Mortality and postinterventional complications after ablative treatment of liver malignancies: A cohort study of 4374 patients.

PURPOSE: Ablative therapies for primary and secondary liver malignancies are increasingly adopted in current guidelines. Nevertheless, surgical resection remains the gold standard in most curative therapy settings. Extensive studies on mortality and morbidity after ablative treatment of the liver are missing. We investigated complications and mortality after ablative treatment in a large, unselected study cohort. MATERIALS AND METHODS: Standardized patient and treatment data in 4374 percutaneous and angiographic ablative procedures of the liver from the DRG-based hospital reimbursement system (diagnosis-related groups) of an academic hospital in Germany were retrospectively evaluated. We analyzed descriptive patient data, length of stay (LOS), pre-existing medical conditions, previous gastrointestinal surgeries, severe complications, and occurrence of death. RESULTS: Treatment of secondary liver malignancies constituted over two-thirds of all procedures (71%, n = 3053). The mean LOS was 4.1 ± 3.5 days. Severe complications were documented in 1.4% and in-house death in 0.2% of cases, significantly more often after treatment with chemoembolization of primary liver malignancies (p = 0.003; p = 0.0001). Previous partial liver resection, partial bowel resection, and chronic renal failure were independent risk factors for the occurrence of severe complications. CONCLUSION: Severe complications and in-hospital death are rare in the treatment of primary and secondary liver malignancies with percutaneous and angiographic procedures. They are a viable alternative or addition to a surgical approach in treating liver lesions.

Quantitative Assessment of Tumor Contact with Neurogenic Zones and Its Effects on Survival: Insights beyond Traditional Predictors.

So far, the cellular origin of glioblastoma (GBM) needs to be determined, with prevalent theories suggesting emergence from transformed endogenous stem cells. Adult neurogenesis primarily occurs in two brain regions: the subventricular zone (SVZ) and the subgranular zone (SGZ) of the hippocampal dentate gyrus. Whether the proximity of GBM to these neurogenic niches affects patient outcome remains uncertain. Previous studies often rely on subjective assessments, limiting the reliability of those results. In this study, we assessed the impact of GBM's relationship with the cortex, SVZ and SGZ on clinical variables using fully automated segmentation methods. In 177 glioblastoma patients, we calculated optimal cutpoints of minimal distances to the SVZ and SGZ to distinguish poor from favorable survival. The impact of tumor contact with neurogenic zones on clinical parameters, such as overall survival, multifocality, MGMT promotor methylation, Ki-67 and KPS score was also examined by multivariable regression analysis, chi-square test and Mann-Whitney-U. The analysis confirmed shorter survival in tumors contacting the SVZ with an optimal cutpoint of 14 mm distance to the SVZ, separating poor from more favorable survival. In contrast, tumor contact with the SGZ did not negatively affect survival. We did not find significant correlations with multifocality or MGMT promotor methylation in tumors contacting the SVZ, as previous studies discussed. These findings suggest that the spatial relationship between GBM and neurogenic niches needs to be assessed differently. Objective measurements disprove prior assumptions, warranting further research on this topic.

IT support in emergency remote teaching in response to COVID-19.

Background: The COVID-19 pandemic hit the German education system unexpectedly and forced its universities to shift to Emergency Remote Teaching (ERT). The Data Integration Center (DIC) of the University Hospital Magdeburg and the Institute of Biometry and Medical Informatics (IBMI) has developed a concept based on existing structures that can be quickly implemented and used by the Medical Faculty at Otto von Guericke University. This manuscript focuses on the IT support for lecturers, which allows them to concentrate on teaching their lessons, although the authors are aware that this is only a small part of the entire subject. Additionally, there is a great awareness that ERT can never replace well-structured in-person classes. Concept: The key feature of the concept uses the well-working management system for all physical rooms of the university by designing a virtual video conference room for every physical room. This allows high interactivity for lectures and seminars while applying proven teaching methods. Additionally, a collaboration software system to document all lessons learned and a technical support team have been available for the teaching staff. Courses with a hands-on approach require more personal interaction than lectures. Therefore, the issues of practical trainings have not been solved with this concept, but been tackled by using questionnaires and minimizing contacts during attestations. Applied IT tools: The concept's requirements were met by Zoom Meetings, Confluence, HIS/LSF and Moodle. Discussion and Conclusion: The concept helped the lecturers to provide high-quality teaching for students at universities. Additionally, it allows for a dynamic response to new needs and problems. The concept will be reviewed as part of a higher Universal Design for Learning concept and may support lecturers in the following semesters in hybrid meetings with real and virtual attendees.

