Development potential of nanoenabled agriculture projected using machine learning.

The controllability and targeting of nanoparticles (NPs) offer solutions for precise and sustainable agriculture. However, the development potential of nanoenabled agriculture remains unknown. Here, we build an NP-plant database containing 1,174 datasets and predict (R2 higher than 0.8 for 13 random forest models) the response and uptake/transport of various NPs by plants using a machine learning approach. Multiway feature importance analysis quantitatively shows that plant responses are driven by the total NP exposure dose and duration and plant age at exposure, as well as the NP size and zeta potential. Feature interaction and covariance analysis further improve the interpretability of the model and reveal hidden interaction factors (e.g., NP size and zeta potential). Integration of the model, laboratory, and field data suggests that Fe2O3 NP application may inhibit bean growth in Europe due to low night temperatures. In contrast, the risks of oxidative stress are low in Africa because of high night temperatures. According to the prediction, Africa is a suitable area for nanoenabled agriculture. The regional differences and temperature changes make nanoenabled agriculture complicated. In the future, the temperature increase may reduce the oxidative stress in African bean and European maize induced by NPs. This study projects the development potential of nanoenabled agriculture using machine learning, although many more field studies are needed to address the differences at the country and continental scales.

VNN2-expressing circulating monocytes exhibit unique functional characteristics and are decreased in patients with primary Sjögren's syndrome.

OBJECTIVE: This study aims to elucidate the significance of VNN2 expression in peripheral blood monocytes and its clinical relevance in primary Sjögren's syndrome (pSS). METHODS: We investigated VNN2 expression by analyzing single-cell RNA sequencing (scRNA-seq) data from peripheral blood mononuclear cells. Flow cytometry was used to detect and compare VNN2 expression in total monocytes, classical monocytes (cMo), intermediate monocytes (iMo) and non-classical monocytes (ncMo). Additionally, we examined the expression of HLA, ICAM1, CD62L, ITGAM, S100A8, S100A9, CCR2, CCR6, CX3CR1 and CXCR3 in VNN2+ and VNN2- cells. We analyzed the correlation between VNN2 expression and clinical indicators and assessed the clinical utility of VNN2+ monocytes in pSS diagnosis using receiver operating characteristic curves. RESULTS: We observed high VNN2 expression in monocytes, with significantly higher levels in CD14++ monocytes compared to ncMo. VNN2+ monocytes exhibited decreased expression of HLA and CD62L and increased expression of ICAM1, ITGAM, S100A8, S100A9, CCR2, CCR6, CX3CR1 and CXCR3 compared to VNN2- monocytes. Although scRNA-seq data showed that VNN2 mRNA was upregulated, cell surface expression of VNN2 was decreased in monocytes from pSS patients compared to healthy controls. The reduced levels of VNN2+ monocyte subpopulations in pSS patients were negatively correlated with anti-ribosome antibody levels and positively correlated with complement 4 levels. Detection of VNN2 expression in monocytes can aid in the auxiliary diagnosis of pSS. CONCLUSION: Monocytes expressing cell surface VNN2 are significantly reduced in pSS patients. This suggests a potential role for VNN2 in pSS development and its potential use as a diagnostic marker for pSS.

Constructing hollow core-shell Z-scheme heterojunction CdS@CoTiO3 nanorods for enhancing the photocatalytic degradation of 2,4-DCP and TC.

