Effectiveness of vestibular rehabilitation on postural balance in Parkinson's disease: a systematic review and meta-analysis of randomized controlled trials.

INTRODUCTION: Postural balance impairment can affect the quality of life of patients with Parkinson's disease. Previous studies have described connections of the vestibular system with postural functions, suggesting a potential participation of the basal ganglia in receiving vestibular stimuli. This systematic review aims to summarize the evidence on the effectiveness of vestibular rehabilitation on postural balance in patients with Parkinson's disease. METHODS: A systematic review was conducted using the electronic databases: PubMed, Embase, Scopus and PEDro. The study selection was independently conducted by two reviewers, and disagreements were evaluated by a third reviewer. The included studies had no restrictions on publication dates or languages and the last update occurred in July 2023. RESULTS: From the 485 studies found in the searches, only 3 studies were deemed eligible for the systematic review involving a total of 130 participants. The Berg Balance Scale was described as the tool for evaluation of postural balance in all studies. The meta-analysis showed statistically significant results in favor of vestibular rehabilitation (MD = 5.35; 95% CI = 2.39, 8.31; P < 0.001), regardless of the stage of Parkinson's disease. Although the effect size was suggested as a useful functional gain, the analysis was done with caution, as it only included 3 randomized controlled trials. The risk of bias using the RoB-2 was considered as being of "some concern" in all studies. Furthermore, the quality of the evidence based on the Grading of Recommendations Assessment Development and Evaluation system, produced by pooling the included studies was considered very low. CONCLUSION: Compared to other interventions, vestibular rehabilitation has potential to assist the postural balance of patients with Parkinson's disease. However, the very low quality of the evidence demonstrates uncertainty about the impact of this clinical practice. More robust studies are needed to confirm the benefits of this therapy in patients with Parkinson's disease. This study was prospectively registered in PROSPERO: CRD42020210185.

The Synthesis and Reactivity of Naphthoquinonynes.

The first systematic exploration of the synthesis and reactivity of naphthoquinonynes is described. Routes to two regioisomeric Kobayashi-type naphthoquinonyne precursors have been developed, and the reactivity of the ensuing 6,7- and 5,6-aryne intermediates has been investigated. Remarkably, these studies have revealed that a broad range of cycloadditions, nucleophile additions and difunctionalizations can be achieved while maintaining the integrity of the highly sensitive quinone unit. The methodologies offer a powerful diversity oriented approach to C6 and C7 functionalized naphthoquinones, which are typically challenging to access. From a reactivity viewpoint, the study is significant because it demonstrates that aryne-based functionalizations can be utilized strategically in the presence of highly reactive and directly competing functionality.

Does BRAF V600E mutation affect recurrence rate of ameloblastomas? Systematic review and meta-analysis.

OBJECTIVE: The objective of this systematic review with meta-analysis was to critically evaluate the available data on the association of the BRAF V600E mutation and recurrence rate of ameloblastomas. MATERIALS AND METHODS: This systematic review was registered in Prospero (CRD42020183645) and performed based on the PRISMA statement. A comprehensive search in PubMed, Web of Science, Scopus and Cochrane Library databases was performed in order to answer the question "Does BRAF V600E mutation affect recurrence rate of ameloblastomas?" Methodological quality and risk of bias of the selected studies were assessed with JBI Critical Appraise Tool. Meta-analysis of quantitative data was conducted with RevMan 5.3 and Jamovi 2.3. RESULTS: The initial search identified 302 articles, and 21 met the inclusion criteria. A total of 855 subjects with ameloblastoma were included in the analysis. The pooled measures for frequency of BRAF V600E mutation was 65.30% (95% CI: 0.56-0.75; p < .001; I2 = 90.85%; τ = 0.205; p < .001), and the pooled recurrence rate was 25.30% (95% CI: 0.19-0.31; p < .001; I2 = 79.44%; τ = 0.118; p < .001). No differences in recurrence rate were observed between the BRAF V600E and wild type BRAF ameloblastomas, with a pooled Odds Ratio of 0.93 (95% CI: 0.56-1.54; p = .78; I2 = 31%; p = .09). CONCLUSIONS: BRAF V600E mutation is a frequent event in ameloblastomas, but does not increase nor reduce its recurrence rate, and thus have a limited value in predicting its prognosis.

Biological and Cellular Properties of Advanced Platelet-Rich Fibrin (A-PRF) Compared to Other Platelet Concentrates: Systematic Review and Meta-Analysis.