Metamaterial-based transmit and receive system for whole-body magnetic resonance imaging at ultra-high magnetic fields.

Magnetic resonance imaging (MRI) at ultra-high fields (UHF), such as 7 T, provides an enhanced signal-to-noise ratio and has led to unprecedented high-resolution anatomic images and brain activation maps. Although a variety of radio frequency (RF) coil architectures have been developed for imaging at UHF conditions, they usually are specialized for small volumes of interests (VoI). So far, whole-body coil resonators are not available for commercial UHF human whole-body MRI systems. The goal of the present study was the development and validation of a transmit and receive system for large VoIs that operates at a 7 T human whole-body MRI system. A Metamaterial Ring Antenna System (MRAS) consisting of several ring antennas was developed, since it allows for the imaging of extended VoIs. Furthermore, the MRAS not only requires lower intensities of the irradiated RF energy, but also provides a more confined and focused injection of excitation energy on selected body parts. The MRAS consisted of several antennas with 50 cm inner diameter, 10 cm width and 0.5 cm depth. The position of the rings was freely adjustable. Conformal resonant right-/left-handed metamaterial was used for each ring antenna with two quadrature feeding ports for RF power. The system was successfully implemented and demonstrated with both a silicone oil and a water-NaCl-isopropanol phantom as well as in vivo by acquiring whole-body images of a crab-eating macaque. The potential for future neuroimaging applications was demonstrated by the acquired high-resolution anatomic images of the macaque's head. Phantom and in vivo measurements of crab-eating macaques provided high-resolution images with large VoIs up to 40 cm in xy-direction and 45 cm in z-direction. The results of this work demonstrate the feasibility of the MRAS system for UHF MRI as proof of principle. The MRAS shows a substantial potential for MR imaging of larger volumes at 7 T UHF. This new technique may provide new diagnostic potential in spatially extended pathologies such as searching for spread-out tumor metastases or monitoring systemic inflammatory processes.

Using measured stocks of biomass and litter carbon to constrain modelled estimates of sequestration of soil organic carbon under contrasting mixed-species environmental plantings.

Reforestation of agricultural land with mixed-species environmental plantings of native trees and shrubs contributes to abatement of greenhouse gas emissions through sequestration of carbon, and to landscape remediation and biodiversity enhancement. Although accumulation of carbon in biomass is relatively well understood, less is known about associated changes in soil organic carbon (SOC) following different types of reforestation. Direct measurement of SOC may not be cost effective where rates of SOC sequestration are relatively small and/or highly spatially-variable, thereby requiring intensive sampling. Hence, our objective was to develop a verified modelling approach for determining changes in SOC to facilitate the inclusion of SOC in the carbon accounts of reforestation projects. We measured carbon stocks of biomass, litter and SOC (0-30cm) in 125 environmental plantings (often paired to adjacent agricultural sites), representing sites of varying productivity across the Australian continent. After constraining a carbon accounting model to observed measures of growth, allocation of biomass, and rates of litterfall and litter decomposition, the model was calibrated to maximise the efficiency of prediction of SOC and its fractions. Uncertainties in both measured and modelled results meant that efficiencies of prediction of SOC across the 125 contrasting plantings were only moderate, at 39-68%. Data-informed modelling nonetheless improved confidence in outputs from scenario analyses, confirming that: (i) reforestation on agricultural land highly depleted in SOC (i.e. previously under cropping) had the highest capacity to sequester SOC, particularly where rainfall was relatively high (>600mmyear-1), and; (ii) decreased planting width and increased stand density and the proportion of eucalypts enhanced rates of SOC sequestration. These results improve confidence in predictions of SOC following environmental reforestation under varying conditions. The calibrated model will be a useful tool for informing land managers and policy makers seeking to understand the dynamics of SOC following such reforestation.

Rapid prediction of particulate, humus and resistant fractions of soil organic carbon in reforested lands using infrared spectroscopy.

