Diagnostic performance of ultrasound reporting systems in evaluation of adnexal masses: A prospective observational study.

OBJECTIVE(S): To evaluate and compare diagnostic performance of ultrasound-based reporting systems IOTA SR, ADNEX, GIRADS, ORADS for discrimination between benign and malignant adnexal masses. STUDY DESIGN: A prospective observational study in a tertiary care hospital's Obstetrics and Gynaecology department evaluated pre-operative ultrasound imaging for adnexal masses in 80 cases, comparing various reporting systems' sensitivity and specificity against histopathology as gold standard using STATA version 17.0 for data analysis. RESULTS: Among the 80 masses, 55 % (44/80) were confirmed as benign on histopathology, while 45 % were identified as malignant. The sensitivity and specificity of SR was 100 % (95 %CI: 90.0-100) and 97.1 % (95 %CI: 84.7-99.9) respectively. Eleven masses (13.8 %) were inconclusive, reducing specificity to 75 % (95 %CI:59.7-86.8).In ADNEX optimal cut-off for risk of malignancy was 34.1 % with sensitivity of 86.1 % (95 % CI: 70.5-95.3) and specificity of 90.9 % (95 % CI: 78.3-97.5). Considering GIRADS 4-5 and risk threshold of ≥10 % (ORADS 4-5) as predictors of malignancy sensitivity was 100 % (95 %CI: 90.3-100) and specificity was 70.5 % (95 %CI: 54.8-83.2) for GIRADS and ORADS. All reporting systems were comparable (p = 0.7). ADNEX identified 72.7 % (8/11) of inconclusive cases, outperforming GIRADS/ORADS which correctly classified 27.2 % (3/11) cases. When applied to misclassified GIRADS/ORADS 4-5 category, ADNEX demonstrated superior performance by correctly classifying 76.9 % (10/13) masses, while SR achieved correct classification in only 38.5 % (5/13) masses. CONCLUSION(S): All classification systems showed comparable accuracy in malignancy risk identification on imaging. GIRADS/ORADS tended to overestimate malignancy risk. The present study recommends a two-step strategy, leveraging higher specificity of ADNEX model for improved stratification of adnexal masses.

Exploring the amyloid degradation potential of nanoformulated carrageenan-bridging in vitro and in vivo perspectives.

Amyloids, with their ß-sheet-rich structure, contribute to diabetes, neurodegenerative diseases, and amyloidosis by aggregating within diverse anatomical compartments. Insulin amyloid (IA), sharing structural resemblances with amyloids linked to neurological disorders, acts as a prototype, while compounds capable of degrading these fibrils hold promise as therapeutic agents for amyloidosis intervention. In this research, liposomal nanoformulated iota carrageenan (nCG) was formulated to disrupt insulin amyloids, demonstrating about a 17-20 % higher degradation efficacy compared to conventional carrageenan through thioflavin T fluorescence, dynamic light scattering analysis, and turbidity quantification. The biocompatibility of the nCG and nCG-treated insulin amyloids was evaluated through MTT assay, live-dead cell assay on V79 cells, and hemolysis testing on human blood samples to establish their safety for use in vivo. Zebrafish embryos were utilized to assess in vivo biocompatibility, while adult zebrafish were employed to monitor the degradation capacity of IA post subcutaneous injection, with fluorescence emitted by the fish captured via IVIS. This demonstrated that the formulated nCG exhibited superior anti-amyloid efficacy compared to carrageenan alone, while both materials demonstrated biocompatibility. Furthermore, through docking simulations, an exploration was conducted into the molecular mechanisms governing the inhibition of the target protein pancreatic insulin by carrageenan.

Analysis of Diagnostic Efficacy of the International Ovarian Tumor Analysis ADNEX Model and the ACR O-RADS US (Ovarian-Adnexal Reporting and Data System) for Benign and Malignant Ovarian Tumors: A Retrospective Study in a Tumor Center in Northeast China.