Platelet concentrates are used for cell induction and stimulation in tissue repair processes. The aim of the present systematic review and meta-analysis was to compare the biological and cellular properties of advanced platelet-rich fibrin (A-PRF) to those of other platelet concentrates. Searches were conducted on the PubMed/Medline, Scopus, Web of Science, Embase and LILACS databases using a search strategy oriented by the guiding question. A total of 589 records were retrieved. Seven articles of in vitro experimental studies were selected for qualitative data analysis and four were selected for meta-analysis. The release of growth factors, distribution of cells in the fibrin membrane, and cell viability, the fibrin network, and fibroblast migration were investigated. In the final analysis, statistically significant differences were found for the A-PRF group with regard to platelet-derived growth factor, transforming growth factor, epidermal growth factor and vascular endothelial growth factor at all assessment times. A difference was found with regard to bone morphogenetic protein only in the later assessment, and no differences among groups were found with regard to platelet-derived growth factor or insulin-like growth factor. The results of this systematic review and meta-analysis suggest that A-PRF has superior cellular properties and better release of growth factors compared to other platelet concentrates.

Structure-Based Identification of Naphthoquinones and Derivatives as Novel Inhibitors of Main Protease Mpro and Papain-like Protease PLpro of SARS-CoV-2.

The worldwide COVID-19 pandemic caused by the coronavirus SARS-CoV-2 urgently demands novel direct antiviral treatments. The main protease (Mpro) and papain-like protease (PLpro) are attractive drug targets among coronaviruses due to their essential role in processing the polyproteins translated from the viral RNA. In this study, we virtually screened 688 naphthoquinoidal compounds and derivatives against Mpro of SARS-CoV-2. Twenty-four derivatives were selected and evaluated in biochemical assays against Mpro using a novel fluorogenic substrate. In parallel, these compounds were also assayed with SARS-CoV-2 PLpro. Four compounds inhibited Mpro with half-maximal inhibitory concentration (IC50) values between 0.41 µM and 9.0 µM. In addition, three compounds inhibited PLpro with IC50 ranging from 1.9 µM to 3.3 µM. To verify the specificity of Mpro and PLpro inhibitors, our experiments included an assessment of common causes of false positives such as aggregation, high compound fluorescence, and inhibition by enzyme oxidation. Altogether, we confirmed novel classes of specific Mpro and PLpro inhibitors. Molecular dynamics simulations suggest stable binding modes for Mpro inhibitors with frequent interactions with residues in the S1 and S2 pockets of the active site. For two PLpro inhibitors, interactions occur in the S3 and S4 pockets. In summary, our structure-based computational and biochemical approach identified novel naphthoquinonal scaffolds that can be further explored as SARS-CoV-2 antivirals.

Raman spectra-based structural classification analysis of quinoidal and derived molecular systems.

This work reports a classification analysis method based on the vibrational Raman spectra of 38 quinones and related structures, spectrally ordering and classifying the compounds. The molecular systems are relevant for chemical and biological processes, with applications in pharmacology, toxicology and medicine. The classification strategy uses a combination of principal component analysis with K-means clustering methods. Both theoretical simulations and experimental data are analysed, thus establishing their spectral characteristics, as related to their chemical structures and properties. The protocol introduced here should be broadly applicable in other molecular and solid state systems.

Low-level laser therapy is effective in controlling postoperative pain in lower third molar extractions: a systematic review and meta-analysis.

This systematic review aimed to evaluate the effectiveness of low-level laser therapy in controlling postoperative pain in lower third molar extractions. A search was carried out in MEDLINE/PubMed, Web of Science and Cochrane Library (CENTRAL) databases, using the "low-level laser therapy", "photobiomodulation therapy", "impacted mandibular third molar", "mandibular third molar", "third molar extraction" descriptors and 2625 studies were found, including only randomized clinical trials published until July 2020, with no restrictions on language and country of study. Selected studies were submitted to initial screening based on the reading of titles, abstracts and full article, and duplicate studies were excluded. Overall, 2562 articles were found, of which only 15 randomized clinical trials were included in this review. A total of 648 patients (16-44 years) who received low-level laser therapy as an intervention and placebo in their control group were evaluated. The pain evaluation criterion was the Visual Analog Scale (VAS) on the second and seventh days after surgery. Photobiomodulation with low-level laser showed statistically significant reduction in postoperative pain in lower third molar extractions, both on the second (MD: - 0.59; CI: - 0.92, - 0.27) and seventh day after surgery (MD: - 0.76; CI: - 1.21, - 0.32).

