Prospective Evaluation of AI Triage of Pulmonary Emboli on CT Pulmonary Angiograms.

Background Artificial intelligence (AI) algorithms have shown high accuracy for detection of pulmonary embolism (PE) on CT pulmonary angiography (CTPA) studies in academic studies. Purpose To determine whether use of an AI triage system to detect PE on CTPA studies improves radiologist performance or examination and report turnaround times in a clinical setting. Materials and Methods This prospective single-center study included adult participants who underwent CTPA for suspected PE in a clinical practice setting. Consecutive CTPA studies were evaluated in two phases, first by radiologists alone (n = 31) (May 2021 to June 2021) and then by radiologists aided by a commercially available AI triage system (n = 37) (September 2021 to December 2021). Sixty-two percent of radiologists (26 of 42 radiologists) interpreted studies in both phases. The reference standard was determined by an independent re-review of studies by thoracic radiologists and was used to calculate performance metrics. Diagnostic accuracy and turnaround times were compared using Pearson χ2 and Wilcoxon rank sum tests. Results Phases 1 and 2 included 503 studies (participant mean age, 54.0 years ± 17.8 [SD]; 275 female, 228 male) and 1023 studies (participant mean age, 55.1 years ± 17.5; 583 female, 440 male), respectively. In phases 1 and 2, 14.5% (73 of 503) and 15.9% (163 of 1023) of CTPA studies were positive for PE (P = .47). Mean wait time for positive PE studies decreased from 21.5 minutes without AI to 11.3 minutes with AI (P < .001). The accuracy and miss rate, respectively, for radiologist detection of any PE on CTPA studies was 97.6% and 12.3% without AI and 98.6% and 6.1% with AI, which was not significantly different (P = .15 and P = .11, respectively). Conclusion The use of an AI triage system to detect any PE on CTPA studies improved wait times but did not improve radiologist accuracy, miss rate, or examination and report turnaround times. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Murphy and Tee in this issue.

Genome-wide association study unravels genomic regions associated with chlorophyll fluorescence parameters in wheat (Triticum aestivum L.) under different sowing conditions.

KEY MESSAGE: Genome-wide association study identified 205 significant marker-trait associations for chlorophyll fluorescence parameters in wheat. Candidate gene mining, in silico expression, and promoter analyses revealed the potential candidate genes associated with the studied parameters. The present study investigated the effect of varied sowing conditions (viz., early, timely, and late) on different chlorophyll fluorescence parameters in diverse wheat germplasm set comprising of 198 lines over two cropping seasons (2020-2021 and 2021-2022). Further, a genome-wide association study was conducted to identify potential genomic regions associated with these parameters. The results revealed significant impacts of sowing conditions on all fluorescence parameters, with the maximum and minimum effects on FI (26.64%) and FV/FM (2.12%), respectively. Among the 205 marker-trait associations (MTAs) identified, 11 high-confidence MTAs were chosen, exhibiting substantial effects on multiple fluorescence parameters, and each explaining more than 10% of the phenotypic variation. Through gene mining of genomic regions encompassing high-confidence MTAs, we identified a total of 626 unique gene models. In silico expression analysis revealed 42 genes with an expression value exceeding 2 TPM. Among them, 10 genes were identified as potential candidate genes with functional relevance to enhanced photosynthetic efficiency. These genes mainly encoded for the following important proteins/products-ankyrin repeat protein, 2Fe-2S ferredoxin-type iron-sulfur-binding domain, NADH-ubiquinone reductase complex-1 MLRQ subunit, oxidoreductase FAD/NAD(P)-binding, photosystem-I PsaF, and protein kinases. Promoter analysis revealed the presence of light-responsive (viz., GT1-motif, TCCC-motif, I-box, GT1-motif, TCT-motif, and SP-1) and stress-responsive (viz., ABRE, AuxRR-core, GARE-motif, and ARE) cis-regulatory elements, which may be involved in the regulation of identified putative candidate genes. Findings from this study could directly help wheat breeders in selecting lines with favorable alleles for chlorophyll fluorescence, while the identified markers will facilitate marker-assisted selection of potential genomic regions for improved photosynthesis.

