Genome-wide association studies and Mendelian randomization analyses provide insights into the causes of early-onset colorectal cancer.

BACKGROUND: The incidence of early-onset colorectal cancer (EOCRC; diagnosed <50 years of age) is rising globally; however, the causes underlying this trend are largely unknown. CRC has strong genetic and environmental determinants, yet common genetic variants and causal modifiable risk factors underlying EOCRC are unknown. We conducted the first EOCRC-specific genome-wide association study (GWAS) and Mendelian randomization (MR) analyses to explore germline genetic and causal modifiable risk factors associated with EOCRC. PATIENTS AND METHODS: We conducted a GWAS meta-analysis of 6176 EOCRC cases and 65 829 controls from the Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO), the Colorectal Transdisciplinary Study (CORECT), the Colon Cancer Family Registry (CCFR), and the UK Biobank. We then used the EOCRC GWAS to investigate 28 modifiable risk factors using two-sample MR. RESULTS: We found two novel risk loci for EOCRC at 1p34.1 and 4p15.33, which were not previously associated with CRC risk. We identified a deleterious coding variant (rs36053993, G396D) at polyposis-associated DNA repair gene MUTYH (odds ratio 1.80, 95% confidence interval 1.47-2.22) but show that most of the common genetic susceptibility was from noncoding signals enriched in epigenetic markers present in gastrointestinal tract cells. We identified new EOCRC-susceptibility genes, and in addition to pathways such as transforming growth factor (TGF) ß, suppressor of Mothers Against Decapentaplegic (SMAD), bone morphogenetic protein (BMP) and phosphatidylinositol kinase (PI3K) signaling, our study highlights a role for insulin signaling and immune/infection-related pathways in EOCRC. In our MR analyses, we found novel evidence of probable causal associations for higher levels of body size and metabolic factors-such as body fat percentage, waist circumference, waist-to-hip ratio, basal metabolic rate, and fasting insulin-higher alcohol drinking, and lower education attainment with increased EOCRC risk. CONCLUSIONS: Our novel findings indicate inherited susceptibility to EOCRC and suggest modifiable lifestyle and metabolic targets that could also be used to risk-stratify individuals for personalized screening strategies or other interventions.

Vertical and horizontal reading training in patients with hemianopia and its effect on reading eye movements.

Vertical reading training (VRTr) increases reading speed (RS) significantly in patients with hemianopic field defects (HFD). We ask, how eye movements (EM) contribute to this improvement and whether EM-behavior is affected by the side of HFD. Twenty-one patients, randomly assigned to VRTr or horizontal RTr, trained reading single lines from a screen at home, for 4 weeks. In the clinic, we recorded EM while reading short sentences aloud from a screen before training (T1), directly (T2) and 4 weeks afterwards (T3). RS-screen was correlated with RS during reading printed paragraphs (RS-print) to assess the transfer to everyday life. RS-screen and RS-print correlated positively (horizontal: r > 0.8, vertical: r > 0.9) at all times. Vertical RS did not exceed horizontal RS. We found significant negative correlations of EM-variables and RS-print: in right-HFD with the number of forward saccades (T1: r = - 0.79, T2: r = - 0.94), in left-HFD with the steps during return sweeps (T1: r = - 0.83, T2: r = - 0.56). Training effects remained stable at T3. EM-improvement was specific for the RTr and the side of the HFD: in right-HFD fewer forward saccades after VRTr, in left-HFD fewer steps during return sweeps after HRTr. RTr on a screen transfers to reading printed text in real-life situations.Trial registration: The study was retrospectively registered in the German Clinical Trials register: DRKS-ID: DRKS00018843, March 13th, 2020.

Artificial intelligence for detection of microsatellite instability in colorectal cancer-a multicentric analysis of a pre-screening tool for clinical application.

