Semi-quantitative Approaches Research Articles

Methods of health risk and impact assessment at industrially contaminated sites: a systematic review.

this paper is based upon work from COST Action ICSHNet. Industrially contaminated sites (ICSs) are a serious problem worldwide and there is growing concern about their impacts on the environment and public health. Health risk assessment methods are used to characterize and quantify the health impacts on nearby populations and to guide public health interventions. However, heterogeneous methods and inconsistent reporting practices compromise comparability risk and impact estimates. to review the literature on assessment of the adverse health effects of ICSs. Specifically, we: - collect published, peer-reviewed literature addressing health assessment of ICSs; - identified and evaluated the methods and tools for the assessment of health impacts related to ICSs; - analysed the methods and tools used in different conditions; - discussed the strengths and weaknesses of the identified approaches; - presented an up-to-date understanding of the available health risk and impact assessment in ICSs. In addition, the terminologies were described and harmonization was proposed. we systematically searched PubMed and Web of Science to identify peer-reviewed reviews and original studies from January 1989 to December 2017. We used a qualitative approach for analysing the different elements (type of ICSs, Country of research, active years of working, distance from sources, pollutants, affected population, methods and tools, health outcomes, main founding, method stage, dose-response assessment, risk characterization) of included studies. We divided risk assessment methods used in the papers into four stages: semi-quantitative, quantitative, health impact, and health burden stage. a total of 92 relevant original papers at ICSs were found and analysed. In current practice, the health risks have been characterized mainly as hazard quotients or hazard indexes (23 studies), and as cancer risk probabilities (60 studies). Only 8 studies estimated the number of cases and one study evaluated years of life lost. hazard quotients and cancer probabilities are suitable for semi-quantitative and quantitative personal risk estimation, respectively. More comparable risk characterization on public health level requires specificity on the type of outcome and corresponding number of cases. Such data is needed for prioritization of action at low to medium risk sites. We found limited amount of studies that have quantified the health impact at industrially contaminated sites. Most of the studies have used semi-quantitative risk characterization approaches and the adopted methods are mostly of toxicological origin, while epidemiological analysis is almost lacking. There is a need to improve quantitative risk assessment and include health impact and environmental burden of disease assessments at ICSs.

Publisher's note

Abstract This paper presents a method for risk assessment and inspection plan development as part of the risk-based structural integrity management of offshore jacket platforms. The method provides a global risk assessment for the whole platform's structure and local risk assessment for the platform's structural components (e.g. tubular joints). The global risk assessment uses semi-quantitative or quantitative approaches depending on the available platform's data. The semi-quantitative method is used either at a high level to perform relative risk ranking of platforms in a fleet in order to identify the platforms most at risk and which require more inspection focus or a detailed risk analysis; or at the unit level to define inspection interval and general inspection requirements. The quantitative method involves either structural analysis results (e.g. reserve strength ratio) with a dedicated metocean hazard curve or structural reliability method; and it is used at the unit level only to define inspection interval and inspection requirements. The local risk assessment uses also semi-quantitative or quantitative approach. The semi-quantitative method is used to provide local risk ranking of the structural components of a platform, which allows, if required, local inspections' scope to be defined. The quantitative method involves a probabilistic fatigue method to define inspection plans for selected tubular joints subjected to fatigue and the failures of which are critical for the overall platform structure. The inspection strategy and program, developed by the method presented in this paper, are focused on the routine underwater inspections and are based on the recommended practice of the American Petroleum Institute for the structural integrity management of fixed offshore platforms. An example of application of the method is set out by showing the results of a project carried out by Bureau Veritas.

