The MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 2.0 Knee Score and Atlas

Objective Since the first introduction of the MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) score, significant progress has been made with regard to surgical treatment options for cartilage defects, as well as magnetic resonance imaging (MRI) of such defects. Thus, the aim of this study was to introduce the MOCART 2.0 knee score — an incremental update on the original MOCART score — that incorporates this progression. Materials and Methods The volume of cartilage defect filling is now assessed in 25% increments, with hypertrophic filling of up to 150% receiving the same scoring as complete repair. Integration now assesses only the integration to neighboring native cartilage, and the severity of surface irregularities is assessed in reference to cartilage repair length rather than depth. The signal intensity of the repair tissue differentiates normal signal, minor abnormal, or severely abnormal signal alterations. The assessment of the variables "subchondral lamina," "adhesions," and "synovitis" was removed and the points were reallocated to the new variable "bony defect or bony overgrowth." The variable "subchondral bone" was renamed to "subchondral changes" and assesses minor and severe edema-like marrow signal, as well as subchondral cysts or osteonecrosis-like signal. Overall, a MOCART 2.0 knee score ranging from 0 to 100 points may be reached. Four independent readers (two expert readers and two radiology residents with limited experience) assessed the 3 T MRI examinations of 24 patients, who had undergone cartilage repair of a femoral cartilage defect using the new MOCART 2.0 knee score. One of the expert readers and both inexperienced readers performed two readings, separated by a four-week interval. For the inexperienced readers, the first reading was based on the evaluation sheet only. For the second reading, a newly introduced atlas was used as an additional reference. Intrarater and interrater reliability was assessed using intraclass correlation coefficients (ICCs) and weighted kappa statistics. ICCs were interpreted according to Koo and Li; weighted kappa statistics were interpreted according to the criteria of Landis and Koch. Results The overall intrarater (ICC = 0.88, P < 0.001) as well as the interrater (ICC = 0.84, P < 0.001) reliability of the expert readers was almost perfect. Based on the evaluation sheet of the MOCART 2.0 knee score, the overall interrater reliability of the inexperienced readers was poor (ICC = 0.34, P < 0.019) and improved to moderate (ICC = 0.59, P = 0.001) with the use of the atlas. Conclusions The MOCART 2.0 knee score was updated to account for changes in the past decade and demonstrates almost perfect interrater and intrarater reliability in expert readers. In inexperienced readers, use of the atlas may improve interrater reliability and, thus, increase the comparability of results across studies

Earth observation : An integral part of a smart and sustainable city

Over the course of the 21st century, a century in which the urbanization process of the previous one is ever on the rise, the novel smart city concept has rapidly evolved and now encompasses the broader aspect of sustainability. Concurrently, there has been a sea change in the domain of Earth observation (EO) where scientific and technological breakthroughs are accompanied by a paradigm shift in the provision of open and free data. While the urban and EO communities share the end goal of achieving sustainability, cities still lack an understanding of the value EO can bring in this direction, an next a consolidated framework for tapping the full potential of EO and integrating it in their operational modus operandi. The “SMart URBan Solutions for air quality, disasters and city growth” H2020 project (SMURBS/ERA-PLANET) sits at this scientific and policy crossroad, and, by creating bottom-up EO-driven solutions against an array of environmental urban pressures, and by expanding the network of engaged and exemplary smart cities that push the state-of-the-art in EO uptake, brings the international ongoing discussion of EO for sustainable cities closer to home and contributes in this discussion. This paper advocates for EO as an integral part of a smart and sustainable city and aspires to lead by example. To this end, it documents the project's impacts, ranging from the grander policy fields to an evolving portfolio of smart urban solutions and everyday city operations, as well as the cornerstones for successful EO integration. Drawing a parallel with the utilization of EO in supporting several aspects of the 2030 Agenda for Sustainable Development, it aspires to be a point of reference for upcoming endeavors of city stakeholders and the EO community alike, to tread together, beyond traditional monitoring or urban planning, and to lay the foundations for urban sustainability.Peer reviewe

