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Objectives To test whether a 4-fold accelerated 3D T2-weighted (T2) CAIPIRINHA SPACE TSE sequence with isotropic voxel size is equivalent to conventional 2DT2 TSE for the evaluation of intrinsic and perilesional soft tissue tumors (STT) characteristics. Methods For 108 patients with histologically-proven STTs, MRI, including 3DT2 (CAIPIRINHA SPACE TSE) and 2DT2 (TSE) sequences, was performed. Two radiologists evaluated each sequence for quality (diagnostic, non-diagnostic), tumor characteristics (heterogeneity, signal intensity, margin), and the presence or absence of cortical involvement, marrow edema, and perilesional edema (PLE); tumor size and PLE extent were measured. Signal-to-noise (SNR) and contrast-to-noise (CNR) ratios and acquisition times for 2DT2 in two planes and 3DT2 sequences were reported. Descriptive statistics and inter-method agreement were reported. Results Image quality was diagnostic for all sequences (100% [108/108]). No difference was observed between 3DT2 and 2DT2 tumor characteristics ( p < 0.05). There was no difference in mean tumor size (3DT2: 2.9 ± 2.5 cm, 2DT2: 2.8 ± 2.6 cm, p = 0.4) or PLE extent (3DT2:0.5 ± 1.2 cm, 2DT2:0.5 ± 1.0 cm, p = 0.9) between the sequences. There was no difference in the SNR of tumors, marrow, and fat between the sequences, whereas the SNR of muscle was higher ( p < 0.05) on 3DT2 than 2DT2. CNR measures on 3DT2 were similar to 2DT2 ( p > 0.1). The average acquisition time was shorter for 3DT2 compared with 2DT2 (343 ± 127 s vs 475 ± 162 s, respectively). Conclusion Isotropic 3DT2 MRI offers higher spatial resolution, faster acquisition times, and equivalent assessments of STT characteristics compared to conventional 2DT2 MRI in two planes. 3DT2 is interchangeable with a 2DT2 sequence in tumor protocols. Key Points • Isotropic 3DT2 CAIPIRINHA SPACE TSE offers higher spatial resolution than 2DT2 TSE and is equivalent to 2DT2 TSE for assessments of soft tissue tumor intrinsic and perilesional characteristics. • Multiplanar reformats of 3DT2 CAIPIRINHA SPACE TSE can substitute for 2DT2 TSE acquired in multiple planes, thereby reducing the acquisition time of MRI tumor protocols. • 3DT2 CAIPIRINHA SPACE TSE and 2DT2 TSE had similar CNR of tissues.

ObjectiveTo determine the threshold signal drop on 3-T chemical shift imaging (CSI), with in-phase (IP) and opposed-phase (OP) sequences, for accurately identifying bone marrow replacement with 100% sensitivity, and determine a clinically useful measurement method for deriving such a threshold.Materials and methodsFrom a convenience series of 157 MRIs, 36 cases with histologically proven marrow-replacing lesions and 22 sites of red marrow (histologically proven (2) or with minimum 6-month stability) with 3-Tesla CSI were included. Two musculoskeletal radiologists performed two measurement methods (first: multiple algorithmic ROIs at the top, middle, and bottom of lesions (M-ROI); second: an ROI was drawn where there appeared to be the least opposed-phase signal reduction qualitatively/visually (Q-ROI)). Lesional and red marrow signal change (%,[(IP-OP)signal/IP signal]*100) was determined. Statistical analyses included Student’s t test, Cohen’s kappa, and receiver operator characteristic curve generation.ResultsBy M-ROI, lesion signal change was − 0.508% (confidence interval (CI) = − 5.537:4.521) and 1.348% (CI = − 3.541:6.311) for readers 1 and 2. By Q-ROI, lesion signal change was − 11.03% (CI = − 17.01:- 5.046) and − 5.657% (CI = − 12.36:1.048) for readers 1 and 2. For all M-ROI and Q-ROI measurement strategies, signal change between lesional tissue and red marrow was significantly different (p < 0.0001). QROI produced the best composite sensitivities and specificities with a maximized Youden index of 0.955–1. A threshold signal drop of 25% with Q-ROI produced at least 100%/86% sensitivity/specificity for both readers for identifying marrow replacement.ConclusionsFor 3-T CSI, a single visually targeted measurement using a 25% threshold is accurate for identifying marrow-replacing lesions.

