High figure-of-merit for ZnO nanostructures by interfacing lowly-oxidized graphene quantum dots.

Thermoelectric technology has potential for converting waste heat into electricity. Although traditional thermoelectric materials exhibit extremely high thermoelectric performances, their scarcity and toxicity limit their applications. Zinc oxide (ZnO) emerges as a promising alternative owing to its high thermal stability and relatively high Seebeck coefficient, while also being earth-abundant and nontoxic. However, its high thermal conductivity (>40 W m-1K-1) remains a challenge. In this study, we use a multi-step strategy to achieve a significantly high dimensionless figure-of-merit (zT) value of approximately 0.486 at 580 K (estimated value) by interfacing graphene quantum dots with 3D nanostructured ZnO. Here, we show the fabrication of graphene quantum dots interfaced 3D ZnO, yielding the highest zT value ever reported for ZnO counterparts; specifically, our experimental results indicate that the fabricated 3D GQD@ZnO exhibited a significantly low thermal conductivity of 0.785 W m-1K-1 (estimated value) and a remarkably high Seebeck coefficient of - 556 µV K-1 at 580 K.

Assessment of Feasibility and Interscan Variability of Short-time Cardiac MRI for Cardiotoxicity Evaluation in Breast Cancer.

Purpose To investigate the feasibility and interscan variability of short-time cardiac MRI protocol after chemotherapy in individuals with breast cancer. Materials and Methods A total of 13 healthy female controls (mean age, 52.4 years ± 13.2 [SD]) and 85 female participants with breast cancer (mean age, 51.8 years ± 9.9) undergoing chemotherapy prospectively underwent routine breast MRI and short-time cardiac MRI using a 3-T scanner with peripheral pulse gating in the prone position. Interscan, intercoil, and interobserver reproducibility and variability of native T1 and extracellular volume (ECV), as well as ventricular functional parameters, were measured using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), or coefficient of variation (CoV). Results Left ventricular functional parameters had excellent interscan reproducibility (ICC ≥ 0.80). Left ventricular ejection fraction showed low interscan variability in control and chemotherapy participants (SEM, 2.0 and 1.2; CoV, 3.1 and 1.9, respectively). Native T1 showed excellent interscan (ICC, 0.75) and intercoil (ICC, 0.81) reproducibility in the control group and good interscan reproducibility (ICC, 0.72 and 0.73, respectively) in the participants undergoing immediate and remote chemotherapy. Interscan reproducibility for ECV was excellent in the control group and in the remote chemotherapy group (ICC, 0.93 and 0.88, respectively) and fair in the immediate chemotherapy group (ICC, 0.52). In the regional analysis, interscan repeatability and variability of native T1 and ECV were superior in the anteroseptum or inferoseptum than in other segments in the immediate chemotherapy group. Native T1 and ECV had good to excellent interobserver agreement across all groups. Conclusion Short-time cardiac MRI showed excellent results for interscan, intercoil, and interobserver reproducibility and variability for ventricular functional or tissue characterization parameters, suggesting that this modality is feasible for routine surveillance of cardiotoxicity evaluation in individuals with breast cancer. Keywords: Cardiac MRI, Heart, Cardiomyopathy ClinicalTrials.gov registration no. NCT03301389 Supplemental material is available for this article. © RSNA, 2024.

Feasibility of UTE-MRI-based radiomics model for prediction of histopathologic subtype of lung adenocarcinoma: in comparison with CT-based radiomics model.