Influence of speech aid prosthesis with speech therapy on speech outcomes in adult patients with persisting velopharyngeal insufficiency: A retrospective analysis.

STATEMENT OF PROBLEM: Prosthetic intervention with a speech aid prosthesis (SAP) along with speech therapy has been reported to improve speech outcomes in patients with persisting velopharyngeal insufficiency (VPI). However, little is known regarding the impact of this treatment on different speech parameters over time in adult patients with VPI. PURPOSE: The purpose of this retrospective study was to evaluate the change in speech parameters after rehabilitation with an SAP and speech therapy in adult patients with VPI using subjective and objective tests. MATERIAL AND METHODS: Patients above 16 years of age who had received prosthetic treatment for VPI and had complete speech assessment records between 2017 and 2020 were included in the analysis. After completion of the prosthetic treatment, speech therapy comprising 2 sessions per week of 45 minutes was provided by a speech pathologist. Speech evaluation was performed using tests that included speech intelligibility calculation, nasal pinch test, audible nasal air emissions, acoustic analysis, and the nasalance check. Assessments were done at 4 time intervals: T0: without an SAP; T1: 1 week with an SAP; T2: 1 month with an SAP; and T3: 3 months with an SAP. A descriptive analysis was followed by a comparison between groups using the Friedman test for subjective assessments and repeated measures ANOVA for objective tests (α=.05). RESULTS: Of 10 individuals who had received an SAP, 5 participants, 2 men and 3 women with a mean age of 38 years were included in the analysis. Statistically significant improvement in mean scores was observed from T0 to T3 concerning speech intelligibility (P<.001), hypernasality (P<.001), audible nasal air emission (P<.001), mean fundamental frequency (P=.034), shimmer percentage (P=.004), and nasalance (P=.004). Improvement in jitter percentage was not statistically significant (P=.218). CONCLUSIONS: An SAP along with speech therapy should be considered as a conservative and effective treatment option for addressing speech issues in adult patients with VPI.

Effects of Secondary Alveolar Bone Grafting on Maxillary Growth in Cleft Lip or Palate Patients: A Systematic Review and Meta-Analysis.

To assess the effect of secondary alveolar bone grafting (SABG) on maxillary growth in patients with unilateral cleft lip or palate (UCL/P).Systematic review and Meta-analysis.Pubmed, Cochrane Library, Embase, Scopus, Web of Science and manual search was performed to assess the maxillary growth following SABG in UCL/P patients.Non-syndromic patients with UCL/P.Comparison of maxillary growth between patients with UCL/P who underwent SABG and UCL/P patients who had not undergone SABG or non-cleft control.39 of the identified 233 articles were assessed for inclusion and exclusion criteria after duplicate removal and title and abstract reading. 7 articles (1 prospective, and 6 retrospective studies) were included in the qualitative analysis and 2 articles were subjected to quantitative analysis. Four studies had a low risk of bias and three studies had a moderate risk of bias. Meta-analysis revealed a significant reduction of SNA and no significant difference in ANB in the SABG group compared to the non-cleft control group(I2 = 0%). There was no significant difference in ANB between SABG and non-cleft control; however, results showed high heterogeneity(I2 = 83%). Meta-analysis of SNA and ANB showed no significant difference between SABG and the cleft control group; however, there was high heterogeneity.The studies showed a low to moderate risk of bias. SABG causes inhibition of maxillary growth in patients with cleft lip or palate when compared to patients with non-cleft control. Due to high heterogeneity, comparison to cleft control showed insufficient evidence.

Marker trait association for biological nitrogen fixation traits in an interspecific cross of chickpea (Cicer arietinum × Cicer reticulatum).