A method for rapid high-throughput biophysical analysis of proteins

Quantitative determination of protein thermodynamic stability is fundamental to many research areas, both basic and applied. Although chemical-induced denaturation is the gold-standard method, it has been replaced in many settings by semi-quantitative approaches such as thermal stability measurements. The reason for this shift is that chemical denaturation experiments are labour-intensive, sample-costly and time-consuming, and it has been assumed that miniaturisation to a high-throughput format would not be possible without concomitantly comprising data quality. Here we exploit current technologies to create a high-throughput label-free chemical denaturation method that is capable of generating replicate datasets on multiple proteins in parallel on a timescale that is at least ten times faster, much more economical on sample, and with the potential for superior data quality, than the conventional methods used in most research labs currently.

Evolution of Diagnostic Tests for Chronic Wasting Disease, a Naturally Occurring Prion Disease of Cervids.

Since chronic wasting disease (CWD) was first identified nearly 50 years ago in a captive mule deer herd in the Rocky Mountains of the United States, it has slowly spread across North America through the natural and anthropogenic movement of cervids and their carcasses. As the endemic areas have expanded, so has the need for rapid, sensitive, and cost effective diagnostic tests—especially those which take advantage of samples collected antemortem. Over the past two decades, strategies have evolved from the recognition of microscopic spongiform pathology and associated immunohistochemical staining of the misfolded prion protein to enzyme-linked immunoassays capable of detecting the abnormal prion conformer in postmortem samples. In a history that parallels the diagnosis of more conventional infectious agents, both qualitative and real-time amplification assays have recently been developed to detect minute quantities of misfolded prions in a range of biological and environmental samples. With these more sensitive and semi-quantitative approaches has come a greater understanding of the pathogenesis and epidemiology of this disease in the native host. Because the molecular pathogenesis of prion protein misfolding is broadly analogous to the misfolding of other pathogenic proteins, including Aβ and α-synuclein, efforts are currently underway to apply these in vitro amplification techniques towards the diagnosis of Alzheimer’s disease, Parkinson’s disease, and other proteinopathies. Chronic wasting disease—once a rare disease of Colorado mule deer—now represents one of the most prevalent prion diseases, and should serve as a model for the continued development and implementation of novel diagnostic strategies for protein misfolding disorders in the natural host.

Infrared spectroscopic characterization of monocytic microvesicles (microparticles) released upon lipopolysaccharide stimulation.

Microvesicles (MVs) are involved in cell-cell interactions, including disease pathogenesis. Nondestructive Fourier-transform infrared (FTIR) spectra from MVs were assessed as a technique to provide new biochemical insights into a LPS-induced monocyte model of septic shock. FTIR spectroscopy provided a quick method to investigate relative differences in biomolecular content of different MV populations that was complementary to traditional semiquantitative omics approaches, with which it is difficult to provide information on relative changes between classes (proteins, lipids, nucleic acids, carbohydrates) or protein conformations. Time-dependent changes were detected in biomolecular contents of MVs and in the monocytes from which they were released. Differences in phosphatidylcholine and phosphatidylserine contents were observed in MVs released under stimulation, and higher relative concentrations of RNA and α-helical structured proteins were present in stimulated MVs compared with MVs from resting cells. FTIR spectra of stimulated monocytes displayed changes that were consistent with those observed in the corresponding MVs they released. LPS-stimulated monocytes had reduced concentrations of nucleic acids, α-helical structured proteins, and phosphatidylcholine compared with resting monocytes but had an increase in total lipids. FTIR spectra of MV biomolecular content will be important in shedding new light on the mechanisms of MVs and the different roles they play in physiology and disease pathogenesis.-Lee, J., Wen, B., Carter, E. A., Combes, V., Grau, G. E. R., Lay, P. A. Infrared spectroscopic characterization of monocytic microvesicles (microparticles) released upon lipopolysaccharide stimulation.

Unsupervised labeling of glomerular boundaries using Gabor filters and statistical testing in renal histology.