OBJECTIVES: To assess the feasibility of the UTE-MRI radiomic model in predicting the micropapillary and/or solid (MP/S) patterns of surgically resected lung adenocarcinoma. MATERIALS AND METHODS: We prospectively enrolled 74 lesions from 71 patients who underwent UTE-MRI and CT before curative surgery for early lung adenocarcinoma. For conventional radiologic analysis, we analyzed the longest lesion diameter and lesion characteristics at both UTE-MRI and CT. Radiomic features were extracted from the volume of interest of the lesions and Rad-scores were generated using the least absolute shrinkage and selection operator with fivefold cross-validation. Six models were constructed by combining the conventional radiologic model, UTE-MRI Rad-score, and CT Rad-score. The areas under the curves (AUCs) of each model were compared using the DeLong method. Early recurrence after curative surgery was analyzed, and Kaplan-Meier survival analysis was performed. RESULTS: Twenty-four lesions were MP/S-positive, and 50 were MP/S-negative. The longitudinal size showed a small systematic difference between UTE-MRI and CT, with fair intermodality agreement of lesion characteristic (kappa = 0.535). The Rad-scores of the UTE-MRI and CT demonstrated AUCs of 0.84 and 0.841, respectively (p = 0.98). Among the six models, mixed conventional, UTE-MRI, and CT Rad-score model showed the highest diagnostic performance (AUC = 0.879). In the survival analysis, the high- and low-risk groups were successfully divided by the Rad-score in UTE-MRI (p = 0.01) and CT (p < 0.01). CONCLUSION: UTE-MRI radiomic model predicting MP/S positivity is feasible compared with the CT radiomic model. Also, it was associated with early recurrence in the survival analysis. CLINICAL RELEVANCE STATEMENT: A radiomic model utilizing UTE-MRI, which does not present a radiation hazard, was able to successfully predict the histopathologic subtype of lung adenocarcinoma, and it was associated with the patient's recurrence-free survival. KEY POINTS: • No studies have reported the ultrashort echo time (UTE)-MRI-based radiomic model for lung adenocarcinoma. • The UTE-MRI Rad-score showed comparable diagnostic performance with CT Rad-score for predicting micropapillary and/or solid histopathologic pattern. • UTE-MRI is feasible not only for conventional radiologic analysis, but also for radiomics analysis.

Chemotherapy-Related Cardiac Dysfunction: Quantitative Cardiac Magnetic Resonance Image Parameters and Their Prognostic Implications.

OBJECTIVE: To quantitatively analyze the cardiac magnetic resonance imaging (CMR) characteristics of chemotherapy-related cardiac dysfunction (CTRCD) and explore their prognostic value for major adverse cardiovascular events (MACE). MATERIALS AND METHODS: A total of 145 patients (male:female = 76:69, mean age = 63.0 years) with cancer and heart failure who underwent CMR between January 2015 and January 2021 were included. CMR was performed using a 3T scanner (Siemens). Biventricular functions, native T1 T2, extracellular volume fraction (ECV) values, and late gadolinium enhancement (LGE) of the left ventricle (LV) were compared between those with and without CTRCD. These were compared between patients with mild-to-moderate CTRCD and those with severe CTRCD. Cox proportional hazard regression analysis was used to evaluate the association between the CMR parameters and MACE occurrence during follow-up in the CTRCD patients. RESULTS: Among 145 patients, 61 had CTRCD and 84 did not have CTRCD. Native T1, ECV, and T2 were significantly higher in the CTRCD group (1336.9 ms, 32.5%, and 44.7 ms, respectively) than those in the non-CTRCD group (1303.4 ms, 30.5%, and 42.0 ms, respectively; P = 0.013, 0.010, and < 0.001, respectively). They were not significantly different between patients with mild-to-moderate and severe CTRCD. Indexed LV mass was significantly smaller in the CTRCD group (65.0 g/m² vs. 78.9 g/m²; P < 0.001). According to the multivariable Cox regression analysis, T2 (hazard ratio [HR]: 1.14, 95% confidence interval [CI]: 1.01-1.27; P = 0.028) and quantified LGE (HR: 1.07, 95% CI: 1.01-1.13; P = 0.021) were independently associated with MACE in the CTRCD patients. CONCLUSION: Quantitative parameters from CMR have the potential to evaluate myocardial changes in CTRCD. Increased T2 with reduced LV mass was demonstrated in CTRCD patients even before the development of severe cardiac dysfunction. T2 and quantified LGE may be independent prognostic factors for MACE in patients with CTRCD.

