Primary staging of rectal cancer on MRI: an updated pictorial review with focus on common pitfalls and current controversies.

Magnetic resonance imaging (MRI) plays a pivotal role in primary staging of rectal cancer, enabling the determination of appropriate management strategies and prediction of patient outcomes. However, inconsistencies and pitfalls exist in various aspects, including rectal anatomy, MRI protocols and strategies for artifact resolution, as well as in T- and N-staging, all of which limit the diagnostic value of MRI. This narrative and pictorial review offers a comprehensive overview of factors influencing primary staging of rectal cancer and the role of MRI in assessing them. It highlights the significance of the circumferential resection margin and its relationship with the mesorectal fascia, as well as the prognostic role of extramural venous invasion and tumor deposits. Special attention is given to tumors of the lower rectum due to their complex anatomy and the challenges they pose in MRI staging. The review also addresses current controversies in rectal cancer staging and the need for personalized risk stratification. In summary, this review provides valuable insights into the role of MRI in the primary staging of rectal cancer, emphasizing key aspects for accurate assessment to enhance patient outcomes.

Integral evaluation of effective conversion of sewage sludge from WWTP into highly porous activated carbon.

Urban sewage sludge (SL) is a major concern due to the number of environmental problems it causes. Its application for different purposes is strictly regulated, limiting the possibilities of recycling and reusing this material. Thus, in this work, a complete study of a simple method to convert SL into activated carbon (AC) was carried out. The comprehensive study involves an evaluation of the main process parameters, such as the activating agent (AA) content (25 %, 33 %, 50 %), using the lowest amount of AA as novelty, different pyrolysis temperatures (600 and 800 °C), and purification conditions (6 M HCl:AC ratio, v:w). Under controlled and optimised conditions and through a single combined activation and pyrolysis step followed by acid purification, ACs with well-developed porosity can be obtained. Surface area values of around 870 m2/g and over 60 % carbon content were achieved, demonstrating that the prepared ACs could have applications in a wide variety of fields as high-value products. As an innovative aspect in this research, the gases streams and liquid effluents generated during the global process were analysed, achieving elimination of over 63 % of the concentration of the chemical elements contained in the SL during the chemical purification stage. Finally, mass, energy, and economic balances were carried out to estimate the production cost of AC derived from SL (<€ 8/kg AC).

Test Bench for Highly Segmented GRIT Double-Sided Silicon Strip Detectors: A Detector Quality Control Protocol.

This work deals with the characteristics of highly segmented double-sided silicon detectors. These are fundamental parts in many new state-of-the-art particle detection systems, and therefore they must perform optimally. We propose a test bench that can handle 256 electronic channels with off-the-shelf equipment, as well as a detector quality control protocol to ensure that the detectors meet the requirements. Detectors with a large number of strips bring new technological challenges and issues that need to be carefully monitored and understood. One of the standard 500 µm thick detectors of the GRIT array was investigated, undergoing studies that revealed its IV curve, charge collection efficiency, and energy resolution. From the data obtained, we calculated, among other things, the depletion voltage (110 V), the resistivity of the bulk material (9 kΩ·cm), and the electronic noise contribution (8 keV). We present, for the first time, a methodology called "the energy triangle'' to visualize the effect of charge sharing between two adjacent strips and to study the hit distribution with the interstrip-to-strip hit ratio (ISR).

Validity of Normative Volumetric Estimates from Open Access Software in Amnestic Mild Cognitive Impairment.

