A novel diagnostic aid for intra-abdominal adhesion detection in cine-MR imaging: Pilot study and initial diagnostic impressions

OBJECTIVES: A non-invasive diagnostic technique for abdominal adhesions is not currently available. Capture of abdominal motion due to respiration in cine-MRI has shown promise, but is difficult to interpret. This article explores the value of a complimentary diagnostic aid to facilitate the non-invasive detection of abdominal adhesions using cine-MRI. METHOD: An image processing technique was developed to quantify the amount of sliding that occurs between the organs of the abdomen and the abdominal wall in sagittal cine-MRI slices. The technique produces a 'sheargram' which depicts the amount of sliding which has occurred over 1-3 respiratory cycles. A retrospective cohort of 52 patients, scanned for suspected adhesions, made 281 cine-MRI sagittal slices available for processing. The resulting sheargrams were reported by two operators and compared to expert clinical judgement of the cine-MRI scans. RESULTS: The sheargram matched clinical judgement in 84% of all sagittal slices and 93-96% of positive adhesions were identified on the sheargram. The sheargram displayed a slight skew towards sensitivity over specificity, with a high positive adhesion detection rate but at the expense of false positives. CONCLUSIONS: Good correlation between sheargram and absence/presence of inferred adhesions indicates quantification of sliding motion has potential to aid adhesion detection in cine-MRI. Advances in Knowledge: This is the first attempt to clinically evaluate a novel image processing technique quantifying the sliding motion of the abdominal contents against the abdominal wall. The results of this pilot study reveal its potential as a diagnostic aid for detection of abdominal adhesions

Genome-wide association meta-analyses and fine-mapping elucidate pathways influencing albuminuria

Increased levels of the urinary albumin-to-creatinine ratio (UACR) are associated with higher risk of kidney disease progression and cardiovascular events, but underlying mechanisms are incompletely understood. Here, we conduct trans-ethnic (n = 564,257) and European-ancestry specific meta-analyses of genome-wide association studies of UACR, including ancestry- and diabetes-specific analyses, and identify 68 UACR-associated loci. Genetic correlation analyses and risk score associations in an independent electronic medical records database (n = 192,868) reveal connections with proteinuria, hyperlipidemia, gout, and hypertension. Fine-mapping and trans-Omics analyses with gene expression in 47 tissues and plasma protein levels implicate genes potentially operating through differential expression in kidney (including TGFB1, MUC1, PRKCI, and OAF), and allow coupling of UACR associations to altered plasma OAF concentrations. Knockdown of OAF and PRKCI orthologs in Drosophila nephrocytes reduces albumin endocytosis. Silencing fly PRKCI further impairs slit diaphragm formation. These results generate a priority list of genes and pathways for translational research to reduce albuminuria

On the genetically meaningful decomposition of grain-size distributions: A comparison of different end-member modelling algorithms

End-member modelling algorithms extract valuable information from grain-size distribution datasets, such as provenance, transport and sedimentation processes, which can subsequently be used to reconstruct past climate variability. Twenty years ago, Weltje (1997) published the algorithm EMMA, first applied to unmixing of grain-size distribution datasets in Prins and Weltje (1999a). In recent years, a range of new non-parametric algorithms developed specifically for unmixing of these datasets has become available. We evaluate whether the new algorithms as well as the original EMMA produce genetically meaningful results. We use artificial datasets and a published dataset from a geological case study. Experiments with the artificial datasets demonstrate that some algorithms are more appropriate for the unmixing of grain-size distribution data than others. Furthermore, the “geologically feasible” number of end members determined by the algorithms depends on the criteria for a statistical goodness of fit and does not necessarily correspond to the true number of end members in a dataset. Our study indicates that when an incorrect number of end members are modelled the shape and modal position of the end member grain-size distributions may deviate. Thus, end-member modelling should be used cautiously and in tandem with geological background information

Storms in a lagoon: flooding history during the last 1200 years derived from geological and historical archives of Schokland (Noordoostpolder, The Netherlands)

Flevoland (central Netherlands) is an area of long-term discontinuous deposition that has been reclaimed from the Zuiderzee in the 20th century. Before the reclamation, the Zuiderzee had been in a phase of enlargement, threatening inhabitants on the islands and the shores, since the Medieval Period. During this phase, a surficial clay cover was deposited on the island of Schokland (World Heritage Site: Noordoostpolder, northern Flevoland). We have studied the clay sequence in order to reconstruct the island's flooding history during the last 1200 years. The depositional history of the youngest clay deposit on Schokland is inferred from a literature study, analyses of a digital elevation model, six coring transects, three new 14C accelerator mass spectrometry (AMS) dates and laboratory analyses. The laboratory analyses include thermogravimetric analysis, grain-size end-member modelling (unmixing grain-size distributions), foraminifera, bivalves and ostracods. The geological data were combined with information from historical archives. Together, the results show that a combination of embankments and proximity to the coastline determined the sedimentation history and spatial distribution pattern of the sediment. The results also indicate that sedimentary remains of Late Holocene storm events are still present in the clay deposit on Schokland

Landscape potential for the adoption of crop cultivation: Role of local soil properties and groundwater table rise during 6000-5400 BP in Flevoland (central Netherlands)

