Highly efficient free-breathing 3D whole-heart imaging in 3-min: single center study in adults with congenital heart disease.

BACKGROUND: Three dimensional, whole-heart (3DWH) MRI is an established non-invasive imaging modality in patients with congenital heart disease (CHD) for the diagnosis of cardiovascular morphology and for clinical decision making. Current techniques utilise diaphragmatic navigation (dNAV) for respiratory motion correction and gating and are frequently limited by long acquisition times. This study proposes and evaluates the diagnostic performance of a respiratory gating-free framework, which considers respiratory image-based navigation (iNAV), and highly accelerated variable density Cartesian sampling in concert with non-rigid motion correction and low-rank patch-based denoising (iNAV-3DWH-PROST). The method is compared to the clinical dNAV-3DWH sequence in adult patients with CHD. METHODS: In this prospective single center study, adult patients with CHD who underwent the clinical dNAV-3DWH MRI were also scanned with the iNAV-3DWH-PROST. Diagnostic confidence (4-point Likert scale) and diagnostic accuracy for common cardiovascular lesions was assessed by three readers. Scan times and diagnostic confidence were compared using the Wilcoxon-signed rank test. Co-axial vascular dimensions at three anatomic landmarks were measured, and agreement between the research and the corresponding clinical sequence was assessed with Bland-Altman analysis. RESULTS: The study included 60 participants (mean age ± [SD]: 33 ± 14 years; 36 men). The mean acquisition time of iNAV-3DWH-PROST was significantly lower compared with the conventional clinical sequence (3.1 ± 0.9 min vs 13.9 ± 3.9 min, p < 0.0001). Diagnostic confidence was higher for the iNAV-3DWH-PROST sequence compared with the clinical sequence (3.9 ± 0.2 vs 3.4 ± 0.8, p < 0.001), however there was no significant difference in diagnostic accuracy. Narrow limits of agreement and mean bias less than 0.08 cm were found between the research and the clinical vascular measurements. CONCLUSIONS: The iNAV-3DWH-PROST framework provides efficient, high quality and robust 3D whole-heart imaging in significantly shorter scan time compared to the standard clinical sequence.

Single-heartbeat cardiac cine imaging via jointly regularized nonrigid motion-corrected reconstruction.

The aim of the current study was to develop a novel approach for 2D breath-hold cardiac cine imaging from a single heartbeat, by combining cardiac motion-corrected reconstructions and nonrigidly aligned patch-based regularization. Conventional cardiac cine imaging is obtained via motion-resolved reconstructions of data acquired over multiple heartbeats. Here, we achieve single-heartbeat cine imaging by incorporating nonrigid cardiac motion correction into the reconstruction of each cardiac phase, in conjunction with a motion-aligned patch-based regularization. The proposed Motion-Corrected CINE (MC-CINE) incorporates all acquired data into the reconstruction of each (motion-corrected) cardiac phase, resulting in a better posed problem than motion-resolved approaches. MC-CINE was compared with iterative sensitivity encoding (itSENSE) and Extra-Dimensional Golden Angle Radial Sparse Parallel (XD-GRASP) in 14 healthy subjects in terms of image sharpness, reader scoring (range: 1-5) and reader ranking (range: 1-9) of image quality, and single-slice left ventricular assessment. MC-CINE was significantly superior to both itSENSE and XD-GRASP using 20 heartbeats, two heartbeats, and one heartbeat. Iterative SENSE, XD-GRASP, and MC-CINE achieved a sharpness of 74%, 74%, and 82% using 20 heartbeats, and 53%, 66%, and 82% with one heartbeat, respectively. The corresponding results for reader scoring were 4.0, 4.7, and 4.9 with 20 heartbeats, and 1.1, 3.0, and 3.9 with one heartbeat. The corresponding results for reader ranking were 5.3, 7.3, and 8.6 with 20 heartbeats, and 1.0, 3.2, and 5.4 with one heartbeat. MC-CINE using a single heartbeat presented nonsignificant differences in image quality to itSENSE with 20 heartbeats. MC-CINE and XD-GRASP at one heartbeat both presented a nonsignificant negative bias of less than 2% in ejection fraction relative to the reference itSENSE. It was concluded that the proposed MC-CINE significantly improves image quality relative to itSENSE and XD-GRASP, enabling 2D cine from a single heartbeat.

