RESUMEN
OBJECTIVE: To determine the inter-reader reliability and diagnostic performance of classification and severity scales of Neuropathy Score Reporting And Data System (NS-RADS) among readers of differing experience levels after limited teaching of the scoring system. METHODS: This is a multi-institutional, cross-sectional, retrospective study of MRI cases of proven peripheral neuropathy (PN) conditions. Thirty-two radiology readers with varying experience levels were recruited from different institutions. Each reader attended and received a structured presentation that described the NS-RADS classification system containing examples and reviewed published articles on this subject. The readers were then asked to perform NS-RADS scoring with recording of category, subcategory, and most likely diagnosis. Inter-reader agreements were evaluated by Conger's kappa and diagnostic accuracy was calculated for each reader as percent correct diagnosis. A linear mixed model was used to estimate and compare accuracy between trainees and attendings. RESULTS: Across all readers, agreement was good for NS-RADS category and moderate for subcategory. Inter-reader agreement of trainees was comparable to attendings (0.65 vs 0.65). Reader accuracy for attendings was 75% (95% CI 73%, 77%), slightly higher than for trainees (71% (69%, 72%), p = 0.0006) for nerves and comparable for muscles (attendings, 87.5% (95% CI 86.1-88.8%) and trainees, 86.6% (95% CI 85.2-87.9%), p = 0.4). NS-RADS accuracy was also higher than average accuracy for the most plausible diagnosis for attending radiologists at 67% (95% CI 63%, 71%) and for trainees at 65% (95% CI 60%, 69%) (p = 0.036). CONCLUSION: Non-expert radiologists interpreted PN conditions with good accuracy and moderate-to-good inter-reader reliability using the NS-RADS scoring system. CLINICAL RELEVANCE STATEMENT: The Neuropathy Score Reporting And Data System (NS-RADS) is an accurate and reliable MRI-based image scoring system for practical use for the diagnosis and grading of severity of peripheral neuromuscular disorders by both experienced and general radiologists. KEY POINTS: ⢠The Neuropathy Score Reporting And Data System (NS-RADS) can be used effectively by non-expert radiologists to categorize peripheral neuropathy. ⢠Across 32 different experience-level readers, the agreement was good for NS-RADS category and moderate for NS-RADS subcategory. ⢠NS-RADS accuracy was higher than the average accuracy for the most plausible diagnosis for both attending radiologists and trainees (at 75%, 71% and 65%, 65%, respectively).
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Imagen por Resonancia Magnética , Variaciones Dependientes del Observador , Enfermedades del Sistema Nervioso Periférico , Humanos , Enfermedades del Sistema Nervioso Periférico/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Estudios Transversales , Estudios Retrospectivos , Reproducibilidad de los Resultados , Femenino , Masculino , Persona de Mediana Edad , Adulto , Anciano , Índice de Severidad de la Enfermedad , Radiólogos , Competencia Clínica , Radiología/educaciónRESUMEN
The purpose of this study was to develop an effective health communication strategy to guide the decision-making process of parents considering getting their children HPV vaccines. Using inoculation theory and findings on tone of voice as theoretical frameworks, the present study conducted a 2 (message type: inoculation vs. supportive) × 2 (tone of voice: human voice vs. organizational voice) mixed experiment with a total of 231 U.S. parents (either mother or father of a child eligible for the HPV vaccine). The results revealed that HPV vaccination promotions based on the inoculation message were more likely to generate positive attitudes toward the vaccination, higher intention to vaccinate their children, and higher intention to spread positive word of mouth (WOM) about HPV vaccination. Also, HPV vaccination promotions in the human voice were likely to increase the WOM intention more than those in the organizational voice. In regard to an interaction effect, human voice turned out to be more effective than organizational voice to generate the WOM intention when it comes to supportive messages; inoculation-based messages were similarly effective across the human and the organizational voice condition.
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Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Niño , Conocimientos, Actitudes y Práctica en Salud , Humanos , Intención , Infecciones por Papillomavirus/prevención & control , Padres , Aceptación de la Atención de Salud , VacunaciónRESUMEN
Outer membrane protein (OMP) biogenesis in Escherichia coli is a robust process essential to the life of the organism. It is catalyzed by the ß-barrel assembly machine (Bam) complex, and a number of quality control factors, including periplasmic chaperones and proteases, maintain the integrity of this trafficking pathway. Little is known, however, about how periplasmic proteases recognize and degrade OMP substrates when assembly is compromised or whether different proteases recognize the same substrate at distinct points in the assembly pathway. In this work, we use well-defined assembly-defective mutants of LptD, the essential lipopolysaccharide assembly translocon, to show that the periplasmic protease DegP degrades substrates with assembly defects that prevent or impair initial contact with Bam, causing the mutant protein to accumulate in the periplasm. In contrast, another periplasmic protease, BepA, degrades a LptD mutant substrate that has engaged the Bam complex and formed a nearly complete barrel. Furthermore, we describe the role of the outer membrane lipoprotein YcaL, a protease of heretofore unknown function, in the degradation of a LptD substrate that has engaged the Bam complex but is stalled at an earlier step in the assembly process that is not accessible to BepA. Our results demonstrate that multiple periplasmic proteases monitor OMPs at distinct points in the assembly process.IMPORTANCE OMP assembly is catalyzed by the essential Bam complex and occurs in a cellular environment devoid of energy sources. Assembly intermediates that misfold can compromise this essential molecular machine. Here we demonstrate distinctive roles for three different periplasmic proteases that can clear OMP substrates with folding defects that compromise assembly at three different stages. These quality control factors help ensure the integrity of the permeability barrier that contributes to the intrinsic resistance of Gram-negative organisms to many antibiotics.