BACKGROUND: Neurodegeneration in Alzheimer's disease (AD) is typically assessed through brain MRI. Although proprietary software can provide normative estimates of regional atrophy, such tools can be cost-prohibitive for research settings. Free software for generating normative estimates has recently been released but has yet to be validated in the context of amnestic mild cognitive impairment (aMCI). OBJECTIVES: Determine whether normative morphometric estimates generated from open-source software replicate established patterns of neurodegeneration in aMCI, and whether these metrics correlate with episodic memory performance. DESIGN: Observational study of brain MRI and cognition in aging and aMCI with two identical study visits occurring approximately 1.2 years apart. SETTING: Participants were recruited from the local community and outpatient clinical settings. PARTICIPANTS: Adults ages 60-85 with aMCI (n = 25) and cognitively normal controls (CN; n = 74). A subset returned for follow-up (aMCI n = 11, CN n = 52). MEASUREMENTS: Participants completed brain MRI and two neuropsychological tests of verbal episodic memory. FreeSurfer v6.0 and Normative Morphometry Image Statistics were used to generate normative morphometric estimates for AD-relevant regions (hippocampus, parahippocampus, entorhinal cortex, amygdala) and control regions (cuneus, lingual gyrus, pericalcarine gyrus), adjusting for age, sex, head size, scanner manufacturer, and field strength. We tested for baseline group differences in ROI volumes and memory and assessed their within-group associations. We also evaluated changes in ROI volumes over time and tested whether these changes corresponded to declines in memory. RESULTS: At baseline, the aMCI group exhibited poorer memory and smaller volumes in AD-relevant regions than the CN group. There were no group differences in control region volumes. Memory was associated with volumes in AD-relevant regions in the aMCI group only. The aMCI group exhibited greater declines than the CN group in hippocampal volume (17% vs. 8% annual decline) and entorhinal volume (54% vs. 5% annual decline). Decrease in hippocampal volume was marginally associated with decline in memory for the aMCI group. CONCLUSIONS: Normative morphometric values generated from freely available software demonstrated expected patterns of group differences in AD-related volumes and associations with memory. Significant effects were localized to AD-relevant brain regions and only occurred in the aMCI group. These findings support the validity of these free tools as reliable and cost-effective alternatives to proprietary software for use in research settings.

The antihypertensive and diuretic effect of crude root extract and saponins from Solanum sisymbriifolium Lam., in L-NAME-induced hypertension in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Solanum sisymbriifolium Lam., is used in Paraguayan folk medicine claiming antihypertensive and diuretic properties. AIM OF THE STUDY: This study aimed to determine the influence of chronic oral administration of the crude root extract and saponins obtained from S. sisymbriifolium Lam., on the blood pressure of male and female rats with hypertension induced by L-NAME, and its consequences on diuresis, the body weight, blood glucose, and level of serum parameters of liver and kidney functionality. MATERIALS AND METHODS: Wistar rats were randomly divided into seven male, and seven female groups (8 animals each), which received as 6-week pretreatment, 0.9% saline solution (two groups; 0.1mL/10 g of b.w.), L-arginine (100.0 mg/kg/day), enalapril (15.0 mg/kg/day), crude extract (CESs 100.0 mg/kg/day), and saponin purified fraction (1.0, and 10.0 mg/kg/day), and treated with L-NAME (20 mg/kg/day/i.p.) twice, 1, and 6 h after pre-treatment. The animals' body weight, glycemia, and blood pressure were recorded weekly, while serum, hepatic, renal, and histological parameters were analyzed at the end of 6-week of treatment. RESULTS: A protective effect of CESs (100.0 mg/kg/day), and saponins (1.0, and 10.0 mg/kg/day) against hypertension induced by L-NAME was verified in the systolic, diastolic, and mean blood pressure values, which were significantly lower than the positive L-NAME-hypertensive control group (male and female) at the end of the 6-week treatment. Also, pretreatment with enalapril (15.0 mg/kg/day) induced an efficient protective activity, which validates the method used. Likewise, the volume of urine, creatinine, uric acid, urea, and electrolyte excretion was enhanced at the end of 6-week of treatment in concordance with the reduction in serum level of the same parameters, compatible with the improvement of the diuretic activity. The glycemia, body weight, heart rate, and functional hepato-renal parameters were not modified after a 6-week of treatment, in comparison to the control group, indicating relatively acceptable harmless properties of CESs and saponins. Interestingly, the HDL level in females was increased in contrast to male rats by chronic saponins treatment when compared with the negative control group. CONCLUSIONS: It can be concluded that either the increment in blood pressure (systolic, diastolic, and median) or cardiorenal remodeling effects in male and female rats submitted to L-NAME-induced hypertensive condition, were prevented and well-preserved without a significant variation during a period of 6-week of pretreatment with CESs and saponins pretreatments. Likewise, an important diuretic effect was revealed after this period of treatment.