Constructing Z-scheme heterojunctions incorporating an exquisite hollow structure is an effective performance regulation strategy for the realization of high quantum efficiency and a strong redox ability over photocatalysts. Herein, we report the delicate design and preparation of a core-shell hollow CdS@CoTiO3 Z-scheme heterojunction with a CdS nanoparticle (NP)-constructed outer shell supported on a CoTiO3 nanorod (NR) inner shell. The in situ growth synthetic method led to a tightly connected interface for the heterojunction between CdS and CoTiO3, which shortened the transport distance of photoinduced charges from the interface to the surface. The promoted charge carrier separation efficiency and the retained strong redox capacity caused by the Z-scheme photoinduced charge-transfer mechanism were mainly responsible for the boosted photocatalytic performance. Additionally, the well-designed core-shell structure afforded a larger interfacial area by the multiple direction contact between CdS and CoTiO3, ensuring sufficient channels for efficient charge transfer, and thus further boosting the photocatalytic activity. As an efficient photocatalyst, the optimized CdS@CoTiO3 nanohybrids displayed excellent 2,4-dichlorophenol (2,4-DCP) and tetracycline (TC) degradation efficiencies of 91.3% and 91.8%, respectively. This study presents a Z-scheme heterojunction based on ecofriendly CoTiO3, which could be valuable for the development of metal perovskite photocatalysts for application in environmental remediation, and also demonstrated the tremendous potential of integrating a Z-scheme heterojunction with the morphology design of photocatalyts.

Determinants of radiation exposure during mobile cone-beam CT-guided robotic-assisted bronchoscopy.

BACKGROUND AND OBJECTIVE: Robotic-assisted bronchoscopy (RAB) is an emerging modality to sample pulmonary lesions. Cone-beam computed tomography (CBCT) can be incorporated into RAB. We investigated the magnitude and predictors of patient and staff radiation exposure during mobile CBCT-guided shape-sensing RAB. METHODS: Patient radiation dose was estimated by cumulative dose area product (cDAP) and cumulative reference air kerma (cRAK). Staff equivalent dose was calculated based on isokerma maps and a phantom simulation. Patient, lesion and procedure-related factors associated with higher radiation doses were identified by logistic regression models. RESULTS: A total of 198 RAB cases were included in the analysis. The median patient cDAP and cRAK were 10.86 Gy cm2 (IQR: 4.62-20.84) and 76.20 mGy (IQR: 38.96-148.38), respectively. Among staff members, the bronchoscopist was exposed to the highest median equivalent dose of 1.48 µSv (IQR: 0.85-2.69). Both patient and staff radiation doses increased with the number of CBCT spins and targeted lesions (p < 0.001 for all comparisons). Patient obesity, negative bronchus sign, lesion size <2.0 cm and inadequate sampling by on-site evaluation were associated with a higher patient dose, while patient obesity and inadequate sampling by on-site evaluation were associated with a higher bronchoscopist equivalent dose. CONCLUSION: The magnitude of patient and staff radiation exposure during CBCT-RAB is aligned with safety thresholds recommended by regulatory authorities. Factors associated with a higher radiation exposure during CBCT-RAB can be identified pre-operatively and solicit procedural optimization by reinforcing radiation protective measures. Future studies are needed to confirm these findings across multiple institutions and practices.

Zinc Finger-Homeodomain Transcriptional Factors (ZHDs) in Cucumber (Cucumis sativus L.): Identification, Evolution, Expression Profiles, and Function under Abiotic Stresses.

Cucumber (Cucumis sativus L.) is a globally prevalent and extensively cultivated vegetable whose yield is significantly influenced by various abiotic stresses, including drought, heat, and salinity. Transcription factors, such as zinc finger-homeodomain proteins (ZHDs), a plant-specific subgroup of Homeobox, play a crucial regulatory role in stress resistance. In this study, we identified 13 CsZHDs distributed across all six cucumber chromosomes except chromosome 7. Phylogenetic analysis classified these genes into five clades (ZHDI-IV and MIF) with different gene structures but similar conserved motifs. Collinearity analysis revealed that members of clades ZHD III, IV, and MIF experienced amplification through segmental duplication events. Additionally, a closer evolutionary relationship was observed between the ZHDs in Cucumis sativus (C. sativus) and Arabidopsis thaliana (A. thaliana) compared to Oryza sativa (O. sativa). Quantitative real-time PCR (qRT-PCR) analysis demonstrated the general expression of CsZHD genes across all tissues, with notable expression in leaf and flower buds. Moreover, most of the CsZHDs, particularly CsZHD9-11, exhibited varying responses to drought, heat, and salt stresses. Virus-induced gene silencing (VIGS) experiments highlighted the potential functions of CsZHD9 and CsZHD10, suggesting their positive regulation of stomatal movement and responsiveness to drought stress. In summary, these findings provide a valuable resource for future analysis of potential mechanisms underlying CsZHD genes in response to stresses.