A set of 165 Recombinant inbred lines (RILs) derived from an interspecific cross of chickpea was used to identify QTLs for key biological nitrogen fixation (BNF) traits. The phenotyping of BNF and related traits was done at two different agroclimatic zones viz., Central plain zone (Ludhiana) and Sub-Mountainous undulating zone (Gurdaspur) for 2 consecutive rabi seasons (2018-2020). Wild parent C. reticulatum ILWC292 showed significantly high performance in terms of biological nitrogen fixation (BNF) traits over the cultivated C. arietinum GPF-2. The triple interaction of genotypes × locations × years was significant (p 0.05) for all BNF traits in parental lines. Highly significant positive correlation was obtained between grain yield and key growth and symbiotic parameters at both the sites. Phenotypic analysis revealed nodule dry weight and leghaemoglobin content as key traits for BNF efficiency and contrasting DNA bulks were constituted on the basis of these traits. Out of 535 SSR markers, 139 exhibited polymorphism between the parental lines on polyacrylamide gel electrophoresis. A total of 30 SSR markers showed polymorphism between the higher and lower bulks for nodule dry weight and leghaemoglobin content. Out of these, 20 SSRs did not show any segregation distortion in RIL population as determined by chi square analysis (p < 0.05) and were used for quantitative trait loci (QTL) analysis. Using QTL cartographer, markers- CAGM02697, CAGM09835, CAGM09777, CAGM09227, CAGM09021, CAGM08679 were found linked with QTLs for BNF. These markers can be validated further for identification of genes for BNF traits and marker assisted selection in chickpea. To the best of our knowledge this is the first report on identification of genomic regions associated with key BNF traits in chickpea across different agro-climatic zones. Supplementary information: The online version contains supplementary material available at 10.1007/s12298-023-01335-3.

Unravelling consensus genomic regions associated with quality traits in wheat using meta-analysis of quantitative trait loci.

MAIN CONCLUSION: Meta-analysis in wheat for three major quality traits identified 110 meta-QTL (MQTL) with reduced confidence interval (CI). Five GWAS validated MQTL (viz., 1A.1, 1B.2, 3B.4, 5B.2, and 6B.2), each involving more than 20 initial QTL and reduced CI (95%) (< 2 cM), were selected for quality breeding programmes. Functional characterization including candidate gene mining and expression analysis discovered 44 high confidence candidate genes associated with quality traits. A meta-analysis of quantitative trait loci (QTL) associated with dough rheology properties, nutritional traits, and processing quality traits was conducted in wheat. For this purpose, as many as 2458 QTL were collected from 50 interval mapping studies published during 2013-2020. Of the total QTL, 1126 QTL were projected onto the consensus map saturated with 249,603 markers which led to the identification of 110 meta-QTL (MQTL). These MQTL exhibited an 18.84-fold reduction in the average CI compared to the average CI of the initial QTL (ranging from 14.87 to 95.55 cM with an average of 40.35 cM). Of the 110, 108 MQTL were physically anchored to the wheat reference genome, including 51 MQTL verified with marker-trait associations (MTAs) reported from earlier genome-wide association studies. Candidate gene (CG) mining allowed the identification of 2533 unique gene models from the MQTL regions. In-silico expression analysis discovered 439 differentially expressed gene models with > 2 transcripts per million expressions in grains and related tissues, which also included 44 high-confidence CGs involved in the various cellular and biochemical processes related to quality traits. Nine functionally characterized wheat genes associated with grain protein content, high-molecular-weight glutenin, and starch synthase enzymes were also found to be co-localized with some of the MQTL. Synteny analysis between wheat and rice MQTL regions identified 23 wheat MQTL syntenic to 16 rice MQTL associated with quality traits. Furthermore, 64 wheat orthologues of 30 known rice genes were detected in 44 MQTL regions. Markers flanking the MQTL identified in the present study can be used for marker-assisted breeding and as fixed effects in the genomic selection models for improving the prediction accuracy during quality breeding. Wheat orthologues of rice genes and other CGs available from MQTLs can be promising targets for further functional validation and to better understand the molecular mechanism underlying the quality traits in wheat.

Colored wheat and derived products: key to global nutritional security.

