Inter-observer agreement of the Coronary Artery Disease Reporting and Data System (CAD-RADS^{TM}) in patients with stable chest pain

Purpose: To assess inter-observer variability of the Coronary Artery Disease - Reporting and Data System (CAD-RADS) for classifying the degree of coronary artery stenosis in patients with stable chest pain. Material and methods: A prospective study was conducted upon 96 patients with coronary artery disease, who underwent coronary computed tomography angiography (CTA). The images were classified using the CAD-RAD system according to the degree of stenosis, the presence of a modifier: graft (G), stent (S), vulnerable plaque (V), or non-diagnostic (n) and the associated coronary anomalies, and non-coronary cardiac and extra-cardiac findings. Image analysis was performed by two reviewers. Inter-observer agreement was assessed. Results: There was excellent inter-observer agreement for CAD-RADS (k = 0.862), at 88.5%. There was excellent agreement for CAD-RADS 0 (k = 1.0), CAD-RADS 1 (k = 0.92), CAD-RADS 3 (k = 0.808), CAD-RADS 4 (k = 0.826), and CAD-RADS 5 (k = 0.833) and good agreement for CAD-RADS 2 (k = 0.76). There was excellent agreement for modifier G (k = 1.0) and modifier S (k = 1.0), good agreement for modifier N (k = 0.79), and moderate agreement for modifier V (k = 0.59). There was excellent agreement for associated coronary artery anomalies (k = 0.845), non-coronary cardiac findings (k = 0.857), and extra-cardiac findings (k = 0.81). Conclusions: There is inter-observer agreement of CAD-RADS in categorising the degree of coronary arteries stenosis, and the modifier of the system and associated cardiac and extra-cardiac findings

Modified Single-Patch Technique Versus Two-Patch Technique in Infants with Complete Atrioventricular Septal Defect

Background: There are many techniques in repairing complete atrioventricular septal defect including: double patch technique, classic single patch technique and modified single patch technique. It's still debated which of these techniques is superior to the other one, our objective was to contrast the outcomes following surgery between the modified single patch and double patch techniques for repair of complete atrioventricular septal defect. Methods: This study includes 100 infants who underwent complete atrioventricular septal defect repair. Individuals were split into patients repaired with modified single patch as group A (n= 50), and patients repaired with double patch as group B (n= 50). Results: Group B showed significantly higher Cardiopulmonary bypass time (110 ±12 vs. 88 ±8 min, P < 0.001) Aortic cross clamp time (81 ±7 vs. 61 ±5 min, P < 0.001), ICU stay (10 ±1 vs. 9 ±1 day, P < 0.001), hospital stay (17 ±2 vs. 15 ±1 day, P < 0.001), and drainage amount (310 ±98 vs. 194 ±80, P < 0.001). No changes observed among groups of the study in other operative or postoperative statistics. Conclusion: Modified single-patch repair and two-patch repair did not yield significantly different results in the total correction of atrioventricular septal defects

Cricopharyngeal Myotomy in National Surgical Quality Improvement Program (NSQIP): Complications for Otolaryngologists versus Non-Otolaryngologists

OBJECTIVE: Comparing outcomes after cricopharyngeal myotomy (CM) performed by otolaryngologists (OTO) and non-otolaryngologists (NO). METHODS: A retrospective analysis of the 2014-19 ACS-NSQIP database (American College of Surgeons National Surgical Quality Improvement Program) of patients who underwent open CM (CPT code 43030) as their primary procedure. Analyzed variables include medical comorbidities, operative time, the total length of stay, readmission, reoperation, concurrent procedures, postoperative complications, and postoperative diagnoses. 183 patients were included, 97 (53%) females and 86 (47%) males. 120 had surgery by OTO and 63 by NO. RESULTS: There were no differences in preoperative morbidity. OTO had more outpatient surgeries compared to NO (p\u3c .001). OTO had a longer mean operating time (p= .008). OTO had a higher proportion of concurrent laryngeal procedures and other unspecified procedures compared to NO, while NO had a higher proportion of concurrent esophageal procedures (p= .028). The total length of stay was not significantly different between the two groups. 5.8% OTO and 7.9% NO patients were readmitted for a related reason (p= .586). Complications were similar between the two groups (p\u3e .05). NO had more postop diagnoses of acquired diverticula and achalasia of the stomach cardia, while OTO had more diagnoses of dysphagia and muscular dystrophy (p\u3c .001). CONCLUSION: There were differences in the surgical setting, length of procedure, concurrent procedures, and postop diagnoses between NO and OTO surgeons but similar complication rates

Role of diffusion-weighted magnetic resonance imaging in the differentiation of benign and malignant pulmonary lesions

Purpose: To evaluate the role of magnetic resonance (MRI) diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) measurement of solid and cystic pulmonary masses in differentiating benign from malignant lesions. Material and methods: The study included 41 patients with pulmonary masses, who underwent conventional MRI and DWI (b value 0, 500, and 1000 s/mm²) examinations with 1.5-T MRI. The diffusion signal and the mean ADC values of the solid and cystic lesions were obtained. Statistical analyses were performed with the Mann-Whitney U test (z), Pearson's chi-square test, and receiver operating characteristic (ROC) analysis. Results: Thirty-three lesions were malignant, and eight lesions were benign. The malignant masses showed significantly higher signal intensity on DWI than benign masses (p = 0.006), and the mean ADC value of malignant solid lesions was significantly lower than that of benign lesions (p = 0.02). By ROC analysis, an ADC cut-off value of 1.4 × 10-3 mm2/s was considered the threshold value, and the sensitivity and specificity were 93.8% and 75%, respectively. There was no significant difference between the ADC value of the cystic parts inside the benign and the malignant lesions. Conclusions: Diffusion-weighted MRI and measurement of ADC value can significantly differentiate between solid benign and malignant pulmonary masses