Simultaneous comprehensive liver T1 , T2 , T2∗ , T1ρ , and fat fraction characterization with MR fingerprinting.

PURPOSE: To develop a novel simultaneous co-registered T1 , T2 , T2∗ , T1ρ , and fat fraction abdominal MR fingerprinting (MRF) approach for fully comprehensive liver-tissue characterization in a single breath-hold scan. METHODS: A gradient-echo liver MRF sequence with low fixed flip angle, multi-echo radial readout, and varying magnetization preparation pulses for multiparametric encoding is performed at 1.5 T. The T2∗ and fat fraction are estimated from a graph/cut water/fat separation method using a six-peak fat model. Water/fat singular images obtained are then matched to an MRF dictionary, estimating water-specific T1 , T2 , and T1ρ . The proposed approach was tested in phantoms and 10 healthy subjects and compared against conventional sequences. RESULTS: For the phantom studies, linear fits show excellent coefficients of determination (r2 > 0.9) for every parametric map. For in vivo studies, the average values measured within regions of interest drawn on liver, spleen, muscle, and fat are statistically different from the reference scans (p < 0.05) for T1 , T2 , and T1⍴ but not for T2∗ and fat fraction, whereas correlation between MRF and reference scans is excellent for each parameter (r2 > 0.92 for every parameter). CONCLUSION: The proposed multi-echo inversion-recovery, T2 , and T1⍴ prepared liver MRF sequence presented in this work allows for quantitative T1 , T2 , T2∗ , T1⍴ , and fat fraction liver-tissue characterization in a single breath-hold scan of 18 seconds. The approach showed good agreement and correlation with respect to reference clinical maps.

Simultaneous T1 , T2 , and T1ρ cardiac magnetic resonance fingerprinting for contrast agent-free myocardial tissue characterization.

PURPOSE: To develop a simultaneous T1 , T2 , and T1ρ cardiac magnetic resonance fingerprinting (MRF) approach to enable comprehensive contrast agent-free myocardial tissue characterization in a single breath-hold scan. METHODS: A 2D gradient-echo electrocardiogram-triggered cardiac MRF sequence with low flip angles, varying magnetization preparation, and spiral trajectory was acquired at 1.5 T to encode T1 , T2 , and T1⍴ simultaneously. The MRF images were reconstructed using low-rank inversion, regularized with a multicontrast patch-based higher-order reconstruction. Parametric maps were generated and matched in the singular value domain to extended phase graph-based dictionaries. The proposed approach was tested in phantoms and 10 healthy subjects and compared against conventional methods in terms of coefficients of determination and best fits for the phantom study, and in terms of Bland-Altman agreement, average values and coefficient of variation of T1 , T2 , and T1⍴ for the healthy subjects study. RESULTS: The T1 , T2 , and T1⍴ MRF values showed excellent correlation with conventional spin-echo and clinical mapping methods in phantom studies (r2 > 0.97). Measured MRF values in myocardial tissue (mean ± SD) were 1133 ± 33 ms, 38.8 ± 3.5 ms, and 52.0 ± 4.0 ms for T1 , T2 and T1⍴ , respectively, against 1053 ± 47 ms, 50.4 ± 3.9 ms, and 55.9 ± 3.3 ms for T1 modified Look-Locker inversion imaging, T2 gradient and spin echo, and T1⍴ turbo field echo, respectively. CONCLUSION: A cardiac MRF approach for simultaneous quantification of myocardial T1 , T2 , and T1ρ in a single breath-hold MR scan of about 16 seconds has been proposed. The approach has been investigated in phantoms and healthy subjects showing good agreement with reference spin echo measurements and conventional clinical maps.

