Evaluation Of Status Research Articles

ESPEN practical guideline on clinical nutrition in hospitalized patients with acute or chronic kidney disease

Hospitalized patients often have acute kidney disease (AKD) or chronic kidney disease (CKD), with important metabolic and nutritional consequences. Moreover, in case kidney replacement therapy (KRT) is started, the possible impact on nutritional requirements cannot be neglected. On this regard, the present guideline aims to provide evidence-based recommendations for clinical nutrition in hospitalized patients with KD. The standard operating procedure for ESPEN guidelines was used. Clinical questions were defined in both the PICO format, and organized in subtopics when needed, and in non-PICO questions for the more general topics. The literature search was from January 1st, 1999 until January 1st, 2020. Each question led to one or more recommendation/statement and related commentaries. Existing evidence was graded, as well as recommendations and statements were developed and agreed upon in a multistage consensus process. The present guideline provides 32 evidence-based recommendations and 8 statements, defining how to assess nutritional status, how to define patients at risk, how to choose the route of feeding, and how to integrate nutrition with KRT. In the final online voting, a strong consensus was reached in 84% at least of recommendations and 100% of statements. The presence of KD in hospitalized patients identifies a highly heterogeneous group of subjects with widely varying nutrient needs and intakes. Considering the high nutritional risk related with this clinical condition, an individualized approach consisting of nutritional status evaluation and monitoring, frequent evaluation of nutritional requirements, and careful integration with KRT should be planned to avoid both underfeeding and overfeeding. Practical recommendations and statements were developed, aiming at defining suggestions for everyday clinical practice in the individualization of nutritional support in this patient setting. Literature areas with scarce or without evidence were also identified, thus requiring further basic or clinical research.

Combined Computed Coronary Tomography Angiography and Transcatheter Aortic Valve Implantation (TAVI) Planning Computed Tomography Reliably Detects Relevant Coronary Artery Disease Pre-TAVI.

Background: Before surgical or transcatheter aortic valve implantation (TAVI), coronary status evaluation is required. The role of combined computed coronary tomography angiography (cCTA) and TAVI planning CT in this context is not yet well elucidated. This study assessed whether relevant proximal coronary disease requiring coronary revascularization can be safely detected by combined cCTA and TAVI planning CT, including CT-derived fractional flow reserve (FFR) calculation in patients with severe aortic stenosis. Methods: This study analyzed patients with successful cCTA combined with TAVI planning CT using a 128-slice dual-source scanner. The detection via cCTA of relevant left main stem stenosis (>50%) or proximal coronary artery stenosis (>70%) was compared to invasive coronary angiography (ICA). Results: This study comprised 101 consecutive TAVI patients with a median age of 83 [77-86] years, a median STS score of 3.7 [2.4-6.1] and 54% of whom had known coronary artery disease. Of 15 patients with relevant coronary stenoses, 14 (93.3%) were detected with cCTA, while false positive results were found in 25 patients. Only in patients with previous percutaneous coronary stent implantation (PCI) were false positive rates (11/29) increased. In the subgroup without previous PCI, an improved classification performance of 87.5%, being mainly due to 11.1% false positive classifications, led to a negative predictive value of 98.5%. Conclusions: Combined cCTA and CT-FFR with TAVI planning CT via state-of-the-art scanners and protocols as a one-stop shop can replace routine ICA in patients prior to TAVI due to its safe detection of relevant coronary artery stenosis, although diagnostic performance of cCTA is only reduced in patients with coronary stents.

Approach to Altered Mental Status in Pregnancy and Postpartum.

The evaluation and diagnosis of altered mental status in the pregnant or postpartum patient largely parallels the approach used for any other patient; however, there are several critical differences including that some neuroobstetric diagnoses require emergent delivery of the fetus. Being familiar with the physiological changes and medical complications of pregnancy and delivery is therefore essential. This review first addresses pregnancy-specific disorders that may result in altered mental status, such as the hypertensive disorders of pregnancy and pregnancy-related metabolic and endocrinopathies. The focus then shifts to the complex physiologic changes in pregnancy and how these changes contribute to the distinct epidemiology of pregnancy-related cerebrovascular complications like intracranial hemorrhage, ischemic stroke, and reversible cerebral vasoconstriction syndrome. Medical disorders that are not unique to pregnancy, such as infections and autoimmune conditions, may present de novo or worsen during pregnancy and the peripartum period and require a thoughtful approach to diagnosis and management. Finally, the unique nervous system complications of obstetric anesthesia are explored. In each section, there is a focus not only on diagnosis and syndrome recognition but also on the emergent treatment needed to reverse these complications, bearing in mind the unique physiology of the pregnant patient.

