype 3 IgG p 0.010, OPA p 0.002). AEs proved more frequent among those receiving PCV13 than HepA, but simultaneous administration did not increase the rates: ≥one AE was reported by 45 of 56 (80.4%) PCV13, 43 of 54 (79.6%) PCV13+HepA, and 25 of 53 (47.2%) HepA recipients providing structured AE data. DISCUSSION: Coadministration of HepA and PCV13 did not cause safety concerns, nor did it impact the patients' response to PCV13, apart from serotype 3. However, coadministered PCV13 significantly impaired antibody responses to HepA.

Superspreading of SARS-CoV-2 Omicron BA.2.23 among vaccinated Finnish adults: symptomatic COVID-19 only contracted by those without recent infection.

An outbreak of SARS-CoV-2 was confirmed after an academic party in Helsinki, Finland, in 2022. All 70 guests were requested to fill in follow-up questionnaires; serologic analyses and whole-genome sequencing (WGS) were conducted when possible.Of those participating - all but one with ≥3 vaccine doses - 21/53 (40%) had test-confirmed symptomatic COVID-19: 7% of those with earlier episodes and 76% of those without. Half (11/21) were febrile, but none needed hospitalisation. WGS revealed subvariant BA.2.23.Compared to vaccination alone, our data suggest remarkable protection by hybrid immunity against symptomatic infection, particularly in instances of recent infections with homologous variants.

Consideration of Comparing Empirical and Evidence-Based Knowledge on Nephrology in the Example of Ahi Çelebi's Fifteenth Century Turkish Treatise on the Urinary Calculus.

The objective of the study is to discuss the question, "how did physicians come to grasp some facts in the absence of scientific experimentation and medical technology?" within the framework of examples from Ahi? Ahmed Çelebi's fifteenth century Turkish treatise on the urinary calculus. Çelebi's monograph on the urinary calculus in the kidneys and the bladder written in Turkish in Arabic alphabet is transliterated and studied within the framework of the medical theory of the period. The sample information for this study was randomly chosen. Examples of epidemiological information, diets against urinary calculus formation, diagnoses of kidney and urinary bladder calculi, and symptomatic therapies noted in Çelebi's treatise are discussed, with results briefly compared with today's data. The study of Çelebi's treatise shows that it was possible to reach some medical facts with the methods of the period.

Evaluation of the frequency and awareness of obesity among healthcare workers.

OBJECTIVE: The aim of this study is to determine the frequency of obesity in healthcare workers and to evaluate the awareness of obesity by using Obesity Awareness Scale. SUBJECTS AND METHODS: This descriptive frequency study was conducted between January 1 and March 31, 2021, in 17 Family Health Centers in the Health Training and Research Area. 119 health personnel working in Family Health Centers were included in the study. The Body Mass Index (BMI) classification accepted by the World Health Organization for adults was used to determine obesity. Obesity Awareness Scale adapted to the Turkish language was used to evaluate obesity awareness. RESULTS: The frequency of obesity among healthcare workers was 11.8% and overweight was 37.8%. 51.9% of physicians were overweight, 14.8% were obese; 38.5% of midwives were overweight, 15.4% were obese; 24.4% of the nurses were overweight and 9.8% were obese. The mean BMI of the participants was 18.00±0.52 for underweight, 22.65±1.35 for normal, 27.32±1.43 for overweight, and 31.53±1.68 for obese. The obesity awareness total score average of the participants was 63.97±7.47 (high level). According to the obesity awareness scale sub-dimension mean scores, obesity awareness was 28.7±3.9 (high), nutrition awareness was 20.0±3.1 (high), and physical activity was 15.3±1.8 (good). CONCLUSIONS: The frequency of obesity was found to be low, and the awareness of obesity was found to be high among HCWs in Family Health Centers. In addition, obesity was mostly detected in physicians, midwives, and nurses. Urgent act policies are needed to encourage both patients and HCWs to the awareness and prevention of obesity and to have a healthy lifestyle.

Spin-Orbit and Zeeman Effects on the Electronic Properties of Single Quantum Rings: Applied Magnetic Field and Topological Defects.

