On the horns of a dilemma: Evaluation of synthetic and natural textile microfibre effects on the physiology of the pacific oyster Crassostrea gigas.

Fast fashion and our daily use of fibrous materials cause a massive release of microfibres (MF) into the oceans. Although MF pollution is commonly linked to plastics, the vast majority of collected MF are made from natural materials (e.g. cellulose). We investigated the effects of 96-h exposure to natural (wool, cotton, organic cotton) and synthetic (acrylic, nylon, polyester) textile MF and their associated chemical additives on the capacity of Pacific oysters Crassostrea gigas to ingest MF and the effects of MF and their leachates on key molecular and cellular endpoints. Digestive and glycolytic enzyme activities and immune and detoxification responses were determined at cellular (haemocyte viability, ROS production, ABC pump activity) and molecular (Ikb1, Ikb2, caspase 1 and EcSOD expression) levels, considering environmentally relevant (10 MF L-1) and worst-case scenarios (10 000 MF L-1). Ingestion of natural MF perturbed oyster digestive and immune functions, but synthetic MF had few effects, supposedly related with fibers weaving rather than the material itself. No concentration effects were found, suggesting that an environmental dose of MF is sufficient to trigger these responses. Leachate exposure had minimal effects on oyster physiology. These results suggest that the manufacture of the fibres and their characteristics could be the major factors of MF toxicity and stress the need to consider both natural and synthetic particles and their leachates to thoroughly evaluate the impact of anthropogenic debris. Environmental Implication. Microfibres (MF) are omnipresent in the world oceans with around 2 million tons released every year, resulting in their ingestion by a wide array of marine organisms. In the ocean, a domination of natural MF- representing more than 80% of collected fibres-over synthetic ones was observed. Despite MF pervasiveness, research on their impact on marine organisms, is still in its infancy. The current study aims to investigate the effects of environmental concentrations of both synthetic and natural textile MF and their associated leachates on a model filter feeder.

Microplastics contamination in pearl-farming lagoons of French Polynesia.

Pearl-farming is the second most important source of income in French Polynesia. However, tropical lagoons are fragile ecosystems with regard to anthropogenic pressures like plastic pollution, which threaten marine life and the pearl oyster-related economy. Here, we investigated the spatial distribution of microplastics (MP) and concentrations in surface water (SW), water column (WC) and cultivated pearl oyster (PO) from three pearl-farming atolls with low population and tourism. Microplastics were categorized by their size class, shape, colour and polymer type identified using FTIR spectroscopy. Widespread MP contamination was observed in every study site (SW, 0.2-8.4 MP m-3; WC, 14.0-716.2 MP m-3; PO, 2.1-125.0 MP g-1 dry weight), with high contamination in the WC highlighting the need to study the vertical distribution of MP, especially as this compartment where PO are reared. A large presence of small (< 200 µm) and fragment-shaped (> 70%) MP suggests that they result from the breakdown of larger plastic debris. The most abundant polymer type was polyethylene in SW (34-39%), WC (24-32%), while in PO, polypropylene (14-20%) and polyethylene were more evenly distributed (9-21%). The most common MP identified as black-grey polyethylene and polypropylene matches the polymer and colour of ropes and collectors questioning a pearl-farming origin.

4D-CT-based motion correction of PET images using 3D iterative deconvolution.

OBJECTIVES: Positron emission tomography acquisition takes several minutes representing an image averaged over multiple breathing cycles. Therefore, in areas influenced by respiratory movement, PET-positive lesions occur larger, but less intensive than they actually are, resulting in false quantitative assessment. We developed a motion-correction algorithm based on 4D-CT without the need to adapt PET-acquisition. METHODS: The algorithm is based on a full 3D iterative Richardson-Lucy-Deconvolution using a point-spread-function constructed using the motion information obtained from the 4D-CT. In a motion phantom study (3 different hot spheres in background activity), optimal parameters for the algorithm in terms of number of iterations and start image were estimated. Finally, the correction method was applied to 3 patient data sets. In phantom and patient data sets lesions were delineated and compared between motion corrected and uncorrected images for activity uptake and volume. RESULTS: Phantom studies showed best results for motion correction after 6 deconvolution steps or higher. In phantom studies, lesion volume improved up to 23% for the largest, 43% for the medium and 49% for the smallest sphere due to the correction algorithm. In patient data the correction resulted in a significant reduction of the tumor volume up to 33.3 % and an increase of the maximum and mean uptake of the lesion up to 62.1 and 19.8 % respectively. CONCLUSION: In conclusion, the proposed motion correction method showed good results in phantom data and a promising reduction of detected lesion volume and a consequently increasing activity uptake in three patients with lung lesions.

Radionuclide intake risks in the clinical administration of 223RaCl2.