Ensuring food and nutritional security of fast-growing population will pose a huge challenge in future. An estimated one-half population who does not go hungry, nonetheless suffers the debilitating effects of unhealthy diets. In view of the nutritional awareness, when the major wheat breeding programs have started shifting to quality, instead of quantity in wheat, the colored wheats give a novel twist of targeting the malnutrition by enhancing the antioxidants such as anthocyanin, carotenoids, flavonoids, polyphenols etc. Moreover, changing consumer demands have picked the trend to prefer a nutritionally balanced diet over the conventional high energy diets and thus, colored wheat has opened up a hidden avenue for providing additional value to the wheat-based products. Besides providing nutrition, these pigments have the potential to replace the synthetic dyes and food colorants prevalent in the market. The review summarizes the genetics and biochemistry of the pigments of colored wheat along with their product development, nutritional status and consumer preference. The review also sheds light on the environmental effect on color accumulation and the effect of increased colorants on other quality traits of wheat.

Bread wheat with enhanced grain carotenoid content: a novel option for wheat biofortification.

Colored wheat has piqued the interest of breeders and consumers alike. The chromosomal segment from 7E of Thinopyrum ponticum, which carries a leaf rust resistant gene, Lr19, has been rarely employed in wheat breeding operations due to its association with the Y gene, which gives a yellow tint to the flour. By prioritizing nutritional content over color preferences, consumer acceptance has undergone a paradigm change. Through marker-assisted backcross breeding, we introduced an alien segment harboring the Y (PsyE1) gene into a high yielding commercial bread wheat (HD 2967) background to generate rust resistant carotenoid biofortified bread wheat. Agro-morphological characterization was also performed on a subset of developed 70 lines having enhanced grain carotene content. In the introgression lines, carotenoid profiling using HPLC analysis demonstrated a considerable increase in ß-carotene levels (up to 12 ppm). Thus, the developed germplasm caters the threat to nutritional security and can be utilized to produce carotenoid fortified wheat. Supplementary Information: The online version contains supplementary material available at 10.1007/s11032-022-01338-0.

Evaluation of Quantitative Aspects of Craniofacial Deformities in Transfusion Dependent Beta-Thalassemia Major Patients: A Cephalometric Study.

PURPOSE: To evaluate the quantitative (cephalometric) aspects of the craniofacial deformities in transfusion-dependent beta-thalassemia (TDT) patients. MATERIALS AND METHODS: Sixty-five TDT patients receiving a regular blood transfusion in the Department of Pediatrics of age group 5 to 8 years (younger) and 15 years and above (older) were compared with control groups of similar age using cephalograms (lateral and posterior-anterior view). RESULTS AND OBSERVATION: The prevalence of skeletal class II tendency is higher in thalassemic patients that do not improve with age. The thalassemic patients were found to show large angle ANB i.e. Angle between points point a, nasion and point B (ANB), large flexure angle, small angle SNB i.e. Angle between points sella, nasion and point B (SNB), and normal angle SNA i.e. Angle between points sella, nasion and point A (SNA) angles suggestive of retrognathic mandible. The thalassemic patients were observed to have smaller transverse widths and thickened calvarium on the posterior-anterior view. CONCLUSION: The skeletal class II malocclusion appears to be a manifestation of generalized growth retardation/delayed puberty in thalassemic patients leading to diminished mandibular growth, rather than maxillary prognathism due to marrow hyperplasia.

Comparative Assessment of Autogenous Cancellous Bone Graft and Bovine-Derived Demineralized Bone Matrix for Secondary Alveolar Bone Grafting in Patients With Unilateral Cleft Lip and Palate.