Does Maxillomandibular Fixation Affect Respiratory Function? A Systematic Review.

ABSTRACT: This systematic review was carried out to determine if maxillomandibular fixation, used in the treatment of maxillary fractures, interferes with respiratory function, and appraised studies that evaluated pulmonary function using spirometry on patients with and without maxillomandibular fixation. Searches were conducted on the following databases: Medline/Pubmed, Embase, Cochrane, Web of Science, Scopus, and Scielo, in addition to a search of the grey literature and a manual search. Five studies were included in the qualitative analysis, but it was not possible to conduct a quantitative study due to the lack of data. Forced vital capacity, forced expiratory volume in the first second, the ratio of these values, and peak expiratory flow were the parameters studied. In all the studies included in this review, it was possible to observe the lowest respiratory parameter values during maxillomandibular fixation and, after removal, normal respiratory function was restored. Accordingly, it was possible to conclude that maxillo-mandibular fixation temporarily affects respiratory function, during use, but it is restored on removal, therefore, not precluding its use on healthy patients who have good nasal breathing prior to the procedure. However, in patients suffering from some form of respiratory limitation or pulmonary disease, and also mouth breathers, maxillomandibular fixation should not be used so as to avoid more severe respiratory complications, underlining the importance of preoperative pulmonary evaluation.

Differential Frequencies of HLA-DRB1, DQA1, and DQB1 Alleles and Haplotypes Are Observed in the Arbovirus-Related Neurological Syndromes.

BACKGROUND: We took advantage of the 2015-2016 Brazilian arbovirus outbreak (Zika [ZIKV]/dengue/chikungunya viruses) associated with neurological complications to type HLA-DRB1/DQA1/DQB1 variants in patients exhibiting neurological complications and in bone marrow donors from the same endemic geographical region. METHODS: DRB1/DQA1/DQB1 loci were typed using sequence-specific oligonucleotides. In silico studies were performed using X-ray resolved dimer constructions. RESULTS: The DQA1*01, DQA1*05, DQB1*02, or DQB1*06 genotypes/haplotypes and DQA1/DQB1 haplotypes that encode the putative DQA1/DQB1 dimers were overrepresented in the whole group of patients and in patients exhibiting peripheral neurological spectrum disorders (PSD) or encephalitis spectrum disorders (ESD). The DRB1*04, DRB1*13, and DQA1*03 allele groups protected against arbovirus neurological manifestation, being underrepresented in whole group of patients and ESD and PSD groups. Genetic and in silico studies revealed that DQA1/DQB1 dimers (1) were primarily associated with susceptibility to arbovirus infections; (2) can bind to a broad range of ZIKV peptides (235 of 1878 peptides, primarily prM and NS2A); and (3) exhibited hydrophilic and highly positively charged grooves when compared to the DRA1/DRB1 cleft. The protective dimer (DRA1/DRB1*04) bound a limited number of ZIKV peptides (40 of 1878 peptides, primarily prM). CONCLUSION: Protective haplotypes may recognize arbovirus peptides more specifically than susceptible haplotypes.

Rapid responses of root traits and productivity to phosphorus and cation additions in a tropical lowland forest in Amazonia.

Soil nutrient availability can strongly affect root traits. In tropical forests, phosphorus (P) is often considered the main limiting nutrient for plants. However, support for the P paradigm is limited, and N and cations might also control tropical forests functioning. We used a large-scale experiment to determine how the factorial addition of nitrogen (N), P and cations affected root productivity and traits related to nutrient acquisition strategies (morphological traits, phosphatase activity, arbuscular mycorrhizal colonisation and nutrient contents) in a primary rainforest growing on low-fertility soils in Central Amazonia after 1 yr of fertilisation. Multiple root traits and productivity were affected. Phosphorus additions increased annual root productivity and root diameter, but decreased root phosphatase activity. Cation additions increased root productivity at certain times of year, also increasing root diameter and mycorrhizal colonisation. P and cation additions increased their element concentrations in root tissues. No responses were detected with N addition. Here we showed that rock-derived nutrients determined root functioning in low-fertility Amazonian soils, demonstrating not only the hypothesised importance of P, but also highlighting the role of cations. The changes in fine root traits and productivity indicated that even slow-growing tropical rainforests can respond rapidly to changes in resource availability.

