The ISMRM Open Science Initiative for Perfusion Imaging (OSIPI): Results from the OSIPI-Dynamic Contrast-Enhanced challenge

PURPOSE

K trans $$ {K}^{\mathrm{trans}} $$ has often been proposed as a quantitative imaging biomarker for diagnosis, prognosis, and treatment response assessment for various tumors. None of the many software tools forK trans $$ {K}^{\mathrm{trans}} $$ quantification are standardized. The ISMRM Open Science Initiative for Perfusion Imaging-Dynamic Contrast-Enhanced (OSIPI-DCE) challenge was designed to benchmark methods to better help the efforts to standardizeK trans $$ {K}^{\mathrm{trans}} $$ measurement.

METHODS

A framework was created to evaluateK trans $$ {K}^{\mathrm{trans}} $$ values produced by DCE-MRI analysis pipelines to enable benchmarking. The perfusion MRI community was invited to apply their pipelines forK trans $$ {K}^{\mathrm{trans}} $$ quantification in glioblastoma from clinical and synthetic patients. Submissions were required to include the entrants'K trans $$ {K}^{\mathrm{trans}} $$ values, the applied software, and a standard operating procedure. These were evaluated using the proposedOSIP I gold $$ \mathrm{OSIP}{\mathrm{I}}_{\mathrm{gold}} $$ score defined with accuracy, repeatability, and reproducibility components.

RESULTS

Across the 10 received submissions, theOSIP I gold $$ \mathrm{OSIP}{\mathrm{I}}_{\mathrm{gold}} $$ score ranged from 28% to 78% with a 59% median. The accuracy, repeatability, and reproducibility scores ranged from 0.54 to 0.92, 0.64 to 0.86, and 0.65 to 1.00, respectively (0-1 = lowest-highest). Manual arterial input function selection markedly affected the reproducibility and showed greater variability inK trans $$ {K}^{\mathrm{trans}} $$ analysis than automated methods. Furthermore, provision of a detailed standard operating procedure was critical for higher reproducibility.

CONCLUSIONS

This study reports results from the OSIPI-DCE challenge and highlights the high inter-software variability withinK trans $$ {K}^{\mathrm{trans}} $$ estimation, providing a framework for ongoing benchmarking against the scores presented. Through this challenge, the participating teams were ranked based on the performance of their software tools in the particular setting of this challenge. In a real-world clinical setting, many of these tools may perform differently with different benchmarking methodology.

A community-endorsed open-source lexicon for contrast agent-based perfusion MRI: A consensus guidelines report from the ISMRM Open Science Initiative for Perfusion Imaging (OSIPI)

This manuscript describes the ISMRM OSIPI (Open Science Initiative for Perfusion Imaging) lexicon for dynamic contrast-enhanced and dynamic susceptibility-contrast MRI. The lexicon was developed by Taskforce 4.2 of OSIPI to provide standardized definitions of commonly used quantities, models, and analysis processes with the aim of reducing reporting variability. The taskforce was established in February 2020 and consists of medical physicists, engineers, clinicians, data and computer scientists, and DICOM (Digital Imaging and Communications in Medicine) standard experts. Members of the taskforce collaborated via a slack channel and quarterly virtual meetings. Members participated by defining lexicon items and reporting formats that were reviewed by at least two other members of the taskforce. Version 1.0.0 of the lexicon was subject to open review from the wider perfusion imaging community between January and March 2022, and endorsed by the Perfusion Study Group of the ISMRM in the summer of 2022. The initial scope of the lexicon was set by the taskforce and defined such that it contained a basic set of quantities, processes, and models to enable users to report an end-to-end analysis pipeline including kinetic model fitting. We also provide guidance on how to easily incorporate lexicon items and definitions into free-text descriptions (e.g., in manuscripts and other documentation) and introduce an XML-based pipeline encoding format to encode analyses using lexicon definitions in standardized and extensible machine-readable code. The lexicon is designed to be open-source and extendable, enabling ongoing expansion of its content. We hope that widespread adoption of lexicon terminology and reporting formats described herein will increase reproducibility within the field.

Contrast-agent-based perfusion MRI code repository and testing framework: ISMRM Open Science Initiative for Perfusion Imaging (OSIPI)

PURPOSE

Software has a substantial impact on quantitative perfusion MRI values. The lack of generally accepted implementations, code sharing and transparent testing reduces reproducibility, hindering the use of perfusion MRI in clinical trials. To address these issues, the ISMRM Open Science Initiative for Perfusion Imaging (OSIPI) aimed to establish a community-led, centralized repository for sharing open-source code for processing contrast-based perfusion imaging, incorporating an open-source testing framework.

