Role of genetic introgression in introducing mutant alleles in Bos indicus cattle and prevalence of lethal genetic disorders in Bos taurus × Bos indicus and Bos indicus cattle in India.

Fertility is an important trait associated with reproductive performance and animal welfare concern. Lethal alleles affect fertility through early embryonic death, abortions, and stillbirth depending on the genetic expression of the allele. Holstein Friesian and Jersey are two major Bos taurus breeds used widely for increasing milk yield along with purebreds of Bos indicus breeds like Gir, Kankrej, Sahiwal, and Tharparkar. In the present study, prevalence of lethal mutants in crossbred Holstein Friesian (CBHF, n = 2435), crossbred Jersey (CBJY, n = 2874), Gir (n = 3288), Kankrej (n = 593), Sahiwal (n = 965), and Tharparkar (n = 18) were studied. Heterozygous carrier animals were identified for bovine leukocyte adhesion deficiency (BLAD), Citrullinemia, complex vertebral malformation (CVM), Brachyspina, Holstein Haplotype 1 (HH1), Holstein Haplotype 3 (HH3),Holstein Haplotype 4 (HH4) and Jersey Haplotype 1 (JH1). Breed purity analysis confirmed inheritance of Bos taurus genes contributing to the presence of lethal mutant alleles like BLAD, Citrullinemia, HH1, and JH1 in apparently phenotypic Bos indicus animals. Screening and elimination of heterozygous carrier bulls/cows is essential to control fertility loss associated with lethal alleles.

Histopathologic correlation of pancreatic fibrosis with pancreatic magnetic resonance imaging quantitative metrics and Cambridge classification.

PURPOSE: To determine the correlation of the T1-weighted signal intensity ratio (T1 SIR, or T1 Score) and arterial-to-delayed venous enhancement ratio (ADV ratio) of the pancreas with pancreatic fibrosis on histopathology. METHODS: Sixty consecutive adult CP patients who had an MRI/MRCP study prior to pancreatic surgery were analyzed. Three blinded observers measured T1 SIR of pancreas to spleen (T1 SIR p/s), pancreas-to-paraspinal muscle (T1 SIR p/m), ADV ratio, and Cambridge grade. Histopathologic grades were given by a gastrointestinal pathologist using Ammann's fibrosis score. Statistical analysis included Spearman's correlation coefficient of the T1 SIR, ADV ratio, Cambridge grade with the fibrosis score, and weighted kappa for interobserver agreement. RESULTS: The study population included 31 female and 29 male patients, with an average age of 52.1 (26-78 years). Correlations between fibrosis score and T1 SIR p/s, T1 SIR p/m, and ADV ratio were ρ = - 0.54 (p = 0.0001), ρ = - 0.19 (p = 0.19), and ρ = - 0.39 (p = 0.003), respectively. The correlation of Cambridge grade with fibrosis score was ρ = 0.26 (p = 0.07). There was substantial interobserver agreement (weighted kappa) for T1 SIR p/s (0.78), T1 SIR p/m (0.71), and ADV ratio (0.64). T1 SIR p/s of ≤ 1.20 provided a sensitivity of 74% and specificity of 50% (AUC: 0.74), while ADV ratio of ≤ 1.10 provided a sensitivity of 75% and specificity of 55% (AUC: 0.68) to detect a fibrosis score of ≥ 6. CONCLUSION: There is a moderate negative correlation between the T1 Score (SIR p/s) and ADV ratio with pancreatic fibrosis and a substantial interobserver agreement. These parenchymal metrics show a higher correlation than the Cambridge grade.

Affective response to volitional input perturbations in obstacle avoidance and target tracking games.

We present the use of two game-like tasks, Catnip and Dinorun, to explore affective responses to volitional control perturbations. We analyze behavioral and physiological measures with the self-assessment manikin (SAM), pupillometry, and electroencephalography (EEG) responses to provide intratrial emotional state as well as inter-trial correlates with selfreported survey responses. We find that subject gameplay characteristics significantly correlate with valence and dominance scores for both games, and that perturbations to the games produce a measurable decrease in response scores for Dinorun. During perturbation events, pupillometry analysis reveals considerable SAM-agnostic dilation, with stronger responses in more rigid trialized event structures. Furthermore, analyses of neural activity from central and parietal regions demonstrate significant measurable evoked responses to perturbed events across the majority of subjects for both games. By introducing perturbations, this set of experiments and analyses inform and enable further studies of affective responses to the loss of volitional control during engaging, game-like tasks.