Within the framework of effective mass theory, we investigate the effects of spin-orbit interaction (SOI) and Zeeman splitting on the electronic properties of an electron confined in GaAs single quantum rings. Energies and envelope wavefunctions in the system are determined by solving the Schrödinger equation via the finite element method. First, we consider an inversely quadratic model potential to describe electron confining profiles in a single quantum ring. The study also analyzes the influence of applied electric and magnetic fields. Solutions for eigenstates are then used to evaluate the linear inter-state light absorption coefficient through the corresponding resonant transition energies and electric dipole matrix moment elements, assuming circular polarization for the incident radiation. Results show that both SOI effects and Zeeman splitting reduce the absorption intensity for the considered transitions compared to the case when these interactions are absent. In addition, the magnitude and position of the resonant peaks have non-monotonic behavior with external magnetic fields. Secondly, we investigate the electronic and optical properties of the electron confined in the quantum ring with a topological defect in the structure; the results show that the crossings in the energy curves as a function of the magnetic field are eliminated, and, therefore, an improvement in transition energies occurs. In addition, the dipole matrix moments present a non-oscillatory behavior compared to the case when a topological defect is not considered.

Safety and immunogenicity of ETVAX®, an oral inactivated vaccine against enterotoxigenic Escherichia coli diarrhoea: a double-blinded, randomized, placebo-controlled trial amongst Finnish travellers to Benin, West Africa.

BACKGROUND: No licensed human vaccines are available against enterotoxigenic Escherichia coli (ETEC), a major diarrhoeal pathogen affecting children in low- and middle-income countries and foreign travellers alike. ETVAX®, a multivalent oral whole-cell vaccine containing four inactivated ETEC strains and the heat-labile enterotoxin B subunit (LTB), has proved promising in Phase 1 and Phase 1/ 2 studies. METHODS: We conducted a Phase 2b double-blinded, randomized, placebo-controlled trial amongst Finnish travellers to Benin, West Africa. This report presents study design and safety and immunogenicity data. Volunteers aged 18-65 years were randomized 1:1 to receive ETVAX® or placebo. They visited Benin for 12 days, provided stool and blood samples and completed adverse event (AE) forms. IgA and IgG antibodies to LTB and O78 lipopolysaccharide (LPS) were measured by electrochemiluminescence. RESULTS: The AEs did not differ significantly between vaccine (n = 374) and placebo (n = 375) recipients. Of the solicited AEs, loose stools/diarrhoea (26.7/25.9%) and stomach ache (23.0/20.0%) were reported most commonly. Of all possibly/probably vaccine-related AEs, the most frequent were gastrointestinal symptoms (54.0/48.8%) and nervous system disorders (20.3/25.1%). Serious AEs were recorded for 4.3/5.6%, all unlikely to be vaccine related. Amongst the ETVAX® recipients, LTB-specific IgA antibodies increased 22-fold. For the 370/372 vaccine/placebo recipients, the frequency of ≥2-fold increases against LTB was 81/2.4%, and against O78 LPS 69/2.7%. The majority of ETVAX® recipients (93%) responded to either LTB or O78. CONCLUSIONS: This Phase 2b trial is the largest on ETVAX® undertaken amongst travellers to date. ETVAX® showed an excellent safety profile and proved strongly immunogenic, which encourages the further development of this vaccine.

A deep neural network for parametric image reconstruction on a large axial field-of-view PET.