Myocardial T1, T2, T2*, and fat fraction quantification via low-rank motion-corrected cardiac MR fingerprinting.

PURPOSE: Develop a novel 2D cardiac MR fingerprinting (MRF) approach to enable simultaneous T1, T2, T2*, and fat fraction (FF) myocardial tissue characterization in a single breath-hold scan. METHODS: Simultaneous, co-registered, multi-parametric mapping of T1, T2, and FF has been recently achieved with cardiac MRF. Here, we further incorporate T2* quantification within this approach, enabling simultaneous T1, T2, T2*, and FF myocardial tissue characterization in a single breath-hold scan. T2* quantification is achieved with an eight-echo readout that requires a long cardiac acquisition window. A novel low-rank motion-corrected (LRMC) reconstruction is exploited to correct for cardiac motion within the long acquisition window. The proposed T1/T2/T2*/FF cardiac MRF was evaluated in phantom and in 10 healthy subjects in comparison to conventional mapping techniques. RESULTS: The proposed approach achieved high quality parametric mapping of T1, T2, T2*, and FF with corresponding normalized RMS error (RMSE) T1 = 5.9%, T2 = 9.6% (T2 values <100 ms), T2* = 3.3% (T2* values <100 ms), and FF = 0.8% observed in phantom scans. In vivo, the proposed approach produced higher left-ventricular myocardial T1 values than MOLLI (1148 vs 1056 ms), lower T2 values than T2-GraSE (42.8 vs 50.6 ms), lower T2* values than eight-echo gradient echo (GRE) (35.0 vs 39.4 ms), and higher FF values than six-echo GRE (0.8 vs 0.3 %) reference techniques. The proposed approach achieved considerable reduction in motion artifacts compared to cardiac MRF without motion correction, improved spatial uniformity, and statistically higher apparent precision relative to conventional mapping for all parameters. CONCLUSION: The proposed cardiac MRF approach enables simultaneous, co-registered mapping of T1, T2, T2*, and FF in a single breath-hold for comprehensive myocardial tissue characterization, achieving higher apparent precision than conventional methods.

Analysis of 18F-Sodium Fluoride Positron Emission Tomography Signal Sources in Atherosclerotic Minipigs Shows Specific Binding of 18F-Sodium Fluoride to Plaque Calcifications.

Objective: 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) imaging is thought to visualize active atherosclerotic plaque calcification. This is supported by the binding of 18F-NaF to plaque calcification ex vivo, but no prior studies have examined binding of 18F-NaF to human-like plaque in vivo. Our aim was to validate the specificity of 18F-NaF PET for plaque calcifications in atherosclerotic minipigs. Approach and Results: Gain-of-function PCSK9D374Y (proprotein convertase/subtilisin kexin type 9) transgenic Yucatan minipigs (n=4) were fed high-fat diet for 2.5 years to develop atherosclerosis and then subjected to 18F-NaF PET/computed tomography imaging. The heart, aorta, and iliac arteries were immediately re-scanned ex vivo after surgical extraction. Lesions from the abdominal aorta, iliac arteries, and coronary arteries were cryo-sectioned for autoradiography. Histological plaque characteristics, PET/computed tomography signal, and autoradiography were linked through regression and co-localization analysis. Arterial 18F-NaF PET signal had intensities comparable to clinical scans and colocalized moderately with calcification detected by computed tomography. Histological analysis showed calcification spanning from microcalcifications near lipid pools and necrotic core to more homogenous macrocalcifications. Comparison with arteries from autopsy cases confirmed the resemblance in localization and appearance with early human plaque calcification. Regression analysis in the abdominal aorta showed correlations with calcified plaque but could not rule out contributions from noncalcified plaque. This was resolved by autoradiography, which showed specific accumulation in plaque calcifications in all examined arteries. In the context of porcine abdominal aorta, 18F-NaF PET imaging was, however, less accurate than computed tomography for detecting small calcifications. Conclusions: 18F-NaF accumulates specifically in calcifications of atherosclerotic plaques in vivo.