Regulatory mechanisms and therapeutic potential of JAB1 in neurological development and disorders.

c-Jun activation domain binding protein-1 (JAB1) is a multifunctional regulator that plays vital roles in diverse cellular processes. It regulates AP-1 transcriptional activity and also acts as the fifth component of the COP9 signalosome complex. While JAB1 is considered an oncoprotein that triggers tumor development, recent studies have shown that it also functions in neurological development and disorders. In this review, we summarize the general features of the JAB1 gene and protein, and present recent updates on the regulation of JAB1 expression. Moreover, we also highlight the functional roles and regulatory mechanisms of JAB1 in neurodevelopmental processes such as neuronal differentiation, synaptic morphogenesis, myelination, and hair cell development and in the pathogenesis of some neurological disorders such as Alzheimer's disease, multiple sclerosis, neuropathic pain, and peripheral nerve injury. Furthermore, current challenges and prospects are discussed, including updates on drug development targeting JAB1.

Predicting Upgrade of Ductal Carcinoma In Situ to Invasive Breast Cancer at Surgery With Ultrafast Imaging.

BACKGROUND. Biopsy-proven ductal carcinoma in situ (DCIS) lesions are often upgraded to invasive cancer at surgery. Therefore, accurate prediction of the likelihood of invasion is helpful for surgical planning, including the need for sentinel lymph node biopsy (SLNB). OBJECTIVE. The purpose of the present study was to investigate whether kinetic features of clinically available ultrafast MRI (UF-MRI) can predict upgrade of biopsy-proven DCIS to invasive cancer at surgical excision. METHODS. Consecutive patients with biopsy-proven pure DCIS lesions who underwent UF-MRI with conventional dynamic contrast-enhanced MRI (DCE-MRI) and subsequently underwent surgery between August 2019 and January 2021 were identified. Patient and lesion characteristics, biopsy method and pathology, and lesion features on mammography, ultrasound, DCE-MRI, and UF-MRI were assessed to determine predictors of upgrade to invasive cancer. The Fisher exact test and Kruskal-Wallis test were used for association analysis. RESULTS. In 68 patients (median age, 52.0 years; range, 31-79 years) with 68 biopsy-proven pure DCIS lesions, 26 lesions (38%) were upgraded from in situ to invasive cancer. An upgrade of DCIS to invasive cancer was significantly associated with a shorter time to enhancement (TTE) on preoperative UF-MRI (p = .03), with a threshold of 11 seconds providing maximum specificity (50%) and sensitivity (76%) for upgrade. Larger lesion size on DCE-MRI (p = .001) and mammography (p = .04) was also significantly associated with upgrade; an optimal predictive threshold of 4.4 cm on DCE-MRI yielded sensitivity of 88% and specificity of 56%. No other specific variables were significantly associated with upgrade after surgery. Logistic regression of selected features combined with TTE produced a higher AUC (0.85) in predicting upgrade to invasive disease than did each factor alone, but this result was not statistically significant. CONCLUSION. Preoperative UF-MRI TTE and lesion size on DCE-MRI and mammography show potential in predicting upgrade of DCIS to invasive cancer at surgery. CLINICAL IMPACT. UF-MRI provides useful information that can be used in surgical planning, including determination of the need to perform SLNB.

Update on Lobular Neoplasia.