An intake monitoring program covering more than half a year of clinical administration of Radium-223-dichloride for the palliative treatment of castration-resistant prostate cancer was carried out in the nuclear medicine department of the university hospital Bonn. Radioactivity in a total of 87 samples of gloves, air filters, faecal bioassays and face masks was measured and evaluated to assess the need for radiation protection measures for the medical staff. The main aim was to quantify or obtain an upper limit for the intake factor. An intake factor of 10-8 was measured when the preparation of patient doses took place in part in a laminar flow cabinet, which indicates an intake factor of 10-7 in more commonplace practice without a cabinet. The intake factor is therefore at the same level as other standard applications of unsealed sources in nuclear medicine. Our findings confirmed that masks are not required under any circumstances. However, the investigation also revealed that contamination risks, especially during the preparation of doses in syringes, should not be neglected.

68Ga-PSMA-PET/CT imaging of localized primary prostate cancer patients for intensity modulated radiation therapy treatment planning with integrated boost.

PURPOSE: The purpose of our study was to show the feasibility and potential benefits of using 68Ga-PSMA-PET/CT imaging for radiation therapy treatment planning of patients with primary prostate cancer using either integrated boost on the PET-positive volume or localized treatment of the PET-positive volume. The potential gain of such an approach, the improvement of tumor control, and reduction of the dose to organs-at-risk at the same time was analyzed using the QUANTEC biological model. METHODS: Twenty-one prostate cancer patients (70 years average) without previous local therapy received 68Ga-PSMA-PET/CT imaging. Organs-at-risk and standard prostate target volumes were manually defined on the obtained datasets. A PET active volume (PTV_PET) was segmented with a 40% of the maximum activity uptake in the lesion as threshold followed by manual adaption. Five different treatment plan variations were calculated for each patient. Analysis of derived treatment plans was done according to QUANTEC with in-house developed software. Tumor control probability (TCP) and normal tissue complication probability (NTCP) was calculated for all plan variations. RESULTS: Comparing the conventional plans to the plans with integrated boost and plans just treating the PET-positive tumor volume, we found that TCP increased to (95.2 ± 0.5%) for an integrated boost with 75.6 Gy, (98.1 ± 0.3%) for an integrated boost with 80 Gy, (94.7 ± 0.8%) for treatment of PET-positive volume with 75 Gy, and to (99.4 ± 0.1%) for treating PET-positive volume with 95 Gy (all p < 0.0001). For the integrated boost with 80 Gy, a significant increase of the median NTCP of the rectum was found, for all other plans no statistical significant increase in the NTCP neither of the rectum nor the bladder was found. CONCLUSIONS: Our study demonstrates that the use of 68Ga-PSMA-PET/CT image information allows for more individualized prostate treatment planning. TCP values of identified active tumor volumes were increased, while rectum and bladder NTCP values either remained the same or were even lower. However, further studies need to clarify the clinical benefit for the patients applying these techniques.

Assessment of Bone Metastases in Patients with Prostate Cancer-A Comparison between 99mTc-Bone-Scintigraphy and [68Ga]Ga-PSMA PET/CT.

PURPOSE: Bone scintigraphy is the standard of reference in bone metastases in prostate cancer patients. However, new radiotracers employed in prostate-specific membrane antigen (PSMA)-ligands has led to the growing importance of PET/CT as diagnostic tool. The aim of our study was to investigate the difference between bone scan and PSMA-PET/CT for the detection of bone metastases in prostate cancer. METHODS: Thirty patients with bone metastases originating from prostate cancer were examined by 99mTc-MDP bone scan and 68Ga-PSMA-PET/CT within an average of 21 days. Bone scans were analyzed visually according to the number of lesions and using the software package ExiniBONE by Exini Diagnostics. PET/CT data was analyzed visually. Numbers of detected lesions were compared for the different methods for the whole patient and for different regions. In addition, results were compared to serum prostate-specific antigen (PSA), alkaline phosphatase (ALP), bone alkaline phosphatase (bALP), pro gastrin releasing peptide (pGRP) and eastern cooperative oncology group (ECOG) performance status. RESULTS: In the bone scans, visual and semiautomatic lesion detection showed similar results with an average of 19.4 and 17.8 detected bone lesion per patient. However, in PSMA-PET/CT, on average double the numbers of lesions (40.0) were detected. The largest differences were found in the thorax and pelvis, which can be explained by the advantages of tomographic imaging. Bland-Altman analysis showed greater differences in patients with large numbers of bone metastases. CONCLUSION: No significant difference was found when using semiautomatic analysis compared to visual reading for bone scans. Fewer bone metastases were detected in bone scans than in PSMA-PET/CT. However, in none of our patients would the difference have led to clinical consequences. Therefore, it seems that for patients undergoing PSMA-PET/CT, there is no need to perform additional bone scans if the appropriate PET/CT protocols are applied.