BACKGROUND: Microsatellite instability (MSI)/mismatch repair deficiency (dMMR) is a key genetic feature which should be tested in every patient with colorectal cancer (CRC) according to medical guidelines. Artificial intelligence (AI) methods can detect MSI/dMMR directly in routine pathology slides, but the test performance has not been systematically investigated with predefined test thresholds. METHOD: We trained and validated AI-based MSI/dMMR detectors and evaluated predefined performance metrics using nine patient cohorts of 8343 patients across different countries and ethnicities. RESULTS: Classifiers achieved clinical-grade performance, yielding an area under the receiver operating curve (AUROC) of up to 0.96 without using any manual annotations. Subsequently, we show that the AI system can be applied as a rule-out test: by using cohort-specific thresholds, on average 52.73% of tumors in each surgical cohort [total number of MSI/dMMR = 1020, microsatellite stable (MSS)/ proficient mismatch repair (pMMR) = 7323 patients] could be identified as MSS/pMMR with a fixed sensitivity at 95%. In an additional cohort of N = 1530 (MSI/dMMR = 211, MSS/pMMR = 1319) endoscopy biopsy samples, the system achieved an AUROC of 0.89, and the cohort-specific threshold ruled out 44.12% of tumors with a fixed sensitivity at 95%. As a more robust alternative to cohort-specific thresholds, we showed that with a fixed threshold of 0.25 for all the cohorts, we can rule-out 25.51% in surgical specimens and 6.10% in biopsies. INTERPRETATION: When applied in a clinical setting, this means that the AI system can rule out MSI/dMMR in a quarter (with global thresholds) or half of all CRC patients (with local fine-tuning), thereby reducing cost and turnaround time for molecular profiling.

Full model selection using regression trees for numeric predictions of biomarkers for metabolic challenges in dairy cows.

Dairy cows suffer poor metabolic adaptation syndrome (PMAS)1 during early post-calving periods caused by negative energy balance. Measurement of blood beta-hydroxy butyric acid (BHBA)2 and blood non-esterified fatty acids (NEFA)3 allow early and accurate detection of negative energy balance. Machine learning prediction of blood BHBA and blood NEFA using milk testing samples represents an opportunity to identify at-risk animals, using less labor than direct blood testing methods. Routine milk testing on modern dairies and computer record keeping provide an immense amount of data which can then be used in machine learning models. Previous research for predicting blood metabolites using Fourier-transform infrared spectroscopy (FTIR)4 milk data has focused mainly on individual models rather than a comparison among the models. Full model selection is the process of comparing different combinations of pre-processing methods, variable selection, and statistical learning algorithms to determine which model results in the lowest prediction error for a given dataset. For this project we used a full model selection approach with regression trees (rtFMS)5 . rtFMS uses the cross-validated performance of different model configurations to feed a regression tree for selecting a final model. A total of 384 possible model configurations (algorithms, predictors and data preprocessing options) for each outcome (blood BHBA and blood NEFA) were considered in the rtFMS technique. rtFMS allows direct comparison of multiple modeling approaches reducing bias due to empirical knowledge, modeling habits, or preferences, identifying the model with minimal root mean squared prediction error (RMSE)6 . An elastic net regression model was selected as the best performing model for both biomarkers. The input data for blood BHBA predictions were FTIR milk spectra, with a second derivative pre-processing, and a filter with 212 wave numbers, obtaining RMSE = 0.354 (0.328-0.392). The best performing model for blood NEFA had input data of FTIR milk spectra, with a second derivative pre-processing, and a filter with 212 wave numbers filter along with the time of milking, obtaining RMSE = 0.601 (0.564-0.654). The comparison of multiple modeling strategies, conducted by rtFMS, present an option for improved FTIR prediction models of blood BHBA and blood NEFA by reducing error due to human bias. The implementation of rtFMS to design future prediction models can guide model inputs and features. Our prediction models have the potential to increase early detection of metabolic disorders in dairy cows during the transition period.

Training of vertical versus horizontal reading in patients with hemianopia - a randomized and controlled study.