PURPOSE: The PET scanners with long axial field of view (AFOV) having ~ 20 times higher sensitivity than conventional scanners provide new opportunities for enhanced parametric imaging but suffer from the dramatically increased volume and complexity of dynamic data. This study reconstructed a high-quality direct Patlak Ki image from five-frame sinograms without input function by a deep learning framework based on DeepPET to explore the potential of artificial intelligence reducing the acquisition time and the dependence of input function in parametric imaging. METHODS: This study was implemented on a large AFOV PET/CT scanner (Biograph Vision Quadra) and twenty patients were recruited with 18F-fluorodeoxyglucose (18F-FDG) dynamic scans. During training and testing of the proposed deep learning framework, the last five-frame (25 min, 40-65 min post-injection) sinograms were set as input and the reconstructed Patlak Ki images by a nested EM algorithm on the vendor were set as ground truth. To evaluate the image quality of predicted Ki images, mean square error (MSE), peak signal-to-noise ratio (PSNR), and structural similarity index measure (SSIM) were calculated. Meanwhile, a linear regression process was applied between predicted and true Ki means on avid malignant lesions and tumor volume of interests (VOIs). RESULTS: In the testing phase, the proposed method achieved excellent MSE of less than 0.03%, high SSIM, and PSNR of ~ 0.98 and ~ 38 dB, respectively. Moreover, there was a high correlation (DeepPET: [Formula: see text]= 0.73, self-attention DeepPET: [Formula: see text]=0.82) between predicted Ki and traditionally reconstructed Patlak Ki means over eleven lesions. CONCLUSIONS: The results show that the deep learning-based method produced high-quality parametric images from small frames of projection data without input function. It has much potential to address the dilemma of the long scan time and dependency on input function that still hamper the clinical translation of dynamic PET.

Comparison of preoperative anxiety, bruxism, and postoperative pain among patients undergoing surgery for septoplasty, endoscopic sinus surgery, and tympanoplasty.

Background: Septoplasty, endoscopic sinus surgery, and tympanoplasty are the most commonly performed elective functional ear-nose-throat surgeries. Aim: This study investigated the relationship between preoperative anxiety, bruxism, and postoperative pain in inpatient groups undergoing three different functional otorhinolaryngologic surgeries. Patients and. Methods: This study was conducted in a single center of a tertiary referral hospital. The patients (n = 90) who had undergone septoplasty (group A), endoscopic sinus surgery (group B), and tympanoplasty (group C) were included. The State-Trait Anxiety Inventory (STAI) questionnaire and the Amsterdam Preoperative Anxiety Information Scale (APAIS) were administered. To evaluate bruxism, a self-questionnaire was administered, and for the evaluation of pain, the visual analogue scale (VAS) was administered. Results: In group C, preoperative STAI and APAIS and early and late pain values were higher than in the other groups. When patients were divided into two groups according to the presence of bruxism. A significant difference was found between the preoperative STAI and immediate and late VAS values (P < 0.001). A strong correlation was observed between APAIS and early and late VAS values in group C (P < 0.001). Conclusion: Patients who will undergo tympanoplasty should be aware of the preoperative anxiety level and pain follow-up. Bruxism can be considered a vital follow-up parameter that manifests due to high preoperative anxiety. It may also be useful to examine preoperative bruxism and take appropriate measures due to its pain-increasing effect in patients.

The level of anxiety in pregnant women in COVID-19 pandemic: a cross-sectional study.

OBJECTIVE: We aimed to determine the COVID-19 anxiety level in pregnant women who presented to an outpatient clinic during the COVID-19 pandemic. PATIENTS AND METHODS: This is a descriptive cross-sectional study including 203 of 310 pregnant women who presented to the outpatient clinic of a training and research hospital of the Ministry of Health between 29 September-1 October, 2020. The level of anxiety was assessed with the COVID-19 Anxiety Inventory (CAS) using a face-to-face survey method. RESULTS: The mean age of the patients was 28.15±5.95 years. In the study, while 6.2% of women over 30 years old was identified to have psychological problems, 0.7% of those under 30 years old had such problems. The rate of diagnosis of COVID-19 in the family/acquaintances of those with an educational level of high school or higher was 56.9%, and those who had an educational level under high school had a corresponding rate of 39.5%. The rate of COVID-19 diagnosis in the family/acquaintances of those with an educational level of high school or higher was significantly higher (p<0.05). The mean COVID-19 anxiety scale score was 0.18±0.47; COVID-19 anxiety was not observed in pregnant women. CONCLUSIONS: This study detected no anxiety in pregnant women. Therefore, it can be said that pregnant women do not need immediate psycho-social support.

CT measurement of prostate volume using OsiriX® viewer is reliable, repeatable, and not dependent on observer, CT protocol, or contrast enhancement in dogs.

