Artifact reduction in low and ultra-low dose chest computed tomography for patients with pacemaker: A phantom study.

INTRODUCTION: Implanted pacemakers (PM) would decrease the detection of lung nodules in chest computed tomography (CT) due to the metal artifact. This study aimed to explore the computer-aided diagnosis (CAD) detectability of pulmonary nodules for the patients implanted with PMs in low- and ultra-low-dose chest CT screening. METHODS: Four different sizes of artificial nodules were placed in an anthropomorphic chest phantom with two alternative diameters utilized. A commercially available PM was placed on the surface of the left chest wall of the phantom. The image acquisitions were performed with 120 kV and 150 kV with a dedicated selective photon shield made of tin filter (Sn150 kV) at low- and ultra-low- radiation doses (1.0 and 0.5 mGy of volume CT dose index), and reconstructed with and without Iterative Metal Artifact Reduction (iMAR, Siemens Healthineers, Erlangen, Germany). The relative artifact index (AIr) was calculated as an index of metal artifacts, and the nodule detectability was evaluated with a CAD system. RESULTS: Sn150 kV reduced AIr in all acquisitions when comparing 120 kV and Sn150 kV. Although PM reduced the detectability of nodules, Sn150 kV showed higher detectability compared to 120 kV. The use of iMAR showed inconsistent results in nodule detectability. CONCLUSION: Sn150 kV reduced PM-induced metal artifacts and improved nodule detectability with CAD compared to 120 kV acquisition in many conditions including low and ultra-low doses and large phantoms, but iMAR did not improve the detectability. IMPLICATIONS FOR PRACTICE: Based on the results of the current phantom study, low and ultra-low dose with Sn150 kV acquisition reduced PM-induced metal artifacts and improved nodule detectability.

The effect of nano hydroxyapatite coating implant surfaces on gene expression and osseointegration.

BACKGROUND: Hierarchical micro-nano structured topography along with surface chemistry modifications of dental implants have been suggested to positively contribute to the osseointegration process. However, the effect of such surface modifications on the molecular response as well as bone formation rate and quality are still unclear, especially in the early healing period. This study aimed to evaluate the effect of coating a double acid etched (DAE) implant surface with nano-sized (20 nm) hydroxyapatite (Nano) with respect to gene expression, histologic parameters, and nanomechanical properties when compared to DAE control at 1 and 2 weeks after implant placement in a rodent femur model. MATERIAL AND METHODS: Expression of bone-related genes was determined by qRT-PCR (Col-I, Runx-2, Osx, Opn, Ocn, Alp). Histomorphometric evaluation of bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) within implant threads was performed using photomicrographs after histologic processing. Mechanical properties, reduced elastic modulus and hardness, were determined through nanoindentation. RESULTS: At 1 week, the Nano group demonstrated significantly higher expression of Col-I and Ocn compared to the DAE group, indicating upregulation of osteoprogenitor and osteoblast differentiation genes. At 2 weeks, Nano surface further exhibited enhanced gene expression of Col-I and Osx in comparison to the DAE surface, suggesting an increased mineralization of the newly formed bone. Nanoindentation analysis revealed that the Nano group presented no significant difference on the ranks of reduced elastic modulus and hardness compared to DAE for both timepoints. Histomorphometric analysis yielded no significant difference in the percentage of BIC and BAFO between the Nano and DAE surfaces at 1 and 2 weeks. However, Nano implants did present a higher mean value, ~50%, of BIC compared to DAE, ~30%, after 2 weeks in vivo. CONCLUSIONS: While no significant differences were observed in the amount and mechanical properties of newly formed bone, Nano surface positively and significantly increased the expression osteogenic genes compared to DAE surface at early healing periods.

Visualization of Nigrosome 1 from the Viewpoint of Anatomic Structure.