Event Identification as a Decision Process with Non-linear Representation of Text

We propose scale-free Identifier Network(sfIN), a novel model for event identification in documents. In general, sfIN first encodes a document into multi-scale memory stacks, then extracts special events via conducting multi-scale actions, which can be considered as a special type of sequence labelling. The design of large scale actions makes it more efficient processing a long document. The whole model is trained with both supervised learning and reinforcement learning.Comment: 8 pages, 8 figure

Bronchiectasis in COPD patients

Background: COPD and brochiectasis are characterized by fixed airway obstruction and chronic cough. The finding of bronchiectasis on HRCT scan in the patient with COPD may indicate the presence of more advanced airway dysfunction, frequent exacerbation and bacterial colonization. Objective: The aim of this study to evaluate the incidence of bronchiectasis on high resolution computed tomography (HRCT) scanning in patients with moderate and severe COPD, and to relate this with the presence of lower airway bacterial colonization, exacerbation frequency, severity. Patients and methods: This study was carried out on 69 patients diagnosed with COPD. All cases were subjected to through history taking, lung function test, sputum culture, HRCT scan of the chest to diagnose bronchiectasis, All the test were performed in a stable phase. Results: 69 COPD patients, 32 patients had moderate COPD, 37 patients had severe COPD, 33 patients (47,8%) presented with brochiectasis, (31.3%) of the patients with moderate COPD and 62.2% of the patients with severe COPD with statistically significant difference, the more severe functional impairment (FEV1 ⩽ 50%) the greater prevalence of brochiectasis, also the greater bacterial colonization and more exacerbation were associated with the presence of brochiectasis

Outcomes of embolization of bone tumors in the pelvic and shoulder girdles: Initial experience

Purpose: To assess the effectiveness of transarterial embolization of bone tumors as preoperative technique to reduce blood loss or as a curative method in bone tumors of shoulder and pelvic girdles. Patients and methods: The study included 25 patients with different bone tumors which are benign tumors (n = 16) and bone metastasis (n = 9). Their ages ranged from 6 to 65 years. Embolization was a palliative treatment in bone metastasis (n = 9), non-ossifying fibroma (n = 2) and osteoblastoma (n = 1). In patients with ABCs (n = 12) and osteoblastoma (n = 1), the technique was used as a curative method. The effectiveness of the technique was assessed using plain X-ray of the affected region, CT scan, CT angiography. Results: In 7 patients operated, reduction of blood loss reached about 400 mL. No perioperative complication or wound complications. Additionally surgery was easier. In the remaining 18 patients tumor regression in (ABCs n = 12, osteoblastoma n = 1) and pain reduction (metastasis n = 5) were detected during the follow up period 1–2 years. Conclusion: Preoperative embolization is useful in reduction of intraoperative blood loss in tumors at shoulder and pelvic girdles. The technique is considered curative method in inaccessible lesions of pelvic and shoulder girdles with multiple interlacing vascular anastomosis. Keywords: Embolization, Bone tumors, Shoulder and pelvic girdle

Mov10 suppresses retroelements and regulates neuronal development and function in the developing brain

Abstract Background Moloney leukemia virus 10 (Mov10) is an RNA helicase that mediates access of the RNA-induced silencing complex to messenger RNAs (mRNAs). Until now, its role as an RNA helicase and as a regulator of retrotransposons has been characterized exclusively in cell lines. We investigated the role of Mov10 in the mouse brain by examining its expression over development and attempting to create a Mov10 knockout mouse. Loss of both Mov10 copies led to early embryonic lethality. Results Mov10 was significantly elevated in postnatal murine brain, where it bound retroelement RNAs and mRNAs. Mov10 suppressed retroelements in the nucleus by directly inhibiting complementary DNA synthesis, while cytosolic Mov10 regulated cytoskeletal mRNAs to influence neurite outgrowth. We verified this important function by observing reduced dendritic arborization in hippocampal neurons from the Mov10 heterozygote mouse and shortened neurites in the Mov10 knockout Neuro2A cells. Knockdown of Fmrp also resulted in shortened neurites. Mov10, Fmrp, and Ago2 bound a common set of mRNAs in the brain. Reduced Mov10 in murine brain resulted in anxiety and increased activity in a novel environment, supporting its important role in the development of normal brain circuitry. Conclusions Mov10 is essential for normal neuronal development and brain function. Mov10 preferentially binds RNAs involved in actin binding, neuronal projection, and cytoskeleton. This is a completely new and critically important function for Mov10 in neuronal development and establishes a precedent for Mov10 being an important candidate in neurological disorders that have underlying cytoarchitectural causes like autism and Alzheimer’s disease

Additional file 9: of Mov10 suppresses retroelements and regulates neuronal development and function in the developing brain

RNA-seq of N2a WT undifferentiated versus WT differentiated N2a. (XLSX 5557 kb