This study is to analyze and compare the diagnostic efficacy of the ADNEX model and O-RADS in Northeast China for benign and malignant ovarian-adnexal tumors. From July 2020 to February 2022, ultrasound images of 312 ovarian-adnexal masses included in the study were analyzed retrospectively, and the properties of these masses were identified using the ADNEX model and O-RADS. The diagnostic efficiency of the ADNEX model and O-RADS was analyzed using a ROC curve, and the capacities of the two models in differentiating benign and malignant ovarian masses at the optimum cutoff value were compared, as well as the consistency of their diagnosis results was evaluated. The study included 312 ovarian-adnexal masses, including 145 malignant masses and 167 benign masses from 287 patients with an average age of (46.8 ± 11.3) years. The AUC of the ADNEX model was 0.974, and the optimum cutoff value was the risk value > 24.2%, with the corresponding sensitivity and specificity being 97.93 and 86.83, respectively. The AUC of the O-RADS was 0.956, and the optimum cutoff value was > O-RADS 3, with the corresponding sensitivity and specificity being 97.24 and 85.03, respectively. The AUCs of the two models were 0.924 and 0.911 at the optimum cutoff values, with no statistical differences between them (P = 0.284). Consistency analysis: the kappa values of the two models for the determination and pathological results of masses were 0.840 and 0.815, respectively, and that for the diagnostic outcomes was 0.910. Both the ADNEX model and O-RADS had good diagnostic performance in people from Northeast China. Their diagnostic capabilities were similar, and diagnostic results were highly consistent at the optimum cutoff values.

Preparation of iota-carrageenan@bentonite@4-phenyl-3-thiosemicarbazide ternary hydrogel for adsorption of Losartan potassium and sulfamethoxazole.

A rising quantity of drugs has been discharged into the aquatic environment, posing a substantial hazard to public health. In the current work, a novel hydrogel (i.Carr@Bent@PTC), comprised of iota-carrageenan, bentonite, and 4-phenyl-3-thiosemicarbazide, was successfully prepared. The introduction of 4-phenyl-3-thiosemicarbazide and bentonite in iota-carrageenan significantly increased the mechanical strength of iota-carrageenan hydrogel and improved its degree of swelling, which can be attributed to the hydrophilic properties of PTC and Bent. The recorded contact angle was 70.8°, 59.1°, 53.9°, and 34.6° for pristine i.Carr, i.Carr@Bent, and i.Carr@Bent@PTC, respectively. The low contact angle measurement of the Bent and PTC loaded-i.Carr hydrogel was attributed to the hydrophilic Bent and PTC. The ternary i.Carr@Bent@PTC hydrogel demonstrated broad pH adaptability and excellent adsorption capacities for sulfamethoxazole (SMX) and losartan potassium (LP), i.e., 467.61 mg. g-1 and 274.43 mg. g-1 at 298.15 K, respectively. The pseudo-first-order (PSO) model provided a better fit for the adsorption kinetics. The adsorption of SMX and LP can be better explained by employing the Sips and Langmuir isotherm models. As revealed by XPS and FTIR investigations, π-π stacking, complexation, electrostatic interaction, and hydrogen bonding were primarily involved in the adsorption mechanisms.

Comparison of Simple Ultrasound Rules by International Ovarian Tumor Analysis (IOTA) with RMI-1 and RMI-4 (Risk of Malignancy Index) in Preoperative Differentiation of Benign and Malignant Adnexal Masses.

Background: IOTA proposed Simple Ultrasound Rules in 2009 for preoperative diagnosis of ovarian masses based on ultrasound only. It is an accurate, simple and inexpensive method. RMI, however, requires CA125 level. While RMI-4 is the latest, RMI-1 is still the most widely used method. The present study was done to compare IOTA Rules with RMI-1 and RMI-4. Purpose: To differentiate benign and malignant adnexal masses preoperatively using IOTA simple rules and compare its accuracy with RMI-1 and RMI-4. Methods: A prospective observational study was performed from 1st November 2019 to 31st March 2021 in the Department of Obstetrics and Gynaecology, ABVIMS and Dr. RML Hospital, New Delhi. This study was conducted on 70 patients with adnexal masses who underwent pre-operative evaluation using IOTA Simple Rules, RMI-1 and RMI-4. Histopathology was used to compare the results. Results: Out of 70 patients, 59 (84.3%) cases were benign and 11 (15.7%) were malignant. The IOTA Rules were applicable to 60 cases (85.7%), and the results were inconclusive in 10 cases (14.3%). Where applicable, the sensitivity and specificity of the IOTA Rules (88.9% and 94.1%, respectively) were significantly higher than RMI-1 (45.5% and 93.2%, respectively) and RMI-4 (45.5% and 89.8%, respectively). When inconclusive results were included as malignant, the sensitivity of the IOTA Rules increased (88.9% vs 90.9%); however, the specificity decreased (94.1% vs 81.4%). Conclusion: IOTA Simple Rules were more accurate at diagnosing benign from malignant adnexal masses than RMI-1 and RMI-4. However, the rules were not applicable to 14% of the cases.