The Relation between Drying Conditions and the Development of Volatile Compounds in Saffron (Crocus sativus).

Saffron is derived from the stigmas of the flower Crocus sativus L. The drying process is the most important post-harvest step for converting C. sativus stigmas into saffron. The aim of this review is to evaluate saffron's post-harvest conditions in the development of volatile compounds and its aroma descriptors. It describes saffron's compound generation by enzymatic pathways and degradation reactions. Saffron quality is described by their metabolite's solubility and the determination of picrocrocin, crocins, and safranal. The drying process induce various modifications in terms of color, flavor and aroma, which take place in the spice. It affects the aromatic species chemical profile. In the food industry, saffron is employed for its sensory attributes, such as coloring, related mainly to crocins (mono-glycosyl esters or di-glycosyl polyene).

Essential oils in vapor phase as alternative antimicrobials: A review.

The antimicrobial effectiveness of essential oils (EOs) against many foodborne microorganisms when applied by direct contact has been extensively demonstrated. However, the vapor phase and volatile components present in EOs have not been thoroughly investigated; there are a small number of published reports on the antimicrobial activity of some EOs and a few of their components against selected microorganisms. It is well known that the antimicrobial activity of EOs depends mainly on their chemical composition. It is also important; however, to understand the volatility of these compounds as well as the methodologies used to evaluate the antimicrobial effectiveness of their vapor phase. This review focuses on recent research regarding the chemical composition of EOs, their biological activity and mechanisms of action, the antimicrobial activity of EOs in the vapor phase, the different techniques that have been proposed to evaluate the antimicrobial effects of EOs in the vapor phase, and actual and potential applications of EOs in the vapor phase. Although there is still no standard methodology for determining the activity of EOs in the vapor phase, results reported thus far are encouraging and suggest possible applications in food preservation.

Quantitative assessment of myocardial blood flow and extracellular volume fraction using 68Ga-DOTA-PET: A feasibility and validation study in large animals.

BACKGROUND: Here we evaluated the feasibility of PET with Gallium-68 (68Ga)-labeled DOTA for non-invasive assessment of myocardial blood flow (MBF) and extracellular volume fraction (ECV) in a pig model of myocardial infarction. We also aimed to validate MBF measurements using microspheres as a gold standard in healthy pigs. METHODS: 8 healthy pigs underwent three sequential 68Ga-DOTA-PET/CT scans at rest and during pharmacological stress with simultaneous injection of fluorescent microspheres to validate MBF measurements. Myocardial infarction was induced in 5 additional pigs, which underwent 68Ga-DOTA-PET/CT examinations 7-days after reperfusion. Dynamic PET images were reconstructed and fitted to obtain MBF and ECV parametric maps. RESULTS: MBF assessed with 68Ga-DOTA-PET showed good correlation (y = 0.96x + 0.11, r = 0.91) with that measured with microspheres. MBF values obtained with 68Ga-DOTA-PET in the infarcted area (LAD, left anterior descendant) were significantly reduced in comparison to remote ones LCX (left circumflex artery, P < 0.0001) and RCA (right coronary artery, P < 0.0001). ECV increased in the infarcted area (P < 0.0001). CONCLUSION: 68Ga-DOTA-PET allowed non-invasive assessment of MBF and ECV in pigs with myocardial infarction and under rest-stress conditions. This technique could provide wide access to quantitative measurement of both MBF and ECV with PET imaging.

Optimization of purification techniques for lumen-loaded magnetoliposomes.

Liposomes encapsulating magnetic nanoparticles (MNPs), known as magnetoliposomes (MLs), have become a hot topic in biomedical research for applications in remote-triggered drug delivery and diagnostic imaging. One of the most crucial steps in the preparation of MLs is the purification of non-encapsulated MNPs, as a non-efficient purification can lead to misleading results. Purification is challenging especially when MNPs are loaded in the liposome lumen due to the small size differences between the MLs and the non-encapsulated MNPs. This work presents a comparison of three well known purification techniques, namely size exclusion chromatography, centrifugation and salt-induced aggregation, using five commercial MNPs with different configurations. The optimal purification techniques for two MNPs were studied further in the synthesis of MLs. In conclusion, we show that an efficient MLs purification requires the performance of a detailed study to select a valid method that is strongly dependent upon MNPs choices.