BACKGROUND AND PURPOSE: Parkinson disease is related to neurodegeneration and iron deposition in the substantia nigra pars compacta and nigrosome 1. However, visualization of nigrosome 1 via MR imaging is poor owing to the bilateral asymmetry, regardless of whether it is healthy. We focused on the magic angle and susceptibility effect and evaluated the anatomic slant structure of nigrosome 1 by tilting subjects' heads in the B0 direction. MATERIALS AND METHODS: To investigate the effectiveness of the magic angle, we tilted the volunteers' heads to the right and left in the B0 direction or not at all for evaluating correlations between the degree of head tilting and visualization of the right nigrosome 1 and left nigrosome 1 using 3D spoiled gradient-echo sequences with multiecho acquisitions. We evaluated the susceptibility of nigrosome 1 and the local field using quantitative susceptibility mapping to assess static magnetic field inhomogeneity. RESULTS: The heads tilted to the right and left showed significantly higher contrasts of nigrosome 1 and the substantia nigra pars compacta than the nontilted heads. No significant differences were observed in the visualization and susceptibility between the right nigrosome 1 and left nigrosome 1 for each head tilt. The effect of the magic angle was remarkable in the nontilted heads. This finding was supported by quantitative susceptibility mapping because the anatomic slant structure of nigrosome 1 was coherent between the axis of nigrosome 1 and the magic angle. CONCLUSIONS: The asymmetric visualization of nigrosome 1 is affected by the magic angle and susceptibility. The anatomic slant structure of nigrosome 1 causes these challenges in visualization.

Sustained rescue of prefrontal circuit dysfunction by antidepressant-induced spine formation.

The neurobiological mechanisms underlying the induction and remission of depressive episodes over time are not well understood. Through repeated longitudinal imaging of medial prefrontal microcircuits in the living brain, we found that prefrontal spinogenesis plays a critical role in sustaining specific antidepressant behavioral effects and maintaining long-term behavioral remission. Depression-related behavior was associated with targeted, branch-specific elimination of postsynaptic dendritic spines on prefrontal projection neurons. Antidepressant-dose ketamine reversed these effects by selectively rescuing eliminated spines and restoring coordinated activity in multicellular ensembles that predict motivated escape behavior. Prefrontal spinogenesis was required for the long-term maintenance of antidepressant effects on motivated escape behavior but not for their initial induction.

Modeling and simulation of bone mineral density in Japanese osteoporosis patients treated with zoledronic acid using tartrate-resistant acid phosphatase 5b, a bone resorption marker.

Annual intravenous administration of zoledronic acid is used in the treatment of osteoporosis. A mathematical model was developed to predict bone mineral density up to 2 years after two annual doses of zoledronic acid from the early values of a bone resorption marker in osteoporosis patients. INTRODUCTION: The measurement of bone mineral density (BMD) has been used as a surrogate marker instead of the observation of incident fractures to detect the efficacy of treatment. However, this method requires a long time to obtain significant changes. On the other hand, bone resorption markers respond to bone resorption inhibitors within a few weeks. Therefore, the aim of this study was to develop a mathematical model predicting long-term BMD after two annual doses of zoledronic acid (ZOL) using the early response of a bone resorption marker in osteoporosis patients. METHODS: The model was constructed using 3410 tartrate-resistant acid phosphatase 5b (TRACP-5b) serum concentrations and 1146 lumbar spine (L2-L4) BMD values from 306 patients with primary osteoporosis. A mathematical model was developed to describe the time-dependent profiles of TRACP-5b and BMD. RESULTS: The percentage changes from baseline of the BMD (%BMD) at up to 2 years were predicted from patients' baseline BMD and baseline and 12-week TRACP-5b values by the model obtained. The simulated 90% prediction interval almost covered the observed %BMD distribution at each time point, and the predictions were comparable to the observed %BMD. CONCLUSIONS: This is the first model to predict BMD for up to 2 years following two annual doses of ZOL using patients' background characteristics and the early response of TRACP-5b. This model allows us to inform patients at the initial stage of ZOL treatment of their predicted response to treatment.

Efficacy and safety of trastuzumab, lapatinib, and paclitaxel neoadjuvant treatment with or without prolonged exposure to anti-HER2 therapy, and with or without hormone therapy for HER2-positive primary breast cancer: a randomised, five-arm, multicentre, open-label phase II trial.