The glomerulus is the blood filtering unit of the kidney. Each human kidney contains [Formula: see text] glomeruli. Several renal conditions originate from structural damage to glomerular microcompartments, such as proteinuria, the excessive loss of blood proteins into urine. The gold standard for evaluating structural damage in renal pathology is histopathological and immunofluorescence examination of needle biopsies under a light microscope. This method is limited by qualitative or semiquantitative manual scoring approaches to the evaluation of glomerular structural features. Computational quantification of equivalent features promises to improve the precision of glomerular structural analysis. One large obstacle to the computational quantification of renal tissue is the identification of complex glomerular boundaries automatically. To mitigate this issue, we developed a computational pipeline capable of extracting and exactly defining glomerular boundaries. Our method, composed of Gabor filtering, Gaussian blurring, statistical [Formula: see text]-testing, and distance transform, is able to accurately identify glomerular boundaries with mean sensitivity/specificity of [Formula: see text] and accuracy of 0.92, on [Formula: see text] glomeruli images stained with standard renal histological stains. Our method will simplify computational partitioning of glomerular microcompartments hidden within dense textural boundaries. Automatic quantification of glomeruli will streamline structural analysis in clinic and can pioneer real-time diagnoses and interventions for renal care.

FDG PET/MR Imaging in Major Neurocognitive Disorders.

PET/MRI tomographs represent the latest development in hybrid molecular imaging, opening new perspectives for clinical and research applications and attracting a large interest among the medical community. This new hybrid modality is expected to play a pivotal role in a number of clinical applications and among these the assessment of neurodegenerative disorders. PET and MRI, acquired separately, are already the imaging biomarkers of choice for a comprehensive assessment of the changes occurring in dementias (major cognitive disorders) as well as in their prodromal phase. In this paper we review the current evidence on the use of integrated PET/MRI scanners to investigate patients with neurodegenerative conditions, and in particular major neurocognitive disorders. The number of studies performed is still limited and shows that the use of PET/MRI gives results overall comparable to PET/CT and MRI acquired independently. We also address the challenges for quantitative aspects in PET/MRI, namely attenuation, partial volume and motion correction and the use of semi-quantitative approaches for FDG PET image analysis in this framework. The recent development of PET tracers for the in vivo differential diagnosis of dementias, able to visualize amyloid and tau deposits, suggests that in the future PET/MRI might represent the investigation of choice for a single session evaluation of morphological, functional and molecular markers.

AUTOMATED QUANTIFICATION OF RENAL FIBROSIS WITH SIRIUS RED: IS A ROUTINE METHOD OF THE KIDNEY BIOPSY EVALUATION?

The Aim of our study was to determine the intra- and interobserver variation of the automated quantitative evaluation if cortical interstitial fibrosis performed on kidney biopsy samples stained with Sirius red compared to conventional approaches.
 Materials and methods. The range of fibrosis was evaluated on 15 renal biopsies obtained from adult patients with minimal change nephropathy, focal segmental glomerulosclerosis and membranous nephropathy. Different methods of fibrosis measurement were used: the automated quantification of Sirius red stained areas with and without polarization, the computerized quantification of the fibrotic interstitium on trichrome-stained samples and the visual assessment offibrotic tissues using quantitative and semiquantitative approaches on trkhrome and PAMS-stained slides. The intra- and interobserver variation of these methods was performed.
 Results. The quantitative evaluation of interstitial fibrosis with Sirius red stain under both polarized and unpolarized light demonstrated nearly perfect inter- and intraobserver reproducibility (ICC=0,85-0,99). Whereas, visual methods had relatively high variance between observations (ICC=0,48-0,66).
 Conclusions. The automated quantification of cortical interstitial fibrosis as performed on renal biopsy samples stained with Sirius red has been shown to be a highly accurate approach that could be used as a routine method of the kidney biopsy evaluation.

Multispectral imaging for highly accurate analysis of tumour-infiltrating lymphocytes in primary melanoma.

