Assessing the image quality of brain magnetic resonance images taken with 1.5T and 3T scanners

Magnetic resonance imaging (MRI) is the ideal modality for brain imaging, as high quality anatomical detail is provided while having a higher sensitivity and specificity over other imaging modalities such as Computed Tomography (CT) (Isalm & Munir, 2019; Khan et al., 2019). MRI does not make use of ionising radiation, but acquires images in multiple planes without repositioning the patient through the generation of powerful electromagnetic fields, and radiofrequency pulses. Depending on the gradient and the number of radiofrequency pulses set, different MRI sequences are created. An MRI sequence is a series of radio-frequency pulses used to obtain a signal from the patient to produce an image of the examined area with a particular appearance (weighting) (Liang et al., 2021). [Excerpt]peer-reviewe

Bilateral breast reduction surgery at Mater Dei Hospital : analysis of physical and psychological symptoms using the BREAST-Q

Introduction: The literature describes the high patient satisfaction rate after breast reduction. In this retrospective study, we use the BREAST-Q to analyse satisfaction with breast appearance and physical, psychosocial and sexual well-being of patients who underwent bilateral breast reduction (BBR) at Mater Dei Hospital (MDH). We also looked into whether age, co-morbidities and weight of breast tissue removed makes a difference to the overall satisfaction rate. Method: Permission to use the BREAST-Q questionnaire and translate it into Maltese was obtained from Mapi Reasearch Trust. The questionnaire was offered either in Maltese or in English, after an official translation was produced following a linguistic validation process. All patients who underwent BBR at MDH under the care of both consultant Plastic Surgeons were invited to complete the BREAST-Q questionnaire via a telephone call and asked to come to MDH to fill it in. Other patient specific information was obtained from their hospital notes. Results: We hope to demonstrate a better quality of life following surgery and aim to compare the results of this study to others carried out worldwide. In this way we can better understand the local situation and see where there is the room for improvement. Conclusion: In this world of evidence-based medicine, the BREAST-Q is ideal for a holistic approach in analysing patient satisfaction after BBR. Having local data at hand makes it easier for patients who are interested in undergoing the surgery to associate themselves with other local individuals.peer-reviewe

Adenolipomas : a case series of 16 patients over 5 years

Introduction: An adenolipoma is a benign, rare variant of a lipoma and is histologically very similar to a lipoma but contains eccrine glands amongst the mature adipose tissue. According to our knowledge, this case series of adenolipomas, is the largest one in the literature. The aim is to increase awareness about this variant of lipoma.Method: The data was collected retrospectively from the histopathology department and patients’ notes.Results: We had a total of 16 cases of adenolipomas between 2013 and 2017 in our hospital. 75% of the patients were being managed by General Surgeons. 88% of them occurred in female patients and the patients’ age varied between 15 and 64 years. The most common location of adenolipomas was the thighs and the largest diameter of the histology specimen varied between 15 and 100mm. 31% were encapsulated, 25% had apocrine glands present and 6% had myxoid changes. None of them had mast cells present. No recurrences were documented.Conclusion: It is a benign lesion and awareness amongst pathologists is imperative so that it can be identified histologically.peer-reviewe

The initial implementation of the sentinel lymph node biopsy (SLNB) for breast cancer management in Malta

Over the past two decades, the sentinel lymph node biopsy (SLNB) based on sentinel node (SN) being the first lymph node that harbors metastases, revolutionized breast cancer management. SLNB presents much less morbidity when compared to radical axillary lymph node dissection (ALND) where all nodes are dissected irrespective of their metas-tatic involvement. The purpose of this study was to evaluate the effectiveness of SLNB by investigating whether the histological characteristics of the SNs identified using scintigraphy are predictive of the histological characteristics of the ALN basin. Methods: Fifty-five female breast cancer patients underwent lymphoscintigraphy and SLNB followed by ALND. The histological status of the SN/s was correlated to the histological status of the ALNs to determine whether the SN accurately stages the ALNs in breast cancer. Results: During surgery, SNs were successfully isolated in 52 out of 55 cases (94.5%) (range, 0 to 9). No SNs were identified in 3 cases (5.5%). Results demonstrate a significant association (p = 0.05) between the metastatic status of SNs and the corresponding ALNs in 42 out of 52 patients (80.8%), but with a high false-negative rate (FNR) of 37.5%. Conclusion: The findings of this study show that the sen-tinel node concept provides the benefits of SLNB in the majority of instances. However, further work is required in re-ducing the FNR. Once the effectiveness of SLNB as a staging technique is locally established, the need of ALND in SN-negative patients would be limited, thus improving the quality of life of Maltese breast cancer patients.peer-reviewe