BACKGROUND: Dual blockade of HER2 promises increased pathological complete response (pCR) rate compared with single blockade in the presence of chemotherapy for HER2-positive (+) primary breast cancer. Many questions remain regarding optimal duration of treatment and combination impact of endocrine therapy for luminal HER2 disease. METHODS: We designed a randomised phase II, five-arm study to evaluate the efficacy and safety of lapatinib and trastuzumab (6 weeks) followed by lapatinib and trastuzumab plus weekly paclitaxel (12 weeks) with/without prolongation of anti-HER2 therapy prior to chemotherapy (18 vs. 6 weeks), and with/without endocrine therapy in patients with HER2+ and/or oestrogen receptor (ER)+ disease. The primary endpoint was comprehensive pCR (CpCR) rate. Among the secondary endpoints, pCR (yT0-isyN0) rate, safety, and clinical response were evaluated. RESULTS: In total, 215 patients were enrolled; 212 were included in the full analysis set (median age 53.0 years; tumour size = T2, 65%; and tumour spread = N0, 55%). CpCR was achieved in 101 (47.9%) patients and was significantly higher in ER- patients than in ER+ patients (ER- 63.0%, ER+ 36.1%; P = 0.0034). pCR with pN0 was achieved in 42.2% of patients (ER- 57.6%, ER+ 30.3%). No significant difference was observed in pCR rate between prolonged exposure groups and standard groups. Better clinical response outcomes were obtained in the prolongation phase of the anti-HER2 therapy. No surplus was detected in pCR rate by adding endocrine treatment. No major safety concern was recognised by prolonging the anti-HER2 treatment or adding endocrine therapy. CONCLUSIONS: This study confirmed the therapeutic impact of lapatinib, trastuzumab, and paclitaxel therapy for each ER- and ER+ subgroup of HER2+ patients. Development of further strategies and tools is required, particularly for luminal HER2 disease.

CO-induced Pd segregation and the effect of subsurface Pd on CO adsorption on CuPd surfaces.

We report results of our study on the adsorption of CO on CuPd surfaces with bulk stoichiometric and nonstoichiometric layers using density functional theory (DFT). We found that the presence of Pd atoms in the subsurface layer promotes the adsorption of CO. We also observed CO-induced Pd segregation on the CuPd surface and we attribute this to the strong CO-Pd interaction. Lastly, we showed that the adsorption of CO promotes Pd-Pd interaction as compared to the pristine surface which promotes strong Cu-Pd interaction. These results indicate that CO adsorption on CuPd surfaces can be tuned by taking advantage of the CO-induced segregation and by considering the role of subsurface Pd atoms.

Association of the clinical efficacy of vancomycin with the novel pharmacokinetic parameter area under the trough level (AUTL) in elderly patients with hospital-acquired pneumonia.

WHAT IS KNOWN AND OBJECTIVE: The pharmacokinetic-pharmacodynamic parameter that best predicts the efficacy of vancomycin is the ratio of the area under the concentration versus time curve (AUC) to the minimum inhibitory concentration (MIC). A 24-h AUC (AUC24 )/MIC ratio ≥ 400 was recommended in an American consensus review, but vancomycin treatment occasionally fails despite maintenance of AUC24 /MIC ≥ 400. We evaluated the association between clinical efficacy of vancomycin and two novel pharmacokinetic parameters, the 'area under the trough level' (AUTL) and the 'area above the trough level' (AATL), in hospitalized elderly patients with methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. METHODS: The subjects were hospitalized elderly patients who were administered vancomycin for treatment of MRSA pneumonia between 2006 and 2012 at Sasebo Chuo Hospital (Nagasaki, Japan). Pharmacokinetic parameters of vancomycin were estimated for each patient by Bayesian analysis using population pharmacokinetic parameters for Japanese patients. Based on the patient-specific parameters thus obtained, AUC24 values were calculated as the vancomycin dosage divided by vancomycin clearance. AUTL was calculated as the trough serum concentration multiplied by 24 h, whereas AATL was calculated by subtracting AUTL from AUC24 . RESULTS AND DISCUSSION: Logistic regression analysis demonstrated that efficacy of vancomycin was more strongly associated with AUTL than AUC24 . The optimal cut-off value of AUTL was 331 µg∙h/mL, which means that the optimal cut-off value of the trough serum concentration was 13·8 µg/mL. WHAT IS NEW AND CONCLUSION: Efficacy of vancomycin was associated with AUTL, a novel pharmacokinetic parameter. Determining the target AUTL or trough concentration may enhance the efficacy of vancomycin therapy in elderly patients with MRSA pneumonia. Given that nephrotoxicity may increase with a Ctrough in excess of 15 µg/mL, this level should ideally not be exceeded.