The quality and quantity of the infiltration of immune cells into tumour tissues have substantial impacts on patients' clinical outcomes, and are associated with response to immunotherapy. Therefore, the precise analysis of tumour-infiltrating lymphocytes (TILs) is becoming an important additional pathological biomarker. Analysis of TILs is usually performed semiquantitatively by pathologists on haematoxylin and eosin-stained or immunostained tissue sections. However, automated quantification outperforms semiquantitative approaches, and is becoming the standard. Owing to the presence of melanin pigment, this approach is seriously hampered in melanoma, because the spectrum of melanin lies close to that of commonly used immunohistochemical stains. Aim of this study is to overcome the technical issues due to the presence of melanin for an automated and accurate quantification of TILs in melanoma. Here, we successfully applied a novel multispectral imaging (MSI) technique to enumerate T cells in human primary melanomas. This microscopy technique combines imaging with spectroscopy to obtain both quantitative expression data and the tissue distributions of different cellular markers. We demonstrate that MSI allows complete and accurate analysis of TILs, successfully avoiding the blurring of images by melanin pigments, in whole tissue slide primary melanoma lesions, which could otherwise not be accurately detected by conventional digital image methodologies. Our study highlights the potential of MSI for accurate assessment of immune cell infiltrates, including those in notoriously difficult tissues, such as pigmented melanomas. Quantification of tumour infiltration by different immune cell types is crucial in the search for new biomarkers to predict patient responses to immunotherapies. Our findings show that this innovative microscopy technique is an important extension of the armamentarium of pathologists.

Increased Echogenicity and Radiodense Foci on Echocardiogram and MicroCT in Murine Myocarditis.

ObjectivesTo address the question as to whether echocardiographic and/or microcomputed tomography (microCT) analysis can be utilized to assess the extent of Coxsackie B virus (CVB) induced myocarditis in the absence of left ventricular dysfunction in the mouse.BackgroundViral myocarditis is a significant clinical problem with associated inflammation of the myocardium and myocardial injury. Murine models of myocarditis are commonly used to study the pathophysiology of the disease, but methods for imaging the mouse myocardium have been limited to echocardiographic assessment of ventricular dysfunction and, to a lesser extent, MRI imaging.MethodsUsing a murine model of myocarditis, we used both echocardiography and microCT to assess the extent of myocardial involvement in murine myocarditis using both wild-type mice and CVB cleavage-resistant dystrophin knock-in mice.ResultsAreas of increased echogenicity were only observed in the myocardium of Coxsackie B virus infected mice. These echocardiographic abnormalities correlated with the extent of von Kossa staining (a marker of membrane permeability), inflammation, and fibrosis. Given that calcium phosphate uptake as imaged by von Kossa staining might also be visualized using microCT, we utilized microCT imaging which allowed for high-resolution, 3-dimensional images of radiodensities that likely represent calcium phosphate uptake. As with echocardiography, only mice infected with Coxsackie B virus displayed abnormal accumulation of calcium within individual myocytes indicating increased membrane permeability only upon exposure to virus.ConclusionsThese studies demonstrate new, quantitative, and semi-quantitative imaging approaches for the assessment of myocardial involvement in the setting of viral myocarditis in the commonly utilized mouse model of viral myocarditis.

On risk assessment and risk acceptance of dangerous goods transportation through road tunnels in Greece

Prescriptive and risk-based methods including qualitative, semi-quantitative and quantitative approaches exist for the risk assessment of road tunnels. This paper provides an overview and a brief discussion of these methods and uses representative traffic and accident data in Greece in a typical tunnel conforming with the minimum infrastructure requirements of the European Directive 2004/54/EC to compare and discuss the resulting risk for each of these methods. Conclusions regarding the implementation of risk analysis methods and the use of the associated existing national guideline are drawn and recommendations for further developments in standards are provided. An integrated framework for the optimal selection of safety measures based on risk reduction and socio-economic considerations is proposed and its applicability in risk analysis of road tunnels is discussed.