METHODS

A repository was established on the OSIPI GitHub website. Python was chosen as the target software language. Calls for code contributions were made to OSIPI members, the ISMRM Perfusion Study Group, and publicly via OSIPI websites. An automated unit-testing framework was implemented to evaluate the output of code contributions, including visual representation of the results.

RESULTS

The repository hosts 86 implementations of perfusion processing steps contributed by 12 individuals or teams. These cover all core aspects of DCE- and DSC-MRI processing, including multiple implementations of the same functionality. Tests were developed for 52 implementations, covering five analysis steps. For T1 mapping, signal-to-concentration conversion and population AIF functions, different implementations resulted in near-identical output values. For the five pharmacokinetic models tested (Tofts, extended Tofts-Kety, Patlak, two-compartment exchange, and two-compartment uptake), differences in output parameters were observed between contributions.

CONCLUSIONS

The OSIPI DCE-DSC code repository represents a novel community-led model for code sharing and testing. The repository facilitates the re-use of existing code and the benchmarking of new code, promoting enhanced reproducibility in quantitative perfusion imaging.

Fostering innovation and sustainable thinking in surgery: an evaluation of a surgical hackathon

INTRODUCTION

Surgery represents a major source of carbon emissions, with numerous initiatives promoting more sustainable practices. Healthcare innovation and the development of a digitally capable workforce are fundamental in leveraging technologies to tackle challenges, including sustainability in surgery.

METHODS

A surgical hackathon was organised with three major themes: (1) how to make surgery greener, (2) the future of plastic surgery in 10 years, and (3) improving healthcare outcomes using machine learning. Lectures were given on sustainability and innovation using the problem, innovation, market size, strategy and team (PIMST) framework to support their presentations, as well as technological support to translate ideas into simulations or minimum viable products. Pre- and post-event questionnaires were circulated to participants.

RESULTS

Most attendees were medical students (65%), although doctors and engineers were also present. There was a significant increase in delegates' confidence in approaching innovation in surgery (+20%, p < 0.001). Reducing waste packaging (70%), promoting recyclable material usage (56%) and the social media dimension of public perceptions towards plastic surgery (40%) were reported as the most important issues arising from the hackathon. The top three prizes went to initiatives promoting an artificial intelligence-enhanced operative pathway, instrument sterilisation and an educational platform to teach students research and innovation skills.

CONCLUSIONS

Surgical hackathons can result in significant improvements in confidence in approaching innovation, as well as raising awareness of important healthcare challenges. Future innovation events may build on this to continue to empower the future workforce to leverage technologies to tackle healthcare challenges such as sustainability.

First Measurement Using Elliptically Polarized Photons of the Double-Polarization Observable E for γp→pπ^{0} and γp→nπ^{+}

We report the measurement of the helicity asymmetry E for the pπ^{0} and nπ^{+} final states using, for the first time, an elliptically polarized photon beam in combination with a longitudinally polarized target at the Crystal Ball experiment at MAMI. The results agree very well with data that were taken with a circularly polarized photon beam, showing that it is possible to simultaneously measure polarization observables that require linearly (e.g., G) and circularly polarized photons (e.g., E) and a longitudinally polarized target. The new data cover a photon energy range 270-1400 MeV for the pπ^{0} final state (230-842 MeV for the nπ^{+} final state) and the full range of pion polar angles, θ, providing the most precise measurement of the observable E. A moment analysis gives a clear observation of the pη cusp in the pπ^{0} final state.

Motion artifact correction in cardiac CT using cross-phase temporospatial information and synergistic attention gate and spatial transformer sub-networks

Objectives.To improve quality of coronary CT angiography (CCTA) images using a generalizable motion-correction algorithm.Approach. A neural network with attention gate and spatial transformer (ATOM) was developed to correct coronary motion. Phantom and patient CCTA images (39 males, 32 females, age range 19-92, scan date 02/2020 to 10/2021) retrospectively collected from dual-source CT were used to create training, development, and testing sets corresponding to 140- and 75 ms temporal resolution, with 75 ms images as labels. To test generalizability, ATOM was deployed for locally adaptive motion-correction in both 140- and 75 ms patient images. Objective metrics were used to assess motion-corrupted and corrected phantom and patient images, including structural-similarity-index (SSIM), dice-similarity-coefficient (DSC), peak-signal-noise-ratio (PSNR), and normalized root-mean-square-error (NRMSE). In objective quality assessment, ATOM was compared with several baseline networks, including U-net, U-net plus attention gate, U-net plus spatial transformer, VDSR, and ResNet. Two cardiac radiologists independently interpreted motion-corrupted and -corrected images at 75 and 140 ms in a blinded fashion and ranked diagnostic image quality (worst to best: 1-4, no ties).Main results. ATOM improved quality metrics (p< 0.05) before/after correction: in phantom, SSIM 0.87/0.95, DSC 0.85/0.93, PSNR 19.4/22.5, NRMSE 0.38/0.27; in patient images, SSIM 0.82/0.88, DSC 0.88/0.90, PSNR 30.0/32.0, NRMSE 0.16/0.12. ATOM provided more consistent improvement of objective image quality, compared to the presented baseline networks. The motion-corrected images received better ranks than un-corrected at the same temporal resolution (p< 0.05): 140 ms images 1.65/2.25, and 75 ms images 3.1/3.2. The motion-corrected 75 ms images received the best rank in 65% of testing cases. A fair-to-good inter-reader agreement was observed (Kappa score 0.58).Significance. ATOM reduces motion artifacts, improving visualization of coronary arteries. This algorithm can be used to virtually improve temporal resolution in both single- and dual-source CT.