Pancreatic cystic neoplasms and post-inflammatory cysts: interobserver agreement and diagnostic performance of MRI with MRCP.

PURPOSE: We aimed to answer several clinically relevant questions; (1) the interobserver agreement, (2) diagnostic performance of MRI with MRCP for (a) branch duct intraductal papillary mucinous neoplasms (BD-IPMN), mucinous cystic neoplasms (MCN) and serous cystic neoplasms (SCN), (b) distinguishing mucinous (BD-IPMN and MCN) from non-mucinous cysts, and (c) distinguishing three pancreatic cystic neoplasms (PCN) from post-inflammatory cysts (PIC). METHODS: A retrospective analysis was performed at a tertiary referral center for pancreatic diseases on 71 patients including 44 PCNs and 27 PICs. All PCNs were confirmed by surgical pathology to be 17 BD-IPMNs, 13 MCNs, and 14 SCNs. Main duct and mixed type IPMNs were excluded. Two experienced abdominal radiologists blindly reviewed all the images. RESULTS: Sensitivity of two radiologists for BD-IPMN, MCN and SCN was 88-94%, 62-69% and 57-64%, specificity of 67-78%, 67-78% and 67-78%, and accuracy of 77-82%, 65-75% and 63-73%, respectively. There was 80% sensitivity, 63-73% specificity, 70-76% accuracy for distinguishing mucinous from non-mucinous neoplasms, and 73-75% sensitivity, 67-78% specificity, 70-76% accuracy for distinguishing all PCNs from PICs. There was moderate-to-substantial interobserver agreement (Cohen's kappa: 0.65). CONCLUSION: Two experienced abdominal radiologists had moderate-to-high sensitivity, specificity, and accuracy for BD-IPMN, MCN, and SCN. The interobserver agreement was moderate-to-substantial. MRI with MRCP can help workup of incidental pancreatic cysts by distinguishing PCNs from PICs, and premalignant mucinous neoplasms from cysts with no malignant potential.

T1 mapping for the diagnosis of early chronic pancreatitis: correlation with Cambridge classification system.

OBJECTIVE: This study aims to determine if T1 relaxation time of the pancreas can detect parenchymal changes in early chronic pancreatitis (CP). METHODS: This study retrospectively analyzed 42 patients grouped as no CP (Cambridge 0; n = 21), equivocal (Cambridge 1; n = 12) or mild CP (Cambridge 2; n = 9) based on magnetic resonance cholangiopancreatography findings using the Cambridge classification as the reference standard. Unenhanced T1 maps were acquired using a three-dimensional dual flip-angle gradient-echo technique on the same 1.5 T scanner with the same imaging parameters. RESULTS: There was no significant difference between the T1 relaxation times of Cambridge 0 and 1 group (p = 0.58). There was a significant difference (p = 0.0003) in the mean T1 relaxation times of the pancreas between the combined Cambridge 0 and 1 (mean = 639 msec, 95% CI: 617, 660) and Cambridge 2 groups (mean = 726 msec, 95% CI: 692, 759). There was significant difference (p = 0.0009) in the mean T1 relaxation times of the pancreas between the Cambridge 0 (mean = 636 msec, 95% CI: 606, 666) and Cambridge 2 groups (mean = 726 msec, 95% CI: 692,759) as well as between Cambridge 1 (mean = 643 msec, 95% CI: 608, 679) and Cambridge 2 groups (mean = 726 msec, 95% CI: 692,759) (p = 0.0017). Bland-Altman analysis showed measurements of one reader to be marginally higher than the other by 15.7 msec (2.4%, p = 0.04). CONCLUSION: T1 mapping is a practical method capable of quantitatively reflecting morphologic changes even in the early stages of chronic pancreatitis, and demonstrates promise for future implementation in routine clinical imaging protocols. ADVANCES IN KNOWLEDGE: T1 mapping can distinguish subtle parenchymal changes seen in early stage CP, and demonstrates promise for implementation in routine imaging protocols for the diagnosis of CP.