Malnutrition among Serious Trauma Patients in Intensive Care

Undernutrition is a frequent situation in intensive care, including serious trauma. Its prevalence is around 50%. It is associated with an increase in morbidity and mortality among patients hospitalized in intensive care. Our study focused on the evaluation of the nutritional status of serious trauma patients admitted to the intensive care unit of the IBN TOFAIL hospital. We used the BUZBY index (NRI) as screening tools. 35% of patients had a normal nutritional status when admitted to intensive care, 65% of patients were undernourished, including 30% who were severely undernourished. The prevalence on the 3rd day of hospitalization was 75% and 100% after 15 days of hospitalization. The worsening of nutritional status during hospitalization was 61.5%. It appears necessary to adopt a nutritional assessment and management of the patient admitted to intensive care in order to hope for an improvement in his prognosis and his chances of survival within the framework of an early rehabilitation program.

Role of nutrition in orthopedic trauma and surgery-A prospective study

: Nutrition is an age-old issue of human civilization with approximately 40% undernourished hospitalized inpatients. This has effect on surgery as healthy individuals have better tolerance than malnourished patients. : This study was designed to evaluate the effect of nutrition on patients who had undergone different types of Orthopedics surgeries. This prospective research involved 200 participants who received various orthopedic surgeries at a tertiary care facility. The evaluation of nutritional status involved measuring anthropometric (BMI) and biochemical markers (pre-albumin and transferrin) before, after, and three months after surgery for various age groups, genders, comorbidities like diabetes and hypertension, as well as for complications like urinary tract infections and surgical wound dehiscence. Version 16 of the SPSS statistical analysis program was used for the analysis. Chi Square and the repeated variable ANNOVA test were the tests employed.: 113 patients were followed up prospectively with 4.42% under nourishment rate. Nutritional markers were statistically significant values at pre,post and at 3 months of post op. Diabetes and age more than 40 years were two important parameters affecting nutrition of patients undergoing different orthopedic surgeries. Surgical wound infection was not related to nutritional status of the patient in this study. Pre albumin was found to be a better predictor of nutrition than transferrin.: This study clearly showed that nutrition has tremendous impact on the outcome different orthopedics surgeries. But needs more extensive research with huge sample size to prove the same in a more accurate way.

Status and Market Evaluation for New Energy and Conventional Vehicles of China

Contemporarily, China’s automobile market has expanded rapidly and become one of the world’s largest automobile producers and consumers. However, facing the environmental pressure and the demand of energy structure transformation, the automobile industry is experiencing a profound change from traditional fuel vehicles to new energy vehicles. This study analyzes the development status and market assessment of traditional fuel vehicles and new energy vehicles in China, and explores the changes and differences between the two. The sales of new energy vehicles show significant growth, and the market share is also rising year by year, while the sales of fuel vehicles show a downward trend. Despite the rapid expansion of the new energy vehicle market, it is still facing problems such as profitability issues, uneven investment in R&D, regulatory mechanisms to be improved and lagging infrastructure construction. In contrast, the fuel vehicle industry is gradually contracting amidst policy restrictions and changes in market demand, and companies need to accelerate their transformation and upgrading, and improve their research capabilities. China’s automobile industry is in a key stage of transformation and upgrading. The traditional fuel vehicle industry needs to shift towards new energy, strengthen collaborative innovation, optimize industrial structure, and focus on the expansion of after-market services. Overall, China is expected to lead the global automotive industry in the direction of green, intelligent and low-carbon development, and realize the historic leap from a large automotive country to a strong automotive country.