Clinical implication of the 2020 International Association for the Study of Lung Cancer histologic grading in surgically resected pathologic stage 1 lung adenocarcinomas: Prognostic value and association with computed tomography characteristics.

OBJECTIVES: To investigate the incremental prognostic value of the 2020 International Association for the Study of Lung Cancer (IASLC) histologic grading system over traditional prognosticators in surgically resected pathologic stage 1 lung adenocarcinomas and to identify the clinical and radiologic characteristics of lung adenocarcinomas reclassified by the 2020 histologic grading system. MATERIALS AND METHODS: We retrospectively enrolled 356 patients who underwent surgery for pathologic stage 1 adenocarcinoma between January 2016 and December 2017. The histologic grading was classified according to the predominant histologic subtype (conventional system) and the updated 2020 IASLC grading system. The clinical and computed tomography (CT) characteristics were compared according to the reclassification of the updated system. The performance of prognostic models for recurrence-free survival based on the combination of pathologic tumor size, histologic grade, and CT-based information was compared using the c-index. RESULTS: Postoperative recurrence occurred in 6.7% of patients during the follow-up period (mean, 1589.2 ± 406.7 days). Fifty-nine of 244 (24.2%) tumors with intermediate grades in the conventional system were reclassified as grade 3 with the updated grading system. They showed significantly larger solid proportions and higher percentages of pure solid nodules on CT compared to tumors without reclassification (n = 185) (P < 0.05). Prognostic prediction models based on pathology tumor size and histologic grades had significantly higher c-indices (0.754-0.803) compared to the model based on pathologic tumor size only (c-index:0.723, P < 0.05). CONCLUSION: The 2020 IASLC histologic grading system has significant incremental prognostic value over the pathologic stage in surgically resected pathologic stage 1 lung adenocarcinoma. Reclassified lung adenocarcinomas using the updated grading system have a larger solid proportion and a higher percentage of pure solid nodules on CT.

Myosteatosis as a prognostic factor of Mycobacterium avium complex pulmonary disease.

Quantitative body composition affects the prognosis of patients with Mycobacterium avium complex pulmonary disease (MAC-PD). However, whether the qualitative body composition obtained indirectly through computed tomography (CT) affects their prognosis is debatable. We retrospectively analyzed patients with MAC-PD who underwent non-contrast CT at MAC-PD diagnosis. The cross-sectional area of the erector spinae muscle (ESM area), the Hounsfield unit of the erector spinae muscle (ESM HU), and the cross-sectional area of subcutaneous fat (SQF area) were measured at the level of the first lumbar vertebra. Myosteatosis were defined below the median value of ESM HU for each sex. Of 377 patients, 45 (11.9%) died during the follow-up. Patients who died were older and had a lower ratio of females (33.3%). In body compositions, SQF area and ESM HU were lower in the patients who died. In multivariable analysis, a low ESM HU was associated with increased mortality (ESM HU adjusted hazard ratio [aHR] 0.95, 95% confidence interval [CI] 0.93-0.97) through body composition. SQF area revealed protective effects in MAC-PD patients with body mass index ≥ 18.5 kg/m2 (aHR 0.98, 95% CI 0.95-1.00). In conclusion, the decrease in ESM HU, which indirectly reflects myosteatosis, is associated with mortality in patients with MAC-PD.

Whole genome sequence analysis of Aeromonas spp. isolated from ready-to-eat seafood: antimicrobial resistance and virulence factors.

