A no-reference respiratory blur estimation index in nuclear medicine for image quality assessment

International audienceBackground - Few indexes are available for nuclear medicine image quality assessment, particularly for respiratory blur assessment. A variety of methods for the identification of blur parameters has been proposed in literature mostly for photographic pictures but these methods suffer from a high sensitivity to noise, making them unsuitable to evaluate nuclear medicine images. In this paper, we aim to calibrate and test a new blur index to assess image quality.Material and Methods – Blur index calibration was evaluated by numerical simulation for various lesions size and intensity of uptake. Calibrated blur index was then tested on gamma- camera phantom acquisitions, PET phantom acquisitions and real-patient PET images and compared to human visual evaluation.Results – For an optimal filter parameter of 9, non-weighted and weighted blur index led to an automated classification close to the human one in phantom experiments and identified each time the sharpest image in all the 40 datasets of four images. Weighted blur index was significantly correlated to human classification (ρ= 0.69 [0.45 ;0.84], p<0.001) when used on patient PET acquisitions.Conclusion – The provided index allows to objectively characterize the respiratory blur in nuclear medicine acquisition, whether in planar or tomographic images and might be useful in respiratory gating applications

UK Guidelines for the Management of Bone Sarcomas

These guidelines have been developed in order to provide an overview and a set of broad-based key recommendations for the management of patients with bone sarcomas in the UK. They have taken into consideration the most up-to-date scientific literature along with the recent recommendations by the European Society of Medical Oncology. The principles of the NICE guidance on both “improving outcomes for patients with sarcomas” and “improving outcomes with children and young people with cancer” have been incorporated. As care evolves, it is acknowledged that these guidelines will need updating. The key recommendations are that bone pain or a palpable mass should always lead to further investigation and patients with clinicoradiological findings suggestive of a primary bone tumour should be sent to a reference centre. Patients should then have their care managed at such a specialist centre by a fully accredited multidisciplinary team

On the role of suppression in spatial attention : evidence from negative BOLD in human subcortical and cortical structures

There is clear evidence that spatial attention increases neural responses to attended stimuli in extrastriate visual areas and, to a lesser degree, in earlier visual areas. Other evidence shows that neurons representing unattended locations can also be suppressed. However, the extent to which enhancement and suppression is observed, their stimulus dependence, and the stages of the visual system at which they are expressed remains poorly understood. Using fMRI we set out to characterize both the task and stimulus dependence of neural responses in the lateral geniculate nucleus (LGN), primary visual cortex (V1), and visual motion area (V5) in humans to determine where suppressive and facilitatory effects of spatial attention are expressed. Subjects viewed a lateralized drifting grating stimulus, presented at multiple stimulus contrasts, and performed one of three tasks designed to alter the spatial location of their attention. In retinotopic representations of the stimulus location, we observed increasing attention-dependent facilitation and decreasing dependence on stimulus contrast moving up the visual hierarchy from the LGN to V5. However, in the representations of unattended locations of the LGN and V1, we observed suppression, which was not significantly dependent on the attended stimulus contrast. These suppressive effects were also found in the pulvinar, which has been frequently associated with attention. We provide evidence, therefore, for a spatially selective suppressive mechanism that acts at a subcortical level

Glycan complexity dictates microbial resource allocation in the large intestine.

The structure of the human gut microbiota is controlled primarily through the degradation of complex dietary carbohydrates, but the extent to which carbohydrate breakdown products are shared between members of the microbiota is unclear. We show here, using xylan as a model, that sharing the breakdown products of complex carbohydrates by key members of the microbiota, such as Bacteroides ovatus, is dependent on the complexity of the target glycan. Characterization of the extensive xylan degrading apparatus expressed by B. ovatus reveals that the breakdown of the polysaccharide by the human gut microbiota is significantly more complex than previous models suggested, which were based on the deconstruction of xylans containing limited monosaccharide side chains. Our report presents a highly complex and dynamic xylan degrading apparatus that is fine-tuned to recognize the different forms of the polysaccharide presented to the human gut microbiota.This work was supported in part by grants to D.N.B. (BBSRC BB/G016186/1) and H.J.G. (Wellcome Trust WT097907AIA).This is the final version. It was first published by NPG at http://dx.doi.org/10.1038/ncomms848