Enhanced Lithium-Ion Battery SOH Estimation Using Bayesian-Optimized CNN Deep Learning Approach

The accurate health status evaluation of lithium-ion batteries is crucial for preemptive identification of potential battery failures and averting hazardous incidents, given its essential role in indicating the extent of battery degradation. The challenge in determining the State of Health (SOH) arises from the absence of a precise and standardized definition, as well as the difficulty in measuring essential input variables. Therefore, this paper utilizes current and voltage data during the charge and discharge process as direct inputs for SOH estimation and proposes a deep learning-based lithium-ion battery SOH estimation approach. Specifically, it leverages Bayesian optimized Convolutional Neural Network (CNN) within a data-driven framework. Experimental results demonstrate that the proposed deep learning method achieves a Mean Absolute Error (MAE) of 1% and a Maximum Error (MAX) below 4% in estimation accuracy, highlighting its enhanced precision and robustness.

DFT simulations of Al-doped MoTe2 monolayer as an HCHO and C2H3Cl gas sensor for status evaluation of a dry-type reactor in the HVDC converter station

This paper using the density functional theory (DFT) investigates the adsorption property of Al-doped MoTe2 (Al-MoTe2) monolayer upon two fault gas species of a dry-type reactor in the high-voltage direct-current (HVDC) convert station, namely HCHO and C2H3Cl molecules, to explore its potential as a typical gas sensor. Results reveal that the Al dopant can be stably anchored on the MoTe2 surface by replacing the Te atom, and the Al-MoTe2 monolayer performs chemisorption for two gas species. The analysis of charge density difference confirms the charge-transfer behaviour using the Hirshfeld population analysis, and the analysis of electronic property and desorption property uncovers the resistive gas sensing potential of Al-MoTe2 monolayer with higher sensing response in the HCHO system and shorter recovery time in the C2H3Cl system. Also, the work function-based and optical sensing potential of the Al-MoTe2 monolayer is elucidated from the analyses of the work function and dielectric function. All the findings in this work shed light on the favourable potential of the Al-MoTe2 monolayer as a resistance-type, work function-based or optical gas sensor upon two faults gases, which are beneficial for further exploration of such sensing material to evaluate the operation status of the dry-type reactors in the HVDC convert station.

Outcome analysis of autologous stem cell transplantation in refractory and relapsed Hodgkin lymphoma: Insights from a North African single-institution study.

172 Background: The standard therapy for primary refractory or relapsed Hodgkin lymphoma (HL) involves the administration of high-dose chemotherapy followed by autologous stem cell transplantation (HDC/ASCT). Nevertheless, several risk factors may influence survival outcomes. We assessed outcomes of patients in this setting who underwent HDC/ASCT by performing survival analysis and studying prognostic factors affecting survival. Methods: We conducted a single-institution retrospective analysis of patients with relapsed/refractory HL who received HDC/ASCT between January 2018 and December 2022. Patients’ status evaluation before ASCT was performed by Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) Scan and Computed Tomography (CT) Scan. The used conditioning regimen was BEAM (Carmustine, Etoposide, Cytarabine, and Melphalan). The primary endpoints were progression-free survival (PFS) and overall survival (OS). Survival analysis was performed using the Kaplan-Meier method, and survival differences between groups were assessed using the Log-Rank test. Results: Thirty-five patients diagnosed with relapsed/refractory HL were included in the study. Among them, 26 patients (74%) had refractory disease, while 9 patients (26%) relapsed following completion of first-line chemotherapy. All patients were treated with HDC/ASCT. Prior to ASCT, 30 patients underwent assessment using FDG-PET Scan, while CT Scan was employed for evaluation in 5 patients. Twenty-three patients (66%) were in complete remission, 8 patients (23%) were in partial remission, and 4 patients (11%) had progressive disease. With a median follow-up of 24.36 months after transplantation, 28 patients (80%) were in remission, 6 patients (17%) had disease progression, and one patients died of septic shock. The 2-year PFS and OS rates for the total population were 85.4% and 97.1%, respectively. Response to first-line chemotherapy did not have a substantial impact on prognosis, as evidenced by a 2-year PFS rate of 76.2% vs. 88.9% (p=0.88) and a 2-year OS rate of 100% vs. 96.2% (p=0.56) for patients with relapsed and refractory disease, respectively. The 2-year PFS and OS rates for patients receiving autograft during complete remission, partial response, and tumor progression were 93.8% vs. 87.5% vs. 50% (p=0.005), respectively; and 95.7% vs. 100% vs. 100%, respectively (p=0.77). Patients who had negative pre-transplant PET-Scans demonstrated a 2-year PFS rate of 92.9% vs. 64.8% for those with positive PET-scans (p=0.004). Conclusions: The findings of our study affirm the established practice of HDC/ASCT for individuals facing relapsed/refractory HL. The disease status at transplant and the pre-transplant PET-Scan status prove to be crucial factors in predicting patients’ outcomes, while response to first-line chemotherapy did not influence prognosis.