Aeromonas are widespread in aquatic environments and are considered emerging pathogens in humans and animals. Multidrug resistant (MDR) Aeromonas circulating in the aquatic environment and food production chain can potentially disseminate antimicrobial resistance (AMR) to humans via the foodborne route. In this study, we aimed to investigate AMR and virulence factors of 22 Aeromonas strains isolated from ready-to-eat (RTE) seafood. A multilocus phylogenetic analysis (MLPA) using the concatenated sequences of six housekeeping genes (gyrB, rpoD, gyrA, recA, dnaJ, and dnaX) in the 22 Aeromonas genomes and average nucleotide identity (ANI) analysis revealed eight different species; A. caviae, A. dhakensis, A. hydrophila, A. media, A. rivipollensis, A. salmonicida, A. bestiarum, and A. piscicola. The presence of virulence genes, AMR genes and mobile genetic elements (MGEs) in the Aeromonas genomes was predicted using different databases. Our data showed that the genes responsible for adherence and motility (Msh type IV pili, tap type IV pili, polar flagella), type II secretion system (T2SS) and hemolysins were present in all strains, while the genes encoding enterotoxins and type VI secretion system (T6SS) including major effectors were highly prevalent. Multiple AMR genes encoding ß-lactamases such as cphA and blaOXA were detected, and the distribution of those genes was species-specific. In addition, the quinolone resistance gene, qnrS2 was found in a IncQ type plasmid of the A. rivopollensis strain A539. Furthermore, we observed the co-localization of a class I integron (intl1) with two AMR genes (sul1 and aadA1), and a Tn521 transposon carrying a mercury operon in A. caviae strain SU4-2. Various MGEs including other transposons and insertion sequence (IS) elements were identified without strongly associating with detected AMR genes or virulence genes. In conclusion, Aeromonas strains in RTE seafood were potentially pathogenic, carrying several virulence-related genes. Aeromonas carrying multiple AMR genes and MGEs could potentially be involved in the dissemination and spread of AMR genes to other bacterial species residing in the same environment and possibly to humans. Considering a One-Health approach, we highlight the significance of monitoring AMR caused by Aeromonas circulating in the food chain.

Influence of computed tomography slice thickness on deep learning-based, automatic coronary artery calcium scoring software performance.

Background: The influence of computed tomography (CT) slice thickness on the accuracy of deep learning (DL)-based, automatic coronary artery calcium (CAC) scoring software has not been explored yet. Methods: This retrospective study included 844 subjects (477 men, mean age of 58.9±10.7 years) who underwent electrocardiogram (ECG)-gated CAC scoring CT scans with 1.5 and 3 mm slice thickness values between September 2013 and October 2020. Automatic CAC scoring was performed using DL-based software (3D patch-based U-Net architectures). Manual CAC scoring was set as the reference standard. The reliability of automatic CAC scoring was evaluated using intraclass correlation coefficients (ICCs) for both the 1.5 and 3 mm datasets. The agreement of CAC severity categories [Agatston score (AS) 0, 1-100, 101-400, >400] between automatic CAC scoring and the reference standard was analyzed using weighted kappa (κ) statistics for both 1.5 and 3 mm datasets. Results: The CAC scoring agreement between the automatic CAC scoring and reference standard was excellent (ICC 0.982 for 1.5 mm, 0.969 for 3 mm, respectively). The categorical agreement of CAC severity between two methods was excellent for both 1.5 and 3 mm scans, with better agreement for 3 mm scans (weighted κ: 0.851 and 0.961, 95% confidence intervals: 0.823-0.879 and 0.945-0.974, respectively). Conclusions: Automatic CAC scoring shows excellent agreement with the reference standard for both 1.5 and 3 mm scans but results in lower agreement in the CAC severity category for 1.5 mm scans.

Production of a 135-residue long N-truncated human keratinocyte growth factor 1 in Escherichia coli.