Lobular neoplasia (LN) is a histopathologic entity that encompasses both lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia (ALH). Management of LN is known to be variable and institutionally dependent. The variability in approach after a diagnosis of LN at percutaneous breast biopsy derives in part from heterogeneity in the literature, resulting in a range of reported upgrade rates to malignancy after initial identification at percutaneous biopsy, and also from historical shifts in understanding of the natural history of LN. It has become increasingly recognized that not all LN is the same and that distinct variants of LN such as pleomorphic LCIS and florid LCIS have distinct natural histories and distinct likelihoods of upgrade to malignancy. In addition, it is also increasingly understood that appropriate management of LN relies on scrupulous radiologic-pathologic correlation. This review details the imaging features and histopathologic nature of ALH, classic-type LCIS, and the LCIS variants; addresses changes in the historical understanding of this entity contributing to confusion regarding its management; and discusses the importance of performing radiologic-pathologic correlation after percutaneous biopsy to help guide appropriate management steps when LN is encountered. In addition to the short-term implications of an LN diagnosis in terms of upgrade and surgical outcomes, the long-term implications of an LN diagnosis regarding risk of developing a later breast cancer are examined. ©RSNA, 2023 Quiz questions for this article are available through the Online Learning Center.

Breast Cancer Screening in Survivors of Childhood Cancer.

Women who survived childhood cancers or cancers at a young age are at high risk for breast cancer later in life. The accentuated risk is notable among those treated at a young age with a high radiation dose but also extends to survivors treated with therapies other than or in addition to radiation therapy. The predisposing risk factors are complex. Advances in radiation therapy continue to curtail exposure, yet the risk of a second cancer has no dose threshold and a long latency period, and concurrent use of chemotherapy may have an additive effect on long-term risk of cancer. Early screening with annual mammography and MRI is recommended for chest radiation exposure of 10 Gy or greater, beginning 8 years after treatment or at age 25 years, whichever is later. However, there is a lack of recommendations for those at high risk without a history of radiation therapy. Because mortality after breast cancer among survivors is higher than in women with de novo breast cancer, and because there is a higher incidence of a second asynchronous breast cancer in survivors than that in the general population, regular screening is essential and is expected to improve mortality. However, awareness and continuity of care may be lacking in these young patients and is reflected in their poor screening attendance. The transition of care from childhood to adulthood for survivors requires age-targeted and lifelong strategies of education and risk prevention that are needed to improve long-term outcomes for these patients. © RSNA, 2023 See the invited commentary by Chikarmane in this issue. Quiz questions for this article are available through the Online Learning Center.

New Horizons: Artificial Intelligence for Digital Breast Tomosynthesis.

The use of digital breast tomosynthesis (DBT) in breast cancer screening has become widely accepted, facilitating increased cancer detection and lower recall rates compared with those achieved by using full-field digital mammography (DM). However, the use of DBT, as compared with DM, raises new challenges, including a larger number of acquired images and thus longer interpretation times. While most current artificial intelligence (AI) applications are developed for DM, there are multiple potential opportunities for AI to augment the benefits of DBT. During the diagnostic steps of lesion detection, characterization, and classification, AI algorithms may not only assist in the detection of indeterminate or suspicious findings but also aid in predicting the likelihood of malignancy for a particular lesion. During image acquisition and processing, AI algorithms may help reduce radiation dose and improve lesion conspicuity on synthetic two-dimensional DM images. The use of AI algorithms may also improve workflow efficiency and decrease the radiologist's interpretation time. There has been significant growth in research that applies AI to DBT, with several algorithms approved by the U.S. Food and Drug Administration for clinical implementation. Further development of AI models for DBT has the potential to lead to improved practice efficiency and ultimately improved patient health outcomes of breast cancer screening and diagnostic evaluation. See the invited commentary by Bahl in this issue. ©RSNA, 2022.

Women 75 Years Old or Older: To Screen or Not to Screen?