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Proteínas de la Membrana Bacteriana Externa/metabolismo , Proteínas de Escherichia coli/metabolismo , Escherichia coli/enzimología , Escherichia coli/metabolismo , Proteínas de Choque Térmico/metabolismo , Metaloproteasas/metabolismo , Péptido Hidrolasas/metabolismo , Proteínas Periplasmáticas/metabolismo , Serina Endopeptidasas/metabolismo , Modelos Biológicos , ProteolisisRESUMEN
Strict environmental laws have been enacted to regulate the emission of exhaust particulate matter (PM), which is one of the most hazardous pollutants that reduce air quality and pose a serious risk to the human health. In addition, non-exhaust PM, such as road wear, tire wear, and brake wear debris, is a significant source of airborne pollutants. Road dust less than 100 µm in size may include tire wear particles (TWPs), which are broken down into finer particles with sizes on the order of tens of micrometers because of weathering. TWPs can be transported to water bodies via runoff, potentially contaminating water systems and negatively affecting aquatic ecosystems. Therefore, ecotoxicity tests using reference TWPs are required to investigate the impact of TWPs on the human health and environment. In this study, aged TWPs were produced using dry-, wet-, and cryo-milling methods, and the dispersion stability of TWPs in dechlorinated water was evaluated. Aged TWPs prepared by dry- and wet-milling had an average particle size of 20 µm, whereas pristine TWPs had an irregular shape and average particle size of 100 µm. The capacity of the ball-milling cylinder and excessively long 28-d generation time constrain the amount of aged TWPs that can be produced through conventional milling. In contrast, cryo-milling reduces the particle size of TWPs at the rate of -275.0 µm/d, which is nine times higher than that upon dry- and wet-milling. Dispersed cryo-milled TWPs had a hydrodiameter of 2.02 µm and were more stable in the aqueous phase in relation to the other aged TWPs. The results of this study suggest that cryo-milled TWPs can be used for aquatic exposure assessments as controls for real-world TWPs.
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Ecosistema , Contaminantes Ambientales , Humanos , Anciano , Material Particulado/toxicidad , Material Particulado/análisis , Tamaño de la Partícula , Polvo/análisis , Emisiones de Vehículos/análisis , Monitoreo del Ambiente/métodosRESUMEN
Tire-wear particles (TWP) from vehicles serves as a non-exhaust emission source. The mass content of metallic species in road dust may increase owing to the traffic of heavy vehicles and industrial activity; consequently, metallic particles are also present in road dust. Herein, road dust collected from steel industrial complexes with high traffic of high-weight vehicles and the composition distribution of five size-fractioned particle sizes were analyzed. Road dust samples were collected from three areas near steelmaking complexes. The mass distribution of TWP, carbon black (CB), bituminous coal, and heavy metals (Fe, Zn, Mn, Pb, Ni, As, Cu, Cd, and Hg) in different size fractions of road dust was quantified by combining four different analytical techniques. In the magnetic separation for <45 µm fraction, 34.4 wt% and 50.9 wt% was removed for steelmaking and steel-related industrial complexes, respectively. As the particle size decreased, the mass content of Fe, Mn, and TWP increased. The enrichment factors of Mn, Zn, and Ni were higher than two, indicating that they were related to industrial activities in steel complexes. The maximum concentrations of TWP and CB originating from the vehicle varied depending on the region and particle size range: TWP 2.066 wt% at 45-75 µm (industrial complex) and CB 5.559 wt% at 75-160 µm (steel complex). Coal was only found in the steel complex. Finally, to reduce the exposure of the finest particles to road dust, three methods were suggested. Magnetic fraction must be removed from road dust using magnetic separation; the fly dust of coal during transportation must be suppressed, and covers must be used in coal yards; the mass contents of TWP and CB in road dust should be removed by vacuum cleaning instead of water flushing.