Reforestation of agricultural lands with mixed-species environmental plantings can effectively sequester C. While accurate and efficient methods for predicting soil organic C content and composition have recently been developed for soils under agricultural land uses, such methods under forested land uses are currently lacking. This study aimed to develop a method using infrared spectroscopy for accurately predicting total organic C (TOC) and its fractions (particulate, POC; humus, HOC; and resistant, ROC organic C) in soils under environmental plantings. Soils were collected from 117 paired agricultural-reforestation sites across Australia. TOC fractions were determined in a subset of 38 reforested soils using physical fractionation by automated wet-sieving and 13C nuclear magnetic resonance (NMR) spectroscopy. Mid- and near-infrared spectra (MNIRS, 6000-450 cm-1) were acquired from finely-ground soils from environmental plantings and agricultural land. Satisfactory prediction models based on MNIRS and partial least squares regression (PLSR) were developed for TOC and its fractions. Leave-one-out cross-validations of MNIRS-PLSR models indicated accurate predictions (R2 > 0.90, negligible bias, ratio of performance to deviation > 3) and fraction-specific functional group contributions to beta coefficients in the models. TOC and its fractions were predicted using the cross-validated models and soil spectra for 3109 reforested and agricultural soils. The reliability of predictions determined using k-nearest neighbour score distance indicated that >80% of predictions were within the satisfactory inlier limit. The study demonstrated the utility of infrared spectroscopy (MNIRS-PLSR) to rapidly and economically determine TOC and its fractions and thereby accurately describe the effects of land use change such as reforestation on agricultural soils.

The Travelling-Wave Primate System: A New Solution for Magnetic Resonance Imaging of Macaque Monkeys at 7 Tesla Ultra-High Field.

INTRODUCTION: Neuroimaging of macaques at ultra-high field (UHF) is usually conducted by combining a volume coil for transmit (Tx) and a phased array coil for receive (Rx) tightly enclosing the monkey's head. Good results have been achieved using vertical or horizontal magnets with implanted or near-surface coils. An alternative and less costly approach, the travelling-wave (TW) excitation concept, may offer more flexible experimental setups on human whole-body UHF magnetic resonance imaging (MRI) systems, which are now more widely available. Goal of the study was developing and validating the TW concept for in vivo primate MRI. METHODS: The TW Primate System (TWPS) uses the radio frequency shield of the gradient system of a human whole-body 7 T MRI system as a waveguide to propagate a circularly polarized B1 field represented by the TE11 mode. This mode is excited by a specifically designed 2-port patch antenna. For receive, a customized neuroimaging monkey head receive-only coil was designed. Field simulation was used for development and evaluation. Signal-to-noise ratio (SNR) was compared with data acquired with a conventional monkey volume head coil consisting of a homogeneous transmit coil and a 12-element receive coil. RESULTS: The TWPS offered good image homogeneity in the volume-of-interest Turbo spin echo images exhibited a high contrast, allowing a clear depiction of the cerebral anatomy. As a prerequisite for functional MRI, whole brain ultrafast echo planar images were successfully acquired. CONCLUSION: The TWPS presents a promising new approach to fMRI of macaques for research groups with access to a horizontal UHF MRI system.

A form-fitted three channel (31) P, two channel (1) H transceiver coil array for calf muscle studies at 7 T.

PURPOSE: To enhance sensitivity and coverage for calf muscle studies, a novel, form-fitted, three-channel phosphorus-31 ((31) P), two-channel proton ((1) H) transceiver coil array for 7 T MR imaging and spectroscopy is presented. METHODS: Electromagnetic simulations employing individually generated voxel models were performed to design a coil array for studying nonpathological muscle metabolism. Static phase combinations of the coil elements' transmit fields were optimized based on homogeneity and efficiency for several voxel models. The best-performing design was built and tested both on phantoms and in vivo. RESULTS: Simulations revealed that a shared conductor array for (31) P provides more robust interelement decoupling and better homogeneity than an overlap array in this configuration. A static B1 (+) shim setting that suited various calf anatomies was identified and implemented. Simulations showed that the (31) P array provides signal-to-noise ratio (SNR) benefits over a single loop and a birdcage coil of equal radius by factors of 3.2 and 2.6 in the gastrocnemius and by 2.5 and 2.0 in the soleus muscle. CONCLUSION: The performance of the coil in terms of B1 (+) and achievable SNR allows for spatially localized dynamic (31) P spectroscopy studies in the human calf. The associated higher specificity with respect to nonlocalized measurements permits distinguishing the functional responses of different muscles.

