Multimodal lung cancer screening using the ITALUNG Biomarker Panel and Low Dose Computed Tomography. Results of the ITALUNG biomarker study

Asymptomatic high-risk subjects, randomized in the intervention arm of the ITALUNG trial (1406 screened for lung cancer), were enrolled for the ITALUNG biomarker study (n = 1356), in which samples of blood and sputum were analysed for plasma DNA quantification (cut off 5ng/ml), loss of heterozygosity and microsatellite instability. The ITALUNG biomarker panel (IBP) was considered positive if at least one of the two biomarkers included in the panel was positive. Subjects with and without lung cancer diagnosis at the end of the screening cycle with LDCT (n = 517) were evaluated. Out of 18 baseline screen detected lung cancer cases, 17 were IBP positive (94%). Repeat screen-detected lung cancer cases were 18 and 12 of them positive at baseline IBP test (66%). Interval cancer cases (2-years) and biomarker tests after a suspect Non Calcific Nodule follow-up were investigated. The single test versus multimodal screening measures of accuracy were compared in a simulation within the screened ITALUNG intervention arm, considering screen-detected and interval cancer cases. Sensitivity was 90% at baseline screening. Specificity was 71%% and 61% for LDCT and IBP as baseline single test, and improved at 89% with multimodal, combined screening. The positive predictive value was 4.3% for LDCT at baseline and 10.6% for multimodal screening. Multimodal screening could improve the screening efficiency at baseline and strategies for future implementation are discussed. If IBP was used as primary screening test, the LDCT burden might decrease of about 60%

One step access to oxindole-based β-lactams through Ugi four-center three-component reaction

A multicomponent Ugi reaction involving isatin, isocyanide and β-amino acid components has been developed

MRI features of pleural endometriosis after catamenial haemothorax

A 43-year-old multiparous woman with a history of pelvic endometriosis and myocardial infarction presented with acute onset of right hemithorax pain and dyspnoea coinciding with dysmenorrhoeic menstruation. A chest CT confirmed the presence of a right hydropneumothorax which was drained. A video-assisted thoracoscopy was unremarkable but at a subsequent menses, an MRI chest demonstrated a lesion in the right costophrenic angle. The patient underwent a hysterectomy and oophorectomy for treatment of endometriosis. Six months later, she was free of thoracic symptoms and a repeat MRI scan showed resolution of the right pleural abnormality

Does UKLS strategy increase the yield of screen-detected lung cancers? A comparison with ITALUNG

No abstract availabl

Initial LDCT appearance of incident lung cancers in the ITALUNG trial

OBJECTIVES: To characterize early features of lung cancers detected with low-dose computed tomography (LDCT) screening. MATERIALS AND METHODS: Two radiologists reviewed prior LDCTs in 20 incident cancers diagnosed at annual repeat screening rounds and 83 benign nodules observed in the ITALUNG trial. RESULTS: No abnormality was observed in 3 cancers. Focal abnormalities in prior LDCT were identified in 17(85%) cancers (14 adenocarcinomas; 14 stage I). Initial abnormalities were intra-pulmonary in 10, subpleural in 4 and perifissural in 3. Average mean diameter was 9mm (range 4.5-18mm). Nine exhibited solid, 4 part-solid and 4 non-solid density. The margins were smooth and regular in 5 cases, lobulated in 6, irregular with spiculations in 3 and blurred in 3. Ten (59%) initial focal abnormalities had a round or oval nodular shape, but 7(41%) had a non-nodular complex (n=5) or "stripe-like" (n=2) shape. Bronchus sign was observed in 3 cases and association with cystic airspace in 2 cases. Non-solid density, complex or "stripe-like" shape, bronchus sign and association with cystic airspace had a specificity higher than 90%, but positive predictive value of every feature of incident lung cancers was low (range 10.4-50%). CONCLUSIONS: The vast majority of cancers diagnosed at annual repeat show corresponding focal lung abnormalities in prior LDCTs. Perifissural location and non-nodular shape do not exclude the possibility of early lung cancer. Since specificity of the early features of incident lung cancer is incomplete and their positive predictive value is low, all focal pulmonary abnormalities detected in screened subjects should be re-evaluated in subsequent LDCTs

Operator-dependent reproducibility of size measurements of small phantoms and lung nodules examined with low dose thin-section

OBJECTIVE: We sought to assess the reproducibility of size measurements of small lung nodules examined with low-dose thin-section computed tomography (LDTSCT). MATERIALS AND METHODS: Three radiologists measured volume with a semiautomatic tool and diameters manually of 20 (equivalent diameter range, 5.3-11 mm) phantom nodules and 37 (mean diameter range, 5-8.5 mm) lung nodules in subjects undergoing LDTSCT. RESULTS: In phantoms, the worst 95% limits of agreement (95% LA) for volume were -3.0% and 3.0% within operator and -3.1% and 2.8% between operators. The coefficient of repeatability (CR) for diameter ranged between 0.51 and 0.67 mm within operator and the 95% LA were from -0.71 to 0.71 mm between operators. In nodules, the worst intraoperator 95% LA for volume were -14.4% and 17.6% within operator and -13.1% and 14.2% between operators. The CR for diameter ranged between 0.48 and 0.73 mm within operator and the 95% LA were from -1.16 to 1.16 mm between operators. CONCLUSION: Operator-dependent variability of size measurements of small nodules examined with LDTSCT is not negligible and should be considered in lung cancer-screening studies

Theoretical Models of Consciousness: A Scoping Review

The amount of knowledge on human consciousness has created a multitude of viewpoints and it is difficult to compare and synthesize all the recent scientific perspectives. Indeed, there are many definitions of consciousness and multiple approaches to study the neural correlates of consciousness (NCC). Therefore, the main aim of this article is to collect data on the various theories of consciousness published between 2007–2017 and to synthesize them to provide a general overview of this topic. To describe each theory, we developed a thematic grid called the dimensional model, which qualitatively and quantitatively analyzes how each article, related to one specific theory, debates/analyzes a specific issue. Among the 1130 articles assessed, 85 full texts were included in the prefinal step. Finally, this scoping review analyzed 68 articles that described 29 theories of consciousness. We found heterogeneous perspectives in the theories analyzed. Those with the highest grade of variability are as follows: subjectivity, NCC, and the consciousness/cognitive function. Among sub-cortical structures, thalamus, basal ganglia, and the hippocampus were the most indicated, whereas the cingulate, prefrontal, and temporal areas were the most reported for cortical ones also including the thalamo-cortical system. Moreover, we found several definitions of consciousness and 21 new sub-classifications

γ-BaFe2O4: a fresh playground for room temperature multiferroicity

The application of multiferroics is often limited by low ordering temperatures. Here, the authors show that BaFe2O4 is a room temperature antiferromagnet with improper ferroelectricity, suggesting it as a playground for the study of multiferroicity