Exploring the functionality of mesh-to-mesh value comparison in pair-matching and its application to fragmentary remains

SIMPLE SUMMARY: Forensic anthropologists often face the task of analysing a mixed group of skeletal remains or matching a solitary bone with the rest of a skeleton to determine if it belongs to the same individual. One of the best ways to do this is by pair-matching left and right bones of the same type. Common pair-matching methods experience issues such as high levels of subjectivity, lack of reliability, or expensive cost of implementation. This study explores the application of the relatively new method, mesh-to-mesh value comparison (MVC), which matches paired bones based on morphological shape to determine the likelihood that they derive from the same individual. This study sought to expand on the success found in past publications using MVC and to see how well it performed on a sample of clavicles, a bone known for having a high degree of bilateral variability, of 80 modern Turkish individuals. This study also explored whether MVC can reliably match fragmented bones to their intact counterpart. Results show MVC successfully matched 88.8% of paired clavicles and suggest the method continues to be a promising avenue for pair-matching that is not affected by ancestry and may be applicable to fragmented remains with further study. ABSTRACT: Many cases encountered by forensic anthropologists involve commingled remains or isolated elements. Common methods for analysing these contexts are characterised by limitations such as high degrees of subjectivity, high cost of application, or low proven accuracy. This study sought to test mesh-to-mesh value comparison (MCV), a relatively new method for pair-matching skeletal elements, to validate the claims that the technique is unaffected by age, sex and pathology. The sample consisted of 160 three-dimensional clavicle models created from computed tomography (CT) scans of a contemporary Turkish population. Additionally, this research explored the application of MVC to match fragmented elements to their intact counterparts by creating a sample of 480 simulated fragments, consisting of three different types based on the region of the bone they originate from. For comparing whole clavicles, this resulted in a sensitivity value of 87.6% and specificity of 90.9% using ROC analysis comparing clavicles. For the fragment comparisons, each type was compared to the entire clavicles of the opposite side. The results included a range of sensitivity values from 81.3% to 87.6%. Overall results are promising and the MVC technique seems to be a useful technique for matching paired elements that can be accurately applied to a Modern Turkish sample

Sex estimation in a contemporary Turkish population based on CT scans of the calcaneus

Building a reliable biological profile from decomposed remains depends heavily on the accurate estimation of sex. A variety of methods based on every single skeletal element have been developed over the years for different populations employing both osteological and virtual methods. The latter seem to be a reasonable alternative in countries lacking osteological reference collections. The current study used 3D virtual models of calcanei from CT scans of living adults to develop a sex estimation method for contemporary Turkish. Four hundred and twenty eight calcanei CT scans were analysed. The sample was divided in two subsamples: an original (N = 348) and a validation sample (N = 80) with similar distribution of males and females. Nine classical measurements were taken using the 3D models of the calcanei and two different statistical methods (Discriminant function analysis and Binary logistic regression) were used. Classification accuracy ranged from 82% to 98% for the validation sample and it was consistently high using any of the two methods. Sex bias seems to be lower for most of the logistic regression equations compared to the discriminant functions. These results, however, need further testing to be verified. Based on the results of this study we recommend the use of both methods for sex estimation from the measurements of the calcaneus bone in a Turkish population. (C) 2017 Elsevier B.V. All rights reserved

Individualized luteal phase support in frozen-thawed embryo transfer after intramuscular progesterone administration might rectify live birth rate