Ultra-high field MRI for primate imaging using the travelling-wave concept.

OBJECT: Ultra-high field (UHF) neuroimaging is usually conducted with volume transmit (Tx) and phased array receive (Rx) coils, both tightly enclosing the object. The travelling-wave (TW) concept allows a remote excitation offering more flexible experimental setups. To investigate the feasibility of primate MRI in horizontal UHF MRI, we first compared the distribution of the electromagnetic fields in an oil phantom and then verified the concept with an in vivo experiment. MATERIALS AND METHODS: In the phantom experiments an in-house circularly polarized hybrid birdcage coil and a self-developed patch antenna were used for Tx and an eight-element phased array antenna for Rx. B1+ fields were calculated and measured for both approaches. For in vivo experiments the Rx part was replaced with an optimized three-element phased array head coil. The SAR was calculated using field simulation. RESULTS: In the phantom the field distribution was homogenous in a central volume of interest of about 10 cm diameter. The TW concept showed a slightly better homogeneity. Examination of a female crab-eating macaque led to homogeneous high-contrast images with a good delineation of anatomical details. CONCLUSION: The TW concept opens up a new approach for MRI of medium-sized animals in horizontal UHF scanners.

Investigation of pore diffusion hindrance of monoclonal antibody in hydrophobic interaction chromatography using confocal laser scanning microscopy.

In this article, hindrance of intraparticle mass transfer during the adsorption of a monoclonal antibody (mAb) on Butyl Sepharose 4FF was investigated under different conditions. In addition to common fluid phase measurements, confocal laser scanning microscopy (CLSM) was applied to evaluate the respective intraparticle concentration profiles. In order to ensure that the observed intraparticle protein distributions are not disturbed by artefacts of CLSM, microscopic data are carefully analysed considering signal attenuation and competitive adsorption between labelled and native species. Using this setup, lower protein concentration in the inner particle region was observed even after long equilibration times in protein solution. Since the observed phenomenon showed a dependency on the amount of adsorbed protein, we assumed that the intraparticle diffusion was hindered by the adsorbed protein molecules. We propose hypotheses on the diffusion hindrance, and compare the experimental results with model-based simulations of single particles that include novel terms for the description of hindered diffusion.

Short-cut method for the correction of light attenuation influences in the experimental data obtained from confocal laser scanning microscopy.

Based on Lambert-Beer law and the light attenuation model, a new method will be introduced in this work in order to eliminate the disturbances caused by signal attenuation in the experimental data measured by confocal laser scanning microscopy (CLSM). This new method considers the attenuation effects which depend on concentration of fluorophore-labelled protein as well as attenuation effects which are independent from protein concentration. Furthermore, no solvent additive is required in order to match the refraction index of solvent to bead material. The determination of correction factors is, thus, easily done using the currently investigated chromatographic phase system, so that the validity of the correction factors in the current system can be guaranteed. The introduced correction method has been applied for the investigation of intraparticle protein distribution inside an HIC (hydrophobic interaction chromatography) particle.

Generation of equally sized particle plaques using solid-liquid suspensions.

A device is presented for the generation of equally sized plaques of sensitive particles in a 96-well format. The resulting particle plaques can be used for the measurement of adsorption isotherms and uptake kinetics in protein chromatography or for immobilization reactions. The particle plaques are formed from suspensions with a vacuum device that is designed as a reusable sandwich module. The particles are retained by a mesh while the solvent is removed by the vacuum. As most particles used for protein chromatography are sensitive to mechanical stress and dehydration, the vacuum device is gentle enough to allow the use of these particles, thus eliminating the uncertainty of slurry preparation and pipetting. Apparatus characteristics and preparation procedures are described precisely. The physical intactness of the particles after the preparation procedure is proved by microscopic analysis. Data on the uniformity of the obtained resin plaques with respect to the reproducibility of their adsorption performance is given. Finally, adsorption isothermal and kinetic data of BSA on an ordinary HIC system obtained by high-throughput measurements are shown as an application example.