Die Bedeutung von Fosfomycin in der empirischen Therapie von Harnwegsinfektionen

Hintergrund: Das Ziel dieser Diplomarbeit war es, eine Resistenztestung des Antibiotikums Fosfomycin mittels Etest durchzuführen, um die fehlenden Daten für den Resistenzbericht der Medizinischen Universität Graz zu erheben. Des Weiteren sollte der Grund ermittelt werden, weshalb der Hemmstofftest mit Fosfomycin-hältigem Harn nicht funktioniert. Ein Vergleich der für die empirische Therapie von unkomplizierten HWI empfohlenen Antibiotika wurde durchgeführt.Methoden: Es wurden 112 Harnproben mit ESBL negativen E. coli und 57 Harnproben mit ESBL positiven Bakterien (E. coli und Klebsiella spp.) mittels Fosfomycin-Etest untersucht. Die Empfindlichkeit von Bacillus licheniformis auf Fosfomycin wurde ebenfalls untersucht. Ergebnisse: Die Resistenzraten der 112 Harnproben mit E. coli wurden mit folgenden Werten erhoben: Fosfomycin (3,6%), Nitrofurantoin (0%) und Mecillinam (3,6%). Die Resistenzraten der ESBL positiven E. coli lagen bei 3,9%, 9,5% und 9,8%. Im Hemmhof auftretende Makrokolonien waren zu ca. 80% resistent. Der Grund, warum der Hemmstofftest mit Fosfomycin-hältigem Harn mit Bacillus licheniformis nicht aussagekräftig ist, wurde mittels Fosfomycin-Etest bestätigt: Bacillus licheniformis ist primär resistent gegen Fosfomycin.Schlussfolgerung:Fosfomycin wurde von den international anerkannten Leitlinien, neben Nitrofurantoin und Mecillinam, zu Recht als Mittel der 1.Wahl für die empirische Therapie von unkomplizierten HWI empfohlen. Fosfomycin ist hoch effektiv, gut verträglich und weist eine geringe Nebenwirkungsrate auf. Probleme ergeben sich bei der routinemäßigen Testung im Labor, da Fosfomycin nicht mit der nach EUCAST standardisierten Plättchentestmethode getestet werden kann. Mecillinam hat genauso wie Fosfomycin alle Berechtigung als Mittel der 1. Wahl eingestuft zu werden, während der Einsatz von Nitrofurantoin aufgrund der schweren und sogar tödlichen Nebenwirkungen nicht ratsam erscheint.Background: The aim of this study was to perfom the Etest method with fosfomycin, to evaluate the susceptibility against E. coli and ESBL-producing bacteria, for the Medical University of Graz. Furthermore we tried to find the reason for the dysfunction of the zone of inhibition test, when using urine containing fosfomycin. We also compared different antibiotic agents from guideline recommendations on empirical therapy in uncomplicated Urinary Tract Infections (UTI).Methods: We analysed 112 urine samples, containing E.coli and 57 urine samples containing ESBL-positive E. coli and Klebsiella spp., using the fosfomycin Etest method. We also tested the susceptibility of Bacillus licheniformis to fosfomycin. Results: The resistance rates of E. coli (ESBL-negative) against fosfomycin, nitrofurantoin and mecillinam were documented with 3,6%, 0% and 3,6%. Resistance rates of E. coli (ESBL-positive) increased up to 3,9%, 9,5% and 9,8%. About 80% of the appearing colonies were determined as resistant. By performing the fosfomycin Etest method, we confirmed the reason for the dysfunction of the zone of inhibition test on Bacillus licheniformis with fosfomycin containing urine: Bacillus licheniformis is primary resistant against fosfomycin.Conclusion: Internationally accepted guidelines on therapy of UTIs recommend fosfomycin, beside mecillinam and nitrofurantoin, correctly as the antibiotics of first choice. Fosfomycin is a highly effective, compliant antimicrobial agent against E. coli and ESBL-producing bacteria, with a low occurrence probability of adverse events. Problems emerge at routine laboratory testing, because fosfomycin cannot be tested with standardised disc diffusion tests. Mecillinam has the same right to be drug of first choice, whereas nitrofurantoin is a highly toxic antibiotic with serious and even deadly adverse events and is not advisable.Gabriela RaudnerAbweichender Titel laut Übersetzung der Verfasserin/des VerfassersZsfassungen in dt. und engl. SpracheGraz, Univ., Dipl.-Arb., 2015(VLID)80944