Locally Low-Rank Denoising of Multi-Echo Functional MRI Data With Application in Resting-State Analysis

OBJECTIVES

Locally low-rank (LLR) denoising of functional magnetic resonance imaging (fMRI) time series image data is extended to multi-echo (ME) data. The proposed method extends the capabilities of non-physiologic noise suppression beyond single-echo applications with a dedicated ME algorithm.

MATERIALS AND METHODS

Following an institutional review board (IRB) approved protocol, resting-state fMRI data were acquired in 7 healthy subjects. A compact 3T scanner enabled whole-brain acquisition of multiband ME fMRI data at high spatial resolution (1.4 × 1.4 × 2.8 mm 3 ) with a 1810 ms repetition time (TR). Image data were denoised with ME-LLR preceding functional processing. The results of connectivity maps generated from denoised data were compared with maps generated with equivalent processing of non-denoised images. To assess ME-LLR as a method to reduce scan time, comparisons were made between maps computed from image data with full and retrospectively truncated durations. Assessments were completed with seed-based connectivity analyses using echo-combined image data. In a feasibility assessment, nondenoised and denoised full-duration echo-combined data were equivalently processed with independent component analysis (ICA) and compared.

RESULTS

ME-LLR denoising yielded strengthened resting-state network connectivity maps after nuisance regression and seed-based connectivity analysis. In assessing ME-LLR as a scan reduction mechanism, maps generated from denoised data at half scan time showed comparable quality with maps generated from full-duration, non-denoised data, at both single subject and group levels. ME-LLR substantially increased temporal signal-to-noise ratio (tSNR) for image data respective to each individual echo and for image data after nuisance regression. Among echo-specific image volumes, increases in tSNR yielded by ME-LLR were most pronounced for image data with the longest echo time and thereby lowest SNR. ICA showed resting-state networks consistently identified between non-denoised and denoised data, with clearer demarcation of networks for ME-LLR.

CONCLUSIONS

ME-LLR is demonstrated to suppress non-physiologic noise, enhance functional connectivity map quality, and could potentially facilitate scan time reduction in ME-fMRI.

High-Pitch Multienergy Coronary CT Angiography in Dual-Source Photon-Counting Detector CT Scanner at Low Iodinated Contrast Dose

OBJECTIVES

The aim of this study was to evaluate the high-helical pitch, multienergy (ME) scanning mode of a clinical dual-source photon-counting detector (PCD) computed tomography (CT) and the benefit of virtual monoenergetic images (VMIs) for low-contrast-dose coronary CT angiography (CTA).

MATERIALS AND METHODS

High-pitch (3.2) ME coronary CTA was performed in PCD-CT in 27 patients using low contrast dose (30 mL of iohexol 350 mg/mL) and in 26 patients at routine contrast dose (60 mL). Low-energy-threshold 120 kV images (also known as T3D images) and 50 kiloelectron volts (50 keV) and 100 kiloelectron volts (100 keV) VMIs were reconstructed using a 1024 × 1024 matrix and 0.6-mm slices. The CT numbers, noise, and contrast-to-noise ratio (CNR) were measured in the ascending aorta (AA), left main coronary artery (LMCA), and distal left anterior descending (LAD) artery. Confidence in grading luminal stenosis with calcific plaque, noncalcific plaque, and stent was evaluated by 2 independent readers on a 0-100 scale (0 the lowest), and a CAD-RADS score was assigned. Image contrast enhancement, sharpness, noise, artifacts, and overall image quality were rated using a 5-point ordinal scale (1 the lowest).