HYPOTHESIS: Patients with hemianopic field defects (HFD) might benefit from reading text in vertical orientation if they place the text in the seeing hemifield along the vertical midline. METHODS: We assigned 21 patients with HFD randomly to either vertical or horizontal reading training. They trained reading single lines of texts from a computer screen at home for 2 × 30 min/day, 5 days/week, for 4 weeks. The main outcome variable was reading speed (RS) during reading standardized paragraphs of printed text (IReST) aloud. RS was assessed before training (T1), directly after training (T2) and 4 weeks later (T3). Quality of life (QoL) was assessed by Impact of Visual Impairment (IVI) questionnaire. RESULTS: Vertical training improved RS in the vertical direction significantly. Only patients with right HFD benefited. Horizontal training improved RS in horizontal diection significantly, but much more in patients with left than in those with right HFD. Both effects remained stable at T3. RS during training at the computer improved highly significantly and correlated strongly with RS of printed text (Pearson r= > 0.9). QoL: Vertical training showed a statistically significant improvement in the complete IVI-score, patients with right HFD in the emotional IVI-score. CONCLUSIONS: The improvements of RS were specific for the training. The stable effect indicates that the patients can apply the newly learned strategies to everyday life. The side of the HFD plays an essential role: Left-HFD patients benefitted from horizontal training, right-HFD patients from vertical training. However, the vertical RS did not reach the level of horizontal RS. The study was registered in the German Clinical Trials register (DRKS-ID: DRKS00018843).

Simulation of a radiobiology facility for the Centre for the Clinical Application of Particles.

The Centre for the Clinical Application of Particles' Laser-hybrid Accelerator for Radiobiological Applications (LhARA) facility is being studied and requires simulation of novel accelerator components (such as the Gabor lens capture system), detector simulation and simulation of the ion beam interaction with cells. The first stage of LhARA will provide protons up to 15 MeV for in vitro studies. The second stage of LhARA will use a fixed-field accelerator to increase the energy of the particles to allow in vivo studies with protons and in vitro studies with heavier ions. BDSIM, a Geant4 based accelerator simulation tool, has been used to perform particle tracking simulations to verify the beam optics design done by BeamOptics and these show good agreement. Design parameters were defined based on an EPOCH simulation of the laser source and a series of mono-energetic input beams were generated from this by BDSIM. The tracking results show the large angular spread of the input beam (0.2 rad) can be transported with a transmission of almost 100% whilst keeping divergence at the end station very low (<0.1 mrad). The legacy of LhARA will be the demonstration of technologies that could drive a step-change in the provision of proton and light ion therapy (i.e. a laser source coupled to a Gabor lens capture and a fixed-field accelerator), and a system capable of delivering a comprehensive set of experimental data that can be used to enhance the clinical application of proton and light ion therapy.

Development and application of a machine learning algorithm for classification of elasmobranch behaviour from accelerometry data.

Discerning behaviours of free-ranging animals allows for quantification of their activity budget, providing important insight into ecology. Over recent years, accelerometers have been used to unveil the cryptic lives of animals. The increased ability of accelerometers to store large quantities of high resolution data has prompted a need for automated behavioural classification. We assessed the performance of several machine learning (ML) classifiers to discern five behaviours performed by accelerometer-equipped juvenile lemon sharks (Negaprion brevirostris) at Bimini, Bahamas (25°44'N, 79°16'W). The sharks were observed to exhibit chafing, burst swimming, headshaking, resting and swimming in a semi-captive environment and these observations were used to ground-truth data for ML training and testing. ML methods included logistic regression, an artificial neural network, two random forest models, a gradient boosting model and a voting ensemble (VE) model, which combined the predictions of all other (base) models to improve classifier performance. The macro-averaged F-measure, an indicator of classifier performance, showed that the VE model improved overall classification (F-measure 0.88) above the strongest base learner model, gradient boosting (0.86). To test whether the VE model provided biologically meaningful results when applied to accelerometer data obtained from wild sharks, we investigated headshaking behaviour, as a proxy for prey capture, in relation to the variables: time of day, tidal phase and season. All variables were significant in predicting prey capture, with predations most likely to occur during early evening and less frequently during the dry season and high tides. These findings support previous hypotheses from sporadic visual observations.