Hypovitaminosis D, oral potentially malignant disorders, and oral squamous cell carcinoma: a systematic review.

BACKGROUND: Oral squamous cell carcinoma (OSCC) and potentially malignant oral disorders (OPMDs) could be associated with low levels of vitamin D. This systematic review aimed to determine the relationship between serum levels of vitamin D with OPMDs and OSCC. MATERIAL AND METHODS: This review was conducted according to Cochrane guidelines (PROSPERO CRD42020207382) on literature retrieved from the PubMed, Cochrane, and Web of Science databases. The antecedents extracted were study design, methodology, sample (country, number of patients, age, and sex), oral manifestations (type of lesion, location, prevalence, and follow-up), serum vitamin D levels or use of vitamin D supplements, results, and conclusions. RESULTS: Twelve articles were selected. Some of the most relevant findings were alterations in vitamin D could favor the progress of OPMDs to OSCC. Higher levels of vitamin D can increase levels of anti-inflammatory mediators, CD4+ T lymphocytes and CD8+ T lymphocytes and CD3+ T lymphocytes in intratumoral tissue. The normalization of vitamin D levels in patients with OSCC can increased cytotoxic activity of natural killer cells, favoring antitumor immune response. Vitamin D supplemented can lower adverse effects associated with chemotherapy like mucositis and pain. Tobacco can increase risk of developing OSCC altering vitamin D levels. CONCLUSIONS: Hypovitaminosis D could increase risk of developing OSCC from OPMDs, thus altering the immune response and it is associated with a lower survival rate in patients with OSCC, a greater recurrence of tumors in patients who underwent surgical treatment, and an increase in adverse reactions to chemotherapy. The use of vitamin D supplements can be a complement to primary therapy to prevent the recurrence of lesions and reduce adverse events associated with treatment.

Queratoquistes odontogénicos maxilares en paciente con síndrome de Gorlin. Descripción de un caso y revisión de la literatura / Maxillary odontogenic keratocysts in a Gorlin síndrome patient: Case report and literatura review

Los queratoquistes maxilares son frecuentes en pacientes con síndrome de Gorlin. Su tratamiento es debatido por su alta tendencia a la recidiva. En los últimos años la cirugía endoscópica nasosinusal ha adquirido importancia en el manejo de esta patología. Exponemos en caso de un varón de 16 años afecto de este síndrome con queratoquistes maxilares donde se realiza un abordaje combinado, endonasal y transoral.

Maxillary keratocysts are frequent in Gorlin Syndrome patients. Its treatment is discussed due to the high tendency to recurrence. In the last years the sinonasal endoscopic surgery has become an important tool in the management of this pathology. We report a 16 years old boy with Gorlin Syndrome and maxillary keratocysts treated with a trans-nasal endoscopic and intra-oral combined approach.

Probiotic Properties of Alcaligenes faecalis Isolated from Argyrosomus regius in Experimental Peritonitis (Rat Model).

A strain of Alcaligenes faecalis A12C (A. faecalis A12C) isolated from Argyrosomus regius is a probiotic in fish. Previous experiments showed that A. faecalis A12C had inhibitory effects on the growth of multidrug-resistant bacteria. We aimed to confirm whether A. faecalis A12C is safe and has adequate intestinal colonization in experimental rats, and evaluate its efficacy in an animal model of peritonitis. We used 30 male rats, randomly divided into 6 groups (n = 5): three groups (HA7, HA15, HA30) received A. faecalis A12C in drinking water (6 × 108 CFU/mL) for 7 days, and three control groups received drinking water only. All groups were evaluated at 7, 15, and 30 days. Survival after A. faecalis A12C administration was 100% in all groups. Mild eosinophilia (1.5%, p < 0.01) and increased aspartate aminotransferase (86 IU/L, p < 0.05) were observed in HA7, followed by progressive normalization. No histological signs of organ injury were found. We observed significant E. coli decline in faeces, parallel to an increase in A. faecalis A12C at 7 days. E. coli had a tendency to recover initial values, while A. faecalis A12C disappeared from the intestinal microbiota at 30 days. To evaluate its efficacy against peritonitis, we studied two additional groups of animals: IA group pretreated with A. faecalis A12C before E. coli intra-abdominal inoculation, and IC group inoculated with no A. faecalis A12C. We found an increase in C-reactive protein, alanine aminotransferase, urea, and eosinophils in IC animals when compared with IA. Peritonitis was more evident in IC than in IA animals. Our findings suggest that A. faecalis A12C altered clinically relevant parameters in sepsis and was associated with a lesser spread of infection.