RESULTS

The radiation doses (CTDI) in low- and routine-contrast cohorts were 2.5 ± 0.6 mGy and 3.1 ± 1.7 mGy, respectively ( P = 0.12). At all measured locations, the mean CT number was >300 HU in 120 kV (LMCA 382.9 ± 76.2, distal LAD 341.0 ± 53.9, AA 399.5 ± 76.1) and 50 keV images (LMCA 667.5 ± 139.9, distal LAD 578.1 ± 121.5, AA 700.8 ± 142.5) in the low-contrast cohort, with a 96% increase in CT numbers for 50 keV over 120 kV. The CT numbers were significantly higher ( P < 0.0001) in 50 keV than 120 kV and 100 keV VMI. The CNR was also significantly ( P < 0.0001) higher in 50 keV than 120 kV and 100 keV images in all vessels. Confidence in the assessment of luminal stenosis in the presence of calcific plaque was significantly higher ( P = 0.001) with the addition of 100 keV VMI (median score, 100) than using 50 keV alone (median score, 70) and 120 kV (median score, 70) for reader 1, but no significant differences were seen for reader 2 who had same median scores of 100 for all image types. The confidence in the assessment of luminal stenosis within a stent improved with the use of 100 keV images for both readers (reader 1: median scores for 50 + 100 keV = 100, 50 keV = 82.5, 120 kV = 82.5; reader 2: 50 + 100 keV = 100, 50 keV = 90, 120 kV = 90). There were no significant differences in confidence scores for assessment of luminal stenosis from noncalcific plaques for both readers. The reader-averaged qualitative scores for vascular enhancement and overall image quality were significantly higher for 50 keV VMI than for 120 kV images in both low- and routine-contrast dose cohorts. The image sharpness was nonsignificantly higher at 50 keV VMI than 120 kV images, and the artifact score was comparable for 50 keV VMI and 120 kV images. The noise was higher in 50 keV VMI than in 120 kV images.

CONCLUSIONS

High-pitch ME PCD-CT mode produced diagnostic quality coronary CTA images at low radiation and iodinated contrast doses. The availability of ME VMIs significantly improved the CNR, overall image quality, and confidence in assessment of luminal stenosis in the presence of calcific plaques and stents, and resulted in change of CAD-RADS categories in 9 patients.

Establishing a quality assurance program for photon counting detector (PCD) CT: Tips and caveats

PURPOSE

To determine the suitability of a quality assurance (QA) program based on the American College of Radiology's (ACR) CT quality control (QC) manual to fully evaluate the unique capabilities of a clinical photon-counting-detector (PCD) CT system.

METHODS

A daily QA program was established to evaluate CT number accuracy and artifacts for both standard and ultra-high-resolution (UHR) scan modes. A complete system performance evaluation was conducted in accordance with the ACR CT QC manual by scanning the CT Accreditation Phantom with routine clinical protocols and reconstructing low-energy-threshold (T3D) and virtual monoenergetic images (VMIs) between 40 and 120 keV. Spatial resolution was evaluated by computing the modulation transfer function (MTF) for the UHR mode, and multi-energy performance was evaluated by scanning a body phantom containing four iodine inserts with concentrations between 2 and 15 mg I/cc.

RESULTS

The daily QA program identified instances when the detector needed recalibration or replacement. CT number accuracy was impacted by image type: CT numbers at 70 keV VMI were within the acceptable range (defined for 120 kV). Other keV VMIs and the T3D reconstruction had at least one insert with CT number outside the acceptable range. The limiting resolution was nearly 40 lp/cm based on MTF measurements, which far exceeds the 12 lp/cm maximum capability of the ACR phantom. The CT numbers in the iodine inserts were accurate on all VMIs (3.8% average percentage error), while the iodine concentrations had an average root mean squared error of 0.3 mg I/cc.

CONCLUSION

Protocols and parameters must be properly selected on PCD-CT to meet current accreditation requirements with the ACR CT phantom. Use of the 70 keV VMI allowed passing all tests prescribed in the ACR CT manual. Additional evaluations such an MTF measurement and multi-energy phantom scans are also recommended to comprehensively evaluate PCD-CT scanner performance.

Improved Resting-State Functional MRI Using Multi-Echo Echo-Planar Imaging on a Compact 3T MRI Scanner with High-Performance Gradients

In blood-oxygen-level-dependent (BOLD)-based resting-state functional (RS-fMRI) studies, usage of multi-echo echo-planar-imaging (ME-EPI) is limited due to unacceptable late echo times when high spatial resolution is used. Equipped with high-performance gradients, the compact 3T MRI system (C3T) enables a three-echo whole-brain ME-EPI protocol with smaller than 2.5 mm isotropic voxel and shorter than 1 s repetition time, as required in landmark fMRI studies. The performance of the ME-EPI was comprehensively evaluated with signal variance reduction and region-of-interest-, seed- and independent-component-analysis-based functional connectivity analyses and compared with a counterpart of single-echo EPI with the shortest TR possible. Through the multi-echo combination, the thermal noise level is reduced. Functional connectivity, as well as signal intensity, are recovered in the medial orbital sulcus and anterior transverse collateral sulcus in ME-EPI. It is demonstrated that ME-EPI provides superior sensitivity and accuracy for detecting functional connectivity and/or brain networks in comparison with single-echo EPI. In conclusion, the high-performance gradient enabled high-spatial-temporal resolution ME-EPI would be the method of choice for RS-fMRI study on the C3T.