Contrast-Enhanced Ultrasound Versus Doppler Ultrasound for Detection of Early Vascular Complications of Pancreas Grafts.

OBJECTIVE. The purpose of this study is to compare conventional duplex ultrasound and contrast-enhanced ultrasound (CEUS) for identifying vascular abnormalities in pancreas allografts in the immediate posttransplant setting. Identification of pancreas allografts at risk of failure may impact patient care because early intervention for vascular insufficiency can lead to graft salvage. MATERIALS AND METHODS. Two radiologists who were blinded to patient outcomes performed a retrospective analysis of the postoperative Doppler ultrasound and CEUS images of 34 pancreas grafts from transplants performed between 2017 and 2019. A total of 28 patients who did not require surgical reexploration were considered the control group. Six patients had surgically proven arterial or venous abnormalities on surgical reexploration. Each radiologist scored grafts as having normal or abnormal vascularity on the basis of image sets obtained using Doppler ultrasound only and CEUS only. Comparisons of both the diagnostic performance of each modality and interobserver agreement were performed. RESULTS. Both readers showed that CEUS had increased sensitivity for detecting vascular abnormalities (83.3% for both readers) compared with Doppler ultrasound (66.7% and 50.0%). For both readers, the specificity of CEUS was similar to that of Doppler imaging (81.6% and 78.9% for reader 1 and reader 2 versus 76.3% and 84.2% for reader 1 and reader 2). For both readers, the negative predictive value of CEUS was higher than that of Doppler ultrasound (96.9% and 96.8% for reader 1 and reader 2 versus 93.5% and 91.4% for reader 1 and reader 2). Interobserver agreement was higher for CEUS than for Doppler ultrasound (κ = 0.54 vs κ = 0.28). CONCLUSION. CEUS may provide radiologists and surgeons with a means of timely and effective evaluation of pancreas graft perfusion after surgery, and it may help identify grafts that could benefit from surgical salvage.

A Wearable Multi-Modal Bio-Sensing System Towards Real-World Applications.

Multi-modal bio-sensing has recently been used as effective research tools in affective computing, autism, clinical disorders, and virtual reality among other areas. However, none of the existing bio-sensing systems support multi-modality in a wearable manner outside well-controlled laboratory environments with research-grade measurements. This paper attempts to bridge this gap by developing a wearable multi-modal bio-sensing system capable of collecting, synchronizing, recording, and transmitting data from multiple bio-sensors: PPG, EEG, eye-gaze headset, body motion capture, GSR, etc., while also providing task modulation features including visual-stimulus tagging. This study describes the development and integration of various components of our system. We evaluate the developed sensors by comparing their measurements to those obtained by a standard research-grade bio-sensors. We first evaluate different sensor modalities of our headset, namely, earlobe-based PPG module with motion-noise canceling for ECG during heart-beat calculation. We also compare the steady-state visually evoked potentials measured by our shielded dry EEG sensors with the potentials obtained by commercially available dry EEG sensors. We also investigate the effect of head movements on the accuracy and precision of our wearable eye-gaze system. Furthermore, we carry out two practical tasks to demonstrate the applications of using multiple sensor modalities for exploring previously unanswerable questions in bio-sensing. Specifically, utilizing bio-sensing, we show which strategy works best for playing "Where is Waldo?" visual-search game, changes in EEG corresponding to true vs. false target fixations in this game, and predicting the loss/draw/win states through bio-sensing modalities while learning their limitations in a "Rock-Paper-Scissors" game.

Mental State Assessment and Validation Using Personalized Physiological Biometrics.