Computed tomography (CT) is an established method for evaluating dogs with suspected prostatic disease; however, publications assessing the effects of varying factors on prostate volume measurements are lacking. The objectives of this two-part, observer agreement, methods comparison study were to assess observer agreement and the effects of varying CT technical parameters for volume measurements of canine prostate glands on CT images using OsiriX® DICOM viewer software. In the first retrospective study, two observers measured prostate volumes of 13 client-owned dogs thrice on noncontrast and contrast CT images. In the second prospective study, two observers measured the prostate volume of 10 cadavers using five different CT protocols and eight cadavers using three slice thicknesses. Observer agreement analyses were performed, and prostatic CT volume measurements were compared with water displacement volume measurements. Intra- and interobserver variability and the effect of contrast enhancement were found to be minimal when a one-way analysis of variance model and intraclass correlation coefficients were used. No significant differences emerged between different protocols and slice thicknesses using a linear mixed effects model. When the prostate CT volume was compared using a Bland-Altman plot with the reference volume acquired by the water displacement method, agreement without consistent bias between the methods was shown, and over 90% of measurements were located within the 95% limits of agreement. The findings supported using OsiriX® software for CT prostatic volume measurements in dogs.

Scent dogs in detection of COVID-19: triple-blinded randomised trial and operational real-life screening in airport setting.

OBJECTIVE: To estimate scent dogs' diagnostic accuracy in identification of people infected with SARS-CoV-2 in comparison with reverse transcriptase polymerase chain reaction (RT-PCR). We conducted a randomised triple-blinded validation trial, and a real-life study at the Helsinki-Vantaa International Airport, Finland. METHODS: Four dogs were trained to detect COVID-19 using skin swabs from individuals tested for SARS-CoV-2 by RT-PCR. Our controlled triple-blinded validation study comprised four identical sets of 420 parallel samples (from 114 individuals tested positive and 306 negative by RT-PCR), randomly presented to each dog over seven trial sessions. In a real-life setting the dogs screened skin swabs from 303 incoming passengers all concomitantly examined by nasal swab SARS-CoV-2 RT-PCR. Our main outcomes were variables of diagnostic accuracy (sensitivity, specificity, positive predictive value, negative predictive value) for scent dog identification in comparison with RT-PCR. RESULTS: Our validation experiments had an overall accuracy of 92% (95% CI 90% to 93%), a sensitivity of 92% (95% CI 89% to 94%) and a specificity of 91% (95% CI 89% to 93%) compared with RT-PCR. For our dogs, trained using the wild-type virus, performance was less accurate for the alpha variant (89% for confirmed wild-type vs 36% for alpha variant, OR 14.0, 95% CI 4.5 to 43.4). In the real-life setting, scent detection and RT-PCR matched 98.7% of the negative swabs. Scant airport prevalence (0.47%) did not allow sensitivity testing; our only SARS-CoV-2 positive swab was not identified (alpha variant). However, ad hoc analysis including predefined positive spike samples showed a total accuracy of 98% (95% CI 97% to 99%). CONCLUSIONS: This large randomised controlled triple-blinded validation study with a precalculated sample size conducted at an international airport showed that trained scent dogs screen airport passenger samples with high accuracy. One of our findings highlights the importance of continuous retraining as new variants emerge. Using scent dogs may present a valuable approach for high-throughput, rapid screening of large numbers of people.

Comparative analysis of COVID-19 vaccine responses and third booster dose-induced neutralizing antibodies against Delta and Omicron variants.

Two COVID-19 mRNA (of BNT162b2, mRNA-1273) and two adenovirus vector vaccines (ChAdOx1 and Janssen) are licensed in Europe, but optimization of regime and dosing is still ongoing. Here we show in health care workers (n = 328) that two doses of BNT162b2, mRNA-1273, or a combination of ChAdOx1 adenovirus vector and mRNA vaccines administrated with a long 12-week dose interval induce equally high levels of anti-SARS-CoV-2 spike antibodies and neutralizing antibodies against D614 and Delta variant. By contrast, two doses of BNT162b2 with a short 3-week interval induce 2-3-fold lower titers of neutralizing antibodies than those from the 12-week interval, yet a third BNT162b2 or mRNA-1273 booster dose increases the antibody levels 4-fold compared to the levels after the second dose, as well as induces neutralizing antibody against Omicron BA.1 variant. Our data thus indicates that a third COVID-19 mRNA vaccine may induce cross-protective neutralizing antibodies against multiple variants.