High-pitch, high temporal resolution, multi-energy cardiac imaging on a dual-source photon-counting-detector CT

OBJECTIVE

To measure the accuracy of material decomposition using a dual-source photon-counting-detector (DS-PCD) CT operated in the high-pitch helical scanning mode and compare the results against dual-source energy-integrating-detector (DS-EID) CT, which requires use of a low-pitch value in dual-energy mode.

METHODS

A DS-PCD CT and a DS-EID CT were used to scan a cardiac motion phantom consisting of a 3-mm diameter iodine cylinder. Iodine maps were reconstructed using DS-PCD in high-pitch mode and DS-EID in low-pitch mode. Image-based circularity, diameter, and iodine concentration of the iodine cylinder were calculated and compared between the two scanners. With institutional review board approval, in vivo exams were performed with the DS-PCD CT in high-pitch mode. Images were qualitatively compared against patients with similar heart rates that were scanned with DS-EID CT in low-pitch dual-energy mode.

RESULTS

On iodine maps, the mean circularity was 0.97 ± 0.02 with DS-PCD in high-pitch mode and 0.95 ± 0.06 with DS-EID in low-pitch mode. The mean diameter was 2.9 ± 0.2 mm with DS-PCD and 3.1 ± 0.2 mm with DS-EID, both of which are close to the 3 mm ground truth. For DS-PCD, the mean iodine concentration was 9.6 ± 0.8 mg/ml and this was consistent with the 9.4 ± 0.6 mg/ml value obtained with the cardiac motion disabled. For DS-EID, the concentration was 12.7 ± 1.2 mg/ml with motion enabled and 11.7 ± 0.5 mg/ml disabled. The background noise in the iodine maps was 15.1 HU with DS-PCD and 14.4 HU with DS-EID, whereas the volume CT dose index (CTDIvol ) was 3 mGy with DS-PCD and 11 mGy with DS-EID. On comparison of six patients (three on PCD, three on EID) with similar heart rates, DS-PCD provided iodine maps with well-defined coronaries even at a high heart rate of 86 beats per minute. Meanwhile, there were substantial motion artifacts in iodine maps obtained with DS-EID for patients with similar heart rates.

CONCLUSION

In a cardiac motion phantom, DS-PCD CT can perform accurate material decomposition in high-pitch mode, providing iodine maps with excellent geometric accuracy and robustness to motion at approximately 38% of the dose for similar noise as DS-EID CT.

876 Veriset Haemostatic Patch, Indications, Benefits and Complications: A Systematic Review

Aim

Achieving haemostasis intraoperatively is important for minimising blood loss, complications, and operation time. Suturing, cauterisation, fibrin glues and patches are used for this purpose. We explore Veriset, a patch consisting of polyethylene glycol and oxidised cellulose, to determine and compare its safety and effectiveness.

Method

Medline, Embase, Web of Science, Scopus, Cinahl and Cochrane databases were searched. Data points collected were Study/subject characteristics/demographics, surgery/specialty, time to haemostasis, proportion of haemostasis achieved, intraoperative adverse events, post operative complications, follow up time, and biochemical/histological analysis. Risk of Bias was assessed by Newcastle-Ottawa Scale

Results

Six studies were included; four human trials (3 RCTs, 1 case series) and two animal trials.

The human trials combined had 250 patients, with 147 using Veriset. In two RCTs, Veriset showed faster time to haemostasis and higher proportion of haemostasis achieved vs suturing and Tachosil haemostatic patch. In all three RCTs, no significant differences in adverse events and complications were seen between Veriset and suturing/Tachosil. Vascular, nephrectomy and hepatic surgery were investigated.

In the animal studies, the pig trial showed similar effectiveness and safety as the human trials. The rat study compared novel experimental patches to Veriset, and showed similar effectiveness to Veriset, at reduced costs.

Conclusions

Although current literature is scarce, Veriset is more effective than alternatives for haemostasis, with similar safety, although there are now other experimental patches that could have better health economic implications. Further clinical trials would be necessary to determine the breadth of applicable surgical fields for Veriset.

541 Pre-Operative Assessment of Patients Undergoing Elective TURBT or Rigid Cystoscopy + Bladder Biopsy: Is a Group & Save Clinically Required?