BackgroundThe serum P concentrations are suggested to have an impact on pregnancy outcome. However there is no consensus about the optimal progesterone cut-off during the luteal phase. Few studies evaluated the effectiveness of a “rescue protocol” for low serum P concentrations and most of these studies used vaginal progesterone administration. There is paucity of data on the effectiveness of rescue protocol using intramuscular progesterone (IM-P) in frozen-thawed embryo transfer (FET).MethodsThis study is a retrospective cohort study included 637 single or double blastocyst FETs with artificially prepared endometrium receiving 100 mg IM progesterone (P) after incremental estrogen treatment. Serum P concentrations were evaluated using blood samples obtained 117-119 hours after the first IM-P administration and 21 ± 2 hours after the last IM-P administration. Patients with serum P concentrations <20.6 ng/ml on the ET day were administrated 400 mg vaginal progesterone for rescue.ResultsDemographic and cycle characteristics were similar between patients receiving rescue vaginal P (embryo transfer (ET)-day P concentration < 20.6 ng/ml) and patients who did not need rescue vaginal P (ET-day P concentration ≥ 20.6 ng/ml). Clinical pregnancy, miscarriage, and live birth rates were similar between two groups: 52.9%(45/85) vs 59.6%(326/552), p=0.287; 11.1%(5/45) vs 14.1%(46/326), p=0.583; and 47.1%(40/85) vs 50.7%(280/552), p=0.526, respectively. Logistic regression analysis revealed that the female age (p = 0.008, OR=0.942, 95% CI = 0.902–0.984) and embryo quality (ref: good quality for moderate: p=0.02, OR=0.469, 95% CI =0.269–0.760; for poor: p=0.013, OR= 0.269, 95% CI = 0.092–0.757) were independent variables for live birth. Following rescue protocol implementation, ET-day P concentration was not a significant predictor of live birth.ConclusionsRescue vaginal P administration for low ET day serum P concentrations following IM-P yields comparable live birth rates

Carbon disulfide. Just toxic or also bioregulatory and/or therapeutic?

The overview presented here has the goal of examining whether carbon disulfide (CS2) may play a role as an endogenously generated bioregulator and/or has therapeutic value. The neuro- and reproductive system toxicity of CS2 has been documented from its long-term use in the viscose rayon industry. CS2 is also used in the production of dithiocarbamates (DTCs), which are potent fungicides and pesticides, thus raising concern that CS2 may be an environmental toxin. However, DTCs also have recognized medicinal use in the treatment of heavy metal poisonings as well as having potency for reducing inflammation. Three known small molecule bioregulators (SMBs) nitric oxide, carbon monoxide, and hydrogen sulfide were initially viewed as environmental toxins. Yet each is now recognized as having intricate, though not fully elucidated, biological functions at concentration regimes far lower than the toxic doses. The literature also implies that the mammalian chemical biology of CS2 has broader implications from inflammatory states to the gut microbiome. On these bases, we suggest that the very nature of CS2 poisoning may be related to interrupting or overwhelming relevant regulatory or signaling process(es), much like other SMBs

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Chest CT Imaging Features of COVID-19-Related Pulmonary Fibrosis: A Case Report

Bozdag, Mustafa/0000-0002-0741-587XWOS:000629028700004Shortly after being identified in China, 2019 coronavirus disease (COVID-19) caused by SARS-CoV-2 has spread rapidly and millions of people were infected as of May 2020; the outbreak resulting in more than 250,000 deaths was declared a pandemic. in this critical stage of the ongoing pandemic of COVID-19, information regarding the long term effects of the disease remains limited. While most of the patients recover completely, some patients may develop complications. in this report, we aimed to present the serial chest high-resolution computed tomography (HRCT) findings in a patient who developed pulmonary fibrosis (PF) similar to usual interstitial pneumonia (UIP) pattern during recovery from severe novel coronavirus pneumonia

Histogram Analysis of ADC Maps for Differentiating Brain Metastases From Different Histological Types of Lung Cancers

Purpose: Our study aimed to investigate the role of histogram analysis derived from apparent diffusion coefficient (ADC) maps in brain metastases (BMs) from lung cancer for differentiating histological subtype. Methods: A total of 61 BMs (45 non-small cell lung cancer [NSCLC] comprising 32 adenocarcinoma [AC], 13 squamous cell carcinoma [SCC], and 16 small-cell lung cancer [SCLC]) in 50 patients with histopathologically confirmed lung cancer were retrospectively included in this study. Pretreatment cranial diffusion-weighted imaging was performed, and the corresponding ADC maps were generated. Regions of interest were drawn on solid components of the BM on all slices of the ADC maps to obtain parameters, including ADC(max), ADC(mean), ADC(min), ADC(median), ADC(range), skewness, kurtosis, entropy, ADC(10), ADC(25), ADC(75), and ADC(90). Apparent diffusion coefficient histogram parameters were compared among histological type groups. Kruskal-Wallis, Mann-Whitney U, chi-square tests, and receiver-operating characteristic (ROC) curve were used for statistical assessment. Results: ADC(min,) ADC(10), and ADC(25) were found to be significantly different among AC, SCC, and SCLC groups; these parameters were higher for AC group, moderate for SCC group, and significantly lower for SCLC group. Skewness and kurtosis were not significantly different among all groups. The ROC analysis for differentiating BMs of NSCLC from SCLC showed that ADC(25) achieved the highest area under the curve at 0.922 with 93.02% sensitivity and 81.25% specificity. Conclusion: Apparent diffusion coefficient histogram analysis of BMs from lung cancer has significant prognostic value in differentiating histological subtypes of lung cancer.NIBIB NIH HHS [U24 EB028980] Funding Source: Medlin