Circulation in the vicinity of Mackenzie Canyon from a year-long mooring array

© The Author(s), 2020. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Lin, P., Pickart, R. S., Fissel, D., Ross, E., Kasper, J., Bahr, F., Torres, D. J., O'Brien, J., Borg, K., Melling, H., & Wiese, F. K. Circulation in the vicinity of Mackenzie Canyon from a year-long mooring array. Progress in Oceanography, 187, (2020): 102396, doi:10.1016/j.pocean.2020.102396.Data from a five-mooring array extending from the inner shelf to the continental slope in the vicinity of Mackenzie Canyon, Beaufort Sea are analyzed to elucidate the components of the boundary current system and their variability. The array, part of the Marine Arctic Ecosystem Study (MARES), was deployed from October 2016 to September 2017. Four distinct currents were identified: an eastward-directed flow adjacent to the coast; a westward-flowing, surface-intensified current centered on the outer-shelf; a bottom-intensified shelfbreak jet flowing to the east; and a recirculation at the base of the continental slope within the canyon. The shelf current transports −0.120.03 Sv in the mean and is primarily wind-driven. The response is modulated by the presence of ice, with little-to-no signal during periods of nearly-immobile ice cover and maximum response when there is partial ice cover. The shelfbreak jet transports 0.030.02 Sv in the mean, compared to 0.080.02 Sv measured upstream in the Alaskan Beaufort Sea over the same time period. The loss of transport is consistent with a previous energetics analysis and the lack of Pacific-origin summer water downstream. The recirculation in the canyon appears to be the result of local dynamics whereby a portion of the westward-flowing southern limb of the Beaufort Gyre is diverted up the canyon across isobaths. This interpretation is supported by the fact that the low-frequency variability of the recirculation is correlated with the wind-stress curl in the Canada Basin, which drives the Beaufort gyre.The authors are indebted to Fisheries and Oceans Canada for building the logistics for MARES into the at-sea missions of the Integrated Beaufort Observatory. We are grateful to the captain and crew of the CCGS Sir Wilfred Laurier for ably deploying and recovering the MARES array. Marshall Swartz assisted with the cruise preparation logistics. We thank the two anonymous reviewers for their input which helped improve the paper. This project was funded by the US Bureau of Ocean Energy Management (BOEM), on behalf of the National Ocean Partnership Program. The Canadian contribution was supported by the Environmental Studies Research Fund (ESRF Project 2014-02N). MARES publication 003

Sur Nin

Ġabra ta’ poeżiji u proża li tinkludi: Lil Ninu Cremona ta’ Rosar Briffa – Lis-Sur Ninu Cremona ta’ Ġużè Delia – Qabel l-irqad ta’ Ġużi Abela – Lis-Sur Ninu Cremona ta’ Manwel Nicholas Borg – Lil Dr. A. Cremona ta’ Ġorġ Chetcuti – Is-Sur Nin ta’ Francis P. Mifsud.peer-reviewe

The effect of session order on the physiological, neuromuscular, and endocrine responses to maximal speed and weight training sessions over a 24-h period