BACKGROUND: Palifermin (trade name Kepivance®) is an amino-terminally truncated recombinant human keratinocyte growth factor 1 (KGF-1) with 140 residues that has been produced using Escherichia coli to prevent and treat oral mucositis following radiation or chemotherapy. In this study, an amino-terminally shortened KGF-1 variant with 135 residues was produced and purified in E. coli, and its cell proliferation activity was evaluated. RESULTS: We expressed soluble KGF-1 fused to thioredoxin (TRX) in the cytoplasmic fraction of E. coli to improve its production yield. However, three N-truncated forms (KGF-1 with 140, 138, and 135 residues) were observed after the removal of the TRX protein from the fusion form by cleavage of the human enterokinase light chain C112S (hEKL C112S). The shortest KGF-1 variant, with 135 residues, was expressed by fusion with TRX via the hEKL cleavage site in E. coli and purified at high purity (> 99%). Circular dichroism spectroscopy shows that purified KGF-1135 had a structure similar to that of the KGF-1140 as a random coiled form, and MCF-7 cell proliferation assays demonstrate its biological activity. CONCLUSIONS: We identified variations in N-terminus-truncated KGF-1 and selected the most stable form. Furthermore, by a simple two-step purification, highly purified KGF-1135 was obtained that showed biological activity. These results demonstrate that KGF-1135 may be considered an alternative protein to KGF-1.

Covalent Scrambling in Porous Polyarylthioethers through a Stepwise SN Ar for Tunable Bandgap and Porosity.

Porous poly(aryl thioether)s offer stability and electronic tunability by robust sulfur-aryl conjugated architecture, but synthetic access is hindered due to limited control over the nucleophilic nature of sulfides and the air sensitivity of aromatic thiols. Here, we report a simple, one-pot, inexpensive, regioselective synthesis of highly porous poly(aryl thioether)s through polycondensation of perfluoroaromatic compounds with sodium sulfide. The unprecedented temperature-dependent para-directing formation of thioether linkages leads to a stepwise transition of the polymer extension into a network, thereby allowing fine control of the porosity and optical band gaps. The obtained porous organic polymers with ultra-microporosity (<1 nm) and sulfur as the surface functional groups show size-dependent separation of organic micropollutants and selective removal of mercury ions from water. Our findings offer easy access to poly(aryl thioether)s with accessible sulfur functionalities and higher complexity, which will help in realizing advanced synthetic designs in applications such as adsorption, (photo)catalysis, and (opto)electronics.

High-level production of keratinocyte growth factor 2 in Escherichia coli.

Recombinant human keratinocyte growth factor 2 (KGF-2), also known as repifermin, is used in various therapeutic applications. However, KGF-2 production has not been optimized for facilitating large-scale production. Therefore, we attempted to attain high-level production of bioactive KGF-2. KGF-2 was fused with 6HFh8 (6HFh8-KGF-2) at the tobacco etch virus protease cleavage site. The 6HFh8-KGF-2 was expressed in Escherichia coli with high expression levels of approximately 33% and 20% of soluble protein in flask culture and 5 L fermentation, respectively. 6HFh8-KGF-2 was purified via nickel affinity chromatography. To maintain a stable form of KGF-2, the conditions of the cleavage reaction were optimized based on the isoelectric point. KGF-2 was purified via ion-exchange chromatography to high purity (>99%) with an optimal purification yield (91%). Circular dichroism spectroscopy demonstrated that purified KGF-2 had a secondary structure and thermal stability similar to that of commercial KGF-2. Bioactivity assays indicated that purified KGF-2 could induce MCF-7 cell proliferation in the same manner as commercial KGF-2. These results demonstrate that bioactive KGF-2 was overexpressed in E. coli and purified to high quality. Our findings indicated that bioactive KGF-2 can be produced in large quantities in E. coli.

The effect of food processing factors on the growth kinetics of Aeromonas strains isolated from ready-to-eat seafood.