Removal and modification of directing groups used in metal-catalyzed C-H functionalization: the magical step of conversion into 'conventional' functional groups.

Over the past few decades, regioselective catalytic C-H functionalization has provided an attractive tool for unique retrosynthetic disconnections. The advancement of the directing group strategy in metal catalyzed synthetic transformation has contributed significantly to the incorporation of a wide range of functionalization reactions in both aromatic systems and aliphatic backbones. However, the extensive utilization of these methodologies depends on the ease of removal of the directing group to restore the free functional group. In this review, we have summarised the reported approaches for removing/modifying versatile directing groups.

Does the Use of Articaine Increase the Risk of Hypesthesia in Lower Third Molar Surgery? A Systematic Review and Meta-Analysis.

PURPOSE: The aim of this study was to assess the risk of hypesthesia with the use of articaine in comparison with other local anesthetics in lower third molar surgery, through a systematic review and meta-analysis. METHODS: MEDLINE/PubMed, EMBASE, Cochrane Library (CENTRAL), Web of Science, and SCOPUS databases were searched. Gray literature and manual searches were also performed. RESULTS: Altogether 342 articles were found; only 13 met the eligibility criteria. A total of 886 third molars were removed; 436 using articaine, 430 using other local anesthetics, and 20 using an anesthetic mixture. Altogether 5 cases of hypesthesia were found in the articaine group, with 4 temporary and 1 with no mention of nerve involved; there was no case of permanent confirmed hypesthesia. A total of 9 articles demonstrated a low risk of bias, and 4 articles showed some concern. The meta-analysis demonstrated a 3.96 relative risk for hypesthesia with the use of articaine compared with other local anesthetics, but this result was not statistically significant. The heterogeneity of the studies was low from a clinical, methodological, and statistical point of view. CONCLUSIONS: Thus, this systematic review and meta-analysis suggests that the use of articaine does not increase the risk of hypesthesia compared with other local anesthetics in lower third molar extraction, and when present, this complication is temporary.

Synthesis of ß-triazolylenones via metal-free desulfonylative alkylation of N-tosyl-1,2,3-triazoles.

Desulfonylative alkylation of N-tosyl-1,2,3-triazoles under metal-free conditions leading to ß-triazolylenones is reported here. The present study encompasses the synthesis of triazoles with a new substitution pattern in a single step from cyclic 1,3-dicarbonyl compounds and N-tosyl triazole in moderate to high yields. Our synthesis takes place with complete regioselectivity as confirmed by crystallographic analysis which is rationalized by a suitable mechanistic proposal. This method provides an efficient, versatile and straightforward strategy towards the synthesis of new functionalized 1,2,3-triazoles.

Crimean-Congo Hemorrhagic Fever Virus Antibodies among Livestock on Corsica, France, 2014-2016.

We conducted a serologic survey for Crimean-Congo hemorrhagic fever virus antibodies in livestock (cattle, sheep, and goats; N = 3,890) on Corsica (island of France) during 2014-2016. Overall, 9.1% of animals were seropositive, suggesting this virus circulates on Corsica. However, virus identification is needed to confirm these results.

Ruthenium(II)-Catalyzed Double Annulation of Quinones: Step-Economical Access to Valuable Bioactive Compounds.

Double ruthenium(II)-catalyzed alkyne annulations of quinones were accomplished. Thus, a strategy is reported that provides step-economical access to valuable quinones with a wide range of applications. C-H/N-H activations for alkyne annulations of naphthoquinones provided challenging polycyclic quinoidal compounds by forming four new bonds in one step. The singular power of the thus-obtained compounds was reflected by their antileukemic activity.

Frequency and Reliability of the Reversed Halo Sign in Patients With Septic Pulmonary Embolism Due to IV Substance Use Disorder.