A DFT+U study on the contribution of 4f electrons to oxygen vacancy formation and migration in Ln-doped CeO2.

A rare earth doped form of ceria (CeO2) is of interest as a potential candidate for solid oxide fuel cells (SOFCs) because of its relatively high oxygen ion conductivity at temperatures below 600 °C. At the present time, computational chemistry has reached a certain maturity which allows the prediction of materials properties that are difficult to observe experimentally. However, understanding of the roles of dopants in the oxygen ion conduction in CeO2 is still incomplete for quantitatively reliable analysis due to the strong electron correlation of 4f electrons. In this study, density functional theory calculations with Hubbard U corrections are used to discuss ionic/covalent interactions in rare-earth-doped CeO2 and their consequences to oxygen ion conduction. This study suggests that the variable occupancy of empty 4f orbitals is important typically for early Ln elements to produce the covalent interactions that essentially affect the formation and migration of oxygen vacancies. This finding is important in understanding the factors responsible for oxygen ion diffusion in doped CeO2.

Hindered rotational physisorption states of H2 on Ag(111) surfaces.

We have investigated the physisorption states of H2 on Ag(111) surfaces. To clarify the accurate adsorption properties of H2 on Ag(111), we performed first-principles calculations based on spin-polarized density functional theory (DFT) with the semiempirical DFT-D2 method and the newly-developed exchange functional with the non-local correlation functional vdW-DF2 (rev-vdW-DF2). We constructed exhaustive potential energy surfaces, and revealed that non-negligible out-of-plane potential anisotropy with a perpendicular orientation preference exists even for H2 physisorption on planar Ag(111), as predicted by previous results of resonance-enhanced multiphoton ionization spectroscopy and temperature-programmed desorption experiments. Therefore, the molecular rotational ground states of ortho-H2 split into two energy levels in the anisotropic potential. The obtained adsorption energy and the number of bound states, including the zero-point energies and the rotational energy shift, agree with diffractive and rotationally mediated selective adsorption scattering resonance measurements. The origin of the potential anisotropy on Ag(111) is a combination of the London dispersion interaction and the virtual transition of the metal electron to the unoccupied molecular state.

Maternal restraint stress during pregnancy in mice induces 11ß-HSD1-associated metabolic changes in the livers of the offspring.

In rats, maternal exposure to restraint stress during pregnancy can induce abnormalities in the cardiovascular and central nervous systems of the offspring. These effects are mediated by long-lasting hyperactivation of the hypothalamic-pituitary-adrenal axis. However, little is known about the potential effects of stress during pregnancy on metabolic systems. We examined the effect of restraint stress in pregnant mice on the liver function of their offspring. The offspring of stressed mothers showed significantly higher lipid accumulation in the liver after weaning than did the controls; this accumulation was associated with increased expression of lipid metabolism-related proteins such as alanine aminotransferase 2 diglyceride acyltransferase 1, peroxisome proliferator-activated receptor gamma and glucocorticoid receptor. Additionally, we observed increased levels of 11ß-hydroxysteroid dehydrogenase type 1, an intercellular mediator that converts glucocorticoid from the inactive to the active form, in the foetal and postnatal periods. These results indicate that restraint stress in pregnancy in mice induces metabolic abnormalities via 11ß-hydroxysteroid dehydrogenase type 1-related pathways in the foetal liver. It is therefore possible that exposure to stress in pregnant women may be a risk factor for metabolic syndromes (e.g. fatty liver) in children.

Interstitial impurity-induced magnetism in α-PbO surface.

We have investigated the effects of 3d transition metal (TM) and non-magnetic interstitial impurities in α-PbO (0 0 1) surface using ab-initio calculations. The calculated impurity-induced magnetic moments are 2.25 µB, 3.11 µB and 0.94 µB for Fe, Mn and Pb interstitials respectively. In the bonding process, TM's lower energy lying d(z2) states form overlaps with nearest neighbour oxygen atoms' p(z) states, with other non-bonding spin split d states situated near or at the Fermi level. These spin split orbitals introduce spin polarised p impurity states of oxygen atoms near the surface.