Background Historically, in-person physical therapy serves as a foundational component of nonoperative treatment of adhesive capsulitis (AC). This study compares the effectiveness of an at-home high-intensity stretch (HIS) device to traditional physical therapy (PT) and to PT in combination with the HIS device. We hypothesize that the HIS device will be as effective as PT alone or as combination therapy in the first-line treatment of AC and use of the HIS device will exhibit improvement at higher rate. Methods Thirty-four patients with idiopathic adhesive capsulitis and a minimum of 12 months follow-up were included in this study. Patients were randomized into one of the three groups: HIS device, PT alone, or HIS device + PT. Passive range of motion (ROM), American Shoulder and Elbow Surgeons (ASES), and Simple Shoulder Test (SST) scores were measured. Additionally, patient satisfaction, compliance and complications were recorded. Paired t-test, ANOVA and Chi-squared tests were used in analysis. Results Final ROM in all planes improved for all groups compared to baseline ( p  < 0.001), with only HIS device group able to restore > 95% of contralateral ROM in all planes at final follow-up. Patients with PT alone were on average slowest to improve ROM from baseline, at 3 months, 6 months, and 1 year in all planes except internal rotation. ASES and SST scores improved for all groups when compared to baseline ( p  < 0.001). Use of HIS-device resulted in greater improvement in SST and ASES Total scores compared to PT alone ( p  = 0.045, and p  = 0.048, respectively). Conclusions Use of an at-home high-intensity stretching device for conservative treatment of idiopathic adhesive capsulitis improves outcomes in ROM and in ASES and SST scores both when used as an adjunct to physical therapy and when used alone. Trial registration The study protocol was registered at www.clinicaltrials.gov (20/05/2022, NCT05384093).

Mice deficient in the Polycomb repressor Bmi1 develop numerous abnormalities including a severe defect in stem cell self-renewal, alterations in thymocyte maturation and a shortened lifespan. Previous work has implicated de-repression of the Ink4a/Arf (also known as Cdkn2a ) locus as mediating many of the aspects of the Bmi1 -/- phenotype. Here we demonstrate that cells derived from Bmi1 -/- mice also have impaired mitochondrial function, a marked increase in the intracellular levels of reactive oxygen species and subsequent engagement of the DNA damage response pathway. Furthermore, many of the deficiencies normally observed in Bmi1 -/- mice improve after either pharmacological treatment with the antioxidant N -acetylcysteine or genetic disruption of the DNA damage response pathway by Chk2 (also known as Chek2) deletion. These results demonstrate that Bmi1 has an unexpected role in maintaining mitochondrial function and redox homeostasis and indicate that the Polycomb family of proteins can coordinately regulate cellular metabolism with stem and progenitor cell function. Surprise role for Polycomb Bmi1 is a member of the Polycomb family of transcriptional repressors that mediate gene silencing by regulating chromatin structure and is essential for the maintenance and self-renewal of both haematopoietic and neural stem cells. Mice lacking Bmi1 are deficient in stem cell self-renewal and thymocyte maturation and have a shortened lifespan. Here Liu et al . demonstrate that cells derived from Bmi1 −/− mice also exhibit marked elevation in the intracellular levels of reactive oxygen species (ROS). This rise in ROS corresponds to the de-repression of previously identified Polycomb target genes that directly regulate mitochondrial function, metabolism and redox balance. They also show that the rise in ROS within Bmi1 −/− tissues is sufficient to engage the DNA damage response pathway. These results demonstrate that Polycomb proteins play an unexpected role in mitochondrial function and redox homeostasis. Mice deficient in the Polycomb repressor Bmi1 have a shortened lifespan and develop numerous abnormalities including defects in stem cell self-renewal and thymocyte maturation. Here it is demonstrated that cells derived from Bmi1 −/− mice also show a marked elevation in the intracellular levels of reactive oxygen species, corresponding to the derepression of previously identified Polycomb target genes and sufficient to engage the DNA damage response pathway.

We present a 2D-stitched, 316MP, 120FPS, high dynamic range CMOS image sensor with 92 CML output ports operating at a cumulative date rate of 515 Gbit/s. The total die size is 9.92 cm × 8.31 cm and the chip is fabricated in a 65 nm, 4 metal BSI process with an overall power consumption of 23 W. A 4.3 µm dual-gain pixel has a high and low conversion gain full well of 6600e- and 41,000e-, respectively, with a total high gain temporal noise of 1.8e- achieving a composite dynamic range of 87 dB.

MicroRNAs (miRNAs) are noncoding small RNAs that regulate the protein expression of coding messenger RNAs. They are used as biomarkers to aid in diagnosing, prognosticating, and surveillance of diseases, especially solid cancers. MiR-193a was shown to be directly pathogenic in an experimental mouse model of focal segmental glomerulosclerosis (FSGS) during the last decade. Its specific binding and downregulation of Wilm’s tumor-1 (WT-1), a transcription factor regulating podocyte phenotype, is documented. Also, miR-193a is a regulator switch causing the transdifferentiation of glomerular parietal epithelial cells to a podocyte phenotype in in vitro study. Interaction between miR-193a and apolipoprotein 1 (APOL1) mRNA in glomeruli (filtration units of kidneys) is potentially involved in the pathogenesis of common glomerular diseases. Since the last decade, there has been an increasing interest in the role of miR-193a in glomerular diseases, including diabetic nephropathy and membranous nephropathy, besides FSGS. Considering the lack of biomarkers to manage FSGS and diabetic nephropathy clinically, it is worthwhile to invest in evaluating miR-193a in the pathogenesis of these diseases. What causes the upregulation of miR-193a in FSGS and how the mechanism is different in different glomerular disorders still need to be elucidated. This narrative review highlights the pathogenic mechanisms of miR-193a elevation in various glomerular diseases and its potential use in clinical management.