Abstract 3919: Phosphorylation of eIF4E is a critical factor in development and progression of breast cancer in women

Abstract Breast cancer survival rates vary according to stage, tumor grade, and receptor status. While some cancer patients respond well to targeted therapy many patients respond poorly. Critical for advancing new therapies is developing a better understanding of the molecular drivers of breast cancer tumorigenesis and malignant progression. The synthesis of new proteins (translation) is important for cancer cell survival, growth, and proliferation. eIF4E is a rate limiting step in translation. Targeting translation has been suggested as a novel strategy for therapy of malignancies originating in the epithelium since eIF4E regulates the translation of multiple malignancy associated mRNAs. eIF4E is activated by phosphorylation downstream of the Mnk 1 and 2 kinases. We hypothesized that phosphorylation of eIF4E plays a critical role in driving breast cancer and is elevated in advanced cancers and metastases. Using immunochemistry and semi-quantitative cellular pathology approaches we analyzed expression of eIF4E and phospho-eIF4E in 168 FFPE archived surgical specimens of normal breast, benign breast disease and pre-invasive, invasive, and metastatic breast cancer. Immunohistochemical stain in the cytoplasm and nuclei of breast epithelial cells was evaluated microscopically by the area of epithelium stained and the intensity of stain (Histoscore = Area X Intensity). We found that expression of eIF4E in the cytoplasm and nuclei of breast epithelial cells was highly correlated with tumor progression (p < 0.0001 and p = 0.0025, respectively). Similarly phospho-eIF4E expression increased in concert with tumor progression (p < 0.0001) in both the cytoplasm and nuclei of breast epithelial cells. Interestingly, while expression of both eIF4E and phospho-eIF4E was not significantly increased in benign breast disease, expression of both eIF4E and phospho-eIF4E was significantly increased in atypical duct hyperplasia (p = 0.01) and in carcinoma in situ (p < 0.0001) as well as in invasive ductal carcinoma (p < 0.0001) relative to normal duct epithelium. Expression of eIF4E and phospho-eIF4E was also increased in lobular carcinoma in situ relative to expression in normal lobules. Breast cancers of all receptor types (ER+/-, PR +/-, Her2+/-, and triple negative) had increased expression of eIF4E and phospho-eIF4E relative to normal duct epithelium. These data are consistent with the conclusion that eIF4E and phospho-eIF4E are critical factors in breast cancer development and progression and that targeting either eIF4E or phosphorylation of eIF4E may be an effective strategy for therapy of all subtypes of breast cancer. Citation Format: Chad A. Dumstorf, Larry E. Douglass, James A. Deddens, Thomas G. Lewis, Kyle Darpel, Christian Gausvik, Jeremy R. Graff, Julia H. Carter. Phosphorylation of eIF4E is a critical factor in development and progression of breast cancer in women. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 3919.

Integrating Quantitative and Qualitative Research Methods in Health Communication Research

Health Educators working to promote health behaviors have realized that mere quantitative research surveys alone not necessarily provide all of the data inputs that are needed to develop effective communication strategies. Therefore, qualitative methods such as focus groups and in-depth interviews, besides less precise, but useful semi-quantitative approaches, such as intercept surveys, have emerged as part of their research gamut. In an ideal Health Education/IEC program, researchers use both quantitative and qualitative data to provide a more complete picture of the issue being addressed, the target audience and the effectiveness of the program itself. The purpose of this paper is to look at how these two different research approaches can be integrated to inform the development of an effective social marketing program.

Development of a novel methodology for root cause analysis and selection of maintenance strategy for a thermal power plant: A data exploration approach

Abstract Performing root cause analysis in technical systems is usually challenging owing to the complex failure associations which often exist between inter-connected system components. The recent adoption of maintenance management systems in industry has enhanced the collection of maintenance data which could assist practitioners derive meaningful failure associations embedded in the data. However, root cause analysis in the maintenance domain is dominated by the use of qualitative and semi-quantitative approaches. Such approaches, however, rely on expert elicitations whereof this elicitation process often introduces bias in the root cause analysis process. On the other hand, quantitative techniques for root cause analysis, for instance, fault trees and Bayesian networks are often limited to analyzing root causes in fairly simple systems. Moreover, the quantitative techniques seldom model the failure dependencies linked to the empirical failure events. Hence, to address these challenges, a novel data exploration methodology for root cause analysis is proposed which consists of four steps: 1) data collection and standardization step; 2) data exploration framework incorporating multivariate and cluster analysis; 3) causal mapping; and 4) maintenance strategy selection. The methodology is demonstrated in the application case of thermal power maintenance data. Moreover, the methodology is compared with two conventional qualitative root cause analysis techniques – Ishikawa cause-and-effect diagram, and the ‘5-whys’ analysis. A detailed discussion is presented whereof the added value of the methodology for maintenance decision support is demonstrated.