Mental state monitoring is a critical component of current and future human-machine interfaces, including semi-autonomous driving and flying, air traffic control, decision aids, training systems, and will soon be integrated into ubiquitous products like cell phones and laptops. Current mental state assessment approaches supply quantitative measures, but their only frame of reference is generic population-level ranges. What is needed are physiological biometrics that are validated in the context of task performance of individuals. Using curated intake experiments, we are able to generate personalized models of three key biometrics as useful indicators of mental state; namely, mental fatigue, stress, and attention. We demonstrate improvements to existing approaches through the introduction of new features. Furthermore, addressing the current limitations in assessing the efficacy of biometrics for individual subjects, we propose and employ a multi-level validation scheme for the biometric models by means of k-fold cross-validation for discrete classification and regression testing for continuous prediction. The paper not only provides a unified pipeline for extracting a comprehensive mental state evaluation from a parsimonious set of sensors (only EEG and ECG), but also demonstrates the use of validation techniques in the absence of empirical data. Furthermore, as an example of the application of these models to novel situations, we evaluate the significance of correlations of personalized biometrics to the dynamic fluctuations of accuracy and reaction time on an unrelated threat detection task using a permutation test. Our results provide a path toward integrating biometrics into augmented human-machine interfaces in a judicious way that can help to maximize task performance.

Can radiologists and urologists reliably determine renal mass histology using standard preoperative computed tomography imaging?

PURPOSE: To determine the extent to which radiologists and urologists can predict histology using multiphasic CT imaging. METHODS: Patients with a preoperative multiphasic CT undergoing surgery for a renal mass were identified between 2003 and 2013. Tumors >10 cm, locally advanced or metastatic disease, and patients managed by reviewers were excluded. A survey and deidentified scans were provided to reviewers. Sensitivity and accuracy in predicting histology was calculated for each reviewer. Correlation was assessed by the Fleiss kappa coefficient. Multivariable logistic regression determined factors associated with predictive accuracy for final pathology. RESULTS: There were 120 patients who met criteria. Mean tumor size was 3.3 cm; there were 102 (85%) that were malignant, and 73% of these were clear-cell renal-cell carcinoma (RCC). The most common benign histology was angiomyolipoma (n=10, 56%) followed by oncocytoma (n=5, 28%). Correlation among reviewers was statistically fair for predicting malignant (κ=0.25) and final pathology (κ=0.22). Sensitivity for predicting malignant masses was 90%. Reviewers accurately predicted malignant pathology in 82% of cases and predicted final pathology in 58% of cases. Adjusted for size, scan type, and reviewer, clear-cell RCC vs benign histology was associated with 21 times increased odds of accurate pathologic identification (P<0.001). CONCLUSIONS: Urologists and radiologists were able to accurately identify malignant histology in 82% of cases, although sensitivity for malignant histology was 90%. Developing a preoperative nomogram for identification of clear-cell RCC may be feasible and should be further explored.

Transgluteal CT-Guided Percutaneous Renal Access for Percutaneous Nephrolithotomy in a Pelvic Horseshoe Kidney.

CT-guided percutaneous renal access has been described as a safe and effective access technique in patients with complex anatomy, including ectopic kidney, retrorenal colon, spinal dysraphism, hepatomegaly, and splenomegaly. In comparison to conventional intraoperative fluoroscopic-guided access, CT imaging allows for delineation of surrounding structures that are at risk for injury during percutaneous access. However, previous reports indicate that pelvic kidneys might be inaccessible percutaneously without laparoscopic assistance. Herein, we present a novel transgluteal route to renal access for percutaneous nephrolithotomy (PCNL) in a patient with a pelvic horseshoe kidney and severe spinal deformity.

Evaluation of antigout activity of Phyllanthus emblica fruit extracts on potassium oxonate-induced gout rat model.