Comparison of O-RADS with the ADNEX model and IOTA SR for risk stratification of adnexal lesions: a systematic review and meta-analysis.

Purpose: This study aims to systematically compare the diagnostic performance of the Ovarian-Adnexal Reporting and Data System with the International Ovarian Tumor Analysis Simple Rules and the Assessment of Different NEoplasias in the adneXa model for risk stratification of ovarian cancer and adnexal masses. Methods: A literature search of online databases for relevant studies up to July 2023 was conducted by two independent reviewers. The summary estimates were pooled with the hierarchical summary receiver-operating characteristic model. The quality of the included studies was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 and the Quality Assessment of Diagnostic Accuracy Studies-Comparative Tool. Metaregression and subgroup analyses were performed to explore the impact of varying clinical settings. Results: A total of 13 studies met the inclusion criteria. The pooled sensitivity and specificity for eight head-to-head studies between the Ovarian-Adnexal Reporting and Data System and the Assessment of Different NEoplasias in the adneXa model were 0.96 (95% CI 0.92-0.98) and 0.82 (95% CI 0.71-0.90) vs. 0.94 (95% CI 0.91-0.95) and 0.83 (95% CI 0.77-0.88), respectively, and for seven head-to-head studies between the Ovarian-Adnexal Reporting and Data System and the International Ovarian Tumor Analysis Simple Rules, the pooled sensitivity and specificity were 0.95 (95% CI 0.93-0.97) and 0.75 (95% CI 0.62-0.85) vs. 0.91 (95% CI 0.82-0.96) and 0.86 (95% CI 0.76-0.93), respectively. No significant differences were found between the Ovarian-Adnexal Reporting and Data System and the Assessment of Different NEoplasias in the adneXa model as well as the International Ovarian Tumor Analysis Simple Rules in terms of sensitivity (P = 0.57 and P = 0.21) and specificity (P = 0.87 and P = 0.12). Substantial heterogeneity was observed among the studies for all three guidelines. Conclusion: All three guidelines demonstrated high diagnostic performance, and no significant differences in terms of sensitivity or specificity were observed between the three guidelines.

Adsorption and antibacterial studies of a novel hydrogel adsorbent based on ternary eco-polymers doped with sulfonated graphene oxide developed from upcycled plastic waste.

A novel ternary blended polymer composed of cost-effective and readily available polymers was synthesized using poly (vinyl alcohol) (PVA), iota carrageenan (IC), and poly (vinyl pyrrolidone) (PVP). Sulfonated graphene oxide (SGO), prepared from recycled drinking water bottles, was utilized as a doping agent. Varying amounts (1-3 wt%) were combined into the polymer matrix. The produced hydrogel film was examined as a potential adsorbent hydrogel film for the removal of methylene blue (MB) and Gentamicin sulfate (GMS) antibiotic from an aqueous solution. The experimental results demonstrate that the presence of SGO significantly increased the adsorption efficiency of PVA/IC/PVP hydrogel film. The antimicrobial tests revealed that the PVA/IC/PVP-3% SGO hydrogel film exhibited the most potent activity against all the tested pathogenic bacteria. However, the adsorption results for MB and GMS showed that the addition of 3 wt% SGO resulted in a removal percentage that was a two fold increase in the removal percentage compared with the undoped PVA/IC/PVP hydrogel film. Furthermore, the response surface methodology (RSM) model was utilized to examine and optimize several operating parameters, including time, pH of the solution, and initial pollutant concentration. The adsorption kinetics were better characterized by the pseudo-second-order kinetics model. The composite film containing 3 wt% SGO had a maximum adsorption capacity of 606 mg g-1 for MB and 654 mg g-1 for GMS, respectively. The generated nanocomposite hydrogel film demonstrated promising potential for application in water purification systems.