Kidney transplantation fails to provide adequate growth in children with chronic kidney disease born small for gestational age.

BACKGROUND: Children with chronic kidney disease are frequently born small for gestational age (SGA) and prone to disproportionately short stature. It is unclear how SGA affects growth after kidney transplantation (KTx). METHODS: Linear growth (height, sitting height, and leg length) was prospectively investigated in a cohort of 322 pediatric KTx recipients, with a mean follow-up of 4.9 years. Sitting height index (ratio of sitting height to total body height) was used to assess body proportions. Predictors of growth outcome in KTx patients with (n = 94) and without (n = 228) an SGA history were evaluated by the use of linear mixed-effects models. RESULTS: Mean z-scores for all linear body dimensions were lower in SGA compared with non-SGA patients (p < 0.001). SGA patients presented with higher target height deficit and degree of body disproportion (p < 0.001). The latter was mainly due to reduced leg growth during childhood. Pubertal trunk growth was diminished in SGA patients, and the pubertal growth spurt of legs was delayed in both groups, resulting in further impairment of adult height, which was more frequently reduced in SGA than in non-SGA patients (50 % vs 18 %, p < 0.001). Use of growth hormone treatment in the pre-transplant period, preemptive KTx, transplant function, and control of metabolic acidosis were the only potentially modifiable correlates of post-transplant growth in SGA groups. By contrast, living related KTx, steroid exposure, and degree of anemia proved to be correlates in non-SGA only. CONCLUSIONS: In children born SGA, growth outcome after KTx is significantly more impaired and affected by different clinical parameters compared with non-SGA patients.

Somatostatin receptor based PET/CT in patients with the suspicion of cardiac sarcoidosis: an initial comparison to cardiac MRI.

Diagnosis of cardiac sarcoidosis is often challenging. Whereas cardiac magnetic resonance imaging (CMR) and positron emission tomography/computed tomography (PET/CT) with 18F-fluorodeoxyglucose (FDG) are most commonly used to evaluate patients, PET/CT using radiolabeled somatostatin receptor (SSTR) ligands for visualization of inflammation might represent a more specific alternative. This study aimed to investigate the feasibility of SSTR-PET/CT for detecting cardiac sarcoidosis in comparison to CMR.15 patients (6 males, 9 females) with sarcoidosis and suspicion on cardiac involvement underwent SSTR-PET/CT imaging and CMR. Images were visually scored. The AHA 17-segment model of the left myocardium was used for localization and comparison of inflamed myocardium for both imaging modalities. In semi-quantitative analysis, mean (SUVmean) and maximum standardized uptake values (SUVmax) of affected myocardium were calculated and compared with both remote myocardium and left ventricular (LV) cavity.SSTR-PET was positive in 7/15, CMR in 10/15 patients. Of the 3 CMR+/PET- subjects, one patient with minor involvement (<25% of wall thickness in CMR) was missed by PET. The remaining two CMR+/PET- patients displayed no adverse cardiac events during follow-up.In the 17-segment model, PET/CT yielded 27 and CMR 29 positive segments. Overall concordance of the 2 modalities was 96.1% (245/255 segments analyzed). SUVmean and SUVmax in inflamed areas were 2.0±1.2 and 2.6±1.2, respectively. The lesion-to-remote myocardium and lesion-to-LV cavity ratios were 1.8±0.2 and 1.9±0.2 for SUVmean and 2.0±0.3 and 1.7±0.3 for SUVmax, respectively.Detection of cardiac sarcoidosis by SSTR-PET/CT is feasible. Our data warrant further analysis in larger prospective series.

Tumour delineation in oesophageal cancer - A prospective study of delineation in PET and CT with and without endoscopically placed clip markers.

PURPOSE: The objective was to analyse the value of F-18-fluorodesoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) for delineation of the Gross Tumour Volumes (GTVs) in primary radiotherapy of oesophageal cancer. METHOD: 20 consecutive and prospective patients (13 men, 7 women) underwent FDG-PET/CT for initial staging and radiation treatment planning. After endoscopy-guided clipping of the tumour another CT study was acquired. The CT and the FDG-PET/CT were registered with a rigid and a non-rigid registration algorithm to compare the overlap between GTV contours defined with the following methods: manual GTV definition in (1) the CT image of the FDG-PET/CT, (2) the PET image of the FDG-PET/CT, (3) the CT study based on endoscopic clips (CT clip), and (4) in the PET-data using different semi-automatic PET segmentation algorithms including a gradient-based algorithm. The absolute tumour volumes, tumour length in cranio-caudal direction, as well as the overlap with the reference volume (CT-clip) were compared for all lesions and separately for proximal/distal tumours. RESULTS: In 6 of the patients, FDG-PET/CT discovered previously unknown tumour locations, which resulted in either altered target volumes (n=3) or altered intent of treatment from curative to palliative (n=3) by upstaging to stage IV. For tumour segmentation a large variability between all algorithms was found. For the absolute tumour volumes with CT-clip as reference, no single PET-based segmentation algorithm performed better compared to using the manual CT delineation alone. The best correlation was found between the CT-clip and the gradient based segmentation algorithm (PET-edge, R(2)=0.84) as well as the manual CT-delineation (CT-manual R(2)=0.89). Non-rigid registration between CT and image FDG-PET/CT did not decrease variability between segmentation methods compared to rigid registration statistically significant. For the analysis of tumour length no homogeneous correlation was found. CONCLUSION: Whereas FDG-PET was highly relevant for staging purposes, CT imaging with clipping of the tumour extension remains the gold standard for GTV delineation.

