Benign enlargement of the subarachnoid spaces and subdural collections—when to evaluate for abuse

In infants without a history of trauma, subdural haemorrhages should raise the concern for an abusive head injury, particularly when they are associated with bridging vein clotting/rupture or with septations. However, non-haemorrhagic, fluid-appearing subdural collections (also called hygromas) may also be the result of abuse. Subdural collections have also been uncommonly observed in patients with benign enlargement of the subarachnoid spaces (BESS) and a few large-scale studies accurately investigate the incidence and the significance. Currently, there is a wide variation of practices in children with BESS and subdural collections. Due to the social risks associated with abuse evaluation and the perceived risk of radiation exposure, there might be a reluctance to fully evaluate these children in some centres. The diagnosis of physical abuse cannot be substantiated nor safely excluded in infants with BESS and subdural collection(s), without investigation for concomitant traumatic findings. The exact prevalence of occult injuries and abuse in these infants is unknown. In macrocephalic infants with subdural collections and imaging features of BESS, thorough investigations for abuse are warranted and paediatricians should consider performing full skeletal surveys even when fundoscopy, social work consult, and detailed clinical evaluation are unremarkable

Controversial aspects of imaging in child abuse: a second roundtable discussion from the ESPR child abuse taskforce

This second roundtable discussion was convened at the 56th European Society of Paediatric Radiology (ESPR) 2022 Annual Meeting in Marseille, France, to discuss controversial aspects of imaging in child abuse. The following topics were discussed: Fracture dating—the published literature is broadly similar with respect to the identification of the radiographic stages of bony healing. The non-expert/general radiologist is encouraged to use broad descriptors of fracture healing (acute, healing or old) within their reports, rather than attempting to date fractures. The more experienced/expert radiologist, who may provide a timeframe/range to assist the courts, should be aware that any published timeframes are not absolute and that recent research indicates that the rate of healing may differ according to the bone affected and the age of the patient. Whole spine imaging in suspected abusive head trauma—this is recommended to enable a complete assessment of the neuraxis when abusive head trauma is suspected or diagnosed, particularly in the presence of intracranial and cervical subdural haemorrhage and cervical ligamentous injury. Cranial imaging in suspected physical abuse—both computed tomography (CT) and magnetic resonance imaging (MRI) remain complimentary depending on the clinical context in which they are used with CT remaining first-line in the assessment of children with (suspected abusive) head trauma prior to an early MRI. MRI is superior in its assessment of parenchymal injury and may be employed as first-line in age appropriate asymptomatic siblings of a child with suspected physical abuse

Following wrong suggestions: self-blame in human and computer scenarios

This paper investigates the specific experience of following a suggestion by an intelligent machine that has a wrong outcome and the emotions people feel. By adopting a typical task employed in studies on decision-making, we presented participants with two scenarios in which they follow a suggestion and have a wrong outcome by either an expert human being or an intelligent machine. We found a significant decrease in the perceived responsibility on the wrong choice when the machine offers the suggestion. At present, few studies have investigated the negative emotions that could arise from a bad outcome after following the suggestion given by an intelligent system, and how to cope with the potential distrust that could affect the long-term use of the system and the cooperation. This preliminary research has implications in the study of cooperation and decision making with intelligent machines. Further research may address how to offer the suggestion in order to better cope with user's self-blame.Comment: To be published in the Proceedings of IFIP Conference on Human-Computer Interaction (INTERACT)201

FSP1 is a glutathione-independent ferroptosis suppressor

Ferroptosis is an iron-dependent form of necrotic cell death marked by oxidative damage to phospholipids1,2. To date, ferroptosis has been believed to be controlled only by the phospholipid hydroperoxide-reducing enzyme glutathione peroxidase 4 (GPX4)3,4 and radical-trapping antioxidants5,6. However, elucidation of the factors that underlie the sensitivity of a given cell type to ferroptosis7 is critical to understand the pathophysiological role of ferroptosis and how it may be exploited for the treatment of cancer. Although metabolic constraints8 and phospholipid composition9,10 contribute to ferroptosis sensitivity, no cell-autonomous mechanisms have been identified that account for the resistance of cells to ferroptosis. Here we used an expression cloning approach to identify genes in human cancer cells that are able to complement the loss of GPX4. We found that the flavoprotein apoptosis-inducing factor mitochondria-associated 2 (AIFM2) is a previously unrecognized anti-ferroptotic gene. AIFM2, which we renamed ferroptosis suppressor protein 1 (FSP1) and which was initially described as a pro-apoptotic gene11, confers protection against ferroptosis elicited by GPX4 deletion. We further demonstrate that the suppression of ferroptosis by FSP1 is mediated by ubiquinone (also known as coenzyme Q10 (CoQ10)): the reduced form, ubiquinol, traps lipid peroxyl radicals that mediate lipid peroxidation, whereas FSP1 catalyses the regeneration of CoQ10 using NAD(P)H. Pharmacological targeting of FSP1 strongly synergizes with GPX4 inhibitors to trigger ferroptosis in a number of cancer entities. In conclusion, the FSP1–CoQ10–NAD(P)H pathway exists as a stand-alone parallel system, which co-operates with GPX4 and glutathione to suppress phospholipid peroxidation and ferroptosis