AIM: The present study has been conducted to evaluate antigout activity of aqueous and alcoholic extracts of Phyllanthus emblica fruits following its 28 days repeated oral administration on potassium oxonate-induced gout rat model. MATERIALS AND METHODS: The study was conducted on 42 male Sprague-Dawely rats dividing them in seven groups having six rats in each group. Groups I, II, and III served as vehicle control group, gout control group, and standard treatment control group, respectively. Rats of all the groups except vehicle control group were administered potassium oxonate at 250 mg/kg (IP), throughout the study period (28 days) for induction of gout. Groups IV and V received aqueous extract of P. emblica at 200 and 400 mg/kg, and Groups VI and VII received alcoholic extract of P. emblica at 200 and 400 mg/kg (daily oral for 28 days). At the end of study, all the rats were subjected to blood collection; blood and serum sample were analyzed for hematological and biochemical parameters, respectively. After collection of blood samples on the 29(th) day, all the rats were sacrificed and subjected to post mortem examination to determine the presence or absence of gross and histopathological lesions in kidney tissues. RESULTS: At the end of study, rats of gout control group showed increase in platelets counts, serum creatinine, uric acid, blood urea nitrogen (BUN), and xanthine oxidase (XO) enzyme level along with alterations in kidney tissues as compared to vehicle control group. Gouty rats treated with aqueous and alcoholic extracts of P. emblica at 200 and 400 mg/kg body weight and standard treatment allopurinol at 5 mg/kg body weight showed reduction in platelets counts, serum creatinine, uric acid, BUN, and XO enzyme level along with significant improvements in histological structure of kidney as compared to rats of gout control group. CONCLUSION: Oral administration of aqueous and alcoholic extracts of P. emblica fruits for 28 days has shown protection against gout in dose-dependent manner in rats.

Acinarization (parenchymal blush) observed during secretin-enhanced MRCP: clinical implications.

OBJECTIVE: T2 hyperintensity of pancreatic acini during secretin-enhanced MRCP is called "acinarization." We sought to determine the clinical significance of this finding. MATERIALS AND METHODS: Patients were selected if the radiology report included the phrases "acin*" (where * represented a wild card search) or "blush" using the institution's customized lexicon-search software. Sixty-seven consecutive patients without acinarization on secretin-enhanced MRCP who also underwent ERCP were enrolled as the control group. The intensity of acinarization was classified into three groups: grade 0, no visible acinarization; grade 1, barely visible parenchymal hyperintensity; or grade 2, easily visible parenchymal hyperintensity. ERCP findings of ductal abnormalities and basal pancreatic sphincter manometry were recorded. RESULTS: There were higher frequencies of divisum (p = 0.001) and of a clinical history of recurrent acute pancreatitis (p < 0.001) and higher basal pancreatic sphincter of Oddi manometric pressure measurements (p = 0.008) in the acinarization group. There was no difference in the frequency of ERCP-defined chronic pancreatitis (p = 0.10) between the groups. In patients with acinarization, a higher mean sphincter pressure was seen in patients with more intense acinarization than in those with faint acinarization, but this difference was not significant (p = 0.22). Ampullary tumors were found in four patients with acinarization. CONCLUSION: Acinarization probably occurs in patients with a propensity for increased pancreatic ductal pressure (i.e., patients with divisum, elevated basal pancreatic sphincter pressure, ampullary tumor) and adequate exocrine function (absence of severe chronic pancreatitis).

R.E.N.A.L. Nephrometry scoring: how well correlated are urologist, radiologist, and collaborator scores?

PURPOSE: R.E.N.A.L. Nephrometry Score (NS) is an imaging-based (CT/MRI) scoring system commonly used by urologists to standardize the reporting of renal masses by enabling quantification of anatomical characteristics. We sought to examine the inter-rater correlation of NS between urologists, radiologists, and tumor-board collaborators. METHODS: We identified adult patients undergoing partial or radical nephrectomy over 10 years (n=2450). Patients with autosomal dominant polycystic kidney disease (ADPKD), metastatic disease, masses >10 cm, and studies in which the study urologists or radiologists partook in patient care were excluded. Preoperative imaging was evaluated and patients with multiphasic CT available were included. Scans were provided to the reviewers to evaluate with a R.E.N.A.L. nephrometry questionnaire. Results were analyzed using kappa correlation coefficients. RESULTS: One hundred twenty patients met inclusion criteria with mean age of 59.5 years. The majority of cases were partial nephrectomies (72%). Eighty-five percent of the tumors were malignant, with 26% having high-grade histology. The mean (standard deviation) overall NS was 6.8 (1.9) with fair correlation among reviewers (κ=0.222). Collaborators had the highest inter-rater correlation, ranging from 0.41 to 0.84 for NS component scores, compared with 0.42-0.85 for radiologists and 0.36-0.86 for urologists. "R" scores were best correlated (κ>0.8). NS correlation ranged between 0.16 and 0.31 for the groups while the NS complexity category correlation ranged between 0.50 and 0.61. CONCLUSIONS: Despite being naive to NS, inter-radiologist scoring patterns were better correlated than inter-urologist. The urologist and radiologist collaborating in tumor board showed the highest agreement, suggesting that a multidisciplinary approach in the characterization of renal masses may provide benefit to patient management.