Effects of plasmon energetics on light emission induced by scanning tunneling microscopy.

A theoretical model of plasmon and molecular luminescence induced by scanning tunneling microscopy using a molecule-covered tip on clean metal surfaces is developed. The effects of coupling between molecular exciton and interface plasmon on the luminescence spectra are investigated for variable energy of plasmon modes by means of the nonequilibrium Green's function method. It is found that spectral features arising from interference between the processes of energy absorption by the molecule and interface plasmons appear near the energy of the excitonic mode. For the energy of plasmon above (below) the energy of excitonic mode, an additional peak structure appears in the energy range slightly below (above) the energy of the excitonic mode. Prominent peak and dip structures observed in recent luminescence experiments are interpreted by the developed theory whereby its utility in the fields of plasmonics and nanophotonics is demonstrated.

Inactivation of koi-herpesvirus in water using bacteria isolated from carp intestines and carp habitats.

Since its first outbreak in Japan in 2003, koi-herpesvirus (KHV) remains a challenge to the carp Cyprinus carpio L. breeding industry. In this study, inactivation of KHV in water from carp habitats (carp habitat water) was investigated with the aim of developing a model for rapidly inactivating the pathogen in aquaculture effluent. Experiments with live fish showed that, in carp habitat water, KHV lost its infectivity within 3 days. Indications were that inactivation of KHV was caused by the antagonistic activity of bacteria (anti-KHV bacteria) in the water from carp habitats. Carp habitat water and the intestinal contents of carp were therefore screened for anti-KHV bacteria. Of 581 bacterial isolates, 23 showed anti-KHV activity. An effluent treatment model for the disinfection of KHV in aquaculture effluent water using anti-KHV bacteria was developed and evaluated. The model showed a decrease in cumulative mortality and in the number of KHV genome copies in kidney tissue of fish injected with treated effluent compared with a positive control. It is thought that anti-KHV bacteria isolated from the intestinal contents of carp and from carp habitat water can be used to control KHV outbreaks.

Predictive index for the onset of medication overuse headache in migraine patients.

Migraine patients are particularly prone to develop medication overuse headache (MOH). However, the risk factors for the transformation of migraine to MOH are still not clear. We investigated gene polymorphisms, personality traits, and characteristics of headache and lifestyle in 47 migraine patients (aged 36.4 ± 10.3) and 22 MOH patients (aged 39.6 ± 9.9) who progressed from migraine and made a scoring system for a predictive index (PI) of the onset of MOH in patients with migraine. By multivariate logistic stepwise regression analysis, type of migraine, regular and sufficient dietary intake, and methylenetetrahydrofolate reductase (MTHFR) C677T (rs1801133) and dopamine D2 receptor (DRD2) C939T (rs6275) polymorphisms were selected as significant factors that contribute independently to the development from migraine to MOH (P < 0.05). The regression coefficients (ß) of these four selected factors were approximated and scored. The PI score in MOH patients (7.32 ± 1.60) was significantly higher than that in migraine patients (4.62 ± 1.83, P < 0.001). The proposed scoring system should in the future be the object of larger studies to confirm its validity.

Analysis of structural and electronic properties of Pr2NiO4 through first-principles calculations.

The structural and electronic properties of bulk Pr(2)NiO(4+δ) (δ = 0 and 0.031) were analyzed using first-principles calculations based on the density functional theory (DFT) for application to electrode materials in solid-oxide fuel cells (SOFCs). Two structures of Pr(2)NiO(4) were analyzed: one in space group I4/mmm associated with the high temperature tetragonal (HTT) structure, and the other in Bmab with the low temperature orthorhombic (LTO) structure. The main difference between the two structures is the pronounced tilting of the nickelate octahedra found in the Bmab structure. Here, we will show that the difference in the electronic properties between the two structures, i.e. half-metallic for the I4/mmm structure and metallic for the Bmab structure, is attributed to the tilting of the nickelate octahedra. Furthermore, we found that the presence of interstitial O atoms at the Pr(2)O(2) bilayers is responsible for the tilting of the octahedra and thus is a dominant factor in the transition from the I4/mmm structure to the Bmab structure. These results would be of great significance to materials design related to the enhancement of O diffusivity in this material.