Breast cancer is the most common cancer in women, with the incidence rising substantially with age. Older women are a vulnerable population at increased risk of developing and dying from breast cancer. However, women aged 75 years and older were excluded from all randomized controlled screening trials, so the best available data regarding screening benefits and risks in this age group are from observational studies and modeling predictions. Benefits of screening in older women are the same as those in younger women: early detection of smaller lower-stage cancers, resulting in less invasive treatment and lower morbidity and mortality. Mammography performs significantly better in older women with higher sensitivity, specificity, cancer detection rate, and positive predictive values, accompanied by lower recall rates and false positives. The overdiagnosis rate is low, with benefits outweighing risks until age 90 years. Although there are conflicting national and international guidelines about whether to continue screening mammography in women beyond age 74 years, clinicians can use shared decision making to help women make decisions about screening and fully engage them in the screening process. For women aged 75 years and older in good health, continuing annual screening mammography will save the most lives. An informed discussion of the benefits and risks of screening mammography in older women needs to include each woman's individual values, overall health status, and comorbidities. This article will review the benefits, risks, and controversies surrounding screening mammography in women 75 years old and older and compare the current recommendations for screening this population from national and international professional organizations. ©RSNA, 2023 Quiz questions for this article are available through the Online Learning Center.

Reliability and validity of the Chinese version of the Copenhagen Multi-Centre Psychosocial Infertility-Fertility Problem Stress Scales.

AIMS: The aim of this study is to introduce the Copenhagen Multi-Centre Psychosocial Infertility (COMPI)-Fertility Problem Stress Scales (COMPI-FPSS) into China and test its applicability in Chinese infertile population. BACKGROUND: Infertility-related stress not only influences patients' psychological well-being but is also strongly associated with reduced pregnancy rates and poorer assisted conception outcomes, thus warranting focussed attention. DESIGN: The design used in this study is a cross-sectional survey. METHODS: A total of 418 participants were recruited by convenience sampling from March to July 2022. The data were randomly divided into two parts: one for item analysis and exploratory factor analysis and the other for confirmatory factor analysis and reliability test. The critical ratio and homogeneity test were used to verify the differentiation and homogeneity of the COMPI-FPSS; the construct validity was determined by explanatory and confirmatory factor analyses; Cronbach's α coefficient and Spearman-Brown coefficient were used to assess the reliability; and criterion validity was expressed using correlation coefficients for the Perceived Stress Scale and the Negative Affect Scale as the validity criteria. RESULTS: The revised Chinese version of COMPI-FPSS has 11 items and 2 dimensions (i.e., personal stress domain and social stress domain). Exploratory factor analysis showed that the cumulative variance contribution rate of the two factors was 68.6%, and confirmatory factor analysis indicated that the model fitted well. The score of the COMPI-FPSS was significantly and positively associated with perceived stress and negative affect. The Cronbach's α coefficient of the total scale was 0.905, and the Spearman-Brown coefficient was 0.836, explaining excellent reliability. CONCLUSION: The revised Chinese version of COMPI-FPSS shows good reliability and validity, and it can be used to evaluate the infertility-related stress of infertile patients in China.

Multiple Bilateral Circumscribed Masses at Screening Breast Ultrasound: Outcomes of New or Enlarging Masses at Follow-Up.