[Biological mechanisms of radiation effects]. / Biologische Mechanismen der Strahlenwirkung.

BACKGROUND: Exposure to ionizing radiation for diagnostic purposes is inevitable in modern medicine. The therapeutic application of irradiation is highly effective against cancer; however, this implies exposure of normal tissue structures to significant doses of radiation. Diagnostic or therapeutic exposure to ionizing radiation can result in tissue changes and tumor induction in the long term. Knowledge of the biological mechanisms underlying these effects is essential for individualization of the application. OBJECTIVES: This article examines the biological mechanisms at the tissue and molecular level, the clinical manifestation of radiation effects, dose-dependence of the risk and the temporal progression as well as influencing factors. RESULTS AND CONCLUSION: The time course of the reaction of tissues to radiation exposure extends over wide ranges up to many decades. The effects of radiation on tissues are classified into early and late and their pathobiology is significantly different. Various factors (R) influencing the clinical manifestation of radiation effects have been identified related to the exposure pattern. The radiation tolerance of normal tissue structures regarding the induction of functional deficits shows great variation but always has a threshold value, which is usually not exceeded in diagnostic procedures. The risk of a radiation-induced fatal malignancy (total body exposure 5%/Gy) for a medical administration of radiation must be considered as very low in comparison to the natural risks. Informed consent of patients must reflect this in a balanced way.

Electronic Stopping of Slow Protons in Transition and Rare Earth Metals: Breakdown of the Free Electron Gas Concept.

The electronic stopping cross sections (SCS) of Ta and Gd for slow protons have been investigated experimentally. The data are compared to the results for Pt and Au to learn how electronic stopping in transition and rare earth metals correlates with features of the electronic band structures. The extraordinarily high SCS observed for protons in Ta and Gd cannot be understood in terms of a free electron gas model, but are related to the high densities of both occupied and unoccupied electronic states in these metals.

Effect of narasin (Skycis) or zinc bacitracin (Albac) inclusion on the growth performance and carcass characteristics of finishing pigs sent for slaughter using a 3-phase marketing strategy.

The objective of this study was to evaluate the effect of dietary inclusion of narasin or zinc bacitracin on the growth performance and carcass characteristics of finishing pigs sent for slaughter using a 3-phase marketing strategy. The study used 2,219 crossbred pigs in a randomized complete block design (blocking factor = start date) with 3 dietary treatments: 1) Control (no feed additive), 2) 15 mg/kg narasin (Skycis, Elanco Animal Health, Greenfield, IN), and 3) 28 mg/kg zinc bacitracin (Albac, Zoetis, Parsippany, NJ). Pigs were housed in single-sex pens of 25 pigs in a commercial wean-to-finish facility and there were 30 pen-replicates of each dietary treatment. All pigs were weighed as a group (i.e., pen) on d 0 (start of experimental feeding period), 77, 91, and 105 (end) of study. Pigs had ad libitum access to feed and water throughout the study period; all feed additions to the feeder were recorded. Pigs were sent for slaughter according to the following marketing strategy: 1) after 77 d on study, the heaviest 20% of each pen was sent for slaughter (Phase 1), 2) after 91 d on study, the next heaviest 48% of each pen were sent for slaughter (Phase 2), and 3) after 105 d on study, the remaining 32% of each pen was sent for slaughter (Phase 3). Pigs within each pen were selected for slaughter by visual appraisal of weight and shipped to a commercial slaughter facility where standard carcass measurements (HCW, LM depth, and backfat depth) were measured. Feeding narasin increased (P < 0.05) final live BW (1.3 kg) and overall ADG (1.1%) compared to the other treatments, which were similar (P > 0.05). Dietary treatment did not impact (P > 0.05) overall G:F. Feeding narasin increased (P < 0.05) HCW (1.4 kg) and carcass yield (0.3% units) compared to the other dietary treatments, which were similar (P > 0.05) for these traits. Overall, these results demonstrate that narasin-fed pigs had improved overall growth rate, HCW, and carcass yield compared to controls or pigs fed zinc bacitracin.