Pathogens Detection in the Small Hive Beetle (Aethina tumida (Coleoptera: Nitidulidae)).

Aethina tumida Murray is currently a worldwide emergent pest of Apis mellifera L. hives. Although the damaging effect on the colony stores and brood is well known, the possible role of these beetles as a disease carrier is not clear. This is the first report of DNA presence of the trypanosome honeybee parasite Lotmaria passim and Crithidia bombi, and the Apis mellifera filamentous virus (AmFV) in A. tumida. Further studies will be needed to determine if A. tumida is indeed a mechanical or biological vector of these pathogens.

Integral evaluation of granular activated carbon at four stages of a full-scale WWTP deodorization system.

Odor emissions from wastewater treatment plants (WWTPs) have always been a public concern. In this work, the physico-chemical, olfactometric and textural characterization of granular active carbon (GAC) used by an urban WWTP as a deodorization system, as well as the chromatographic quantification of the retained odoriferous compounds, have been carried out. These techniques have allowed an integral evaluation of the contaminated GAC and the characterization of the retained gaseous emission from four different stages of the wastewater treatment (pretreatment header: GAC-1; sand and fat removal: GAC-2; sludge thickening: GAC-3; sludge dehydration: GAC-4). A larger amount and variety of retained odoriferous compounds were found in GAC samples from the wastewater line deodorization (GAC-1 and GAC-2) after the same operation time (one year), GAC-1 being the adsorbent bed that retained the highest mass of volatile compounds (approximately 150µg/g GAC). Furthermore, some variables such as the removed specific odor concentration and free micropore volume were inversely correlated (R2=0.9945). The analysis of odor contribution showed that sulfur-containing compounds were the major odor contributors (61-97%). However, hydrogen sulfide cannot be considered a key odorant in this particular WWTP, since the elimination of this compound does not reduce the significant contribution of other (organic) sulfur compounds to the global odor (especially dimethyl disulfide). Consequently, multi-technical analysis might be a suitable alternative to better understand odor removal by GAC adsorption.

¿Cuál es el impacto de la implantación de recomendaciones «No hacer» en un bloque quirúrgico hospitalario? / What is the impact of «Do not do» recommendations in a hospital surgical department?

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Improving membrane photobioreactor performance by reducing light path: operating conditions and key performance indicators.

Microalgae cultivation has been receiving increasing interest in wastewater remediation due to their ability to assimilate nutrients present in wastewater streams. In this respect, cultivating microalgae in membrane photobioreactors (MPBRs) allows decoupling the solid retention time (SRT) from the hydraulic retention time (HRT), which enables to increase the nutrient load to the photobioreactors (PBRs) while avoiding the wash out of the microalgae biomass. The reduction of the PBR light path from 25 to 10 cm increased the nitrogen and phosphorus recovery rates, microalgae biomass productivity and photosynthetic efficiency by 150, 103, 194 and 67%, respectively.The areal biomass productivity (aBP) also increased when the light path was reduced, reflecting the better use of light in the 10-cm MPBR plant. The capital and operating operational expenditures (CAPEX and OPEX) of the 10-cm MPBR plant were also reduced by 27 and 49%, respectively. Discharge limits were met when the 10-cm MPBR plant was operated at SRTs of 3-4.5 d and HRTs of 1.25-1.5 d. At these SRT/HRT ranges, the process could be operated without a high fouling propensity with gross permeate flux (J20) of 15 LMH and specific gas demand (SGDp) between 16 and 20 Nm3air·m-3permeate, which highlights the potential of membrane filtration in MPBRs. When the continuous operation of the MPBR plant was evaluated, an optical density of 680 nm (OD680) and soluble chemical oxygen demand (sCOD) were found to be good indicators of microalgae cell and algal organic matter (AOM) concentrations, while dissolved oxygen appeared to be directly related to MPBR performance. Nitrite and nitrate (NOx) concentration and the soluble chemical oxygen demand:volatile suspended solids ratio (sCOD:VSS) were used as indicators of nitrifying bacteria activity and the stress on the culture, respectively. These parameters were inversely related to nitrogen recovery rates and biomass productivity and could thus help to prevent possible culture deterioration.