CT imaging of dogs with perineal hernia reveals large prostates with morphological and spatial abnormalities.

The etiology of canine perineal hernia (PH) remains unclear, although as a disease of older male dogs, it is likely to be hormonal. The role of the prostate in the formation of PH has been questioned; however, prospective and systematic evaluation of prostates in these dogs is absent in the literature. In this prospective case-control study, CT imaging was used to assess prostatic changes in dogs with PH (n = 46) and compare these findings with those of intact age-matched male dogs (n = 23). Using the OsiriX® DICOM viewer, we measured prostatic volume and correlated it with the size of the dog by using the length of the sixth lumbar vertebra. In addition, we recorded spatial and morphological changes of the prostate, such as heterogenicity, intra- and paraprostatic cysts, and mineralizations, as well as prostatic location and rotation. We found that dogs with PH had larger prostates (P < .001) that more often contained cysts (P < .001) and had larger cyst diameters (P = .013) than age-matched controls. Prostates of PH dogs also contained paraprostatic cysts (17.4%) and focal mineralizations (32.6%), which were absent in the control group. Abnormal rotation and location of the prostate were common in dogs with PH. In conclusion, these findings support the use of CT as an adjunct diagnostic imaging modality for the evaluation of the prostate in dogs with PH. Further studies are needed to evaluate nonprostatic CT findings in the pelvic cavity of PH dogs.

A novel technique in septal perforation: Fascia lata and costal cartilage sandwich graft.

BACKGROUND: Nasal septum perforation (NSP) is an anatomical defect of the mucosa, cartilage/bone of nasal septum and septoplasty is the most common cause of it. A perforated septum rarely heals on its own, it is more likely to get worse. The success for large perforations is approximately 78%, it is harder to be successful in vertically larger perforations. We introduce a new technique to close large perforations by the fascia lata and costal cartilage sandwich graft (FLSG). The main advantage of this technique is that the fascia lata eliminates the opening between the septal mucosal flaps in case the septal mucosal flaps may not meet each other. PATIENTS AND METHODS: 16 cases presenting with nasal septum perforation were repaired with the FLSG technique. Grafts were harvested, the perforation was accessed through open rhinoplasty approach, FLSG is inserted and sutured. RESULTS: 16 cases consisting of 9 males (56.25%) and 7 females (43.75%) were operated. The age range was between 20 and 43 years (mean 32.6 ± 6.94). 3 cases (18.75%) had medium and 13 cases (81.25%) had large NSP. 8 cases (50%) were smokers. Nine month postoperatively, all medium NSP were closed. During this period, 14 NSP (87.5%) medium size NSP achieved complete closure, while the remaining two NSP that were yet to close had large defects (>2 cm) and smokers. CONCLUSION: FLSG is an effective, easy, and novel technique in NSP repair and the postoperative controls have proven a high success rate even in large NSP.

Characterization of low-density granulocytes in COVID-19.

Severe COVID-19 is characterized by extensive pulmonary complications, to which host immune responses are believed to play a role. As the major arm of innate immunity, neutrophils are one of the first cells recruited to the site of infection where their excessive activation can contribute to lung pathology. Low-density granulocytes (LDGs) are circulating neutrophils, whose numbers increase in some autoimmune diseases and cancer, but are poorly characterized in acute viral infections. Using flow cytometry, we detected a significant increase of LDGs in the blood of acute COVID-19 patients, compared to healthy controls. Based on their surface marker expression, COVID-19-related LDGs exhibit four different populations, which display distinctive stages of granulocytic development and most likely reflect emergency myelopoiesis. Moreover, COVID-19 LDGs show a link with an elevated recruitment and activation of neutrophils. Functional assays demonstrated the immunosuppressive capacities of these cells, which might contribute to impaired lymphocyte responses during acute disease. Taken together, our data confirms a significant granulocyte activation during COVID-19 and suggests that granulocytes of lower density play a role in disease progression.