Current use, training, and barriers in point-of-care ultrasound in nephrology: A national survey of VA medical centers.

Point-of-care ultrasound (POCUS) can improve diagnostic accuracy, reduce procedural complications and enhance physician-patient interactions in nephrology. Currently, there is limited knowledge about how practicing nephrologists are using POCUS. This study aimed to characterize current POCUS use, training needs, and barriers to use among nephrology groups. A prospective observational study of all Veterans Affairs (VA) medical centers was conducted between August 2019 and March 2020 using a web-based survey sent to all chiefs of staff and nephrology specialty chiefs. Chiefs of staff (n=130) and nephrology chiefs (n=79) completed surveys on facility- and service-level POCUS use (response rates of 100% and 77%, respectively). Current diagnostic or procedural POCUS use was reported by 41% of nephrology groups, and the most common POCUS applications were central line insertion (28%) and assessment of urinary retention (23%), hydronephrosis (18%), volume status (15%), and bladder (14%). Lack of training was the most common barrier (72%), and most nephrology groups (65%) desired POCUS training. Limited access to ultrasound equipment and POCUS training were barriers reported by 54% and 18% of groups, respectively. A minority of nephrology groups currently use common POCUS applications including evaluation of urinary retention, hydronephrosis, and volume status. The most common barriers to POCUS use in nephrology were lack of trained providers and ultrasound equipment. Investment in POCUS training and infrastructure is needed to expand and standardize POCUS use in nephrology.

Helen Knight and Margaret Macdonald on the meaning of ‘good’

ABSTRACT I argue that Helen Knight and Margaret Macdonald expressed views on the nature of ‘good’ in aesthetic contexts which anticipate to a striking extent the dispute between Peter Geach and R. M. Hare over ethical uses of ‘good’ several years later. I show that Knight introduced a distinction between uses of adjectives later drawn also by Geach, and that she employed that distinction, as Geach did, in order to defend a descriptivist approach to ‘good’ according to which ‘good’ is not ambiguous. I also show that Macdonald conceived of evaluative statements as commendatory, and that her conception of evaluative language therefore closely resembles the position which Hare would later advance.

Shear-wave elastography as a supplementary tool for axillary staging in patients undergoing breast cancer diagnosis

BackgroundPreoperative evaluation of axillary lymph node status is crucial for the selection of both systemic and surgical treatment in early breast cancer. This study assessed the particular role of additional shear wave elastography (SWE) in axillary staging in patients undergoing initial breast cancer diagnostics.MethodsOne hundred patients undergoing axillary lymph node biopsy due to a sonographically suspicious axillary lymph node were prospectively evaluated with SWE using virtual touch tissue imaging quantification (VTIQ). Mean values of tissue stiffness for axillary tissue and lymph node tissue were measured prior to core-cut biopsy of the lymph node. All lymph nodes were clip-marked during the biopsy. Cut-off values to differentiate between malignant and benign lymph nodes were defined using Youden’s index.ResultsLymph nodes with evidence of malignant tumor cells in the final pathological examination showed a significantly higher velocity as measured by SWE, with a mean velocity of 3.48 ± 1.58 m/s compared to 2.33 ± 0.62 m/s of benign lymph nodes (p < 0.0001). The statistically optimal cutoff to differentiate between malignant and benign lymph nodes was 2.66 m/s with a sensitivity of 69.8% and a specificity of 87.5%.ConclusionsLymph node metastases assessed with SWE showed significantly higher elasticity values compared to benign lymph nodes. Thus, SWE provides an additional useful and quantifiable parameter for the sonographic assessment of suspicious axillary lymph nodes in the context of pre-therapeutic axillary staging in order to differentiate between benign and metastatic processes and support the guidance of definitive biopsy work-up.Critical relevance statementShear-wave elastography provides an additional useful and quantifiable parameter for the assessment of suspicious axillary lymph nodes in the context of pre-therapeutic axillary staging in order to differentiate between benign and metastatic processes and support guiding the definitive biopsy work-up.Key PointsSWE is a quantifiable ultrasound parameter in breast cancer diagnosis.SWE shows a significantly higher velocity in malignant lymph nodes.SWE is useful in improving the sensitivity and specificity of axillary staging.Graphical