Aim

Method

Results

Conclusions

Deeply Virtual Compton Scattering Cross Section at High Bjorken x_{B}

We report high-precision measurements of the deeply virtual Compton scattering (DVCS) cross section at high values of the Bjorken variable x_{B}. DVCS is sensitive to the generalized parton distributions of the nucleon, which provide a three-dimensional description of its internal constituents. Using the exact analytic expression of the DVCS cross section for all possible polarization states of the initial and final electron and nucleon, and final state photon, we present the first experimental extraction of all four helicity-conserving Compton form factors (CFFs) of the nucleon as a function of x_{B}, while systematically including helicity flip amplitudes. In particular, the high accuracy of the present data demonstrates sensitivity to some very poorly known CFFs.

Measurement of Compton Scattering at MAMI for the Extraction of the Electric and Magnetic Polarizabilities of the Proton

A precise measurement of the differential cross sections dσ/dΩ and the linearly polarized photon beam asymmetry Σ_{3} for Compton scattering on the proton below pion threshold has been performed with a tagged photon beam and almost 4π detector at the Mainz Microtron. The incident photons were produced by the recently upgraded Glasgow-Mainz photon tagging facility and impinged on a cryogenic liquid hydrogen target, with the scattered photons detected in the Crystal Ball/TAPS setup. Using the highest statistics Compton scattering data ever measured on the proton along with two effective field theories (both covariant baryon and heavy-baryon) and one fixed-t dispersion relation model, constraining the fits with the Baldin sum rule, we have obtained the proton electric and magnetic polarizabilities with unprecedented precision: α_{E1}=10.99±0.16±0.47±0.17±0.34, β_{M1}=3.14±0.21±0.24±0.20±0.35; in units of 10^{-4}  fm^{3} where the errors are statistical, systematic, spin polarizability dependent, and model dependent.

Form Factors and Two-Photon Exchange in High-Energy Elastic Electron-Proton Scattering

We present new precision measurements of the elastic electron-proton scattering cross section for momentum transfer (Q^{2}) up to 15.75  (GeV/c)^{2}. Combined with existing data, these provide an improved extraction of the proton magnetic form factor at high Q^{2} and double the range over which a longitudinal or transverse separation of the cross section can be performed. The difference between our results and polarization data agrees with that observed at lower Q^{2} and attributed to hard two-photon exchange (TPE) effects, extending to 8  (GeV/c)^{2} the range of Q^{2} for which a discrepancy is established at >95% confidence. We use the discrepancy to quantify the size of TPE contributions needed to explain the cross section at high Q^{2}.

Characterization and optimization of ZnS thin film properties synthesis via chemical bath deposition method for solar cell buffer layer

Zinc Sulphide is one of most studied semiconductor with wide band gap (3.5–3.9 eV) versatile material due to its physical and chemical properties. ZnS is a non-toxic material and a suitable candidate to be a buffer layer for heterojunction solar cells. In this study, Zinc Sulphide (ZnS) thin films were deposited by chemical bath deposition technique using Zinc Acetate Dihydrate [Zn (CH3COO)2. 2H2O] and Thiourea [CH4N2S]. The ZnS thin films samples were characterized by UV-Vis NIR Spectroscopy, X-ray diffraction (XRD), Scanning Electron Microscopy (SEM), Energy Dispersive Spectroscopy (EDX), Fourier-Transform Infrared Spectroscopy (FTIR) and Thin-Film Measurement Instrument. FTIR spectra confirmed the presence of ZnS bond in the crystalline thin film. XRD data confirmed the cubic structure of the deposited thin film only when the amount of Thiourea was increased and the complexing agent Hydrazine Hydrate was replaced with Tri-Sodium Citrate. Crystallite size and strain were estimated using Debye-Scherrer model and Williamson-Hall model and lattice constant was estimated using Nelson-Riley plot. Otherwise, XRD showed the amorphous phase. UV-Vis data confirmed ZnS thin films as enough transmittive and it showed higher bandgap. Thin-Film Measurement Instrument was used to measure the thickness of the ZnS thin films. Synthesized ZnS thin films exhibited promising characteristics for using as the buffer layer of the heterojunction solar cells. Highlights • ZnS thin films were prepared successfully by simple, low cost and environment friendly chemical bath deposition method. • XRD measurement confirmed both Amorphous and Crystalline phase of ZnS thin films. • By changing the precursor only can be achieved crystalline phase from amorphous phase of ZnS thin film. • The amount of precursor and deposition conditions can be optimized to produce crystalline ZnS thin film.