Publisher's Note: Realizing and Detecting a Topological Insulator in the AIII Symmetry Class [Phys. Rev. Lett. 119, 115301 (2017)].

This corrects the article DOI: 10.1103/PhysRevLett.119.115301.

First and recurrent events after percutaneous coronary intervention: implications for survival analyses.

Objectives. Using composite endpoints and/or only first events in clinical research result in information loss and alternative statistical methods which incorporate recurrent event data exist. We compared information-loss under traditional analyses to alternative models. Design. We conducted a retrospective analysis of patients who underwent percutaneous coronary intervention (Jan2010-Dec2014) and constructed Cox models for a composite endpoint (readmission/death), a shared frailty model for recurrent events, and a joint frailty (JF) model to simultaneously account for recurrent and terminal events and evaluated the impact of heart failure (HF) on the outcome. Results. Among 4901 patients, 2047(41.8%) experienced a readmission or death within 1 year. Of those with recurrent events, 60% had ≥1 readmission and 6% had >4; a total of 121(2.5%) patients died during follow-up. The presence of HF conferred an adjusted Hazard ratio (HR) of 1.32 (95% CI: 1.18-1.47, p < .001) for the risk of composite endpoint (Cox model), 1.44 (95% CI: 1.36-1.52, p < .001) in the frailty model, and 1.34 (95% CI:1.22-1.46, p < .001) in the JF model. However, HF was not associated with death (HR 0.87, 95% CI: 0.52-1.48, p = .61) in the JF model. Conclusions. Using a composite endpoint and/or only the first event yields substantial loss of information, as many individuals endure >1 event. JF models reduce bias by simultaneously providing event-specific HRs for recurrent and terminal events.

Structural, Physical, and Antifungal Characterization of Starch Edible Films Added with Nanocomposites and Mexican Oregano (Lippia berlandieri Schauer) Essential Oil.

The aim of this study was to evaluate the structural, physical, and antifungal characteristics of starch edible films added with nanocomposites and Mexican oregano (Lippia berlandieri Schauer) essential oil (EO). Starch edible films were formulated with Mexican oregano EO (0%, 1%, or 2% v/v) and bentonite or halloysite (2%). Physical properties such as L* (luminosity), hue, film thickness, and O2 and CO2 permeability were determined. Structural analysis was carried out via atomic force microscopy (AFM). Antifungal activity against Aspergillus niger, Fusarium spp., and Rhizopus spp. was evaluated. The addition of EO and nanocomposites reduced luminosity, providing color to the edible films. Film thickness increased through the addition of EO concentration. O2 and CO2 permeability was increased by bentonite/EO films, and for halloysite films, CO2 permeability decreased as EO concentration increased. The addition of EO with both nanocomposites shows an evident morphological change in film structure, decreasing pore density and increasing pore size. In general, Mexican oregano EO added to edible starch films has an adequate fungicidal effect. The most sensitive microorganism tested was A. niger. Edible films added with Mexican oregano EO and nanocomposites show better physical and antifungal properties due to an adequate structural change in the biopolymer matrix.

Prognostic value of urinary 11-dehydro-thromboxane B2 for mortality: A cohort study of stable coronary artery disease patients treated with aspirin.