Patellar clunk syndrome in a current high flexion total knee design.

This retrospective study of 208 (204 patients) total knee arthroplasties evaluated the incidence of patellar clunk syndrome for two high-flex posterior stabilized knee prostheses; a high-flex fixed bearing prosthesis and a high-flex mobile bearing prosthesis. Patients were followed for up to two years and were evaluated for patellar clunk and component position. Knees receiving the mobile bearing had a significantly higher (p < 0.001) incidence of patellar clunk (15%) than knees receiving the fixed bearing (0%). There was a significantly higher incidence of patellar clunk in males (34.1%; p < 0.01) compared to females (8.6%). Fibrous nodules were treated surgically in 11 of the knees with patellar clunk. The design of this particular mobile bearing knee seems to contribute to patellar clunk syndrome.

Planting the seeds of success: CT-guided gold seed fiducial marker placement to guide robotic radiosurgery.

Fiducial marker (FM)-guided stereotactic body radiation therapy (SBRT) allows for precise targeting and delivery of radiation to a tumor site. In this article, we briefly discuss SBRT, provide examples to describe CT-guided FM placement to guide SBRT, and discuss some of the associated risks and benefits. This article serves as a pictorial review for body imagers and interventional radiologists who perform CT-guided procedures and interpret diagnostic studies for oncology patients. CT-guided FMs were placed in patients who were appropriate candidates for SBRT. One week following placement, patients underwent diagnostic CT and/or MR examinations in order to include the FM data in the development of a treatment plan. From October 2007-November 2009, a total of 89 patients were implanted with FMs. Sites of implantation included lung, liver, bone, chest and abdominal wall, and peritoneum/retroperitoneum. Complications included pneumothorax and FM migration. Twenty-one patients (33%) with lung FM placement experienced at least a small pneumothorax and 6 patients (9%) required thoracostomy tubes. FM migration occurred in 5 patients (8%) with lung placement. SBRT provides a safer and more effective alternative to conventional radiotherapy, and CT-guided FM implantation of tumor sites increases the precision of SBRT. Technical improvements in FM placement can limit the complications associated with the procedure and further enable highly localized tumor therapy.

MR features of primary and secondary malignant lymphoma of the pancreas: a pictorial review.

OBJECTIVE: To describe the imaging findings of primary and secondary pancreatic malignant lymphoma on magnetic resonance imaging (MRI), to help differentiate lymphoma of the pancreas from primary adenocarcinoma and autoimmune pancreatitis among others, and to discuss a few atypical presentations of pancreatitis mimicking lymphoma. CONCLUSION: Knowledge of these imaging manifestations of lymphoma may be helpful to arrive at an accurate diagnosis and avoid unnecessary morbidity and mortality from inadvertent surgery. MAIN MESSAGES: • Pancreatic malignant lymphoma is shown as a nodular low-density area with mild enhancement on CT. • It sometimes shows variable manifestations mimicking other tumours and inflammatory conditions. • MRI provides useful information for differentiating malignant lymphoma from other mimickers.

Flaps, slings, and other things: CT after reconstructive surgery--expected changes and detection of complications.

OBJECTIVE: This article will discuss the typical CT appearance of myocutaneous surgically placed flaps as well as some frequently encountered complications of this surgery. We will discuss the appearance of relatively new, but increasingly encountered, nonnative materials used in reconstructive surgery, such as spacers, bulking agents, hemostatic agents, and other reconstructive materials. CONCLUSION: Oncologic surgery often requires reconstruction using myocutaneous flaps. Therefore, an understanding of the type of reconstruction performed is important for the accuracy of postoperative radiologic interpretation to recognize presence of a flap to avoid misdiagnosis of tumor recurrence.