OBJECTIVE: Comparison between bovine-derived demineralized bone matrix (DMBM) and iliac crest graft over long term for secondary alveolar bone grafting (SABG) in patients with unilateral cleft lip and palate (UCLP) in terms of radiological and clinical outcomes. DESIGN: Prospective, randomized, parallel groups, double-blind, controlled trial. SETTING: Unit of Oral and Maxillofacial Surgery, Oral Health Science Centre, Postgraduate Institute of Medical Education & Research, Chandigarh. PARTICIPANTS: Twenty patients with UCLP. INTERVENTIONS: Patients were allocated into group I (Iliac crest bone graft) and group II (DMBM) for SABG. Outcomes were assessed at 2 weeks, 6 months, and then after mean follow-up period of 63 months. OUTCOMES MEASURES: Volumetric analysis of the grafted bone in the alveolar cleft site was done through cone beam computed tomography using Cavalieri principle and modified assessment tool. Clinical assessment was performed in terms of pain, swelling, duration of hospital stay, cost of surgery, alar base symmetry, and donor site morbidity associated with iliac crest harvesting. RESULTS: Volumetric analysis through Cavalieri principle revealed comparable bone uptake at follow-up of 6 months between group I (70%) and group II (69%). Modified assessment tool showed no significant difference between horizontal and vertical bone scores over short- and long-term follow-up. In group II, there was higher cost of surgery, but no donor site morbidity unlike group I. CONCLUSIONS: Demineralized bone matrix proved analogous to iliac crest bone graft as per volumetric analysis over shorter period. However, although statistically insignificant, net bone volume achieved was lower than the iliac crest graft at longer follow-up.

Nasalance Scores as a Function of Skeletal Malocclusion of English-Speaking Adults in the North Indian Population.

OBJECTIVE: The objective of this study is quantitative assessment of nasalance for skeletal Class I (normative values), Class II, and III malocclusion in the English language for the North Indian population and to compare the normative values with the nasalance scores obtained from individuals with skeletal Class II and III malocclusion and to evaluate the normative values as a function of gender. MATERIAL AND METHODS: The study was conducted on a total sample of 200 patients with 100, 50, and 50 in group 1 (control group, Skeletal Class I), group 2 (Skeletal Class II), and group 3 (Skeletal Class III), respectively. ANB angle (anteroposterior angle formed by point A, nasion, and point B) measured on lateral cephalogram was used to categorize the patients into 3 groups. The normative nasalance scores were compared for males and females in the control group. The nasalance scores of skeletal Class II and III subjects were compared to the combined normative scores of the control group. The NasalView was used for the objective assessment of nasalance. Oral syllables (/pa/and/pi/), nasal syllables (/ma/and/mi/), and 3 passages (Zoo passage, Rainbow passage, and Nasal sentences) were used to determine the nasalance scores. RESULTS: The intragroup comparison of nasalance scores in group 1 showed statistically significant differences for different stimuli. The gender-related comparison showed no statistically significant differences in nasalance scores. The intergroup comparison of nasalance scores for skeletal malocclusion showed no statistically significant differences for different stimuli except statistically significant lower nasalance values for nasal sentences in group 3 compared to the control group. CONCLUSION: The study concluded that the nasalance scores for nasal sentences in skeletal Class III malocclusion were significantly lower than in the control group and were not statistically significant between the 3 groups for all other stimuli.

Strategies for accelerating genetic gains in crop plants: special focus on speed breeding.

Feeding 10 billion people sustainably by 2050 in the era of slow genetic progress has spurred urgent calls to bring more crops per unit time. Over the last century, crop physiologists and breeders have been trying to alter plant biology to investigate and intervene in developmental processes under controlled chambers. Accelerating the breeding cycle via "speed breeding" was the outcome of these experiments. Speed breeding accelerates the genetic gain via phenome and genome-assisted trait introgression, re-domestication, and plant variety registration. Furthermore, early varietal release through speed breeding offers incremental benefits over conventional methods. However, a lack of resources and species-specific protocols encumber the technological implementation, which can be alleviated by reallocating funds to establish speed breeding units. This review discusses the limitations of conventional breeding methods and various alternative strategies to accelerate the breeding process. It also discusses the intervention at various developmental stages to reduce the generation time and global impacts of speed breeding protocols developed so far. Low-cost, field-based speed breeding protocol developed by Punjab Agricultural University, Ludhiana, Punjab, India to harvest at least three generations of wheat in a year without demanding the expensive greenhouses or growth chambers is also discussed.