Aeromonas are ubiquitous aquatic bacteria and frequently isolated from seafood. There is growing awareness of Aeromonas as foodborne pathogens, particularly in connection with consumption of ready-to-eat (RTE) seafood. The aim of this study was to investigate the effect of food processing factors on the growth kinetics of eight Aeromonas strains (representing seven species) isolated from RTE seafood. The effect of low temperature (4 and 8 °C) in combination with different NaCl concentrations (0.5-6.5 %) or with two purified condensate smokes (PCSs; Red Arrow SmokEz VTABB and JJT01) at different concentrations (0-0.26 %) was studied in Trypton Soy Broth (TSB). In food processing, application of PCS is considered healthier than traditional smoking. Growth kinetics parameters of each strain were estimated by using a primary predictive model. Our result showed that the addition of 3.5 % NaCl at refrigeration temperature (4 °C) was not sufficient to inhibit the growth of A. media, A. bestiarum, A. piscicola, and A. salmonicida, while higher NaCl concentration (≥5.0 %) at 8 °C suppressed their growth. On the other hand, our result demonstrated the antimicrobial potential of using PCS at maximal allowed concentration (0.26 %) against Aeromonas. PCS concentration and phenol content were important factors influencing the growth kinetics parameters of Aeromonas. Moreover, the growth kinetics of three Aeromonas strains were further studied in commercially produced vacuum-packed fresh and cold-smoked salmon stored at 4 °C for 14 and 21 days, respectively. Our results demonstrate that vacuum packing combined with cold storage at 4 °C was insufficient to inhibit the growth of Aeromonas in fresh salmon, while the growth was inhibited in a minimally salted cold-smoked salmon (salt content of 1.8 %). Our study implies that mild food processing factors applied in the production of RTE seafood might not guarantee the total inhibition of Aeromonas. Even though further studies on evaluating the antimicrobial potential of PCSs in actual seafood matrixes are necessary, the present study suggests that PCS technology might be a promising approach to prevent the potential growth of Aeromonas.

Synthesis of N-substituted quaternary carbon centers through KOt-Bu-catalyzed aza-Michael addition of pyrazoles to cyclic enones.

This study reports an efficient and mild method for the synthesis of cyclic ß-amino ketones containing N-substituted quaternary carbon centers via the KOt-Bu-catalyzed aza-Michael addition reaction of pyrazoles to ß-substituted cyclic α,ß-enones. The amination was promoted by KOt-Bu (3 mol%) at ambient temperature and a wide range of new and versatile ß-pyrazolyl ketones were obtained in good yields. Furthermore, the KOt-Bu-catalyzed one-pot diamination of a cyclic dienone with pyrazoles via an aza-1,6-conjugate addition followed by an aza-1,4-conjugate addition was also explored.

A Challenge for Emphysema Quantification Using a Deep Learning Algorithm With Low-dose Chest Computed Tomography.

PURPOSE: We aimed to identify clinically relevant deep learning algorithms for emphysema quantification using low-dose chest computed tomography (LDCT) through an invitation-based competition. MATERIALS AND METHODS: The Korean Society of Imaging Informatics in Medicine (KSIIM) organized a challenge for emphysema quantification between November 24, 2020 and January 26, 2021. Seven invited research teams participated in this challenge. In total, 558 pairs of computed tomography (CT) scans (468 pairs for the training set, and 90 pairs for the test set) from 9 hospitals were collected retrospectively or prospectively. CT acquisition followed the hospitals' protocols to reflect the real-world clinical setting. Using the training set, each team developed an algorithm that generated converted LDCT by changing the pixel values of LDCT to simulate those of standard-dose CT (SDCT). The agreement between SDCT and LDCT was evaluated using the intraclass correlation coefficient (ICC; 2-way random effects, absolute agreement, and single rater) for the percentage of low-attenuated area below -950 HU (LAA-950 HU), κ value for emphysema categorization (LAA-950 HU, <5%, 5% to 10%, and ≥10%) and cosine similarity of LAA-950 HU. RESULTS: The mean LAA-950 HU of the test set was 14.2%±10.5% for SDCT, 25.4%±10.2% for unconverted LDCT, and 12.9%±10.4%, 11.7%±10.8%, and 12.4%±10.5% for converted LDCT (top 3 teams). The agreement between the SDCT and converted LDCT of the first-place team was 0.94 (95% confidence interval: 0.90, 0.97) for ICC, 0.71 (95% confidence interval: 0.58, 0.84) for categorical agreement, and 0.97 (interquartile range: 0.94 to 0.99) for cosine similarity. CONCLUSIONS: Emphysema quantification with LDCT was feasible through deep learning-based CT conversion strategies.

