Evaluation of renal function by dynamic MR imaging: effect of water load.

The aim of this study was to investigate the usefulness of magnetic resonance (MR) imaging in the evaluation of renal function, with particular attention to the effects of water load. Ten healthy volunteers underwent dynamic MR imaging after an injection of gadolinium diethylene-triaminepenta-acetic acid (Gd-DTPA) as a contrast agent to evaluate renal function by the following four methods: the positive method [longitudinal relaxation time (T1) shortening is the dominant effect], the negative method [transverse relaxation time (T2) shortening is the dominant effect] and two intermediate methods by switching the Gd-DTPA concentrations used in the positive and negative methods. A prolonged cortical peak time and a reduced medullary peak level were observed by the positive method under a dehydrated condition, suggesting that these variables were slightly influenced by Gd-DTPA concentrated in the medulla. By the negative method, low signals due to T2* (T2* is the effective transverse relaxation time, typically shorter than T2) shortening appeared in the medulla under normal conditions, but these signals were unclear when the subject was under an overhydrated condition. These results indicate that water metabolism, in addition to imaging parameters and Gd-DTPA dose levels, should be considered when renal function is evaluated by dynamic MR imaging. Analysis of both the pattern of MR images and the time-signal intensity curves may be useful in the evaluation of renal function. The results also indicate that the positive method is preferred when the patient is overhydrated as it allows the evaluation of the local renal kinetic function by recording changes in the regional contrast agent levels.</p

Bottom of the Ninth Circuit: Senne v. Kansas City Royals Baseball Corporation

Major League Baseball (“MLB”) is a multi-billion-dollar business. While MLB contracts can be worth well over $300 million, there are thousands of minor leaguers in the shadows of MLB making between$3000 to $7500 a year. These players survive in poor living conditions, receiving salaries far below federal minimum wage. They endure years of financial struggle for the marginally slim chance of playing in “The Show.” In Senne v. Kansas City Royals Baseball Corporation, minor leaguers took a stand and voiced their frustration with this unfeasible lifestyle. They filed a class action lawsuit against MLB asserting claims under the Fair Labor Standards Act (“FLSA”) and various state wage and hour laws. Over the last five years, the two parties have been battling over whether the minor leaguer’s claims can continue as a class action or if they must pursue their claims individually. On August 16, 2019, the Ninth Circuit Court of Appeals, in a 2-1 split decision, certified all proposed classes by the minor leaguers. This Comment analyzes the class certification arguments of each side and asserts that the Ninth Circuit correctly ruled in favor of the minor league players. Using both practicality and public policy, this Comment underscores the majority’s arguments and ultimately contends that the decision should be upheld if writ of certiorari were to be granted

Animal & Human Leptospirosis In A High Transmission Setting In Fiji

Leptospirosis is a neglected zoonotic disease with a worldwide distribution, yet disproportionally affects poor rural subsistence farmers in the tropics. The animal reservoirs for spill-over infection to humans in such settings in the South Pacific have not been well delineated, thus hampering effective control efforts. We conducted a case control investigation among households that participated in a seroprevalence survey for leptospirosis in Western Fiji. We surveyed domestic animals and trapped rodents at 45 cases and 73 control households who had one or more, and no inhabitants with evidence for anti-leptospire agglutinating antibodies. We performed serology among all animals and used polymerase chain reaction to detect Leptospira DNA in kidneys of trapped rodents. One or more seropositive animals were identified among 78% of the 96 households with domestic animals or trapped rodents. There was not a significant difference between the presence of seropositive animals between case and control household (67% vs 85%, respectively). Agglutinating antibodies were detected from a high proportion of households with horses (85%) and cattle (73%), indicating that the seroprevalence of leptospirosis in livestock was high in this region. Agglutinating antibodies against serogroup Australis, which was recognized by 64% of the seropositive human inhabitants, were detected from six of the seven animal species. Additionally, a proportional similarity index analysis indicated that cattle, horses, dogs, rodents and humans form a transmission network. There was a non-significant trend for Leptospira DNA positive rats to be trapped in case vs control households (OR 5.71, p=0.09). Our studying findings indicate that there exists a complex network of transmission between livestock, domestic animals and rodents in Western Fiji, and the source for human leptospirosis cannot be attributed to a single reservoir species. Therefore, control of leptospirosis in rural Fiji and similar high transmission settings will need to rely on multiple intersectorial strategies that target prevention of leptospirosis in livestock, rodent control, the use of personal protection and barrier approaches, and reduction of high risk behaviors

Differential diagnosis of adrenal masses by chemical shift and dynamic gadolinium enhanced MR imaging.

Chemical shift MRI is widely used for identifying adenomas, but it is not a perfect method. We determined whether combined dynamic MRI methods can lead to improved diagnostic accuracy. Fifty-seven adrenal masses were examined by chemical shift and dynamic MR imaging using 2 MR systems. The masses included 38 adenomas and 19 non-adenomas. In chemical shift MRI studies, the signal intensity index (SI) was calculated, and the lesions classified into 5 types in the dynamic MRI studies. Of the 38 adenomas studied, 37 had an SI greater than 0. In the dynamic MRI, 34 of 38 adenomas showed a benign pattern (type 1). If the SI for the adenomas in the chemical shift MRI was considered to be greater than 0, the positive predictive value was 0.9, and the negative predictive value was 0.94 and kappa = 0.79. If type 1 was considered to indicate adenomas in the dynamic MRI, the corresponding values were 0.94, 0.81 and kappa = 0.77 respectively. The results obtained when the 2 methods were combined were 1, 0.95 and kappa = 0.96 respectively. The chemical shift MRI was found to be useful for identifying adenomas in most cases. If the adrenal mass had a low SI (0 &#60; SI &#60; 5), dynamic MRI was also found to be helpful for making a differential diagnosis.</p

Conversation Clustering Based on PLCA Using Within-cluster Sparsity Constraints

Publication in the conference proceedings of EUSIPCO, Bucharest, Romania, 201