BACKGROUND. Breast screening ultrasound (US) has limited specificity but is increasingly performed because of widening state and federal legislation regarding breast density. There is a need for evidence-based management guidelines. OBJECTIVE. The purpose of this study was to assess outcomes of new or enlarging oval circumscribed parallel masses in the setting of multiple bilateral circumscribed masses (MBCM) at sequential rounds of US screening. METHODS. In this retrospective study of women found to have MBCM on screening breast US without mammography abnormalities, longitudinal review was performed to identify development of any new or enlarging or changing masses. Outcomes were recorded using biopsy results or minimum of 12 months of follow-up as reference standards. Lesion characteristics, BI-RADS classification, breast density, patient age, demographics, and risk factors were reviewed. Statistical analysis included multivariable logistic regression analysis. RESULTS. There were 284 (2.4%) cases of MBCM in a total of 48,488 bilateral screening US examinations performed in 11,826 asymptomatic women between January 1, 2014, and July 31, 2019, that fit inclusion criteria. Of the 284 women (mean age, 46 years; range, 20-83 years), 150 (52.8%) subsequently developed 465 new, enlarging, and/or changing masses, 107 (23.0%) of which underwent biopsy. Of the 465 masses, 408 (87.7%) were oval circumscribed parallel masses and similar to other MBCM, and 57 (12.3%) were unique findings that were nonoval noncircumscribed masses. None of the new or enlarging oval circumscribed parallel masses were malignant. In total, the malignancy rate was 0% for women with MBCM with follow-up (median, 40.8 months; range, 12-75 months) and 0% for those that underwent biopsy (95% CI, 0-1.2%). Among women with concurrent MBCM and unique findings, four cancers were detected. Three were new irregular masses, and one previously oval mass changed in morphology to have new calcifications and an irregular border. A younger age was related to the likelihood of having enlarging masses (p < .001). CONCLUSION. In the setting of MBCM, new or enlarging oval circumscribed parallel masses are a common and benign event. Concurrent new irregular masses or previously oval masses that develop suspicious morphologic features should be carefully evaluated for malignancy. CLINICAL IMPACT. Breast radiologists who encounter new or enlarging oval circumscribed parallel masses with no suspicious morphologic change in the setting of MBCM can safely defer biopsies.

Health Disparity and Breast Cancer Outcomes in Asian Women.

Health disparities in Asian women are complex and multifactorial. Screening attendance is low among Asian women, regardless of nativity or acculturation, and breast cancer detection has decreased by more than half in this population during the COVID-19 pandemic. The follow-up rate after abnormal screening results is similarly poor among Asian women compared with that among other groups, often resulting in a delay of cancer diagnosis. Yet the incidence of breast cancer in Asian women is increasing in the United States, with no such increase observed in other racial and ethnic groups in recent years. The age distribution of breast cancer in Asian women is distinct and peaks in younger women, underscoring the importance of early screening. The predilection for human epidermal growth factor receptor 2 (HER2)-enriched tumors may reflect the unique biologic characteristics of breast cancer among Asian subgroups, which are not well understood. Known biomarkers for breast cancer risk such as body mass index and mammographic density do not perform the same way in Asian women, as compared with other groups, owing to a lack of Asian population-specific data. Within that limitation, the association between body mass index and breast cancer is strongest in older Asian women, and the association between breast density and breast cancer is strongest in younger Asian women. There is an unmet need to improve breast cancer care in Asian women, a heterogeneous and growing population that is facing an increasing burden of breast cancer. An invited commentary by Leung is available online. ©RSNA, 2022.

Non-BRCA Early-Onset Breast Cancer in Young Women.

The incidence of breast cancer in younger women is rising. Although early-onset breast cancer is highly associated with biologically aggressive tumors such as triple-negative and human epidermal growth factor 2 (HER2)-positive cancers, the more recent increase is disproportionately driven by an increase in the incidence of luminal cancer. In particular, the increase in de novo stage IV disease and the inherent age-based poorer survival rate among younger women with even early-stage luminal cancers suggest underlying distinct biologic characteristics that are not well understood. Further contributing to the higher number of early-onset breast cancers is pregnancy-associated breast cancer (PABC), which is attributed to persistent increases in maternal age over time. Although guidelines for screening of patients who carry a BRCA1 or BRCA2 gene mutation are well established, this population comprises only a fraction of those with early-onset breast cancer. A lack of screening in most young patients precludes timely diagnosis, underscoring the importance of early education and awareness. The disproportionate disease burden in young women of certain racial and ethnic groups, which is further exacerbated by socioeconomic disparity in health care, results in worse outcomes. An invited commentary by Monticciolo is available online. ©RSNA, 2022.