Alternative sanction to short-term imprisonment in England and Wales and Poland

Niniejsza praca ma na celu przedstawienie i porównanie kształtu kary alternatywnej dla krótkoterminowego pozbawienie wolności w Anglii i Walii oraz Polsce. Kara alternatywna dla pozbawienia wolności powinna spełniać wszystkie podstawowe funkcje kary pozbawienia wolności, będąc jednocześnie czymś konkurencyjnym i bardziej pożądanym, w sytuacji gdy kara pozbawienia wolności wydaje się być zbyt dolegliwa, natomiast sam środek karny może okazać się niewystarczający. Praca składa się z czterech części. Na początku przedstawione zostały międzynarodowe regulacje dotyczące kar alternatywnych dla ograniczenia wolności: Rekomendacja Nr R (92) 16 Europejskie Reguły dotyczące sankcji i środków alternatywnych oraz Wzorcowe reguły minimalne Narodów Zjednoczonych dotyczące środków o charakterze nieizolacyjnym (Zasady Tokijskie). Rezolucja Zgromadzenia Ogólnego ONZ 45/110 z dnia 14 grudnia 1990r. W dalszej części przedstawiony został kształt "kary wykonywanej w społeczeństwie" w systemie common law w Anglii i Walii. Trzecia część przedstawia kształt kary ograniczenia wolności w Polsce. Na końcu dokonane zostaje porównanie "kary wykonywanej w społeczeństwie" i kary ograniczenia wolności oraz zaprezentowane zostały proponowane przez Ministerstwo Sprawiedliwości zmiany w kształcie kary ograniczenia wolności w Polsce.The aim of this dissertation is to present the shape of alternative sanction to short-term imprisonment in England and Wales and Poland. At the beginning, there are described international rules concerning alternative sanctions to imprisonment: the European rules on community sanctions and measures and the United Nations Standard Minimum Rules for Non-custodial Measures (The Tokyo Rules). The second part of the dissertation describes the regulation of community sentence in common law system in England and Wales. In the third part, there is presented community sentence in the way it is regulated in Poland. At the conclusion of the dissertation the author present a comparison of the English and Polish regulations of the community sentence. Although, in this regulations we could see many differences, both of this sanctions satisfy basic international requirements. In the proposed government’s draft of a new Polish Criminal Code we could find solutions similar to this which are contained in Criminal Justice Act 2003

Synthetic Contrasts in Musculoskeletal MRI: A Review.

This review summarizes the existing techniques and methods used to generate synthetic contrasts from magnetic resonance imaging data focusing on musculoskeletal magnetic resonance imaging. To that end, the different approaches were categorized into 3 different methodological groups: mathematical image transformation, physics-based, and data-driven approaches. Each group is characterized, followed by examples and a brief overview of their clinical validation, if present. Finally, we will discuss the advantages, disadvantages, and caveats of synthetic contrasts, focusing on the preservation of image information, validation, and aspects of the clinical workflow

Frontiers of Sodium MRI Revisited: From Cartilage to Brain Imaging

Sodium magnetic resonance imaging (23Na-MRI) is a highly promising imaging modality that offers the possibility to noninvasively quantify sodium content in the tissue, one of the most relevant parameters for biochemical investigations. Despite its great potential, due to the intrinsically low signal-to-noise ratio (SNR) of sodium imaging generated by low in vivo sodium concentrations, low gyromagnetic ratio, and substantially shorter relaxation times than for proton (1H) imaging, 23Na-MRI is extremely challenging. In this article, we aim to provide a comprehensive overview of the literature that has been published in the last 10\u201315 years and which has demonstrated different technical designs for a range of 23Na-MRI methods applicable for disease diagnoses and treatment efficacy evaluations. Currently, a wider use of 3.0T and 7.0T systems provide imaging with the expected increase in SNR and, consequently, an increased image resolution and a reduced scanning time. A great interest in translational research has enlarged the field of sodium MRI applications to almost all parts of the body: articular cartilage tendons, spine, heart, breast, muscle, kidney, and brain, etc., and several pathological conditions, such as tumors, neurological and degenerative diseases, and others. The quantitative parameter, tissue sodium concentration, which reflects changes in intracellular sodium concentration, extracellular sodium concentration, and intra\u2013/extracellular volume fractions is becoming acknowledged as a reliable biomarker. Although the great potential of this technique is evident, there must be steady technical development for 23Na-MRI to become a standard imaging tool. The future role of sodium imaging is not to be considered as an alternative to 1H MRI, but to provide early, diagnostically valuable information about altered metabolism or tissue function associated with disease genesis and progression. Level of Evidence: 1. Technical Efficacy Stage: 1