MR diffusion imaging in preoperative evaluation of depth of myometrial invasion in endometrial carcinoma

AbstractObjectiveTo investigate the accuracy of high b value Diffusion Weighted Imaging (DWI) combined with T2-WI in estimating the depth of myometrial invasion in endometrial carcinoma compared to the accuracy of post contrast MRI.Subjects and methodsTwenty-seven patients with histologically proven endometrial carcinoma were enrolled in this study. T2-weighted, post contrast T1-weighted after 30, 60, 120s, and DWI with b values of 0, 500 and 1000s/mm2 were obtained. The Depth of myometrial invasion was assessed. The ADC values were measured and correlated with the depth of myometrial invasion and with the histological grade.ResultsThe high b value DWI showed similar sensitivity and higher specificity in evaluating the depth of myometrial invasion compared to the post contrast MRI. No correlation was found between the ADC values and the depth of myometrial invasion. No correlation was found between the ADC values and the histologic tumor grade.ConclusionDW-MRI has a high diagnostic efficacy comparable to that of post contrast study, making it a good alternative in preoperative evaluation of depth of myometrial invasion in endometrial carcinoma patients. DW-MRI thus should be considered part of the routine pre-operative pelvic MRI in this group of patients

Unveiling the Impact of Eco-Friendly Synthesized Nanoparticles on Vegetative Growth and Gene Expression in <i>Pelargonium graveolens</i> and <i>Sinapis alba</i> L.

Nanoscale geranium waste (GW) and magnesium nanoparticle/GW nanocomposites (Mg NP/GW) were prepared using green synthesis. The Mg NP/GW samples were subjected to characterization using X-ray diffraction (XRD) and Fourier-transform infrared spectroscopy (FTIR-FT). The surface morphology of the materials was examined using a scanning electron microscope (SEM), and their thermal stability was assessed through thermal gravimetric analysis (TG). The BET-specific surface area, pore volume, and pore size distribution of the prepared materials were determined using the N2 adsorption–desorption method. Additionally, the particle size and zeta potentials of the materials were also measured. The influence of the prepared nanomaterials on seed germination was intensively investigated. The results revealed an increase in seed germination percent at low concentrations of Mg NP/GWs. Upon treatment with Mg NP/GW nanoparticles, a reduction in the mitotic index (MI) was observed, indicating a decrease in cell division. Additionally, an increase in chromosomal abnormalities was detected. The efficacy of GW and Mg NP/GW nanoparticles as new elicitors was evaluated by studying their impact on the expression levels of the farnesyl diphosphate synthase (FPPS1) and geranylgeranyl pyrophosphate (GPPS1) genes. These genes play a crucial role in the terpenoid biosynthesis pathway in Sinapis alba (S. alba) and Pelargonium graveolens (P. graveolens) plants. The expression levels were analyzed using reverse transcription–quantitative polymerase chain reaction (RT-qPCR) analysis. The qRT-PCR analysis of FPPS and GPPS gene expression was performed. The outputs of FPPS1 gene expression demonstrated high levels of mRNA in both S. alba and P. graveolens with fold changes of 25.24 and 21.68, respectively. In contrast, the minimum expression levels were observed for the GPPS1 gene, with fold changes of 11.28 and 6.48 in S. alba and P. graveolens, respectively. Thus, this study offers the employment of medicinal plants as an alternative to fertilizer usage resulting in promoting environmental preservation, optimal waste utilization, reducing water consumption, and cost reduction

Bad manners in the Emergency Department: Incivility among doctors

<div><p>Introduction</p><p>Negative workplace behaviour, especially negative communication is a recognised problem in many organisations and is known to have serious impact on workplace performance, productivity and personal wellbeing. Emergency Departments (ED) can be high stress environments in which communication and perceptions of respect between physicians and other staff may underlie individual functioning. We conducted a study to estimate the influence of incivility (ICV) among physicians in the ED.</p><p>Methods</p><p>We developed an online survey to assess workplace incivility in the ED. We focussed on frequency, origin, reasons and situations where ICV was reported. To measure the levels and the potential influence of ICV on psychological safety, social stress and personal wellbeing we correlated our questionnaire to standard psychological scales. Statistical analysis included Students t-test, chi squared distribution and Pearson correlation coefficient.</p><p>Results</p><p>We invited all seventy-seven ED physicians to participate in our survey. Among those that completed (n = 50, 65%) the survey, 9% of ED physicians reported frequent (1/week) and 38% occasional (1/month) incidents of ICV. 28% of physicians reported experiencing ICV once per quarter and 21% reported a frequency of only once per year, no physician reported ICV on a daily basis. Levels of ICV were significantly higher in interactions with specialists from outside then within the ED (<i>p</i><0.01).</p><p>ICV was perceived particularly during critical situations. Our findings showed a significant correlation between internal (within the ED team) ICV and psychological safety. To ED physicians internal ICV was associated with lower levels of psychological safety (<i>p</i><0.01). ICV displayed from sources outside the ED team was not associated with psychological safety, but we found a significant influence of external ICV on personal irritability and reduced wellbeing (<i>p</i><0.01).</p><p>Discussion</p><p>The incidence of incivility was high among the ED physicians. Although this was a small sample, the association between workplace ICV and psychological safety, personal irritation as well personal comfort suggests that ICV may be an important variable underlying ED team performance. These findings further underscore the need to foster a culture of respect and good communication between departments, as levels of ICV were highest with physicians from outside the ED. Future research would benefit from examining strategies to prevent and reduce ICV and identify reasons for personal variation in perception of ICV. During critical situations and in general collaboration with specialists, awareness of ICV and countermeasures are important to avoid decreased performance and negative impact on staff and patient.</p></div

Quality of communication compared inside and outside the ED team.

Quality of communication compared inside and outside the ED team.</p

Mimickers of novel coronavirus disease 2019 (COVID-19) on chest CT: spectrum of CT and clinical features

AbstractCOVID-19 (coronavirus disease 2019) is a recently emerged pulmonary infection caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2). It started in Wuhan, China, in December 2019 and led to a highly contagious disease. Since then COVID-19 continues to spread, causing exponential morbidity and mortality and threatening economies worldwide. While the primary diagnostic test for COVID-19 is the reverse transcriptase–polymerase chain reaction (RT-PCR) assay, chest CT has proven to be a diagnostic tool of high sensitivity. A variety of conditions demonstrates CT features that are difficult to differentiate from COVID-19 rendering CT to be of low specificity. Radiologists and physicians should be aware of imaging patterns of these conditions to prevent an erroneous diagnosis that could adversely influence management and patients’ outcome. Our purpose is to provide a practical review of the conditions that mimic COVID-19. A brief description of the forementioned clinical conditions with their CT features will be included. </jats:p

Subjective interpretation of perceived ICV.

<p>(n = 106, multiple answers possible).</p

Perceived intensity of ICV after Cortina et al.[15] comparing inside and outside the ED team.

<p>We asked the physicians how often they perceived the following within the last year, range: 1 = low to 6 = high (n = 47 no answer = 3), *(<i>p</i><0.01).</p