Improved Crystallinity of Graphene Grown on Cu/Ni (111) through Sequential Mobile Hot-Wire Heat Treatment.

Over the past few years, many efforts have been devoted to growing single-crystal graphene due to its great potential in future applications. However, a number of issues remain for single-crystal graphene growth, such as control of nanoscale defects and the substrate-dependent nonuniformity of graphene quality. In this work, we demonstrate a possible route toward single-crystal graphene by combining aligned nucleation of graphene nanograins on Cu/Ni (111) and sequential heat treatment over pregrown graphene grains. By use of a mobile hot-wire CVD system, prealigned grains were stitched into one continuous film with up to ∼97% single-crystal domains, compared to graphene grown on polycrystalline Cu, which was predominantly high-angle tilt boundary (HATB) domains. The single-crystal-like graphene showed remarkably high thermal conductivity and carrier mobility of ∼1349 W/mK at 350 K and ∼33 600 (38 400) cm2 V-1 s-1 for electrons (holes), respectively, which indicates that the crystallinity is high due to suppression of HATB domains.

Progostic value of coronary artery calcium scores from 1.5 mm slice reconstructions of electrocardiogram-gated computed tomography scans in asymptomatic individuals.

It is unknown whether the thinner slice reconstruction has added value relative to 3 mm reconstructions in predicting major adverse cardiac events (MACEs). This retrospective study included 550 asymptomatic individuals who underwent cardiac CT. Coronary artery calcium (CAC) scores and severity categories were assessed from 1.5 and 3 mm scans. CAC scores obtained from 1.5 and 3 mm scans were compared using Wilcoxon signed-rank tests. Cox proportional hazard models were developed to predict MACEs based on the degree of coronary artery stenosis on coronary CT angiography and the presence of CAC on both scans. Model performances were compared using the time-dependent ROC curve and integrated area under the curve (iAUC) methods. The CAC scores obtained from 1.5 mm scans were significantly higher than those from 3 mm scans (median, interquartile range 4.5[0-71] vs. 0[0-48.4]; p < 0.001). Models showed no difference in predictive accuracy of the presence of CAC between 1.5 and 3 mm scans (iAUC, 0.625 vs. 0.672). In conclusion, CAC scores obtained from 1.5 mm scans are significantly higher than those from 3 mm scans, but do not provide added prognostic value relative to 3 mm scans.

The usefulness of patient-specific 3D nasal silicone implant using 3D design and order form.

PURPOSE: The need for customized implants has continuously increased, but patient-specific silicone implants are not yet commonly used in the plastic surgery market. We sought to validate the effectiveness of a 3D customized nasal implant design in terms of design and lead time compared with a manually customized implant by a surgeon. MATERIALS AND METHODS: Based on the computed tomography (CT) findings of 15 patients who planned rhinoplasty, a surgeon wrote order forms reflecting the surgical plan and subsequently designed implants manually using epoxy on a 3D printed skull. Separately, engineers analyzed the CT findings and designed 3D implants based on the order forms. RESULTS: Epoxy designs were 3D-scanned, converted into a stereolithography format and compared with 3D implant designs to assess which method had a smaller margin of error as per the preoperative order form. Moreover, the lead time in all steps are compared. Nasion thickness, tip thickness, glabella starting point, glabella width, radix width, and total volume were comparatively analyzed. In all parameters, the error rate of the 3D design is relatively lower than that of the epoxy design. The former also had a lower total volume and a faster manufacturing time. CONCLUSION: With novel 3D customized nasal implants, the limitations of ready-made silicone implants are addressed, and it is now possible to preoperatively design implants more accurately, quickly, and conveniently.