NO dissociation on Cu(111) and Cu2O(111) surfaces: a density functional theory based study.

NO dissociation on Cu(111) and Cu(2)O(111) surfaces is investigated using spin-polarized density functional theory. This is to verify the possibility of using Cu-based catalyst for NO dissociation which is the rate limiting step for the NO(x) reduction process. The dissociation of molecularly adsorbed NO on the surface is activated for both cases. However, from the reaction path of the NO-Cu(2)O(111) system, the calculated transition state lies below the reference energy which indicates the possibility of dissociation. For the NO-Cu(111) system, the reaction path shows that NO desorption is more likely to occur. The geometric and electronic structure of the Cu(2)O(111) surface indicates that the surface Cu atoms stabilize themselves with reference to the O atom in the subsurface. The interaction results in modification of the electronic structure of the surface Cu atoms of Cu(2)O(111) which greatly affects the adsorption and dissociation of NO. This phenomenon further explains the obtained differences in the dissociation pathways of NO on the surfaces.

Delta-ADC (apparent diffusion coefficient) analysis in patients with idiopathic normal pressure hydrocephalus.

We have developed the delta-apparent diffusion coefficient (ADC), a new parameter of the water dynamics of brain tissue using MRI. Delta-ADC is the changes in regional ADC values of the brain during the cardiac cycle. The study included 6 idiopathic normal pressure hydrocephalus (iNPH) patients (iNPH group) and 12 healthy volunteers (control group). ECG-triggered single-shot diffusion echo planar imaging (b = 0 and 1,000 s/mm(2)) was used on a 1.5-T MRI. The delta-ADC image was calculated from the maximum minus the minimum ADC value of all cardiac phase images (20 phases) on a pixel-by-pixel basis. Delta-ADC values in the white matter of the frontal, temporal, and occipital lobe were obtained. Delta-ADC values in the iNPH group were significantly higher than those in the control group in all regions. ADC values in the iNPH were also significantly higher than those in the control group, but the differences in the ADC between the groups in each region were much lower than those for the delta-ADC. Although the changes in the delta-ADC and ADC values were similar, there was no significant correlation between the delta-ADC and the ADC. These results suggest that the ADC and the delta-ADC may reflect different kinds of water dynamics. The ADC depends on the water content in brain tissue. On the other hand, delta-ADC depends on not only the water content, but also on the degree of the fluctuation of the water molecules. Delta-ADC analysis makes it possible to obtain non-invasively new and more detailed information on the regional brain condition in iNPH.

Surface magnetism in O2 dissociation-from basics to application.

First-principles calculations were performed to investigate magnetic phenomena in surface reactions involving O(2). We present two magnetized surface cases: (1) oxidation of paramagnetic Ag, and magnetic properties of the high coverage oxide phase, which correspond to a magnetic impurity superlattice on paramagnetic surfaces and (2) oxidation of ferromagnetic Pt, represented by the Pt layer on M (M = Fe and Co) relevant to the oxidation reduction reaction (ORR) on Pt, in relation to both fundamental and application interests. In the first case, we found that the dissociative adsorption of O(2), resulting in oxide phases in Ag(111), reveals interesting magnetic interactions. We note that the magnetic states are induced by the ferromagnetic superexchange interactions and Ruderman-Kittel-Kasuya-Yosida (RKKY) interactions. Specifically, the superlattice structures with short O-O distances have an effective ferromagnetic superexchange and RKKY interaction. In the second case, we found that a magnetic moment is induced on the Pt layer by the M substrate. The spin polarization of Pt-d states is due to hybridization with M-d states. The d-band center (ε(d)) of Pt (on M), is shifted downwards with respect to pure Pt. However, because of the spin polarization, the otherwise filled spin-down d(zz) orbital in paramagnetic pure Pt is shifted towards the Fermi level. This promotes π(z↑)-d(zz↓) interactions, which influences the O(2)-Pt interaction at O(2) far from the surface. Details and mechanisms of these two magnetic phenomena are discussed.