Multiinstitutional U.S. Academic Radiology Perspectives on Inpatient Diagnostic Imaging of Patients With Coronavirus Disease (COVID-19) and Persons Under Investigation.

OBJECTIVE. This article presents the perspectives of radiologists in different sub-specialties at three institutions across the United States regarding inpatient imaging of patients confirmed to have coronavirus disease (COVID-19) and persons under investigation (i.e., patients suspected to have COVID-19). CONCLUSION. The COVID-19 pandemic has prompted radiologists to become aware of imaging findings related to the disease and to develop workflows for the imaging of patients with COVID-19 and persons under investigation, to optimize care for all patients and preserve the health of health care workers.

Inter-estuarine and seasonal to decadal variations of heavy metal pollution in the Gulf of Cambay, India.

Toxic heavy metals adsorbed preferentially onto suspended sediments enter our food chain by bio-assimilation in coastal ocean organisms. To decipher metal pollution status in the Gulf of Cambay (food hub of India) under rising anthropogenic pressure, we present seasonal abundances of Ti, Cr, Co, Ni, Cu, Zn, Cd, and Pb in > 150 samples of suspended sediments (> 0.45 µm) collected in four seasons (2016-2017) from two large estuaries (Narmada and Tapi). The suspended sediments of both the estuaries generally show low heavy metal pollution (Igeo < 1). The hotspots of moderate-to-high pollution of Pb (Igeo < 4), Cd (Igeo < 3), and Zn (Igeo < 2) are found at salinity < 2, and those of Co (Igeo < 2) at salinity ~ 20-30 in the Tapi estuary during the non-monsoon seasons indicating their decoupled sources in Surat. The PLI values show no or little seasonality in the overall metal pollution status of both the estuaries. A comparison with the literature data suggests that suspended sediments efficiently capture active metal pollution in Indian estuaries. Furthermore, a recent decline (2004-2017) in estuarine metal pollution in the Gulf of Cambay found in this study could be due to enhanced organic matter supplies by enhanced urban sewage discharge and/or more trapping of contaminated riverine sediments upstream of the newly built large dam reservoirs counteracting the growth of anthropogenic metal inputs in the Narmada and Tapi watersheds. The data scarcity of heavy metal concentrations in suspended sediments limits reporting unambiguously the current pollution status of other major Indian estuaries.

Primary Intrathoracic Sarcomas: A Review of Cross-sectional Imaging and Pathology.

The most common sarcomas in the thorax are metastasis from an extrathoracic primary malignancy. Primary intrathoracic sarcomas are rare albeit aggressive malignancies that are diagnosed on histopathology. Although a few imaging characteristics have been described that are common to sarcomas, it is still a diagnosis of exclusion as other tumors are much more common. Like elsewhere, primary thoracic sarcomas are also classified according to their histologic features. They are a rare group of tumors that can arise from the mediastinal structures, lung, pleura, or chest wall. On imaging, differentiating these from more common malignancies like lung cancer is difficult and often requires multimodality workup and tissue sampling. A few sarcomas are very specific to their locations, such as angiosarcoma in the right atrium, leiomyosarcoma in the pulmonary artery, where imaging has high accuracy for the diagnosis. Despite being nonspecific in a majority of cases, imaging plays a pivotal role in determining the organ of origin, tumor extent, invasion of adjacent structures, and thus help to assess the surgical resectability. Although sarcomas arising from chest wall are the most common primary sarcomas in the chest, they are excluded from this review to focus only on primary intrathoracic sarcomas. The article provides a comprehensive imaging and pathology review of the rare primary intrathoracic sarcomas, including but not limited to angiosarcoma, Kaposi sarcoma, fibrosarcoma, malignant transformation of fibrous tumor of pleura, sarcomatoid mesothelioma, leiomyosarcoma, and malignant small round blue cell tumors.Key points:Primary intrathoracic sarcomas are rare but clinically important.Imaging helps to determine local extent, invasion, metastases and appropriate site/mode of biopsy.Role of pathology is paramount in diagnosis and guiding treatment based on immunogenetic/molecular typing.