In this paper we present a low-noise, high-frame-rate global shutter CMOS image sensor with UHD resolution (3840 × 2160), targeting high-speed machine vision applications. The sensor (ForzaFAST581) supports video capture at up to 1141 FPS at 12 bits and 1694 FPS at 8 bits at full resolution, consuming a total power of 5.5 W. Fabricated in a 65 nm, four-metal BSI process, the imager features a 5 µm voltage-domain global shutter pixel with dual-gain capability for improved dynamic range and a read noise of 3.04 e− in global shutter and 2.15 e− in rolling shutter mode for high-gain at maximum frame rate operation. For compact camera integration and low power consumption, the sensor is designed to stream video through 16 CML data ports, each operating at 7.44 Gbps, achieving a total aggregate throughput of 119 Gbps. Additionally, the sensor supports selectable output bit depths—8-bit, 10-bit, and 12-bit—allowing frame rate optimization based on application-specific requirements.

The concept of a pulmonary embolism response team (PERT) is multidisciplinary, with the hope that it may positively impact patient care, hospital efficiency, and outcomes in the treatment of patients with intermediate and high risk pulmonary embolism (PE). Clinical characteristics of a baseline population of patients presenting with submassive and massive PE to URMC between 2014 and 2016 were examined (n = 159). We compared this baseline population before implementation of a PERT to a similar population of patients at 3-month periods, and then as a group at 18 months after PERT implementation (n = 146). Outcomes include management strategies and efficiency of the emergency department (ED) in diagnosing, treating, and dispositioning patients. Before PERT, patients with submassive and massive PE were managed fairly conservatively: heparin alone (85%), or additional advanced therapies (15%). Following PERT, submassive and massive PE were managed as follows: heparin alone (68%), or additional advanced therapies (32%). Efficiency of the ED in managing high risk PE significantly improved after PERT compared with before PERT; where triage to diagnosis time was reduced (384 vs. 212 min, 45% decrease, p = 0.0001), diagnosis to heparin time was reduced (182 vs. 76 min, 58% decrease, p = 0.0001), and the time from triage to disposition was reduced (392 vs. 290 min, 26% decrease, p < 0.0001). Our analysis showed that following PERT implementation, patients with intermediate and high risk acute PE received more aggressive and advanced treatment modalities and received significantly expedited care in the ED.

Purpose To compare prevalence and severity of multi-compartment pelvic floor dysfunction between supine magnetic resonance defecography with defecation (MRD) and supine dynamic MRI during Valsalva, both with and without rectal distention. Methods This was an IRB-approved, HIPAA-compliant retrospective review of consecutive patients referred for MR Defecography. MRD protocol included imaging at rest, during pre-defecation Valsalva (Pre-DV), defecation (Def), and post-defecation Valsalva (Post-DV). The Post-DV images were performed after complete evacuation either during the defecation acquisition or, in cases where patient was unable to defecate during the examination, in a conventional toilet. Size of cystocele, vaginal prolapse, anorectal (AR) descent, and enterocele were measured on all acquisitions relative to the pubococcygeal line. Rectocele size was recorded in anteroposterior dimension. The presence or absence of rectal intussusception (RI) was documented. The prevalence, absolute size, and grades of prolapse, rectocele, and RI were compared between the acquisitions using pair-wise ANOVA, Friedman, Dunn pair-wise, and Cochran–Mantel–Haenszel tests. Results 30 patients were included in the final analysis. Higher prevalence of cystocele, vaginal prolapse, enterocele, AR descent grade 2 or higher, rectocele grade 2 or higher, and RI were seen on Def compared to Post-DV and Pre-DV. Cystocele, vaginal prolapse, enterocele, AR descent, and rectocele sizes were significantly larger on Def compared to Post-DV by 0.7−1.95 cm ( p  ≤ 0.007). Prolapse in all compartments and rectocele size were significantly larger on Def compared to Pre-DV ( p  < 0.0001). Cystocele, vaginal prolapse, and enterocele sizes were significantly larger on Post-DV compared to Pre-DV ( p  < 0.0001). There were significant differences in grading of all types of prolapse and rectocele between the various acquisitions of MRD ( p  < 0.0001). Cystocele, AR descent, and rectocele grades were significantly higher on Def compared to Post-DV ( p range ≤ 0.0002). Grading of all types of prolapse and rectocele was significantly higher on Def compared to Pre-DV ( p  < 0.0001). Cystocele, vaginal prolapse, and enterocele grades were all significantly higher on Post-DV compared to Pre-DV ( p  ≤ 0.0007). Conclusion Defecation images during supine MRD elicit higher prevalence and size of prolapse of all pelvic compartments in comparison to both pre- and post-defecation Valsalva images. Post-defecation Valsalva images show larger size of anterior and middle compartment prolapse than pre-defecation Valsalva images. Functional evaluation of pelvic floor dysfunction with MRI should include image acquisition during defecation. If Valsalva images are acquired, these should be performed after the defecation acquisition and without rectal distention.