OBJECTIVE. The purpose of this article is to assess the "reversed halo" sign in patients with septic pulmonary embolism (PE) due to IV substance use disorder. MATERIALS AND METHODS. A retrospective analysis was performed of chest CT scans obtained between 2007 and 2017 that had findings of septic PE associated with IV substance use disorder. Inclusion criteria were history of IV substance use disorder, findings of septic PE on chest CT scans, and confirmation of infection. Image analysis was performed by three radiologists to assess the frequency, appearance, and evolution of the reversed halo sign. Interreader agreement to characterize the reversed halo sign was assessed using kappa statistical analysis. The chi-square test was used to correlate reversed halo sign shape with evolution on follow-up scans. RESULTS. Of 62 patients who met the inclusion criteria (54.8% women; mean age, 32.8 ± 8.3 [SD] years), 59.7% (37/62) had reversed halo signs (κ = 0.837-0.958, p < 0.0001). The mean number of unique reversed halo signs per patient was 2.1 ± 1.7 (46.7% of patients had more than one reversed halo sign). Of 78 unique reversed halo signs, 93.6% (73/78) were peripherally located and 51.3% (40/78) were located at the lower lobe, 52.6% (41/78) were pyramidal and 47.4% (37/78) were round shaped, 89.7% (70/78) had central low-attenuation areas, and 34.6% (27/78) had internal reticulations. Cavitation developed in 37.2% (29/78) of reversed halo signs and more often in pyramid-shaped ones (70.8%, 17/24), whereas consolidation occurred in 30.8% (24/78) and more often in round-shaped ones (58.6%; 17/29, p = 0.03). CONCLUSION. Septic PE should be considered in the differential diagnosis of patients with IV substance use disorder presenting with reversed halo sign. The reversed halo sign was reliably and frequently observed on the chest CT scans of patients with IV substance use disorder-related septic PE. Characteristics of reversed halo sign presentation were identified as potential features to differentiate septic PE from other causes of pulmonary infarct manifesting with reversed halo sign.

Strategies towards potent trypanocidal drugs: Application of Rh-catalyzed [2 + 2 + 2] cycloadditions, sulfonyl phthalide annulation and nitroalkene reactions for the synthesis of substituted quinones and their evaluation against Trypanosoma cruzi.

Rhodium-catalyzed [2 + 2 + 2] cycloadditions, sulfonyl phthalide annulations and nitroalkene reactions have been employed for the synthesis of 56 quinone-based compounds. These were evaluated against Trypanosoma cruzi, the parasite that causes Chagas disease. The reactions described here are part of a program that aims to utilize modern, versatile and efficient synthetic methods for the one or two step preparation of trypanocidal compounds. We have identified 9 compounds with potent activity against the parasite; 3 of these were 30-fold more potent than benznidazole (Bz), a drug used for the treatment of Chagas disease. This article provides a comprehensive outline of reactions involving over 120 compounds aimed at the discovery of new quinone-based frameworks with activity against T. cruzi.

MicroRNA expression profiles discriminate childhood T- from B-acute lymphoblastic leukemia.

MicroRNAs (miRNAs) play a critical role on biological and cellular processes; the search for functional markers may be of importance for differential diagnosis, prognosis, and development of new therapeutic regimens. In this context, we evaluated the bone marrow miRNA profile of Brazilian children exhibiting T- or B-cell acute lymphoblastic leukemia (T-ALL or B-ALL), using massive parallel sequencing, using the HiSeq 2500 platform (Illumina). The differential expression analysis was conducted considering a leave-one-out approach and FDR ≤ 0.05. Machine learning algorithms were applied to search for the disease subset biomarkers. Target prediction, functional enrichment, and classification of biological categories were also performed. Sixteen miRNAs were differentially expressed between T- and B-ALL, of which 10 (miR-708-5p, miR-497-5p, miR-151a-5p, miR-151b, miR-371b-5p, miR-455-5p, miR-195-5p, miR-1266-5p, miR-574-5p, and miR-425-5p) were downregulated and six (miR-450b-5p, miR-450a-5p, miR-542-5p, miR-424-5p, miR-629-5p, and miR-29c-5p) were upregulated in childhood T-ALL. These miRNAs may be used for distinguishing childhood lymphoblastic leukemia subtypes, since it provided the clear separation of patients in these two distinct groups. Six relevant biological pathways were identified according to their role in leukemia, namely, viral carcinogenesis, cell cycle, and B-cell receptor signaling pathways for induced miRNAs and TGF-beta signaling, apoptosis, and NF-kappa B signaling for the repressed miRNAs, of which several miRNA gene targets participate in cell differentiation and hematopoiesis processes. Machine learning analysis pointed out miR-29c-5p expression as the best discriminator between childhood T- and B-ALL, which is involved in calcium signaling, critical for B-cell lymphocyte fate. Further studies are needed to assure the role of the 16 miRNAs and miR-29c-5p on acute lymphoblastic leukemia subtypes and on disease prognosis.

Impact of Radiology Report Wording on Care of Patients With Acute Epiploic Appendagitis.