Conformational dynamics of a neurotransmitter:sodium symporter in a lipid bilayer.

Neurotransmitter:sodium symporters (NSSs) are integral membrane proteins responsible for the sodium-dependent reuptake of small-molecule neurotransmitters from the synaptic cleft. The symporters for the biogenic amines serotonin (SERT), dopamine (DAT), and norepinephrine (NET) are targets of multiple psychoactive agents, and their dysfunction has been implicated in numerous neuropsychiatric ailments. LeuT, a thermostable eubacterial NSS homolog, has been exploited as a model protein for NSS members to canvass the conformational mechanism of transport with a combination of X-ray crystallography, cysteine accessibility, and solution spectroscopy. Despite yielding remarkable insights, these studies have primarily been conducted with protein in the detergent-solubilized state rather than embedded in a membrane mimic. In addition, solution spectroscopy has required site-specific labeling of nonnative cysteines, a labor-intensive process occasionally resulting in diminished transport and/or binding activity. Here, we overcome these limitations by reconstituting unlabeled LeuT in phospholipid bilayer nanodiscs, subjecting them to hydrogen-deuterium exchange coupled with mass spectrometry (HDX-MS), and facilitating interpretation of the data with molecular dynamics simulations. The data point to changes of accessibility and dynamics of structural elements previously implicated in the transport mechanism, in particular transmembrane helices (TMs) 1a and 7 as well as extracellular loops (ELs) 2 and 4. The results therefore illuminate the value of this strategy for interrogating the conformational mechanism of the more clinically significant mammalian membrane proteins including SERT and DAT, neither of which tolerates complete removal of endogenous cysteines, and whose activity is heavily influenced by neighboring lipids.

Usefulness of right ventricular strain assessment in submassive pulmonary thromboembolism undergoing ultrasound-facilitated thrombolysis.

Massive and submassive pulmonary thromboembolism carry significant morbidity and mortality. We present an elderly female who was diagnosed with a submassive pulmonary embolism by computed tomographic angiography and treated with ultrasound-facilitated thrombolysis (UFT). This case demonstrates the usefulness of right ventricular longitudinal strain measurements by two-dimensional speckle tracking echocardiography in the evaluation of right ventricular function before and after UFT. Evaluation of right ventricle longitudinal strain by speckle tracking echocardiography may supplement other parameters in the assessment of right ventricular function in these patients.

Thoracic versus nonthoracic MR imaging for patients with an MR nonconditional cardiac implantable electronic device.

BACKGROUND: Observational studies have explored the safety of magnetic resonance (MR) scanning of patients with cardiac implantable electronic devices (CIEDs) that are not Food and Drug Administration approved for MR scanning ("nonconditional"). However, concern has been raised that MR scanning that includes the thoracic region may pose a higher risk. This study examines the safety of MR scanning of thoracic versus nonthoracic regions of patients with CIEDs. METHODS: Patients underwent MR scanning utilizing an institutional protocol. CIED variables examined included sensing value, pacing capture threshold, lead impedance, and battery voltage. Regression analysis of the CIED variable differences (pre- to immediately post-MR and pre-MR to long-term follow-up) was performed to determine if CIED variable differences were dependent on region scanned (thoracic vs nonthoracic), time from CIED implant to MR scanning, or CIED type (pacemaker vs implantable cardioverter defibrillator). RESULTS: 238 patients (38% female, age 65 ± 15 years) underwent 339 MR scans, including 99 MR scans of the thoracic region. CIED variable differences to immediately post-MR or to long-term follow-up were not significantly different from zero (P > 0.05) and there was no dependence upon region scanned (thoracic vs nonthoracic), time from CIED implant to MR scan, or CIED type. One power-on reset occurred in a patient that underwent a cardiac MR and the CIED was successfully reprogrammed. There were no clinical adverse effects. CONCLUSIONS: CIED variable differences following MR scan were not dependent on the region scanned (thoracic vs nonthoracic) and there were no clinical adverse effects in this prospective cohort.