Development and characterization of semi-refined iota carrageenan/fish gelatin-based biocomposite film incorporated with SiO2/ZnO nanoparticles.

Food packaging based on natural polymers from polysaccharides and proteins can be an alternative to replace conventional plastics. In the present study, semi-refined iota carrageenan (SRIC) and fish gelatin (FG) were used as polymer matrix film with different concentration ratios (0.5:1.5 %, 1.0:1.0 % and 1.5:0.5 % w/w) and SiO2-ZnO nanoparticles were incorporated as fillers with the same concentration in all formulas (0.5:1.5 % w/w carrageenan-fish gelatin). This study aimed to develop films for food packaging applications with desirable physical, mechanical, optical, chemical, and microbiological properties. The results showed that incorporating SiO2-ZnO nanoparticles significantly (p < 0.05) improved the films' elongation at break, UV-screening properties, and antimicrobial activity. Also, the films' thickness, degradability, and transparency significantly (p < 0.05) increased with the higher concentration of fish gelatin addition in the SRIC matrix polymer. The best formula was obtained on the SRIC-FG film at the ratio of 1.5:0.5 % w/w, which performed excellent antimicrobial activity. Thus, semi-refined iota carrageenan/fish gelatin-based biocomposite film incorporated with SiO2-ZnO nanoparticles can be potentially developed as eco-friendly and intelligent food packaging materials to resolve traditional plastic-related issues and prevent food waste.

E3 ubiquitin ligase RNF2 protects polymerase ι from destabilization.

Human DNA polymerase ι (Polι) belongs to the Y-family of specialized DNA polymerases engaged in the DNA damage tolerance pathway of translesion DNA synthesis that is crucial to the maintenance of genome integrity. The extreme infidelity of Polι and the fact that both its up- and down-regulation correlate with various cancers indicate that Polι expression and access to the replication fork should be strictly controlled. Here, we identify RNF2, an E3 ubiquitin ligase, as a new interacting partner of Polι that is responsible for Polι stabilization in vivo. Interestingly, while we report that RNF2 does not directly ubiquitinate Polι, inhibition of the E3 ubiquitin ligase activity of RNF2 affects the cellular level of Polι thereby protecting it from destabilization. Additionally, we indicate that this mechanism is more general, as DNA polymerase η, another Y-family polymerase and the closest paralogue of Polι, share similar features.

Toward Verification of DAG-Based Distributed Ledger Technologies through Discrete-Event Simulation.

As the potential of directed acyclic graph (DAG)-based distributed ledgers in IoT systems unfolds, a need arises to understand their intricate dynamics in real-world scenarios. It is well known that discrete event simulations can provide high-fidelity evaluations of protocols. However, there is a lack of public discrete event simulators capable of assessing DAG-based distributed ledgers. In this paper, a discrete-event-based distributed ledger simulator is introduced, with which we investigate a custom Python-based implementation of IOTA's Tangle DAG protocol. The study reveals the dynamics of Tangle (particularly Poisson processes in transaction dynamics), the efficiency and intricacies of the random walk in Tangle, and the quantitative assessment of node convergence. Furthermore, the research underscores the significance of weight updates without depth limitations and provides insights into the role, challenges, and implications of the coordinator/validator in DAG architectures. The results are striking, and although the findings are reported only for Tangle, they demonstrate the need for adaptable and versatile discrete event simulators for DAG architectures and tip selection methodologies in general.

Validation of ADNEX and IOTA two-step strategy and estimation of risk of complications during follow-up of adnexal masses in low-risk population.