AIM: There is a variable cardiovascular risk reduction attributable to aspirin because of individual differences in the suppression of thromboxane A2 and its downstream metabolite 11-dehydro-thromboxane B2 (11dhTxB2 ). The aim of this study is to evaluate the optimal cut point of urinary 11dhTxB2 for the risk of mortality in aspirin-treated coronary artery disease (CAD) patients. METHODS AND RESULTS: This was a prospective cohort study including stable CAD patients who visited the Baylor Heart and Vascular Hospital in Dallas or the Texas Heart Hospital Baylor Plano, TX between 2010 and 2013. The outcome of all-cause mortality was ascertained from chart review and automated sources. The 449 patients included in this analysis had a mean age of 66.1 ± 10.1 years. 67 (14.9%) patients died within 5 years; 56 (87.5%) of the 64 patients with known cause of death suffered a cardiovascular related mortality. Baseline ln(urinary 11dhTxB2 /creatinine) ranged between 5.8 and 11.1 (median = 7.2) with the higher concentrations among those who died (median: 7.6) than those who survived (median = 7.2, P < 0.001). Using baseline ln(11dhTxB2 ) to predict all-cause mortality, the area under the curve was 0.70 (95% CI: 0.64-0.76). The optimal cut point was found to be ln(7.38) = 1597.8 pg/mg, which had the following decision statistics: sensitivity = 0.67, specificity = 0.62, positive predictive value = 0.24, negative predictive value = 0.92, and accuracy = 0.63. CONCLUSION: Our data indicate the optimal cut point for urine 11dhTxB2 is 1597.8 (pg/mg) for the risk prediction of mortality over five years in stable patients with CAD patients treated with aspirin.

Efficacy and safety of transcatheter valve-in-valve replacement for Mitroflow bioprosthetic valve dysfunction.

OBJECTIVES: Bioprostheses with pericardial leaflets mounted externally on the stent pose a high risk for valve-in-valve (ViV) procedures. This study analyzed the efficacy and safety of ViV procedures for treating structural valve deterioration (SVD) in Mitroflow bioprostheses. METHODS: Between January 2012 and August 2017, 11 patients (mean age 80.3 ± 5.6 years) were treated for SVD of Mitroflow bioprostheses with transcatheter ViV procedures (six transapical [TA] and five transfemoral [TF]) using balloon expandable bioprostheses. RESULTS: All patients but one were in NYHA class III-IV. Mean STS PROM, euroSCORE I, and euroSCORE II were 8 ± 6.5%, 27.8 ± 11.5%, and 12 ± 5.9%, respectively. Two patients had a "porcelain aorta." The size of implanted valves were 23 mm in 10 cases and 26 mm in one case. One patient suffered a coronary occlusion during a TF approach. The mean volume of contrast used in TF implants was 163 ± 69.8 mL. No contrast media were used in TA procedures. There was one in-hospital death (10%). At 1 year of follow-up, peak and mean aortic gradients were 25.5 ± 5.8 mmHg and 15.5 ± 5.7 mmHg, respectively. One patient had mild paravalvular regurgitation. Cumulative survival was 90.9% at 1 year, 70.7% at 2 years, and 53% at 3 years. CONCLUSIONS: ViV procedures with balloon-expandable aortic valves provide good hemodynamic and clinical mid-term results for treating patients with a degenerated Mitroflow aortic bioprosthesis. Special care must be taken in small aortic roots, when the stented valve is in the supra-annular position to avoid coronary ostial obstruction.

Growth modeling to control (in vitro) Fusarium verticillioides and Rhizopus stolonifer with thymol and carvacrol.

The aim of this study was to evaluate the antifungal activity (in vitro) of thymol and carvacrol alone or in mixtures against Fusarium verticillioides and Rhizopus stolonifer, and to obtain primary growth models. Minimal inhibitory concentration (MIC) was evaluated with fungal radial growth with thymol or carvacrol concentrations (0-1600mg/l). Mixtures were evaluated using concentrations below MIC values. Radial growth curves were described by the modified Gompertz equation. MIC values of carvacrol were 200mg/l for both fungi. Meanwhile, MIC values of thymol were between 500 and 400mg/l for F. verticillioides and R. stolonifer, respectively. A synergistic effect below MIC concentrations for carvacrol (100mg/l) and thymol (100-375mg/l) was observed. Significant differences (p<0.05) between the Gompertz parameters for the antimicrobial concentrations and their tested mixtures established an inverse relationship between antimicrobial concentration and mycelial development of both fungi. Modified Gompertz parameters can be useful to determine fungistatic concentrations.