[The reverse shoulder arthroplasty Delta Xtend : Mid-term results]. / Die inverse Schulterendoprothese Delta Xtend : Mittelfristige Ergebnisse.

BACKGROUND: Reverse shoulder arthroplasty (RSA) has become a frequently used and established treatment for patients with cuff tear arthropathy, increasingly also for patients with fracture sequelae (FS), failed rotator cuff reconstruction and omarthrosis with cuff insufficiency. Since 2007 new generation prostheses, for example Delta Xtend (Depuy, Warsaw, USA), have been used, but few mid-term results have been published. OBJECTIVES: The aim of this study is to report on the outcome after RSA after a mean follow-up of 68 months (range 63-75), to verify the already published, encouraging early results and to learn about the function and pain situation after RSA in the mid-term period. METHODS: 60 patients underwent RSA with the Depuy Delta Xtend prosthesis in the years 2007 and 2008, performed by the senior author of this study. 39 of these patients were available for follow up and were asked to complete a questionnaire (msCS, modified subjective Constant Score). In addition, 28 patients agreed to a clinical examination. With these patients, in addition, the constant score, age and gender-adjusted constant score and range of motion were evaluated. RESULTS: The mean msCS of preoperative 39.15 points (range 12-69) improved to 71.74 points (range 44-100) after 5 years. The mean CS at 5 years was 65.79 points (range 21-93) and the mean age and gender-adjusted constant score was 92%. The mean active anterior elevation was 139° (range 70-180°), the mean abduction was 135° (range 50-170°) and the mean active external rotation was 17° (range -20-40°). CONCLUSION: This study confirms good early results after RSA after more than 5 years. We see very good outcomes in patients with CTA and omarthrosis, whilst the rate of complication is low.

(2 + 1)D-CAIPIRINHA accelerated MR spectroscopic imaging of the brain at 7T.

PURPOSE: To compare a new parallel imaging (PI) method for multislice proton magnetic resonance spectroscopic imaging (1 H-MRSI), termed (2 + 1)D-CAIPIRINHA, with two standard PI methods: 2D-GRAPPA and 2D-CAIPIRINHA at 7 Tesla (T). METHODS: (2 + 1)D-CAIPIRINHA is a combination of 2D-CAIPIRINHA and slice-CAIPIRINHA. Eight healthy volunteers were measured on a 7T MR scanner using a 32-channel head coil. The best undersampling patterns were estimated for all three PI methods. The artifact powers, g-factors, Cramér-Rao lower bounds (CRLB), and root mean square errors (RMSE) were compared quantitatively among the three PI methods. Metabolic maps and spectra were compared qualitatively. RESULTS: (2 + 1)D-CAIPIRINHA allows acceleration in three spatial dimensions in contrast to 2D-GRAPPA and 2D-CAIPIRINHA. Thus, this sequence significantly decreased the RMSE of the metabolic maps by 12.1 and 6.9%, on average, for 4 < R < 11, compared with 2D-GRAPPA and 2D-CAIPIRINHA, respectively. The artifact power was 22.6 and 8.4% lower, and the CRLB were 3.4 and 0.6% lower, respectively. CONCLUSION: (2 + 1)-CAIPIRINHA can be implemented for multislice MRSI in the brain, enabling higher accelerations than possible with two-dimensional (2D) parallel imaging methods. An eight-fold acceleration was still feasible in vivo with negligible PI artifacts with lipid decontamination, thus decreasing the measurement time from 120 to 15 min for a 64 × 64 × 4 matrix. Magn Reson Med 78:429-440, 2017. © 2016 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Outcome of preterm infants born to overweight and obese mothers†.