OBJECTIVES: To evaluate the ability of the Assessment of Different NEoplasias in the adneXa (ADNEX) model and the International Ovarian Tumour Analysis (IOTA) two-step strategy to predict malignancy in adnexal masses detected in an outpatient low-risk setting, and to estimate the risk of complications in masses with benign ultrasound morphology managed using clinical and ultrasound follow-up. METHODS: This single-center study was performed at Hospital Universitari Dexeus, Barcelona, Spain, using interim data from the ongoing prospective observational IOTA Phase-5 (IOTA5) study. The primary aim of the IOTA5 study is to describe the cumulative incidence of complications during follow-up of adnexal masses classified as benign on ultrasound examination. Consecutive patients with an adnexal mass detected between June 2012 and September 2016 in a private center offering screening for gynecological cancer were included and followed up until February 2020. Tumors were classified as benign or malignant based on histology (if patients underwent surgery) or the outcome of clinical and ultrasound follow-up at 12 (range, 10-14) months. Multiple imputation was used when outcomes were uncertain. The ability of the ADNEX model without CA125 and of the IOTA two-step strategy to distinguish benign from malignant masses was evaluated retrospectively using the prospectively collected data. We assessed performance with regard to discrimination (area under the receiver-operating-characteristics curve (AUC)), calibration, classification (sensitivity and specificity) and clinical utility (Net Benefit). In the group of patients with a mass judged to be benign who were selected for conservative management, we evaluated the occurrence of spontaneous resolution or any mass complication during the first 5 years of follow-up by assessing the cumulative incidence of malignancy, torsion, cyst rupture and minor mass complications (inflammation, infection or adhesions) and the time to occurrence of an event. RESULTS: A total of 2654 patients were recruited to the study. After application of exclusion criteria, 2039 patients with a newly detected mass were included for the model validation. Of those, 1684 (83%) masses were benign, 49 (2%) masses were malignant and, for 306 (15%) masses, the outcome was uncertain and therefore imputed. The AUC was 0.95 (95% CI, 0.89-0.98) for ADNEX without CA125 and 0.94 (95% CI, 0.88-0.97) for the two-step strategy. Calibration performance could not be meaningfully interpreted because the small number of malignancies resulted in very wide confidence intervals. The two-step strategy had better clinical utility than did the ADNEX model at malignancy risk thresholds < 3%. There were 1472 (72%) patients whose mass was judged to be benign based on pattern recognition by an experienced ultrasound examiner and were managed with clinical and ultrasound follow-up. In this group, the 5-year cumulative incidence was 66% (95% CI, 63-69%) for spontaneous resolution of the mass, 0% (95% CI, 0-0.2%) for torsion, 0.1% (95% CI, < 0.1-0.4%) for cyst rupture, 0.2% (95% CI, 0.1-0.6%) for a borderline tumor and 0.2% (95% CI, 0.1-0.6%) for invasive malignancy. CONCLUSIONS: The ADNEX model and IOTA two-step strategy performed well to distinguish benign from malignant adnexal masses detected in a low-risk population. Conservative management is safe for masses with a benign ultrasound appearance in this population. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.

Photo-/thermo-responsive bioink for improved printability in extrusion-based bioprinting.

Extrusion-based bioprinting has demonstrated significant potential for manufacturing constructs, particularly for 3D cell culture. However, there is a greatly limited number of bioink candidates exploited with extrusion-based bioprinting, as they meet the opposing requirements for printability with indispensable rheological features and for biochemical functionality with desirable microenvironment. In this study, a blend of silk fibroin (SF) and iota-carrageenan (CG) was chosen as a cell-friendly printable material. The SF/CG ink exhibited suitable viscosity and shear-thinning properties, coupled with the rapid sol-gel transition of CG. By employing photo-crosslinking of SF, the printability with Pr value close to 1 and structural integrity of the 3D constructs were significantly improved within a matter of seconds. The printed constructs demonstrated a Young's modulus of approximately 250 kPa, making them suitable for keratinocyte and myoblast cell culture. Furthermore, the high cell adhesiveness and viability (maximum >98%) of the loaded cells underscored the considerable potential of this 3D culture scaffold applied for skin and muscle tissues, which can be easily manipulated using an extrusion-based bioprinter.