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Metales Pesados , Hollín , Monitoreo del Ambiente , Polvo/análisis , Metales Pesados/análisis , Carbón Mineral , Medición de Riesgo , CiudadesRESUMEN
Cyanotoxins are toxins produced by cyanobacteria; they negatively impact water resources used by humans and disrupt ecosystems worldwide. Among cyanotoxins, saxitoxin (STX) is a small molecule that causes paralysis in humans and contamination in freshwater resources. To monitor low concentration of STX levels, a sensitive and high fidelity detection system is required. In this study, a round-type micro-gap electrode (RMGE) was fabricated that provides the high signal fidelity for STX detection in real freshwater sample. The RMGE has the 15 pairs of identical electrode wire length between gap that gives the high signal fidelity. In addition, the sensitivity for STX detection was improved by introducing the porous platinum nanoparticle (pPtNP) that enahced the electrochemical sensitivity and the STX aptamer was used as the bioprobe. An electrochemical measurement method (square wave voltammetry (SWV) and electrochemical impedance spectroscopy (EIS)) was introduced to construct STX biosensor. To evaluate the biosensor performance, the limit of detection (LOD) and selectivity test were performed on real freshwater samples. The biosensor demonstrated high selectivity even in freshwater samples over a wide linear concentration range of 10 pg/mL to 1 µg/mL and a detection limit of 4.669 pg/mL. These results suggest that the designed biosensor shows a wide range of possibilities for the detection of toxicants in freshwater that provide the new direction to the biosensor electrode design.
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Técnicas Biosensibles , Nanopartículas , Técnicas Biosensibles/métodos , Ecosistema , Técnicas Electroquímicas/métodos , Electrodos , Agua Dulce , Humanos , Límite de Detección , Oligonucleótidos , Platino (Metal) , Porosidad , SaxitoxinaRESUMEN
Exhaust and non-exhaust particulate matter (PM) is regarded as the most significant airborne during driving. Among the source of non-exhaust PM, the tire-wear particles (TWP) can be quantified using pyrolysis-gas chromatography/mass spectrometry (Py-GC-MS). TWPs are fragmented by continuous weathering once exposed to the road. Approximately 5 wt% of carbon black (CB) bound in the rubber matrix of TWPs tends to detach from it, and thus some portion of free-bound CB could be co-existed in the road dust. Although there are existing methods for analyzing pure CB and TWPs, only few analysis techniques on the amount of free-bound CB in contaminant samples have been discovered. Herein, we propose a method for quantifying the total and free-bound CB in road dust using a combination of four analytical tools: a semi-continuous carbon analyzer, element analyzer, thermogravimetric analyzer, and Py-GC-MS. This study is the first attempt in quantifying the concentration of nano-CB derived from TWPs in road dust. The proposed methodology was applied to the samples collected from five open sites, three closed sites, and four types of air conditioner (AC) filters in passenger vehicles. Compared to the samples obtained in open sites, the road dust in the closed sites exhibited 21.5 times higher TWP content (59,747 mg/kg) and 5.1 times higher free-bound CB content (14,632 mg/kg). In addition, unintentional driver respiratory exposure to PM fixed in the vehicle filters was discovered owing to the increase in CB and TWP contents in aged AC filters.
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Contaminantes Atmosféricos , Polvo , Contaminantes Atmosféricos/análisis , Polvo/análisis , Monitoreo del Ambiente/métodos , Tamaño de la Partícula , Material Particulado/análisis , Hollín/análisis , Emisiones de Vehículos/análisisRESUMEN
Particulate matter (PM) from automobile exhaust has drastic effects on human health. The enforcement of environmental laws has controlled vehicle emissions and reduced the total PM. However, another significant source of PM is debris from tire wear, break wear, and road wear. In particular, tire-wear particles (TWPs) are further fragmented into nanoparticles, similar to the PMx or black carbon (BC) sources. As approximately 30 wt% of carbon black (CB) is used as filler in tires, TWPs can fragment into free-bound nano-CB. This study evaluates the emission factors of BC from the ternary plots of PMx and BC to estimate the concentration of nano-CB in TWPs. Based on the emission factors of BC for TWP, approximately 500 monitoring data points were acquired at four different sites. Semi-closed sites in a field measurement test have 2.9-4.0 times larger BC concentration than open sites. The mass concentration of nano-CB evaluated with the BC data and emission factors at the open sites is 22.47-23.96 ng/m3, whereas that at the semi-closed sites is 66.32-90.33 ng/m3. Transmission electron microscopy analysis with scanning mobility particle sizer and selected-area electron diffraction reveals grape-like aggregated nanoparticles, which is considered as CB. To compare the effect of the washing out of airborne particulates by rain, further analysis is conducted on the interior and exterior of the tunnel on a rainy day. While the concentration of PMs was effectively reduced by rainfall, the amount of BC and CB in the interior of a tunnel was not changed. Namely, even under rainfall, nano-CB still exists in the tunnels and thus free-bound CB and nanoparticles released from TWP will be effected on the human health.