Life history traits and fishery patterns of teleosts caught by the tuna longline fishery in the South Atlantic and Indian Oceans

The identification and mitigation of adverse effects of the bycatch of tuna longline fishery have been mainly developed and implemented for seabirds, sharks and turtles and, the knowledge on teleost bycatch for this fishery, remains very poor. This paper contributes to a comprehensive assessment of life history traits and fishery attributes of target and bycatch species caught by the tuna longline fishery in the South Atlantic and Indian Oceans. Data was compiled on seven life history traits and three fishery attributes for 33 and 27 teleost stocks caught by longliners in South Atlantic and Indian Oceans, respectively. In addition, each species was assigned into four categories describing the fate of the catch: target species for commercial use, bycatch species kept for consumption, bycatch species kept for commercial use and discarded bycatch. Life history traits and fishery attributes did not differ between oceans. However, non-target but commercialized species were smaller in the Atlantic Ocean. Teleosts caught by the tuna longline fishery was segregated into three main groups: (1) the fast growing species represented mainly by dolphinfishes (Coryphaena hippurus and C. equisellis), skipjack tuna (Katsuwonus pelamis), kawakawa (Euthynnus affinis), bullet tuna (Auxis rochei), snoek (Thyrsites atun) and blackfin tuna (Thunnus atlanticus); (2) target tunas and most other bycatch species which were part of an intermediate group and (3) billfishes including swordfish representing the large and slow growing species with moderate to high market values and unknown or highly uncertain stock status. Investment in some key life history traits (such as growth coefficient) and the development of quantitative or semi-quantitative approaches (stock assessment and Ecological Risk Assessment) should be priorized as precautionary management measures for these species.

The rationale for simple approaches for sustainability assessment and management in contaminated land practice

The scale of land-contamination problems, and of the responses to them, makes achieving sustainability in contaminated land remediation an important objective. The Sustainable Remediation Forum in the UK (SuRF-UK) was established in 2007 to support more sustainable remediation practice in the UK. The current international interest in ‘sustainable remediation’ has achieved a fairly rapid consensus on concepts, descriptions and definitions for sustainable remediation, which are now being incorporated into an ISO standard. However the sustainability assessment methods being used remain diverse with a range of (mainly) semi-quantitative and quantitative approaches and tools developed, or in development. Sustainability assessment is site specific and subjective. It depends on the inclusion of a wide range of considerations across different stakeholder perspectives. Taking a tiered approach to sustainability assessment offers important advantages, starting from a qualitative assessment and moving through to semi-quantitative and quantitative assessments on an ‘as required’ basis only. It is also clear that there are a number of ‘easy wins’ that could improve performance against sustainability criteria right across the site management process. SuRF-UK has provided a checklist of ‘sustainable management practices’ that describes some of these. This paper provides the rationale for, and an outline of, and recently published SuRF-UK guidance on preparing for and framing sustainability assessments; carrying out qualitative sustainability assessment; and simple good management practices to improve sustainability across contaminated land management activities.