Realizing and Detecting a Topological Insulator in the AIII Symmetry Class.

Topological insulators in the AIII (chiral unitary) symmetry class lack experimental realization. Moreover, fractionalization in one-dimensional topological insulators has not been yet directly observed. Our work might open possibilities for both challenges. We propose a one-dimensional model realizing the AIII symmetry class which can be realized in current experiments with ultracold atomic gases. We further report on a distinctive property of topological edge modes in the AIII class: in contrast to those in the well-studied BDI (chiral orthogonal) class, they have nonzero momentum. Exploiting this feature we propose a path for the detection of fractionalization. A fermion added to an AIII system splits into two halves localized at opposite momenta, which can be detected by imaging the momentum distribution.

Myocardial Infarction Related to Trauma.

Myocardial infarction (MI) secondary to acute coronary occlusion related to trauma is rare. A previously healthy man developed acute MI shortly after a motor vehicle accident. This case illustrates the feasibility of primary percutaneous coronary intervention for acute MI due to complete coronary artery occlusion related to trauma, including the use of manual thrombectomy, stents, and dual antiplatelet therapy. This approach requires the intervention of a multidisciplinary team in a Level 1 trauma center that can rapidly evaluate the patient and rule out other life-threatening injuries that could preclude antiplatelet therapy.

Studying the impact of plating on ratings of the food served in a naturalistic dining context.

An experiment conducted in a naturalistic dining context is reported, in which the impact of different styles of plating on diners' experience of the food was assessed. A hundred and sixty three diners were separated into two groups during a luncheon event held in a large dining room. Each group of diners was served the same menu, with a variation in the visual presentation of the ingredients on the plate. The results revealed that the diners were willing to pay significantly more for the appetizer (a salad), when arranged in an artistically-inspired manner (M = £5.94 vs. £4.10). The main course was liked more, and considered more artistic, when the various elements were presented in the centre of the plate, rather than placed off to one side. The participants also reported being willing to pay significantly more for the centred than for the offset plating (M = £15.35 vs. £11.65). These results are consistent with the claim that people "eat first with their eyes", and that a diner's experience of the very same ingredients can be significantly enhanced (or diminished) simply by changing the visual layout of the food elements of the dish. Results such as these suggest that theories regarding the perception of food can potentially be confirmed (or disconfirmed) outside of the confines of the laboratory (i.e., in naturalistic dining settings).

Oral Finasteride Presents With Sexual-Unrelated Withdrawal in Long-Term Treated Androgenic Alopecia in Men.

Side effects associated with oral finasteride (FT) (1 mg/d) and topical 5% minoxidil (M5) have been previously described. The authors have evaluated long-term adverse effects and causes of long-term therapy withdrawal in patients with androgenic alopecia (AGA) treated with M5+FT vs M5 without FT. A total of 130 AGA patients with a minimum 2-year follow-up volunteered to complete a questionnaire on side effects. Patients' responses were classified as "never," "rarely," "sometimes," "often," and "all the time." An adverse effect was considered in the presence of an "often" or "all the time" response. A total of 100 patients received combined M5+FT and were compared with 30 patients receiving single-therapy M5 according to the physician's clinical criteria. Erectile dysfunction (3%), diminished libido (4%), and reduced ejaculation (7%) were present in patients taking M5+FT but were absent in patients taking M5. Only 1 of 100 patients taking M5+FT quit long-term therapy due to sexual adverse effects (diminished libido). The main causes for therapy withdrawal in the FT group were lack of positive results in 11% and in the M5 group side effects in 4% (P < .02). Increased body hair was different between groups: with 6.6% in the M5 group and 4% in the M5+FT group (P < .03). FT demonstrates sexual-unrelated reasons as the main cause of therapy withdrawal in long-term treated AGA patients.