This paper presents a new perspective for the temporal variation of crop cultivation adoption during the period 6000-5400BP in Flevoland (central Netherlands) based on the spatial evolution of soils and hydrology. To determine the role of soil properties and groundwater level rise in the adoption of crop cultivation in wetlands, mapping of the mid-Holocene palaeotopography, palaeohydrology, soil conditions and distribution of Swifterbant archaeological remains was combined with grain size analyses of cored sediments in two selected study areas. Results show that the low natural fertility and water holding capacity of the sandy soils on the Pleistocene surface in southern Flevoland compared to the loamy soils in the northern part of Flevoland, can explain the lack of crop cultivation in the south. The relation between natural soil fertility and initial adoption of crop cultivation in the IJssel/Vecht valley corresponds with examples from other wetlands in northwest Europe. © 2014 Elsevier Ltd and INQUA

An improved method for paleoflood reconstruction and flooding phase identification, applied to the Meuse River in the Netherlands

This study investigates Holocene floodplain evolution and flooding phases as experienced in the Lower Meuse catchment, primarily based on grain-size distributions of channel-fill and floodplain deposits in sediment cores. The presence of post-depositional FeMn concretions and resistant organic particulate materials impedes the direct use of grain-size data. By combining end-member modelling results with laboratory observations, we have constructed a Flood Energy Index (FEI), which allows identification of phases of past increased flooding from the grain-size signal. Since concretions and organic-rich sediments regularly occur in floodplain sediments, we emphasize that the quality of a grain-size dataset should be assessed prior to its use for reconstruction of flood events. We suggest that the new approach has potential to become standardized within paleoflood research. The temporal variation of FEI in Meuse sediment cores highlights multi-centennial flooding phases occurring at c. 8500, c. 8000, c. 7600, c. 7000 and c. 5900 cal BP within the fluvio-lacustrine environment (early–middle Holocene). The record of low flood activity in the Subboreal is attributed to a cooler and dryer climate anomaly after the Holocene Climatic Optimum. In the late Holocene, the first flooding phase occurring at c. 2800 cal BP can be linked to the 2.8 ka climate anomaly. During the last two thousand years, the variation of FEI index reveals oscillating flood regimes in the Lower Meuse floodplain. The last three recorded flooding phases most likely coincide with the Roman Period (c. 12 BCE–250 CE), the Medieval Warm Period (c. 950–1400 CE) and the Little Ice Age (c. 1400–850 CE). Despite uncertainty in the age-model, the rapid accumulation rate and amplified flood magnitudes imply increased fluvial instability during the late Holocene, indicating that humans exerted a profound influence on fluvial dynamics in the Meuse

Effectiveness and side effects of UVB-phototherapy, dithranol inpatient therapy and a care instruction programme of short contact dithranol in moderate to severe psoriasis.

Contains fulltext : 58617.pdf (publisher's version ) (Closed access)The efficacy of UVB-phototherapy (UVB) and dithranol treatment for psoriasis is well established. However, well-conducted clinical trials on the efficacy of dithranol are not available, making comparison between these time-honoured treatments with currently available therapies impossible. We studied the effectiveness of dithranol in a care instruction programme using short time exposures (short contact treatment), UVB-phototherapy and dithranol treatment in an inpatient setting. In an open randomised study we included 250 patients with moderate to severe psoriasis. The intention to treat group existed of 238 patients. 100 patients were treated with short contact dithranol, 78 Patients were treated with UVB and 60 patients underwent inpatient dithranol treatment. We found UVB and dithranol treatment to be effective and safe in moderate to severe psoriasis. The efficacy of short contact dithranol treatment equals the efficacy of UVB-phototherapy. Dithranol treatment at the inpatient department showed superior efficacy in clinical response rate and treatment duration as compared to UVB and short contact treatment. The median number of days in remission was significantly longer after short contact treatment as compared to inpatient treatment. Although the use of dithranol is hampered by skin irritation and staining, the present study shows that dithranol treatment has an outstanding efficacy and safety profile. Comparison between different antipsoriatic treatments should, besides clearing capacity, reconcile duration of remission, safety, patient acceptability and costs

An improved method for paleoflood reconstruction and flooding phase identification, applied to the Meuse River in the Netherlands

This study investigates Holocene floodplain evolution and flooding phases as experienced in the Lower Meuse catchment, primarily based on grain-size distributions of channel-fill and floodplain deposits in sediment cores. The presence of post-depositional FeMn concretions and resistant organic particulate materials impedes the direct use of grain-size data. By combining end-member modelling results with laboratory observations, we have constructed a Flood Energy Index (FEI), which allows identification of phases of past increased flooding from the grain-size signal. Since concretions and organic-rich sediments regularly occur in floodplain sediments, we emphasize that the quality of a grain-size dataset should be assessed prior to its use for reconstruction of flood events. We suggest that the new approach has potential to become standardized within paleoflood research. The temporal variation of FEI in Meuse sediment cores highlights multi-centennial flooding phases occurring at c. 8500, c. 8000, c. 7600, c. 7000 and c. 5900 cal BP within the fluvio-lacustrine environment (early–middle Holocene). The record of low flood activity in the Subboreal is attributed to a cooler and dryer climate anomaly after the Holocene Climatic Optimum. In the late Holocene, the first flooding phase occurring at c. 2800 cal BP can be linked to the 2.8 ka climate anomaly. During the last two thousand years, the variation of FEI index reveals oscillating flood regimes in the Lower Meuse floodplain. The last three recorded flooding phases most likely coincide with the Roman Period (c. 12 BCE–250 CE), the Medieval Warm Period (c. 950–1400 CE) and the Little Ice Age (c. 1400–850 CE). Despite uncertainty in the age-model, the rapid accumulation rate and amplified flood magnitudes imply increased fluvial instability during the late Holocene, indicating that humans exerted a profound influence on fluvial dynamics in the Meuse