Gemmological Investigations on Pearls and Emeralds using Neutron Imaging

Gemmology deals with the characterization of coloured stones, diamonds and pearls used in the jewellery sector. As the investigated objects are in general rather valuable, a large variety of non-destructive testing methods (e.g. X-ray luminescence, X-ray tomography, UV/VIS spectroscopy, etc.) is routinely used for their inspection and characterisation. In a joint project of Paul Scherrer Institut (PSI), Swiss Gemmological Institute (SSEF) and the University Freiburg, potential application fields of neutron imaging methods (i.e. radiography, microtomography and neutron grating interferometry) in the characterisation and testing of pearls and emeralds were investigated and compared to already established X-ray methods. Neutron tomography yields results with comparable image quality but a different contrast, highlighting in the case of pearls the regions containing organic and hence hydrogen containing material. As such regions composed of low-Z material can be very hard to distinguish from voids inside an object using X-ray tomography, neutron tomography provides important additional information on the tested object due to its complementary properties. The complementarity between neutron and X-ray data shows also in the case of emeralds, where fissures filled with organic fillers are highlighted in the neutron data, while staying concealed in the X-ray data. Metallic inclusions in the emeralds on the other hand appear much more pronounced in the X-ray data, then using neutron imaging. The utilization of both methods on the same sample yields hence additional information on the composition of different regions within the object

Community fire use, resource change, and livelihood impacts: the downward spiral in the wetlands of southern Sumatra

Fire is an important community wetland management tool in Indonesia, but its increasing use in the wetlands of southern Sumatra is degrading the landscape and diminishing household incomes and livelihood options. We studied evolving community land and fire use, resource and livelihood impacts on two sites of roughly 250 km2 each using satellite image analysis and biological and socio-economic surveys. Uncontrolled fire use expanded over time in relation to sonor or swamp rice cultivation, logging, fishing, grazing, and annual cropping on drained wetlands. As a result, most of the landscape has been subject to repeated fires of varying intensities, more extensive in El Niño years. Direct burning by companies played a smaller transitory role in fire ignition over the two decades. But company activities and other large-scale developments contributed to expanding community fire-based land use by bringing in more people, improving access to remote wetlands or making them more flammable. Widespread, repeated fires have transformed the landscape from mature high swamp forests to uniform stands of fire-resistant Gelam (Melaleuca cajuputi) forests and thickets, open savannas and grasslands. These new types of land cover are also degrading. Local communities have rapidly adapted to the changing resources and new opportunities. Logging and fishing declined in importance, and sonor and harvesting of Gelam expanded. But resource depletion has led to falling incomes and fewer livelihood options. The impacts extend beyond local areas as workers migrate into neighbouring forests to extract resources. Large-scale developments, community fire-based management practices and landscape transformation are spreading from accessible to formerly more remote wetlands

Continue intraveneuze thuisbehandeling met antibiotica van luchtweginfecties bij 11 patiënten met cystische fibrose in Noord-Nederland

Assessment of intravenous home treatment of respiratory infections of cystic fibrosis (CF) patients. Provinces Groningen, Drente, Friesland and Overijssel. Open study. Eleven CF patients, aged 10 to 28 years participated. Thirty episodes of home i.v. treatment with antibiotics were arranged. Differences in vital capacity (VC) and forced expiratory volume in one second (FEV1) and in body weight before and after treatment were compared with the same variables obtained during hospitalisation in the year before they were treated at home. Adverse events during home treatment were recorded. No differences were noted in changes in VC, FEV1 and body weight between home and hospital treatments. During 30 episodes of home treatment a new intravenous catheter had to be implanted only twice. In these 11 patients, intravenous treatment of respiratory infections at home was as efficacious as in hospital. No serious adverse events were observe