Carrageenan-Containing Nasal Spray Alleviates Allergic Symptoms in Participants with Grass Pollen Allergy: A Randomized, Controlled, Crossover Clinical Trial.

Purpose: Nonpharmacological, barrier-forming nasal sprays are used to manage symptoms of allergic rhinitis. We aim to evaluate the safety and effectiveness of Callergin (investigational product, IP), a nasal spray containing barrier-forming iota-carrageenan, in the treatment of allergic rhinitis (AR). Methods: In this randomized, controlled, crossover trial, adults with grass pollen allergy underwent a treatment sequence with IP, VisAlpin (comparator product, CP), and no treatment in random order. Treatment blocks consisted in prophylactic administration of the assigned treatment or no treatment, followed by a 3-hr allergen exposure, and were separated by a washout period of 7 days. Primary endpoint was a mean change from baseline in "Total Nasal Symptom Score" (TNSS, sum of rhinorrhea, itching, sneezing, and congestion scores) over 3 hr, recorded every 15 min during the challenge period. Results: A total of 42 participants underwent randomization. Exposure to grass pollen for 3 hr induced a notable TNSS increase from baseline in all participants at all times. Mean TNSS change from baseline over 3 hr was lower when participants received IP compared to no treatment, although the difference did not reach statistical significance (untreated 6.96 ± 2.30; IP 6.59 ± 1.93; difference 0.37 points [95% CI (confidence interval) -0.17 to 0.91]; p=0.170). In a post-hoc analysis, mean TNSS at 3 hr was significantly reduced after IP treatment compared to no treatment (untreated 8.29 ± 2.64; IP 7.70 ± 2.56; difference 0.60 points [95% CI -0.10 to 1.29] p=0.028). While all individual nasal symptoms contributed to this effect, rhinorrhea (p=0.013) and congestion (p=0.076) contributed most. Consistently, nasal secretion weight was slightly reduced with IP treatment (p=0.119). IP was safe and well-tolerated, with similar incidence of adverse events across treatment groups. Conclusion: Prophylactic treatment with the iota-carrageenan nasal spray IP is safe, well-tolerated, and alleviates nasal allergy symptoms in adults with grass pollen-induced AR. Trial Registration: NCT04531358.

IHIBE: A Hierarchical and Delegated Access Control Mechanism for IoT Environments.

Ensuring authorized access control in the IoT is vital for privacy and safety protection. Our study presents the novel IHIBE framework, which combines IOTA (a distributed ledger technology) with hierarchical identity-based encryption (HIBE), thereby enhancing both IoT security and scalability. This approach secures access tokens and policies while reducing the computational demand on data owners. Our empirical findings reveal a significant performance gap, with access rights delegation on the Raspberry Pi 4 exceeding those on AWS by over 250%. Moreover, our analysis uncovers optimal identity policy depths: up to 640 identities on AWS and 640 on the Raspberry Pi 4 for systems with higher tolerable delays, and 320 identities on AWS versus 160 on the Raspberry Pi 4 for systems with lower tolerable delays. The system shows practical viability, exhibiting insignificant operational time differences compared to Zhang et al.'s schemes, particularly in access rights verification processes, with a minimal difference of 33.35%. Our extensive security assessment, encompassing scenarios like encrypted token theft and compromise of authority, affirms the efficacy of our challenge-response and last-word challenge (LWC) mechanisms. This study underscores the importance of platform choice in IoT system architectures and provides insights for deploying efficient, secure, and scalable IoT environments.

IOTA-Based Distributed Ledger in the Mining Industry: Efficiency, Sustainability and Transparency.

The paper presents a traceability framework founded upon a methodological approach specifically designed for the integration of the IOTA-based distributed ledger within the mining industry. This framework constitutes an initial stride towards the certification and labelling of sustainable material production. The efficacy of this methodology is subject to real-world evaluation within the framework of the European Commission funded project DIG_IT. Within the architectural framework, the integration of decentralized identifiers (DIDs) and the IOTA network are instrumental in effecting the encryption of data records, with associated hashes securely anchored on the explorer. Recorded environmental parameters, encompassing metrics such as pH level, turbidity, electrical conductivity, and emissions, serve as tangible evidence affirming their adherence to prevailing regulatory standards. The overarching system architecture encompasses a sophisticated Industrial Internet of Things platform (IIoTp), facilitating the seamless connection of data from a diverse array of sensors. End users, including governmental entities, mining managers, and the general public, stand to derive substantial benefits from tailored dashboards designed to facilitate the validation of data for emission compliance.