Coping Style, Insomnia, and Psychological Distress Among Persons With Gastrointestinal Cancer.

BACKGROUND: Although insomnia has been shown to play an important role in psychological distress among gastrointestinal cancer patients, little is known about the internal mechanisms underlying this relation. Coping styles have been shown to moderate the effect of sleep on emotion, and this moderating effect may be age-dependent. OBJECTIVE: The aim of this study was to test how age and coping styles moderate the role of insomnia on psychological distress among gastrointestinal cancer patients. METHODS: This was a descriptive cross-sectional study with a convenience sample. A total of 352 patients with gastrointestinal cancer from two tertiary hospitals were recruited to participate in this study. The Kessler Psychological Distress Scale, the Insomnia Severity Index, and the Simplified Coping Style Questionnaire were used to assess patients' psychological distress, insomnia, and coping styles, respectively. We performed hierarchical multiple regression and Johnson-Neyman statistical analysis to probe the moderating effect of coping styles and age. RESULTS: The mean age of the participants was 58.32 years. Nearly half of the participants reported psychological distress, and many reported insomnia. Insomnia was significantly positively associated with psychological distress. Coping styles and age moderated the relationship between insomnia and distress. Specifically, positive coping buffered the effect of insomnia on psychological distress only for subjects aged 34 years and younger; negative coping exacerbated the above relationship in patients aged 68 years and older while weakening the relationship in participants aged 51 years and younger. DISCUSSION: There are age differences in the moderating role of coping styles on the relationship between insomnia and distress among gastrointestinal cancer patients. This study provides preliminary evidence to inform tailored guidance on coping styles by age groups to attenuate the risk for psychological distress related to insomnia in the cancer population.

Chondrogenic potential of manganese-loaded composite scaffold combined with chondrocytes for articular cartilage defect.

Cartilage is an alymphatic, avascular and non-innervated tissue. Lack of potential regenerative capacity to reconstruct chondral defect has accelerated investigation and development of new strategy for cartilage repair. We prepared a manganese ion-incorporated natupolymer-based scaffold with chitosan-gelatin by freeze-drying procedure. The scaffold was characterized by Fourier transform infrared spectroscopy, thermogravimetric analysis, scanning electron microscopy, energy dispersive spectroscopy, compressive testing, and analysis of porosity and flexibility. Live/dead assay confirmed the good cytocompatibility of prepared scaffold on rat articular chondrocytes after 10 days and 4 weeks of culture. The manganese-loaded composite scaffold upregulated the expression of chondrogenic-related markers (Sox9, integrin, and Col II) in chondrocytes. Western blot analysis of proteins extracted from chondrocytes grown on scaffolds indicated the signaling pathways of p-Akt and p-ERK1/2 played a key role. Histological analysis following implantation of current composite scaffold loaded with chondrocytes into a rat articular cartilage defect model showed that the scaffolds promoted the formation of collagen II and cartilage repair. These findings suggested the potential of manganese-loaded scaffold to promote new cartilage formation and a promising strategy for articular cartilage engineering application.

Digital Breast Tomosynthesis: Update on Technology, Evidence, and Clinical Practice.