Objectives: Athletes are often required to undertake multiple training sessions on the same day with these sessions needing to be sequenced correctly to allow the athlete to maximize the responses of each session. We examined the acute effect of strength and speed training sequence on neuromuscular, endocrine, and physiological responses over 24 hours. Design: 15 academy rugby union players completed this randomized crossover study. Method: Players performed a weight traiing session followed 2 hours later by a speed training session (WS) and on a separate day reversed the order (SW). Countermovement jumps (CMJ), perceived muscle soreness (MS), and blood samples were collected immediately prior, immediately post, and 24 hours post sessions one and two respectively. Jumps were analyzed for power, jump height, rate of force development, and velocity. Blood was analyzed for testosterone (T), cortisol (C), lactate and creatine kinase (CK). Results: There were no differences between CMJ variables at any of the post training time points (p > 0.05). Likewise, CK, T, C , and MS were unaffected by session order (p > 0.05). However, 10 meter sprint time was significantly faster (Mean ± SD; SW 1.80s ± 0.11 vs. WS 1.76 ± 0.08s; p > 0.05) when speed was sequenced second. Lactate levels were significantly higher immediately post speed sessions versus weight training sessions at both time points (p < 0.05). Conclusions: The sequencing of strength and speed training does not affect the neuromuscular, endocrine, and physiological recovery over 24 hours. However, speed may be enhanced when performed as the second session

Fluorescence-Tagged Transgenic Lines Reveal Genetic Defects in Pollen Growth—Application to the Eif3 Complex

BACKGROUND: Mutations in several subunits of eukaryotic translation initiation factor 3 (eIF3) cause male transmission defects in Arabidopsis thaliana. To identify the stage of pollen development at which eIF3 becomes essential it is desirable to examine viable pollen and distinguish mutant from wild type. To accomplish this we have developed a broadly applicable method to track mutant alleles that are not already tagged by a visible marker gene through the male lineage of Arabidopsis. METHODOLOGY/PRINCIPAL FINDINGS: Fluorescence tagged lines (FTLs) harbor a transgenic fluorescent protein gene (XFP) expressed by the pollen-specific LAT52 promoter at a defined chromosomal position. In the existing collection of FTLs there are enough XFP marker genes to track nearly every nuclear gene by virtue of its genetic linkage to a transgenic marker gene. Using FTLs in a quartet mutant, which yields mature pollen tetrads, we determined that the pollen transmission defect of the eif3h-1 allele is due to a combination of reduced pollen germination and reduced pollen tube elongation. We also detected reduced pollen germination for eif3e. However, neither eif3h nor eif3e, unlike other known gametophytic mutations, measurably disrupted the early stages of pollen maturation. CONCLUSION/SIGNIFICANCE: eIF3h and eIF3e both become essential during pollen germination, a stage of vigorous translation of newly transcribed mRNAs. These data delimit the end of the developmental window during which paternal rescue is still possible. Moreover, the FTL collection of mapped fluorescent protein transgenes represents an attractive resource for elucidating the pollen development phenotypes of any fine-mapped mutation in Arabidopsis

A Context-Specific Role for Retinoblastoma Protein-Dependent Negative Growth Control in Suppressing Mammary Tumorigenesis

The ability to respond to anti-growth signals is critical to maintain tissue homeostasis and loss of this negative growth control safeguard is considered a hallmark of cancer. Negative growth regulation generally occurs during the G0/G1 phase of the cell cycle, yet the redundancy and complexity among components of this regulatory network has made it difficult to discern how negative growth cues protect cells from aberrant proliferation.The retinoblastoma protein (pRB) acts as the final barrier to prevent cells from entering into the cell cycle. By introducing subtle changes in the endogenous mouse Rb1 gene (Rb1(ΔL)), we have previously shown that interactions at the LXCXE binding cleft are necessary for the proper response to anti-growth signals such as DNA damage and TGF-β, with minimal effects on overall development. This disrupts the balance of pro- and anti-growth signals in mammary epithelium of Rb1(ΔL/ΔL) mice. Here we show that Rb1(ΔL/ΔL) mice are more prone to mammary tumors in the Wap-p53(R172H) transgenic background indicating that negative growth regulation is important for tumor suppression in these mice. In contrast, the same defect in anti-growth control has no impact on Neu-induced mammary tumorigenesis.Our work demonstrates that negative growth control by pRB acts as a crucial barrier against oncogenic transformation. Strikingly, our data also reveals that this tumor suppressive effect is context-dependent

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London