IOTA simple rules: An efficient tool for evaluation of ovarian tumors by non-experienced but trained examiners - A prospective study.

Objectives: A simple and efficient tool for evaluating ovarian tumors in general hospitals where radiologists without experience in gynecological ultrasound is necessary. This study aims to evaluate the diagnostic performance of IOTA simple rules in initial classification of ovarian tumors by non-experienced examiners who have received simple training. Materials and method: A prospective single-center study was conducted at Hanoi Obstetrics and Gynecology Hospital. Three resident gynecologists trained themselves for two weeks and then received hands-on practice under the supervision of experts for another two weeks. The examiners performed ultrasound on 424 eligible women scheduled for surgery for ovarian tumors and classified the tumors based on IOTA simple rules. The postoperative pathology of ovarian tumors was used as the gold standard. Results: 90.8 % (385/424) of the tumors were benign. Simple rules were applicable in 399/424 (94.1 %) tumors, with a sensitivity of 84.8 % (95 % CI, 70.2-94.3), specificity of 98.9 % (95 % CI, 97.5-99.7), positive predictive value of 87.5 % (95 % CI, 73.3-95.9), and negative predictive value of 98.6 % (95 % CI, 97.1-99.5). The sensitivity of IOTA simple rules was higher in postmenopausal women (91.7 % vs. 81.0 %), while the specificity was higher in premenopausal women (99.4 % vs. 95.8 %). Accuracy was 100 % in all ten pregnant women were assessed using these rules. Conclusion: In conclusion, in the hands of non-expert examiners who were trained thoroughly, IOTA simple rules are a simple and efficient tool for clinical practice in centers where expert radiologists in gynecology are not always available. The training program is simple and could be applied widely in other clinical centers. Further studies are necessary to evaluate the effectiveness of the IOTA simple rules in assessing ovarian tumors among pregnant women.

Ultrasonographic diagnosis of adnexal masses: interobserver agreement in the interpretation of videos, using IOTA terminology.

OBJECTIVES: Aim of this study is to estimate interobserver agreement in classifying adnexal tumors using IOTA terms, simple rules and subjective assessment. In addition, we related observers' accuracy with their experience in gynecological ultrasonography and the year of IOTA certification. METHODS: Eleven observers with three different levels of experience evaluated videoclips of 70 adnexal masses, defining tumor type according to IOTA terms and definitions, classifying the mass using IOTA Simple rules and Subjective assessment as well as providing Color Score evaluation. Sensitivity, specificity and area under the ROC curve were calculated and the year of IOTA certification was related with operators' accuracy through Pearson correlation coefficient. Interobserver agreement was estimated calculating percentage of agreement, Fleiss kappa and Cohen's kappa. RESULTS: We found a positive correlation between the year of IOTA certification and operators' accuracy (Pearson coefficient 0.694), especially among the observers with the least experience, the residents (p = 0.003). For tumor type classification, identification of papillary projections and classification of tumors using subjective assessment, agreement among all observers was moderate (Fleiss kappa 0.455, 0.552, and 0.476, respectively) and increased with the years of experience. Agreement in the application of Simple Rules was moderate in all examiners with IOTA certification, with Fleiss kappa in the range of (0.403, 0.498). For Color Score assignment interobserver agreement among all observers was fair (Cohen's kappa 0.380). CONCLUSIONS: Even among expert examiners, the results of adnexal lesion assessment can be inconsistent. Experience impacts on accuracy and agreement in subjective assessment, while the application of Simple Rules can mitigate the role of experience in interobserver agreement. The knowledge of IOTA models among residents seams to improve their diagnostic accuracy, showing the benefits of IOTA terminology for in training sonographers.