Preliminary data set to assess the performance of an outdoor membrane photobioreactor.

This data in brief (DIB) article is related to a Research article entitled 'Optimising an outdoor membrane photobioreactor for tertiary sewage treatment' [1]. Data related to the effect of substrate turbidity, the ammonium concentration at which the culture reaches nitrogen-deplete conditions and the microalgae growth rate under outdoor conditions is provided. Microalgae growth rates under different substrate turbidity were obtained to assess the reduction of the culture's light availability. Lab-scale experiments showed growth rates reductions of 22-44%. Respirometric tests were carried to know the limiting ammonium concentration in this microalgae-based wastewater treatment system. Growth rates (µ) of green microalgae Scenedesmus and Chlorella obtained under outdoor conditions; i.e. 0.40 d-1 (R2 = 0.993) and 0.43 d-1 (R2 = 0.995), respectively, can be useful to obtain optimum operating conditions of membrane photobioreactor (MPBR).

Pancreatic Cancer Incidence, Mortality, and Survival in Puerto Rico, 2001-2015.

OBJECTIVE: To perform an epidemiologic profile of pancreatic cancer (PC) in Puerto Rico (PR) with data gathered from 2001 to 2015. METHODS: Using data from the PR Central Cancer Registry we estimated incidence and mortality rates and trends of PC in PR, and performed survival analyses. We also compared the age-standardized incidence and mortality rates of PC in people in PR with those of Hispanics, non-Hispanic whites, and non Hispanic blacks in the United States (US). RESULTS: From 2011 to 2015, 7.8 per 100,000 persons were diagnosed with PC in PR; higher rates were observed in men than in women (9.2 vs. 6.7 per 100,000, respectively) and in persons 65 years old and older (42.7 per 100,000 persons). For the same period, 6.7 per 100,000 persons died from PC; men and persons 65 years and older had higher mortality rates. Incidence and mortality trends of PC in PR increased from 2001-2015 (annual percent change [APC] = 3.8% and 1.9%, respectively (p<0.05). Lower risk of being diagnosed with and dying from PC was seen in PR than in members of several racial/ethnic groups in the US. The median survival time for PC cases diagnosed in PR during the period of 2008 to 2012 was 5.3 months. CONCLUSION: We observed increasing mortality rates and low survival in PC patients in PR. Research on access and response to treatment is needed to elucidate the reasons for the observed results and have a positive impact on PC burden and survival.

Towards the Limits of Existence of Nuclear Structure: Observation and First Spectroscopy of the Isotope

The most remote isotope from the proton dripline (by 4 atomic mass units) has been observed: ^{31}K. It is unbound with respect to three-proton (3p) emission, and its decays have been detected in flight by measuring the trajectories of all decay products using microstrip detectors. The 3p emission processes have been studied by the means of angular correlations of ^{28}S+3p and the respective decay vertices. The energies of the previously unknown ground and excited states of ^{31}K have been determined. This provides its 3p separation energy value S_{3p} of -4.6(2) MeV. Upper half-life limits of 10 ps of the observed ^{31}K states have been derived from distributions of the measured decay vertices.

Belimumab alters transitional B-cell subset proportions in patients with stable systemic lupus erythematosus.