Liquid Chromatography with Orbitrap High-Resolution Mass Spectrometry for the Determination of Glucose in Saliva Following Derivatization with Dibenzylamine

As an important circulating metabolite in the body, the accurate determination of glucose in body fluids is very important for the evaluation of physiological status. However, liquid chromatography–mass spectrometry (LC–MS) methods present challenges for glucose due to poor ionization combined with weak chromatographic retention. Here, a method for determining salivary glucose using LC–MS after derivation by dibenzylamine is described in which 3-O-methyl-D-glucopyranose was used as internal standard. Saliva samples were prepared by protein precipitation, and the analytes were separated on a polar-copolymerized C18 reversed phase column. Detection took place by high-resolution orbitrap mass spectrometry after ionization in the positive mode. The calibration function was linear from 0.35 to 50 ng/mL. The recoveries were from 97.82 to 104.51% for intraday assays and 98.96 to 106.61% for interday assays. The intraday precision of salivary glucose was from 0.37% to 1.43% and the interday precision from 1.33% to 1.43%. The limits of detection and quantification in saliva were 0.2 and 0.6 ng/mL. The samples after derivatization were stored at 4 °C and 25 °C and analyzed every two days with five repeats. The relative standard deviations were 0.09% and 0.27% at 4 °C and 25 °C. This method was employed for the determination of the glucose in saliva for healthy male college students after exercise.

Radiomics nomogram based on CT radiomics features and clinical factors for prediction of Ki-67 expression and prognosis in clear cell renal cell carcinoma: a two-center study

ObjectivesTo develop and validate a radiomics nomogram combining radiomics features and clinical factors for preoperative evaluation of Ki-67 expression status and prognostic prediction in clear cell renal cell carcinoma (ccRCC).MethodsTwo medical centers of 185 ccRCC patients were included, and each of them formed a training group (n = 130) and a validation group (n = 55). The independent predictor of Ki-67 expression status was identified by univariate and multivariate regression, and radiomics features were extracted from the preoperative CT images. The maximum relevance minimum redundancy (mRMR) and the least absolute shrinkage and selection operator algorithm (LASSO) were used to identify the radiomics features that were most relevant for high Ki-67 expression. Subsequently, clinical model, radiomics signature (RS), and radiomics nomogram were established. The performance for prediction of Ki-67 expression status was validated using area under curve (AUC), calibration curve, Delong test, decision curve analysis (DCA). Prognostic prediction was assessed by survival curve and concordance index (C-index).ResultsTumour size was the only independent predictor of Ki-67 expression status. Five radiomics features were finally identified to construct the RS (AUC: training group, 0.821; validation group, 0.799). The radiomics nomogram achieved a higher AUC (training group, 0.841; validation group, 0.814) and clinical net benefit. Besides, the radiomics nomogram provided a highest C-index (training group, 0.841; validation group, 0.820) in predicting prognosis for ccRCC patients.ConclusionsThe radiomics nomogram can accurately predict the Ki-67 expression status and exhibit a great capacity for prognostic prediction in patients with ccRCC and may provide value for tailoring personalized treatment strategies and facilitating comprehensive clinical monitoring for ccRCC patients.

Risk of behavioural and developmental difficulties in early childhood in the Australian Capital Territory.