Polymerase iota plays a key role during translesion synthesis of UV-induced lesions in the absence of polymerase eta.

Xeroderma pigmentosum (XP) variant cells are deficient in the translesion synthesis (TLS) DNA polymerase Polη (eta). This protein contributes to DNA damage tolerance, bypassing unrepaired UV photoproducts and allowing S-phase progression with minimal delay. In the absence of Polη, backup polymerases perform TLS of UV lesions. However, which polymerase plays this role in human cells remains an open question. Here, we investigated the potential role of Polι (iota) in bypassing ultraviolet (UV) induced photoproducts in the absence of Polη, using NER-deficient (XP-C) cells knocked down for Polι and/or Polη genes. Our results indicate that cells lacking either Polι or Polη have increased sensitivity to UVC radiation. The lack of both TLS polymerases led to increased cell death and defects in proliferation and migration. Loss of both polymerases induces a significant replication fork arrest and G1/S-phase blockage, compared to the lack of Polη alone. In conclusion, we propose that Polι acts as a bona fide backup for Polη in the TLS of UV-photoproducts.

Comparison of International Ovarian Tumor Analysis ADNEX model and Ovarian-Adnexal Reporting and Data System with final histological diagnosis in adnexal masses: a retrospective study.

OBJECTIVE: The International ovarian tumor analysis (IOTA)-Assessment of Different NEoplasias in the adneXa (ADNEX) model and the ovarian-adnexal reporting and data system (O-RADS) were developed to improve the diagnostic accuracy of adnexal masses in the preoperative period. This study aimed to evaluate the predictive values of both models in patients who underwent surgery for an adnexal mass at our hospital, based on the final pathological results. METHODS: This study included patients who underwent surgery for adnexal masses at our hospital between 2019 and 2021 and met the inclusion criteria. The IOTA ADNEX model and O-RADS scores were calculated preoperatively. RESULTS: Of the 413 patients, 295 were diagnosed with benign tumors and 118 were diagnosed with malignant tumors. The mean cancer antigen 125 (CA-125) levels for patients diagnosed with benign and malignant were 15.2 unit/mL and 72.5 unit/mL, respectively. According to the receiver operator characteristic analysis for serum CA-125 in postmenopausal and premenopausal patients, the cutoff value of 34.8 unit/mL had a sensitivity of 70.8% and specificity of 83.8% and 180.5 unit/mL had a sensitivity of 32.1% and a specificity of 92.7%, respectively (P<0.001). The sensitivity and specificity values of the IOTA ADNEX model and O-RADS were found as 78.8-48.3% and 97.9-93.5% respectively (P<0.001). There was moderate agreement between the IOTA ADNEX model and O-RADS (Kappa=0.53). CONCLUSION: The IOTA ADNEX model has a similar specificity to the O-RADS in malignancy risk assessment, but the sensitivity of the IOTA ADNEX model is higher than that of the O-RADS. The IOTA-ADNEX model can help avoid unnecessary surgeries.

Cellular Uptake and Cytotoxicity of Clostridium perfringens Iota-Toxin.

Clostridium perfringens iota-toxin is composed of two separate proteins: a binding protein (Ib) that recognizes a host cell receptor and promotes the cellular uptake of a catalytic protein and (Ia) possessing ADP-ribosyltransferase activity that induces actin cytoskeleton disorganization. Ib exhibits the overall structure of bacterial pore-forming toxins (PFTs). Lipolysis-stimulated lipoprotein receptor (LSR) is defined as a host cell receptor for Ib. The binding of Ib to LSR causes an oligomer formation of Ib in lipid rafts of plasma membranes, mediating the entry of Ia into the cytoplasm. Ia induces actin cytoskeleton disruption via the ADP-ribosylation of G-actin and causes cell rounding and death. The binding protein alone disrupts the cell membrane and induces cytotoxicity in sensitive cells. Host cells permeabilized by the pore formation of Ib are repaired by a Ca2+-dependent plasma repair pathway. This review shows that the cellular uptake of iota-toxin utilizes a pathway of plasma membrane repair and that Ib alone induces cytotoxicity.