Diagnostic role of apparent diffusion coefficient combined with intratumoral susceptibility signals in differentiating high-grade gliomas from brain metastases

Bozdag, Mustafa/0000-0002-0741-587XWOS:000627527600001PubMed: 33307971Objective: The aim of this study was to assess whether tumoral and peritumoral apparent diffusion coefficient values and intratumoral susceptibility signals on susceptibility-weighted imaging could distinguish between high-grade gliomas and brain metastases, and to investigate their associations with the Ki-67 proliferation index. Materials and methods: Fifty-seven patients with pathologically confirmed diagnoses of either high-grade glioma or brain metastasis were enrolled in this study (23 with high-grade gliomas and 34 with brain metastases). The minimum and mean apparent diffusion coefficients in the enhancing tumoral region (ADC(min) and ADC(mean)) and the minimum apparent diffusion coefficient in the peritumoral region (ADC(edema)) were measured from apparent diffusion coefficient maps, and intratumoral susceptibility signal grades acquired by susceptibility-weighted imaging were calculated. Ki-67 proliferation index values were obtained from the hospital database. These parameters were evaluated using the Mann-Whitney U test, independent-sample Hest, Spearman correlation analysis, receiver operating characteristic curve, and logistic regression analyses. Results: ADC(mean) ADC(min) values, and intratumoral susceptibility signal grades in brain metastases were significantly lower than those in high-grade gliomas (all p 0.05). According to receiver operating characteristic curve analysis, ADC(mean) achieved the highest diagnostic performance for discriminating high-grade gliomas from brain metastases. Furthermore, the combination of tumoral apparent diffusion coefficient parameters with intratumoral susceptibility signal grade provided a higher area under the curve than univariate parameters. Conclusion: The combination of tumoral apparent diffusion coefficient with intratumoral susceptibility signal grade can offer better diagnostic performances for differential diagnosis. Apparent diffusion coefficient and intratumoral susceptibility signal may reflect cellular proliferative activity in brain metastases, but not in high-grade gliomas

MRI assessment of pituitary Iron accumulation by using pituitary-R2 in beta-thalassemia patients

WOS: 000432868300016PubMed ID: 28882060Background: Patients with thalassemia major (TM) require repeated blood transfusions, which leads to accumulation of iron in a wide variety of tissues. Accumulation of iron in the pituitary gland can lead to irreversible hypogonadotropic hypogonadism (HH) in this group of patients. Purpose: To investigate the reliability of pituitary-R.2 as a marker to estimate the extent of pituitary iron load by comparing the pituitary magnetic resonance imaging (MRI) findings with hepatic iron load and serum ferritin levels. Material and Methods: A total of 38 beta-TM patients were classified into HH (group A, n = 18) and non-HH (group B, n = 17) groups. A third group, group C, consisted of 17 healthy participants. Each participant underwent 1.5-T MRI examinations. Pituitary gland heights (PGH), pituitary-R2 values, and liver-R2 values were measured by using multi-echo spin-echo sequences. Results: Pituitary-R2 values were significantly higher in group A compared with group B Rho < 0.05). A positive correlation was detected between the pituitary-R2 values and serum ferritin levels in TM patients Rho < 0. 01) A threshold value of 14.1 Hz for pituitary-R2 was found to give a high specificity and sensitivity in distinguishing the TM patients with HH from those with normal pituitary functions. PGH measurements were significantly lower in group A compared with group B Rho < 0.05). Conclusion: MRI-assessed pituitary-R2 seems to be a reliable marker for differentiating the TM patients with normal pituitary function from those with secondary hypogonadism due to iron toxicity