Integrated assessment for vulnerability to climate change in Germany - a brief overview of methodology and results

Within the scope of the German Adaptation Strategy (DAS), a standardized, cross-sector assessment of current and future climate change impacts and vulnerabilities for Germany was carried out from 2011to 2015. For this assessment, an institutional Vulnerability Network was established, composed of sixteen Federal agencies and institutes. Supported by a scientific consortium, the Vulnerability Network developed a collaborative scientific concept for an integrative and spatially explicit assessment. For each pre-defined action field, impact chains were generated as the basis for the selection, prioritization and assessment of indicators. Exposure, sensitivities and adaptive capacities were described by means of quantitative and semi-quantitative approaches, leading to a variety of products at different conceptual levels of aggregation. This paper introduces the methodology pursued for the assessment and then presents some examples illustrating the variety of outcomes produced. The conclusions drawn are based on critical procedural and methodological reflection.

A nanomedicine based combination therapy based on QLPVM peptide functionalized liposomal tamoxifen and doxorubicin against Luminal A breast cancer

Though combination chemotherapy or antitumor nanomedicine is extensively investigated, their combining remains in infancy. Additionally, enhanced delivery of estrogen or its analogs to tumor with highly-expressed estrogen-receptor (ER) is seldom considered, despite its necessity for ER-positive breast cancer treatment. Here, nanomedicine based combination therapy using QLPVM conjugated liposomal tamoxifen (TAM) and doxorubicin (DOX) was designed and testified, where the penta-peptide was derived from Ku70 Bax-binding domain. Quantitative, semi-quantitative and qualitative approaches demonstrated the enhanced endocytosis and cytotoxicity of QLPVM conjugated sterically stabilized liposomes (QLPVM-SSLs) in vitro and in vivo. Mechanism studies of QLPVM excluded the possible electrostatic, hydrophobic or receptor–ligand interactions. However, as a weak cell-penetrating peptide, QLPVM significantly induced drug release from QLPVM-SSLs during their interaction with cells, which was favorable for drug internalization. These findings suggested that the nanomedicine based combination therapy using QLPVM-SSL-TAM and QLPVM-SSL-DOX might provide a rational strategy for Luminal A breast cancer. From the Clinical EditorBreast cancer remains a leading cause of mortality in women worldwide. Although combined therapy using hormonal antagonist and chemotherapy is the norm nowadays, the use of these agents together in a single delivery system has not been tested. Here, the authors investigated this approach using QLPVM conjugated liposomes in in-vitro and in-vivo models. The positive findings may provide a novel direction for breast cancer treatment in the near future.

MR Imaging-based Semi-quantitative Methods for Knee Osteoarthritis.

Magnetic resonance imaging (MRI)-based semi-quantitative (SQ) methods applied to knee osteoarthritis (OA) have been introduced during the last decade and have fundamentally changed our understanding of knee OA pathology since then. Several epidemiological studies and clinical trials have used MRI-based SQ methods to evaluate different outcome measures. Interest in MRI-based SQ scoring system has led to continuous update and refinement. This article reviews the different SQ approaches for MRI-based whole organ assessment of knee OA and also discuss practical aspects of whole joint assessment.

Lights and shadows of cardiac magnetic resonance imaging in acute myocarditis.

Cardiac magnetic resonance (CMR) is considered a primary tool for the diagnosis of acute myocarditis, due to its unique potential for non-invasive identification of the various hallmarks of the inflammatory response, with relevant impact on patient management and prognosis. Nonetheless, a marked variation in sensitivity and negative predictive value has been reported in the literature, reflecting the intrinsic drawbacks of current diagnostic criteria, which are based mainly on the use of conventional CMR pulse sequences. As a consequence, a negative exam cannot reliably exclude the diagnosis, especially in patients who do not present an infarct-like onset of disease. The introduction of new-generation mapping techniques further widened CMR potentials, allowing quantification of tissue changes and opening new avenues for non-invasive workup of patients with inflammatory myocardial disease.Main messages• CMR sensitivity varies in AM, reflecting its clinical polymorphism and the intrinsic drawbacks of LLc.• Semiquantitative approaches such as EGEr or T2 ratio have limited accuracy in diffuse disease forms.• T1 mapping allows objective quantification of inflammation, with no need to normalize measurements.• A revised protocol including T2-STIR, T1 mapping and LGE could be hypothesized to improve sensitivity.