Transepithelial migration of neutrophils into the lung requires TREM-1

Acute respiratory infections are responsible for more than 4 million deaths each year. Neutrophils play an essential role in the innate immune response to lung infection. These cells have an armamentarium of pattern recognition molecules and antimicrobial agents that identify and eliminate pathogens. In the setting of infection, neutrophil triggering receptor expressed on myeloid cells 1 (TREM-1) amplifies inflammatory signaling. Here we demonstrate for the first time that TREM-1 also plays an important role in transepithelial migration of neutrophils into the airspace. We developed a TREM-1/3–deficient mouse model of pneumonia and found that absence of TREM-1/3 markedly increased mortality following Pseudomonas aeruginosa challenge. Unexpectedly, TREM-1/3 deficiency resulted in increased local and systemic cytokine production. TREM-1/3–deficient neutrophils demonstrated intact bacterial killing, phagocytosis, and chemotaxis; however, histologic examination of TREM-1/3–deficient lungs revealed decreased neutrophil infiltration of the airways. TREM-1/3–deficient neutrophils effectively migrated across primary endothelial cell monolayers but failed to migrate across primary airway epithelia grown at the air-liquid interface. These data define a new function for TREM-1 in neutrophil migration across airway epithelial cells and suggest that it amplifies inflammation through targeted neutrophil migration into the lung

Multidisciplinary consensus guideline for the diagnosis and management of spontaneous intracranial hypotension

BACKGROUND: We aimed to create a multidisciplinary consensus clinical guideline for best practice in the diagnosis, investigation and management of spontaneous intracranial hypotension (SIH) due to cerebrospinal fluid leak based on current evidence and consensus from a multidisciplinary specialist interest group (SIG). METHODS: A 29-member SIG was established, with members from neurology, neuroradiology, anaesthetics, neurosurgery and patient representatives. The scope and purpose of the guideline were agreed by the SIG by consensus. The SIG then developed guideline statements for a series of question topics using a modified Delphi process. This process was supported by a systematic literature review, surveys of patients and healthcare professionals and review by several international experts on SIH. RESULTS: SIH and its differential diagnoses should be considered in any patient presenting with orthostatic headache. First-line imaging should be MRI of the brain with contrast and the whole spine. First-line treatment is non-targeted epidural blood patch (EBP), which should be performed as early as possible. We provide criteria for performing myelography depending on the spine MRI result and response to EBP, and we outline principles of treatments. Recommendations for conservative management, symptomatic treatment of headache and management of complications of SIH are also provided. CONCLUSIONS: This multidisciplinary consensus clinical guideline has the potential to increase awareness of SIH among healthcare professionals, produce greater consistency in care, improve diagnostic accuracy, promote effective investigations and treatments and reduce disability attributable to SIH

The availability of snack food displays that may trigger impulse purchases in Melbourne supermarkets

<p>Abstract</p> <p>Background</p> <p>Supermarkets play a major role in influencing the food purchasing behaviours of most households. Snack food exposures within these stores may contribute to higher levels of consumption and ultimately to increasing levels of obesity, particularly within socioeconomically disadvantaged neighbourhoods. We aimed to examine the availability of snack food displays at checkouts, end-of-aisle displays and island displays in major supermarket chains in the least and most socioeconomically disadvantaged neighbourhoods of Melbourne.</p> <p>Methods</p> <p>Within-store audits of 35 Melbourne supermarkets. Supermarkets were sampled from the least and most socioeconomically disadvantaged suburbs within 30 km of the Melbourne CBD. We measured the availability of crisps, chocolate, confectionery, and soft drinks (diet and regular) at the checkouts, in end-of-aisle displays, and in island bin displays.</p> <p>Results</p> <p>Snack food displays were most prominent at checkouts with only five stores not having snack foods at 100% of their checkouts. Snack foods were also present at a number of end-of-aisle displays (at both the front (median 38%) and back (median 33%) of store), and in island bin displays (median number of island displays: 7; median total circumference of island displays: 19.4 metres). Chocolate items were the most common snack food item on display. There was no difference in the availability of these snack food displays by neighbourhood disadvantage.</p> <p>Conclusions</p> <p>As a result of the high availability of snack food displays, exposure to snack foods is almost unavoidable in Melbourne supermarkets, regardless of levels of neighbourhood socioeconomic disadvantage. Results of this study could promote awareness of the prominence of unhealthy food items in chain-brand supermarkets outlets.</p

The state of research into children with cancer across Europe : new policies for a new decade

Overcoming childhood cancers is critically dependent on the state of research. Understanding how, with whom and what the research community is doing with childhood cancers is essential for ensuring the evidence-based policies at national and European level to support children, their families and researchers. As part of the European Union funded EUROCANCERCOMS project to study and integrate cancer communications across Europe, we have carried out new research into the state of research in childhood cancers. We are very grateful for all the support we have received from colleagues in the European paediatric oncology community, and in particular from Edel Fitzgerald and Samira Essiaf from the SIOP Europe office. This report and the evidence-based policies that arise from it come at a important junction for Europe and its Member States. They provide a timely reminder that research into childhood cancers is critical and needs sustainable long-term support.peer-reviewe