Digital breast tomosynthesis (DBT) has been widely adopted in breast imaging in both screening and diagnostic settings. The benefits of DBT are well established. Compared with two-dimensional digital mammography (DM), DBT preferentially increases detection of invasive cancers without increased detection of in-situ cancers, maximizing identification of biologically significant disease, while mitigating overdiagnosis. The higher sensitivity of DBT for architectural distortion allows increased diagnosis of invasive cancers overall and particularly improves the visibility of invasive lobular cancers. Implementation of DBT has decreased the number of recalls for false-positive findings at screening, contributing to improved specificity at diagnostic evaluation. Integration of DBT in diagnostic examinations has also resulted in an increased percentage of biopsies with positive results, improving diagnostic confidence. Although individual DBT examinations have a longer interpretation time compared with that for DM, DBT has streamlined the diagnostic workflow and minimized the need for short-term follow-up examinations, redistributing much-needed time resources to screening. Yet DBT has limitations. Although improvements in cancer detection and recall rates are seen for patients in a large spectrum of age groups and breast density categories, these benefits are minimal in women with extremely dense breast tissue, and the extent of these benefits may vary by practice environment and by geographic location. Although DBT allows detection of more invasive cancers than does DM, its incremental yield is lower than that of US and MRI. Current understanding of the biologic profile of DBT-detected cancers is limited. Whether DBT improves breast cancer-specific mortality remains a key question that requires further investigation. ©RSNA, 2021.

Breast MRI for Evaluation of Response to Neoadjuvant Therapy.

Neoadjuvant therapy is increasingly being used to treat early-stage triple-negative and human epidermal growth factor 2-overexpressing breast cancers, as well as locally advanced and inflammatory breast cancers. The rationales for neoadjuvant therapy are to shrink tumor size and potentially decrease the extent of surgery, to serve as an in vivo test of response to therapy, and to reveal prognostic information for the patient. MRI is the most accurate modality to demonstrate response to therapy and to help ensure accurate presurgical planning. Changes in lesion diameter, volume, and enhancement are used to predict complete response, partial response, or nonresponse to therapy. However, residual disease may be overestimated or underestimated at MRI. Fibrosis, necrotic tumors, and residual benign masses may be causes of overestimation of residual disease. Nonmass lesions, invasive lobular carcinoma, hormone receptor-positive tumors, nonconcentric shrinkage patterns, the use of antiangiogenic therapy, and late-enhancing foci may be causes of underestimation of residual disease. In patients with known axillary lymph node metastasis, neoadjuvant therapy may be followed by targeted axillary dissection to avoid the potential morbidity associated with an axillary lymph node dissection. Diffusion-weighted imaging, radiomics, machine learning, and deep learning methods are under investigation to improve MRI accuracy in predicting treatment response.©RSNA, 2021.

Effect of folic acid combined with docosahexaenoic acid intervention on mild cognitive impairment in elderly: a randomized double-blind, placebo-controlled trial.

PURPOSE: This study aimed to assess the effects of folic acid (FA) combined with a docosahexaenoic acid (DHA) intervention on the cognitive function and inflammatory cytokines in elderly subjects with mild cognitive impairment (MCI). METHODS: This randomized, double-blind, placebo-controlled trial recruited 240 individuals with MCI in Tianjin, China, and randomly allocated into 4 groups: FA + DHA (FA 800 µg/d + DHA 800 mg/d), FA (FA 800 µg/d), DHA (DHA 800 mg/d), and placebo. Cognitive function, serum folate and homocysteine (Hcy), plasma DHA and inflammatory cytokines levels were measured at baseline and 6 months. RESULTS: Daily oral FA, DHA and their combined use for 6 months significantly improved the full-scale intelligence quotient (FSIQ) and some subtests of Wechsler Adult Intelligence Scale compared to the placebo. The increases of FSIQ, arithmetic, picture completion scores in the FA group and picture completion, block design scores in the DHA group were significantly less than that in the FA combined DHA group (P < 0.05). Meanwhile, daily oral FA, DHA and their combined use for 6 months significantly decreased plasma inflammatory cytokines compared to the placebo. The changes of interleukin-1ß levels in the FA group and interleukin-6 levels in the DHA group were significantly less than that in the FA + DHA group (P < 0.05). CONCLUSIONS: Daily oral FA, DHA and their combined use for 6 months can significantly improve cognitive function and decrease plasma inflammatory cytokines in MCI individuals. The combination of FA and DHA was more beneficial than each individual nutrient on their own.