OBJECTIVE. The purpose of this study was to evaluate the association between the diagnostic certainty expressed by the wording of CT report impressions and subsequent use of standard treatment with analgesics versus nonstandard antibiotic administration in patients with acute epiploic appendagitis (EA). MATERIALS AND METHODS. Demographic, clinical, and radiologic data from a 10-year cohort of patients with acute EA were retrospectively analyzed and correlated with standard treatment with analgesics versus nonstandard treatment with antibiotics. A level of certainty was assigned to the CT report language based on the wording of the impression statements by two radiologists; their interreader agreement was assessed with kappa statistics. Bivariate analyses were performed to correlate all variables with antibiotic administration and to assess for collinearity. Multivariate logistic regression was performed to identify independent predictors of antibiotic use in patients with acute EA. RESULTS. Of 124 patients with CT-diagnosed acute EA, 22% (27/124) received antibiotic treatment. After the CT report impressions were evaluated, 27% (34/124) were categorized as low certainty and 73% (90/124) as high certainty (κ = 0.958, p < 0.001). Multivariate regression was significant (p < 0.001, Nagelkerke R2 = 0.249) and found CT report impressions' level of certainty (odds ratio [OR] = 6.1, p < 0.001) and evaluation in an outpatient clinic rather than an emergency department (ED) (OR = 4.4, p = 0.003) to be independent predictors of antibiotic administration for patients with acute EA. Outpatient presentation was also correlated with age, abdominal pain duration, and left-colonic involvement in the bivariate analysis (all p ≤ 0.01). CONCLUSION. The diagnostic certainty conveyed by the wording of CT report impressions correlated with antibiotic treatment decisions for patients with acute EA. Patients whose report impressions expressed low rather than high certainty were six times more likely to receive antibiotic therapy; patients evaluated at outpatient clinics rather than EDs were four times more likely.

Accuracy and timeliness of an abbreviated emergency department MRCP protocol for choledocholithiasis.

PURPOSE: To determine the diagnostic accuracy and time savings of an abbreviated magnetic resonance cholangiopancreatography (A-MRCP) protocol for detecting choledocholithiasis in patients visiting the emergency department (ED) for suspected biliary obstruction. METHODS AND MATERIALS: This retrospective study evaluated adult patients (ages 18+ years) visiting an academic Level 1 trauma center between January 1, 2016, and December 31, 2017, who were imaged with MRCP for suspected biliary obstruction. Patients were scanned with either a four-sequence A-MRCP protocol or a conventional eight-sequence MRCP (C-MRCP) protocol. Image acquisition and MRI room time were compared. The radiology report was used to determine whether a study was limited by motion or prematurely aborted, as well as for the presence of pertinent biliary findings. Diagnostic accuracy of A-MRCP studies were compared with any available endoscopic retrograde cholangiopancreatography (ERCP) report within 30 days. RESULTS: One hundred sixteen patients met inclusion criteria; 85 were scanned with the A-MRCP protocol (45.9% male, mean 57.4 years) and 31 with the C-MRCP protocol (38.7% male, mean 58.3 years). Mean image acquisition time and MRI room time for the A-MRCP protocol were significantly lower compared to those for the C-MRCP protocol (16 and 34 min vs. 42 and 61 min, both p < 0.0001). Choledocholithiasis was seen in 23.5% of A-MRCP cases and 19.4% of C-MRCP cases. Non-biliary findings were common in both cohorts, comprising 56.5% of A-MRCP cases and 41.9% of C-MRCP cases. 44.7% of A-MRCP patients received subsequent (diagnostic or therapeutic) ERCP (mean follow-up time 3 days), in which A-MRCP accurately identified choledocholithiasis in 86.8% of cases, with sensitivity of 85%, specificity of 88.9%, positive predictive value (PPV) of 89.5%, and negative predictive value (NPV) of 84.2%. In comparison, 38.7% of C-MRCP patients underwent ERCP (mean follow-up of 2.3 days) with an accuracy of 91.7%, sensitivity of 80%, specificity of 100%, PPV of 100%, and NPV of 87.5%. Only 4.7% of A-MRCP exams demonstrated motion artifact vs. 12.9% of C-MRCP exams. One study was prematurely aborted due to patient discomfort in the A-MRCP cohort while no studies were terminated in the C-MRCP cohort. CONCLUSION: An abbreviated MRCP protocol to evaluate for choledocholithiasis provides significant time savings and reduced motion artifact over the conventional MRCP protocol while providing similar diagnostic accuracy.