OBJECTIVES: To evaluate perinatal morbidity and mortality among preterm neonates who were born to overweight and obese mothers compared to preterm neonates who were born to mothers with normal pre-pregnancy body mass index (BMI). METHODS: Retrospective recordings of medical charts of 110 preterm infants born to overweight (n = 68) and obese (n = 42) mothers at gestational age (GA) 28-34 weeks, as well as 110 controls matched for GA and birth weight. All infants were born at the Sheba Medical Center between 2007 and 2014. Data regarding maternal pre-pregnancy weight and height were recorded, as well as maternal and neonatal complications and feeding methods. RESULTS: Obese mothers had more pregnancy-induced hypertension (52.4% versus 21.4%, p = 0.006) and caesarean section deliveries (81% versus 52.4%, p = 0.018). Overweight mothers had more gestational diabetes (20.6% versus 2.9%, p = 0.001). The study and control groups were similar on all neonatal outcome parameters. No differences between the groups were recorded throughout hospitalization with respect to Apgar score, respiratory distress and support, hypotension, cardiac manifestations, brain pathologies, infection, feeding type and total hospitalization days. CONCLUSIONS: Although the maternal complications are greater among obese and overweight women, it seems that preterm infants born to these women are not at increased risk for neonatal complications.

The effect of healthy dietary consumption on executive cognitive functioning in children and adolescents: a systematic review.

A systematic review was conducted to evaluate whether healthier dietary consumption among children and adolescents impacts executive functioning. PubMed, Education Resources Information Center, PsychINFO and Thomson Reuters' Web of Science databases were searched, and studies of executive functioning among children or adolescents aged 6-18 years, which examined food quality, macronutrients and/or foods, were included. Study quality was also assessed. In all, twenty-one studies met inclusion criteria. Among the twelve studies examining food quality (n 9) or macronutrient intakes (n 4), studies examining longer-term diet (n 6) showed positive associations between healthier overall diet quality and executive functioning, whereas the studies examining the acute impact of diet (n 6) were inconsistent but suggestive of improvements in executive functioning with better food quality. Among the ten studies examining foods, overall, there was a positive association between healthier foods (e.g. whole grains, fish, fruits and/or vegetables) and executive function, whereas less-healthy snack foods, sugar-sweetened beverages and red/processed meats were inversely associated with executive functioning. Taken together, evidence suggests a positive association between healthy dietary consumption and executive functioning. Additional studies examining the effects of healthier food consumption, as well as macronutrients, on executive functioning are warranted. These studies should ideally be conducted in controlled environments and use validated cognitive tests.

Three decades of longlining in Bimini, Bahamas, reveals long-term trends in lemon shark Negaprion brevirostris (Carcharhinidae) catch per unit effort.

In Bimini, Bahamas, the consistent employment of longlines, beginning in 1982, provided a rare opportunity to explore population trends for large resident sharks. This study assessed three shallow water longline survey periods at this location; 1982-1989, 1992-2002 and 2003-2014, with the aim of determining trends in annual catch per unit effort (CPUE) for an IUCN listed near-threatened species, the lemon shark Negaprion brevirostris. A general additive model (GAM) was used to analyse the non-linear annual CPUE values over the entire 32-year research period. The GAM displayed high variability of annual CPUE, with a peak value of 0·026 N. brevirostris per hook day (hooks day(-1) ) in 2000. The temporal pattern of CPUE indicated an abundance trend with a complete cycle, from trough to trough, occurring over a period of approximately 18 years. The 1982-1989 survey period saw the highest proportion of mature individuals (19·8%) and the smallest average pre-caudal length (LPC ; 124·8 cm). The 1992-2002 survey period had the highest average annual CPUE (0·018 hooks day(-1) ), while the 2003-2014 research period saw largest average LPC size (134·8 cm) and the lowest average CPUE values (0·009 hooks day(-1) ) of the entire research period. The long-term trend identified in this study provides a baseline for future assessment.