We aimed to estimate the prevalence of risk for developmental and behavioural problems for children in their first year of full-time primary education in the Australian Capital Territory (ACT). We conducted an analysis of the 2014-2017 Kindergarten Health Check (KHC), an annual series of complete enumeration surveys of all children in their first year of full-time primary education in the ACT. Risk for developmental and behavioural problems was determined using the Parents' Evaluation of Developmental Status (PEDS) questionnaire. 19 414 children (mean age 5.56 years; 51.4% boys; 2.3% Aboriginal and Torres Strait Islander; 18.4% quintile of greatest relative disadvantage) who participated in the 2014-2017 KHC were included in the study (87%). More than half of ACT children in their first year of primary education had low/no developmental risk identified through the PEDS questionnaire, with 1 in 10 at high risk. Those more likely to have a high risk PEDS score were boys, those from the areas experiencing relative disadvantage, and Aboriginal and Torres Strait Islander children. While we can identify children at risk through screening, the greater challenge remains to identify and address the underlying causes of healthy inequalities, even within highly socioeconomically advantaged communities.

Obesity prevalence, nutritional status, and physical activity levels in Turkish adults during the COVID-19 pandemic.

Although nutritional status is influenced by multidimensional aspects encompassing physical factors, there is limited research on this complex relationship. This study aimed to examine the interaction between physical activity level indicators and the nutritional status of adults in Türkiye. A total of 3,970 individuals aged 18 years or older, residing in Afyonkarahisar (Türkiye), participated in this study. Data were obtained through face-to-face interviews with a questionnaire, using simple random sampling among adults. One-day food consumption was recorded using a 24-h dietary recall (24HDR). Physical activity levels were assessed using the International Physical Activity Questionnaire (IPAQ). This study comprised 3,970 participants: 2,087 (52.57%) men and 1,883 (47.42%) women. Among them, 32.64% smoked cigarettes, and 8.72% consumed alcohol. About 40% of adults were overweight, and 16.33% were obese. All participants had inadequate intake levels of potassium, calcium, and iron when compared to the recommended amounts. Physical activity levels showed a weak positive correlation with dietary energy, carbohydrates, protein, fat, and cholesterol, and a weak negative correlation with age, waist-to-hip ratio, and BMI of participants. This study provides insights into the importance of addressing both physical activity and nutritional status. It was found that the weekly duration of physical activity for women was lower than for men. As a result of the nutritional status evaluation, it was found that the daily energy intake of men was higher than that of women.

Flexible/Regenerative Nanosensor with Automatic Sweat Collection for Cytokine Storm Biomarker Detection.

The real-time monitoring of low-concentration cytokines such as TNF-α in sweat can aid clinical physicians in assessing the severity of inflammation. The challenges associated with the collection and the presence of impurities can significantly impede the detection of proteins in sweat. This issue is addressed by incorporating a nanosphere array designed for automatic sweat transportation, coupled with a reusable sensor that employs a Nafion/aptamer-modified MoS2 field-effect transistor. The nanosphere array with stepwise wettability enables automatic collection of sweat and blocks impurities from contaminating the detection zone. This device enables direct detection of TNF-α proteins in undiluted sweat, within a detection range of 10 fM to 1 nM. The use of an ultrathin, ultraflexible substrate ensures stable electrical performance, even after up to 30 extreme deformations. The findings indicate that in clinical scenarios, this device could potentially provide real-time evaluation and management of patients' immune status via sweat testing.

An evaluation of fusion status following lumbar fusion surgery utilizing multi-planar computed tomography.

To report the rate of fusion in a sample of patients undergoing lumbar fusion surgery and assess interrater reliability of computed tomography (CT)-based parameters for the assessment of fusion. All adult patients who underwent lumbar fusion surgery from 2017 to 2021 were retrospectively identified. Patient demographics and surgical characteristics were collected through chart review of the electronic medical records. CT scans were reviewed independently by two attending spine surgeons and two spine fellows. Fusion was defined as evidence of bone bridging in any one of (1) posterolateral gutters, (2) facets, or (3) interbody (when applicable) on any CT views. Evidence of screw haloing was indicative of nonunion. Interrater reliability was determined using cohen's kappa. Afterwards, a consensus agreement for each component of fusion was reached between participants. The overall fusion rate among all procedures was 63/69 (91.3%). Overall 22/25 (88.0%) TLIF, 16/19 (84.2%) PLDF, 3/3 (100%) LLIF, and 22/22 (100%) circumferential fusions experienced a successful fusion. Interrater reliability was good for interbody fusion (k = 0.734) and moderate for all other measures (k = 0.561 for posterolateral fusion; k = 0.471 for facet fusion; k = 0.458 for screw haloing). Overall, interrater reliability as to whether a patient had a fusion or nonunion was moderate (k = 0.510). There was only moderate interrater reliability across most radiographic measures used in assessing lumbar fusion status. Reliability was highest when evaluating the presence of interbody fusion. The majority of fusions occurred across the facet joints.