Patterns of growth after kidney transplantation among children with ESRD.

BACKGROUND AND OBJECTIVES: Poor linear growth is a frequent complication of CKD. This study evaluated the effect of kidney transplantation on age-related growth of linear body segments in pediatric renal transplant recipients who were enrolled from May 1998 until August 2013 in the CKD Growth and Development observational cohort study. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Linear growth (height, sitting height, arm and leg lengths) was prospectively investigated during 1639 annual visits in a cohort of 389 pediatric renal transplant recipients ages 2-18 years with a median follow-up of 3.4 years (interquartile range, 1.9-5.9 years). Linear mixed-effects models were used to assess age-related changes and predictors of linear body segments. RESULTS: During early childhood, patients showed lower mean SD scores (SDS) for height (-1.7) and a markedly elevated sitting height index (ratio of sitting height to total body height) compared with healthy children (1.6 SDS), indicating disproportionate stunting (each P<0.001). After early childhood a sustained increase in standardized leg length and a constant decrease in standardized sitting height were noted (each P<0.001), resulting in significant catch-up growth and almost complete normalization of sitting height index by adult age (0.4 SDS; P<0.01 versus age 2-4 years). Time after transplantation, congenital renal disease, bone maturation, steroid exposure, degree of metabolic acidosis and anemia, intrauterine growth restriction, and parental height were significant predictors of linear body dimensions and body proportions (each P<0.05). CONCLUSIONS: Children with ESRD present with disproportionate stunting. In pediatric renal transplant recipients, a sustained increase in standardized leg length and total body height is observed from preschool until adult age, resulting in restoration of body proportions in most patients. Reduction of steroid exposure and optimal metabolic control before and after transplantation are promising measures to further improve growth outcome.

Methylthioureas and their morpholine and dioxane adducts; hydrogen-bonding patterns.

We have redetermined the known structures of (i) methylthiourea (MTU) and (ii) 1,1-dimethylthiourea (1,1-DMTU), and investigated the structure of 1,3-dimethylthiourea (1,3-DMTU), which was however severely disordered. We report the structures of crystalline adducts of (iii) MTU with morpholine (1:1), (iv) 1,1-DMTU with 1,4-dioxane (2:1) and (v) 1,3-DMTU with 1,4-dioxane (2:1). Finally, (vi) we determined the structure of tetramethylthiourea (TetMTU). (i) In both independent molecules of MTU, the methyl group is trans to the C=S group across the C-N bond. The two molecules are connected to form an R2(2)(8) dimer by mutual N-H...S=C interactions. The packing involves six N-H...S=C interactions and is three-dimensional. (ii) The packing of the MTU-morpholine adduct is a layer structure, within which both molecules form linear aggregates parallel to the b axis. (iii) The packing of 1,1-DMTU involves N-H...S=C hydrogen bonds forming a corrugated layer structure. (iv) In the 2:1 adduct between 1,1-DMTU and 1,4-dioxane, the DMTU molecule occupies a general position whereas the dioxane molecule lies across an inversion centre. The crystal packing involves chains of alternating 1,1-DMTU R2(2)(8) dimers and dioxanes, both across inversion centres. (v) In the 2:1 adduct between 1,3-DMTU and dioxane, the 1,3-DMTU molecule occupies a general position, while the dioxane molecule lies across an inversion centre. One methyl group of the DMTU is trans and one cis to the sulfur across the corresponding C-N bond. The molecules form chains of alternating 1,3-DMTU R2(2)(8) dimers and dioxanes, both across inversion centres. Crystals of the 2:1 adduct between 1,3-DMTU and morpholine were also obtained, and were isotypic with the dioxane adduct. The morpholine molecule is disordered across the inversion centre. (vi) The molecule of TetMTU displays crystallographic twofold symmetry. Significant distortions reflect the steric pressure between methyl groups trans to sulfur. The packing of TetMTU involves only a weak hydrogen bond, C-Hmethyl...S, which connects the molecules to form layers.