Safety and efficacy of pharmacological cardioversion of recent-onset atrial fibrillation: a single-center experience.

BACKGROUND AND AIM: The management of patients with recent-onset atrial fibrillation (AF) presenting at emergency departments (EDs) varies widely. Our aim was to describe the management of patients with recent-onset (<48 hours) AF, to determine safety and efficacy of pharmacological cardioversion at the ED, and to evaluate the incidence of thromboembolism or death at 30 days. METHODS: In a prospective, observational, single-center study, 236 subjects with recent-onset AF were consecutively enrolled from January 2011 until January 2013. Follow-up information was obtained by reviewing all available clinical records. RESULTS: As first-line therapy, 45.3% (n = 107) received ibutilide, 28.8% (n = 68) vernakalant, 25% (n = 59) flecainide, and 0.8% (n = 2) amiodarone, respectively. Successful cardioversion was achieved in 72.5% (n = 171) of patients after first-line therapy. There was no significant difference between treatment groups. In univariable logistic regression analysis, age (odds ratio [OR] = 1.027; 95% confidence interval [CI], 1.003-1.052; P= .03), duration of symptoms (OR = 0.968; 95% CI, 0.938-0.999; P= .045), as well as the CHA2DS2-VASc score (1 point for Congestive heart failure, Hypertension, Age between 65 and 74 years, Diabetes, Vascular disease, Sex category if female and 2 points for previous TIA/Stroke and Age ≥ 75 years) (OR = 1.237; 95% CI, 1.01-1.515; P= .04) were associated with success of pharmacological cardioversion. Within 30 days, 1 patient suffered from fatal ischemic stroke. CONCLUSION: Pharmacological cardioversion followed by discharge after a short observation period is safe. There was no significant difference between the agents used in terms of short-term safety and efficacy. Importantly, the coherence of the ED to recent guidelines regarding first-line therapy is high.

Using genetic inference to re-evaluate the minimum longevity of the lemon shark Negaprion brevirostris.

A combination of mark-recapture and genetic sampling was used to extend the minimum longevity of an elasmobranch species and the life span estimate of the lemon shark Negaprion brevirostris was increased conservatively from 20·2 to 37 years. This increase in longevity means higher vulnerability and a longer recovery time from exploitation.

Diffusion-weighted imaging of breast tumours at 3 Tesla and 7 Tesla: a comparison.

OBJECTIVES: To compare bilateral diffusion-weighted MR imaging (DWI) at 3 T and 7 T in the same breast tumour patients. METHODS: Twenty-eight patients were included in this IRB-approved study (mean age 56 ± 16 years). Before contrast-enhanced imaging, bilateral DWI with b = 0 and 850 s/mm(2) was performed in 2:56 min (3 T) and 3:48 min (7 T), using readout-segmented echo planar imaging (rs-EPI) with a 1.4 × 1.4 mm(2) (3 T)/0.9 × 0.9 mm(2) (7 T) in-plane resolution. Apparent diffusion coefficients (ADC), signal-to-noise (SNR) and contrast-to-noise ratios (CNR) were assessed. RESULTS: Twenty-eight lesions were detected (18 malignant, 10 benign). CNR and SNR were comparable at both field strengths (p > 0.3). Mean ADC values at 7 T were 4-22% lower than at 3 T (p ≤ 0.03). An ADC threshold of 1.275 × 10(-3) mm(2)/s resulted in a diagnostic specificity of 90% at both field strengths. The sensitivity was 94% and 100% at 3 T and 7 T, respectively. CONCLUSION: 7-T DWI of the breast can be performed with 2.4-fold higher spatial resolution than 3 T, without significant differences in SNR if compared to 3 T. KEY POINTS: • 7 T provides a 2.4-fold higher resolution in breast DWI than 3 T • 7 T DWI has a high diagnostic accuracy comparable to that at 3 T • At 7 T malignant lesions had 22 % lower ADC than at 3 T (p < 0.001).