OBJECTIVE: We evaluated the effects of the B-cell activating factor (BAFF)-targeting antibody Belimumab on human nonmemory B-cell pools. Human B-cell pools were identified using surface markers adapted from mouse studies that specifically assessed reductions in immature B cells due to BAFF depletion. Patients with systemic lupus erythematosus (SLE) have high levels of both BAFF and immature B cells. Mechanistic mouse studies provide a framework for understanding human responses to therapies that target B cells. METHODS: Peripheral blood mononuclear cells were isolated from healthy donors and SLE patients on Belimumab or standard-of-care therapy (SCT). Cells were stained for flow cytometry to identify B-cell subsets based on CD21/CD24. Differences in subset proportions were determined by one-way ANOVA and Tukey's post hoc test. RESULTS: Patients treated with Belimumab show alterations in the nonmemory B-cell pool characterized by a decrease in the Transitional 2 (T2) subset (p = 0.002), and an increase in the proportion of Transitional 1 (T1) cells (p = 0.005) as compared with healthy donors and SCT patients. The naïve B-cell compartment showed no significant differences between the groups (p = 0.293). CONCLUSION: Using a translational approach, we show that Belimumab-mediated BAFF depletion reduces the T2 subset in patients, similar to observations in mouse models with BAFF depletion.

Optimising an outdoor membrane photobioreactor for tertiary sewage treatment.

The operation of an outdoor membrane photobioreactor plant which treated the effluent of an anaerobic membrane bioreactor was optimised. Biomass retention times of 4.5, 6, and 9 days were tested. At a biomass retention time of 4.5 days, maximum nitrogen recovery rate:light irradiance ratios, photosynthetic efficiencies and carbon biofixations of 51.7 ±â€¯14.3 mg N·mol-1, 4.4 ±â€¯1.6% and 0.50 ±â€¯0.05 kg CO2·m3influent, respectively, were attained. Minimum membrane fouling rates were achieved when operating at the shortest biomass retention time because of the lower solid concentration and the negligible amount of cyanobacteria and protozoa. Hydraulic retention times of 3.5, 2, and 1.5 days were tested at the optimum biomass retention times of 4.5 days under non-nutrient limited conditions, showing no significant differences in the nutrient recovery rates, photosynthetic efficiencies and membrane fouling rates. However, nitrogen recovery rate:light irradiance ratios and photosynthetic efficiency significantly decreased when hydraulic retention time was further shortened to 1 day, probably due to a rise in the substrate turbidity which reduced the light availability in the culture. Optimal carbon biofixations and theoretical energy recoveries from the biomass were obtained at hydraulic retention time of 3.5 days, which accounted for 0.55 ±â€¯0.05 kg CO2·m-3influent and 0.443 ±â€¯0.103 kWh·m-3influent, respectively.

Posttraumatic stress disorder in African American and Latinx adults: Clinical course and the role of racial and ethnic discrimination.

Research has suggested that African American and Latinx adults may develop posttraumatic stress disorder (PTSD) at higher rates than White adults, and that the clinical course of PTSD in these minority groups is poor. Factors that may contribute to higher prevalence and poorer outcome in these groups are sociocultural factors and racial stressors, such as experiences with discrimination. To date, however, no research has explored the relationship between experiences with discrimination and risk for PTSD, and very little research has examined the course of illness for PTSD in African American and Latinx samples. The present study examined these variables in the only longitudinal clinical sample of 139 Latinx and 152 African American adults with anxiety disorders, the Harvard/Brown Anxiety Research Project-Phase II. Over 5 years of follow-up, remission rates for African Americans and Latinx adults with PTSD in this sample were 0.35 and 0.15, respectively, and reported frequency of experiences with discrimination significantly predicted PTSD diagnostic status in this sample, but did not predict any other anxiety or mood disorder. These findings demonstrate the chronic course of PTSD in African American and Latinx adults, and highlight the important role that racial and ethnic discrimination may play in the development of PTSD among these populations. Implications for an increased focus on these sociocultural stressors in the assessment and treatment of PTSD in African American and Latinx individuals are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).