Improving coronary artery imaging in single source CT with cardiac motion correction using attention and spatial transformer based neural networks

Motion artifact is a major challenge in cardiac CT which hampers accurate delineation of key anatomic (e.g. coronary lumen) and pathological features (e.g. stenosis). Conventional motion correction techniques are limited on patients with high / irregular heart rate, due to simplified modeling of CT systems and cardiac motion. Emerging deep learning based cardiac motion correction techniques have demonstrated the potential of further quality improvement. Yet, many methods require CT projection data or advanced motion simulation tools that are not readily available. We aim to develop an image-domain motion-correction method, using convolutional neural network (CNN) integrated with customized attention and spatial transformer techniques. Forty cardiac CT exams acquired from a clinical dual-source CT system were retrospectively collected to generate training (n=26) and testing (n=14) sets. Dual-source data uniquely allow image reconstruction with different temporal resolutions from the same patient scan. Slow temporal resolution (140ms; equivalent to single-source CT (SSCT) half scan) and fast temporal resolution (75ms; dual source) images were reconstructed to generate paired samples of motion-corrupted and reference images. The combinations of 2 training-inference strategies and 3 CNNs were evaluated: strategy #1 - whole-heart images in training / inference; strategy #2 - vessel patches in training / inference; CNN #1 - attention only; CNN #2 - spatial-transformer (STN) only; CNN #3 - attention & STN synergy. Testing data showed that CNN #3 with strategy #2 provided relatively better performance: improving vessel delineation, increasing structural similarity index from 0.85 to 0.91, and reducing mean CT number error of lumen by 71.0%. Our method could improve the image quality in cardiac exams with SSCT.

Quantitative assessment of motion effects in dual-source dual-energy CT and dual-source photon-counting detector CT

Conventional dual-source CT scanners can be used to either provide better temporal resolution or dual-energy imaging, but not both at the same time. This presents a dilemma in cardiac CT as both high temporal resolution and multi-energy imaging are desirable. The current study evaluated a dual-source photon-counting-detector (DS-PCD) CT which can acquire multi-energy images at high temporal resolution. A cardiac motion phantom with a 3-mm diameter iodinated rod, mimicking the right coronary artery, was scanned 25 times using a DS-PCD CT (66 ms resolution) and a dual-source dual-energy (DS-DE, 125 ms resolution) CT. Low/high energy images and iodine maps were reconstructed at 40% and 75% cardiac phases. To quantify the impact of motion on image quality, dice similarity coefficient was computed between the low/high energy images while the circularity and effective diameter of the iodinated rod were computed on the iodine maps. The dice coefficients were higher for DS-PCD with a mean of 0.89 and 0.91 at the 40% and 70% phases, while DS-DE had a lower mean of 0.20 and 0.78, respectively. The circularity was excellent for DS-PCD with a mean of 0.97 and 0.98 at the 40% and 75% phases, while DS-DE had a mean of 0.71 and 0.98, respectively. The effective diameter was accurate for DS-PCD with a mean of 2.9 mm (true size of 3 mm) at both phases, while DS-DE had a mean of 4.0 mm and 3.2 mm at the 40% and 75% phases, respectively. These results indicate that DS-PCD CT enables simultaneous high temporal resolution and multi-energy cardiac imaging with minimal motion artifacts.

Protocol design and preliminary evaluation of the REAL-Health Triple Aim, an open-cohort CVD-care optimisation initiative

Introduction

Effective treatment of cardiovascular disease (CVD) in primary care could be improved. We aim to assess the efficacy of a scalable treatment optimisation programme in unselected community populations in South East England, with the triple aim of improved blood pressure control in people with hypertension, increased high-intensity statin use in people with CVD and reduced gastrointestinal bleeding in patients on antithrombotic medication.

Method

This observational study comprises an open cohort of approximately 200,000 adults at high cardiovascular risk registered with general practitioners in five South East England Clinical Commissioning Groups (CCGs). An intervention programme is planned in four of these CCGs with a further non-intervention CCG acting as a control group. The intervention will consist of: clinical guidelines and educational outreach; virtual patient-reviews software; peer-performance “dashboards” and, where available, financial incentives.

The study will examine 3 primary outcomes: 1. Diagnosed hypertension with a blood pressure &lt;140/90mmHg; 2. Diagnosed CVD on a high-intensity statin; 3. A cardiovascular indication for antithrombotic therapy with one or more factors for increased risk of gastrointestinal bleeding (e.g. age ≥65) on gastroprotection. A further 17 secondary outcomes related to these three aims will be assessed.

Analysis

We will use an interrupted time series analysis over 18 months, representing the pre-implementation, implementation and the post-implementation phases with comparison to the control CCG and applicable national Quality and Outcomes Framework and national prescribing statistics (e.g. OpenPrescribing). Secondary outcomes include an equity impact analysis with results stratified by age, gender, ethnic group and index of deprivation.