Evaluation of the Ostium in Anomalous Origin of the Right Coronary Artery with an Interarterial Course Using Dynamic Cardiac CT and Implications of Ostial Findings.

OBJECTIVE: We aimed to evaluate the ostium of right coronary artery of anomalous origin from the left coronary sinus (AORL) with an interarterial course throughout the cardiac cycle on CT and analyze the clinical significance of the ostial findings. MATERIALS AND METHODS: From January 2011 to December 2015, 68 patients (41 male, 57.3 ± 12.1 years) with AORL with an interarterial course and retrospective cardiac CT data were included. AORL was classified as high or low ostial location based on the pulmonary annulus in the diastolic and systolic phases on cardiac CT. In addition, the height, width, height/width ratio, area, and angle of the ostium were measured in both cardiac phases. After cardiac CT, patients were followed until December 31, 2020 for major adverse cardiac events (MACE). Clinical and CT characteristics associated with MACE were explored using Cox regression analysis. RESULTS: During a median follow-up period of 2071 days (interquartile range, 1180.5-2747.3 days), 13 patients experienced MACE (19.1%, 13/68). Seven (10.3%, 7/68) had the ostial location change from high in the diastolic phase to low in the systolic phase. In the univariable analysis, younger age (hazard ratio [HR] = 0.918, p < 0.001), high ostial location (HR = 4.008, p = 0.036), larger height/width ratio (HR = 5.621, p = 0.049), and smaller ostial angle (HR = 0.846, p = 0.048) in the systolic phase were significant predictors of MACE. In multivariable cox regression analysis, younger age (adjusted HR = 0.917, p = 0.002) and high ostial location in the systolic phase (adjusted HR = 4.345, p = 0.026) were independent predictors of MACE. CONCLUSION: The ostial location of AORL with an interarterial course can change during the cardiac cycle, and high ostial location in the systolic phase was an independent predictor of MACE.

Radiomics Feature Analysis Using Native T1 Mapping for Discriminating Between Cardiac Tumors and Thrombi.

RATIONALE AND OBJECTIVES: Accurate differential diagnosis is essential because cardiac tumors and thrombi have different prognoses and therapeutic approaches. Native T1 map provides an objective T1 time quantifications of cardiac mass without the need for a contrast agent. We examined the diagnostic performance of radiomics features for differentiating cardiac tumors from thrombi using cardiac magnetic resonance imaging T1 mapping technique compared to that of late gadolinium enhancement (LGE) imaging. MATERIALS AND METHODS: This retrospective study included 22 cardiac tumors and 21 thrombi of 41 patients who underwent cardiac magnetic resonance imaging from December 2013 to May 2018. Fifty-six radiomics features were extracted from native T1 images. The least absolute shrinkage and selection operator method was used for feature selection and rad score extraction. The diagnostic performance of the rad score was compared to that of the native T1 value (mean T1) and LGE ratio. RESULTS: The area under the receiver operating characteristic curve of the rad score was higher than that of the mean T1 and LGE ratio (0.98 vs. 0.86 vs. 0.82, p = 0.001). With the optimal cut-off value, the rad score showed sensitivity, specificity, and accuracy of 95.4%, 95.2%, and 95.2%, respectively. Combination of the rad score and mean T1 showed a significantly higher diagnostic performance than mean T1 (p = 0.019) or LGE ratio (p = 0.022). CONCLUSION: The rad score derived from native T1 maps can differentiate thrombi from tumors better than the mean T1 or LGE ratio. This is valuable for determining a treatment strategy for cardiac lesions in patients who cannot tolerate contrast agents.