Diagnosing dysplasia in Barrett’s oesophagus still requires Seattle protocol biopsy in the era of modern video endoscopy: results from a tertiary centre Barrett’s dysplasia database.

Objectives: The role of random, four-quadrant biopsy (i.e. systematic biopsy) in Barrett’s oesophagus surveillance has been questioned given its drawbacks and the emergence of high-resolution endoscopy and advanced imaging modalities. Our study aims to assess whether neoplastic pathology is typically diagnosed in routine clinical practice by random, four-quadrant or targeted biopsy whilst using high-resolution endoscopy. Methods: The Nottingham University Hospital Barrett’s oesophagus dysplasia database was retrospectively analysed. Endoscopic and histopathologic data pertaining to the initial endoscopy in which pathology was diagnosed was extracted from the medical records. The most advanced histopathologic abnormality at initial diagnosis and within twelve months were noted. The corresponding endoscopic impression at initial diagnosis was used to group cases per type of biopsy – random, four-quadrant or targeted. Pearson’s chi-squared test of independence was used to analyse the relationship between the type of biopsy and diagnosis, indication for endoscopy, endoscopist level and advanced techniques used. Results: Of the 222 patients involved in the study - a higher proportion were diagnosed through random, four-quadrant biopsy (72.97%) than targeted biopsy (27.03%). 90.91% of low-grade dysplasia, 71.43% of high-grade dysplasia and 50% of intramucosal adenocarcinoma cases were diagnosed by random, four-quadrant biopsy. Across all grades of clinicians, patients were typically diagnosed through random, four-quadrant biopsy. However, amongst specialist consultant endoscopists (n=10) the proportion was equal. Conclusions: Our findings strongly emphasize the importance of random, four-quadrant biopsy in the detection of not only low-grade dysplasia, but also high-grade dysplasia and early invasive carcinoma as part of Barrett’s oesophagus surveillance

Common Genetic Polymorphisms Influence Blood Biomarker Measurements in COPD

Implementing precision medicine for complex diseases such as chronic obstructive lung disease (COPD) will require extensive use of biomarkers and an in-depth understanding of how genetic, epigenetic, and environmental variations contribute to phenotypic diversity and disease progression. A meta-analysis from two large cohorts of current and former smokers with and without COPD [SPIROMICS (N = 750); COPDGene (N = 590)] was used to identify single nucleotide polymorphisms (SNPs) associated with measurement of 88 blood proteins (protein quantitative trait loci; pQTLs). PQTLs consistently replicated between the two cohorts. Features of pQTLs were compared to previously reported expression QTLs (eQTLs). Inference of causal relations of pQTL genotypes, biomarker measurements, and four clinical COPD phenotypes (airflow obstruction, emphysema, exacerbation history, and chronic bronchitis) were explored using conditional independence tests. We identified 527 highly significant (p 10% of measured variation in 13 protein biomarkers, with a single SNP (rs7041; p = 10−392) explaining 71%-75% of the measured variation in vitamin D binding protein (gene = GC). Some of these pQTLs [e.g., pQTLs for VDBP, sRAGE (gene = AGER), surfactant protein D (gene = SFTPD), and TNFRSF10C] have been previously associated with COPD phenotypes. Most pQTLs were local (cis), but distant (trans) pQTL SNPs in the ABO blood group locus were the top pQTL SNPs for five proteins. The inclusion of pQTL SNPs improved the clinical predictive value for the established association of sRAGE and emphysema, and the explanation of variance (R2) for emphysema improved from 0.3 to 0.4 when the pQTL SNP was included in the model along with clinical covariates. Causal modeling provided insight into specific pQTL-disease relationships for airflow obstruction and emphysema. In conclusion, given the frequency of highly significant local pQTLs, the large amount of variance potentially explained by pQTL, and the differences observed between pQTLs and eQTLs SNPs, we recommend that protein biomarker-disease association studies take into account the potential effect of common local SNPs and that pQTLs be integrated along with eQTLs to uncover disease mechanisms. Large-scale blood biomarker studies would also benefit from close attention to the ABO blood group

Synthesis and application of titanium dioxide photocatalysis for energy, decontamination and viral disinfection: a review

International audienceGlobal pollution is calling for advanced methods to remove contaminants from water and wastewater, such as TiO2-assisted photocatalysis. The environmental applications of titanium dioxide have started after the initial TiO2 application for water splitting by Fujishima and Honda in 1972. TiO2 is now used for self-cleaning surfaces, air and water purification systems, microbial inactivation and selective organic conversion. The synthesis of titanium dioxide nanomaterials with high photo-catalytic activity is actually a major challenge. Here we review titanium dioxide photocatalysis with focus on mechanims, synthesis, and applications. Synthetic methods include sol-gel, sonochemical, microwave, oxidation, deposition, hydro/sol-vothermal, and biological techniques. Applications comprise the production of energy, petroleum recovery, and the removal of microplastics, pharmaceuticals, metals, dyes, pesticides, and of viruses such as the severe acute respiratory syndrome coronavirus 2

Synthesis and application of titanium dioxide photocatalysis for energy, decontamination and viral disinfection: a review

International audienceGlobal pollution is calling for advanced methods to remove contaminants from water and wastewater, such as TiO2-assisted photocatalysis. The environmental applications of titanium dioxide have started after the initial TiO2 application for water splitting by Fujishima and Honda in 1972. TiO2 is now used for self-cleaning surfaces, air and water purification systems, microbial inactivation and selective organic conversion. The synthesis of titanium dioxide nanomaterials with high photo-catalytic activity is actually a major challenge. Here we review titanium dioxide photocatalysis with focus on mechanims, synthesis, and applications. Synthetic methods include sol-gel, sonochemical, microwave, oxidation, deposition, hydro/sol-vothermal, and biological techniques. Applications comprise the production of energy, petroleum recovery, and the removal of microplastics, pharmaceuticals, metals, dyes, pesticides, and of viruses such as the severe acute respiratory syndrome coronavirus 2

Patient-Centered and Specialty-Specific Case Work-Up: An Effective Method for Teaching Appropriateness of Imaging to Medical Students.

RATIONALE AND OBJECTIVES: Our institution has developed a mini-course program within the diagnostic radiology elective curriculum that promotes active learning, using patient cases specifically tailored to students\u27 future specialties. The purpose of this study is to evaluate the effectiveness of this mini-course on medical student knowledge of imaging appropriateness and attitude toward radiologist consultation. MATERIALS AND METHODS: During each month-long radiology elective course, students were divided into teams of up to four students based on their specialty interest and assigned recent patient cases with imaging findings relevant to their specialties. The students researched their customized patient cases, integrated pertinent clinical and imaging findings, and presented their findings in a final preceptor-led session. A five-point Likert-type item preprogram and postprogram survey assessing knowledge of imaging appropriateness and attitude toward radiologist consultation was sent to the enrolled medical students. RESULTS: Out of 36 medical students, 33 (92%) completed the preprogram survey and 31 (86%) completed the postprogram survey. Students reported improved confidence in knowledge of imaging appropriateness, such as indications for intravenous contrast (p \u3c 0.0005) and oral contrast (p \u3c 0.0005). Furthermore, students reported an improved understanding of how to utilize radiologists (p \u3c 0.005) and how to provide pertinent clinical historical information when requesting a radiology exam (p \u3c 0.0005). Students reported that researching the patient\u27s historical and clinical information in conjunction with the radiology images made them more invested in the case. CONCLUSION: Assigning customized patient cases to medical students on diagnostic radiology elective, tailored to their future specialties, is an effective and active way to teach imaging appropriateness and to improve attitudes toward radiologist consultation