Unlocking rivers' hidden diversity and ecological status using DNA metabarcoding in Northwest Spain.

Rivers are crucial ecosystems supporting biodiversity and human well-being, yet they face increasing degradation globally. Traditional river biomonitoring methods based on morphological identification of macroinvertebrates present challenges in terms of taxonomic resolution and scalability. This study explores the application of DNA metabarcoding analysis in both bulk and environmental DNA (eDNA) samples for comprehensive assessment of macrozoobenthic biodiversity, detection of invasive and endangered species, and evaluation of river ecological status in northwestern Spain. DNA metabarcoding of homogenized bulk samples and water eDNA revealed a mean of 100 and 87 macrozoobenthos species per sample respectively. However, the specific composition was significantly different with only 27.3% of the total species being shared. It was not possible to identify all the OTUs to species level; only 17.43% and 49.4% of the OTUs generated could be identified to species level in the bulk and eDNA samples, respectively. Additionally, a total of 11 exotic species (two first records for the Iberian Peninsula and another three first records for Asturias region) and one endangered species were detected by molecular tools. Molecular methods showed significant correlations with morphological identification for EQR values (Ecological Quality Ratio) of IBMWP index, yet differences in inferred river ecological status were noted, with bulk samples tending to indicate higher status. Overall, DNA metabarcoding offers a promising approach for river biomonitoring, providing insights into biodiversity, invasive species, and ecological status within a single analysis. Further optimization and intercalibration are required for its implementation in routine biomonitoring programmes, but its scalability and multi-tasking capabilities position it as a valuable tool for integrated monitoring of river ecosystems.

Arterial Mucosal Linear Enhancement at Contrast-enhanced MRI to Exclude Residual Tumor after Neoadjuvant Chemotherapy and Radiation Therapy for Rectal Cancer.

Background A watch-and-wait regimen for locally advanced rectal cancer after neoadjuvant chemotherapy and radiation therapy (NCRT) relies on identifying complete tumor response. However, the concordance between a complete response at combined T2-weighted and diffusion-weighted MRI (T2DWI) and pathologic complete response (pCR; ie, ypT0N0) in the tumor is unsatisfactory. Purpose To assess whether identification of mucosal linear enhancement (MLE) at arterial-phase contrast-enhanced (CE) T1-weighted MRI is associated with ypT0 status in patients with locally advanced rectal cancer after NCRT and to evaluate whether combining MLE at CE T1-weighted MRI and negative lymph node metastasis (LNM) at T2DWI can improve identification of pCR. Materials and Methods This retrospective study included patients with locally advanced rectal cancer who underwent total mesorectal excision after NCRT between July 2020 and July 2023 at a tertiary referral academic center. Restaging MRI included T2DWI and arterial-phase CE T1-weighted MRI for primary tumor assessment and T2DWI for evaluation of LNM status. Imaging features associated with ypT0 status were identified at multivariable regression analysis. Results In total, 239 patients (mean age, 58 years ± 12 [SD]; 180 male patients) were assessed. MLE was more common in the ypT0 group than in the ypT1-4 group after NCRT (73% vs 4%, respectively; P < .001). MLE was associated with higher odds of ypT0 status in an adjusted analysis (odds ratio, 137; 95% CI: 25, 767; P < .001). The combination of MLE and negative LNM status achieved an area under the receiver operating characteristic curve of 0.84 (95% CI: 0.79, 0.88) for pCR. Conclusion MLE at CE MRI was associated with higher odds of complete tumor response. Combining MLE and negative LNM status showed good performance for identifying complete tumor response and may exclude residual tumors after NCRT in patients with locally advanced rectal cancer. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Schoellnast in this issue.