Preliminary data

We present preliminary data on Key Performance Indicators (KPIs) collected from 191 GP practices including [percentage achievement on 01/09/2019, on 01/09/2020]: 1. Patients with hypertension and most recent blood pressure ≤140/90mmHg [68.7%, 60.6%]. 2. Patients eligible for treatment with a high-intensity statin on such treatment [53.8%, 55.8%]. 3. Patients on antithrombotics with ≥1 risk factors for gastrointestinal bleeding on gastroprotection [59.0%, 60.1%]. We also present our virtual patient-review software tool and outcome visualisation dashboard.

Conclusion

The REAL-Health Triple Aim initiative is a large-scale primary care cardiovascular risk reduction initiative which was launched almost contemporaneously with the United Kingdom's first SARS-CoV-2 related lockdown. Preliminary data justify the need for the Triple Aim initiative and give us an insight on the impact of the pandemic on its implementation.

Funding Acknowledgement

Type of funding sources: Other. Main funding source(s): Barts CharityBritish Heart Foundation

Deep Exclusive Electroproduction of π^{0} at High Q^{2} in the Quark Valence Regime

We report measurements of the exclusive neutral pion electroproduction cross section off protons at large values of x_{B} (0.36, 0.48, and 0.60) and Q^{2} (3.1 to 8.4  GeV^{2}) obtained from Jefferson Lab Hall A experiment E12-06-014. The corresponding structure functions dσ_{T}/dt+εdσ_{L}/dt, dσ_{TT}/dt, dσ_{LT}/dt, and dσ_{LT^{'}}/dt are extracted as a function of the proton momentum transfer t-t_{min}. The results suggest the amplitude for transversely polarized virtual photons continues to dominate the cross section throughout this kinematic range. The data are well described by calculations based on transversity generalized parton distributions coupled to a helicity flip distribution amplitude of the pion, thus providing a unique way to probe the structure of the nucleon.

Improved Constraints on Primordial Gravitational Waves using Planck, WMAP, and BICEP/Keck Observations through the 2018 Observing Season

We present results from an analysis of all data taken by the BICEP2, Keck Array, and BICEP3 CMB polarization experiments up to and including the 2018 observing season. We add additional Keck Array observations at 220 GHz and BICEP3 observations at 95 GHz to the previous 95/150/220  GHz dataset. The Q/U maps now reach depths of 2.8, 2.8, and 8.8  μK_{CMB} arcmin at 95, 150, and 220 GHz, respectively, over an effective area of ≈600 square degrees at 95 GHz and ≈400 square degrees at 150 and 220 GHz. The 220 GHz maps now achieve a signal-to-noise ratio on polarized dust emission exceeding that of Planck at 353 GHz. We take auto- and cross-spectra between these maps and publicly available WMAP and Planck maps at frequencies from 23 to 353 GHz and evaluate the joint likelihood of the spectra versus a multicomponent model of lensed ΛCDM+r+dust+synchrotron+noise. The foreground model has seven parameters, and no longer requires a prior on the frequency spectral index of the dust emission taken from measurements on other regions of the sky. This model is an adequate description of the data at the current noise levels. The likelihood analysis yields the constraint r_{0.05}<0.036 at 95% confidence. Running maximum likelihood search on simulations we obtain unbiased results and find that σ(r)=0.009. These are the strongest constraints to date on primordial gravitational waves.

Protective effects of vitexin on cadmium-induced renal toxicity in rats

Cadmium (Cd) is an industrial contaminant that poses severe threats to human and animal health. Vitexin (VIT) is a polyphenolic flavonoid of characteristic pharmacological properties. We explored the curative role of vitexin on Cd-induced mitochondrial-dysfunction in rat renal tissues. Twenty-four rats were equally divided into four groups and designated as control, Cd, Cd + vitexin and vitexin treated groups. The results showed that Cd exposure increased urea and creatinine levels while decreased creatinine clearance. Cd reduced the activities of antioxidant enzymes, i.e., catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione content in the Cd exposed group. Cd exposure significantly (p < 0.05) elevated the reactive oxygen species (ROS) and Thiobarbituric acid reactive substances (TBARS) levels in rat kidney. Cd also caused a significant (p < 0.05) reduction in the mitochondrial TCA-cycle enzymes, including isocitrate dehydrogenase, succinate dehydrogenase, alpha-ketoglutarate dehydrogenase, and malate-dehydrogenase activities. Besides, mitochondrial respiratory chain enzymes, including NADH-dehydrogenase, coenzyme Q-cytochrome reductase, succinic-coenzyme Q, and cytochrome c-oxidase activities were also decreased under Cd exposure. Cd exposure also damaged the mitochondrial membrane potential (MMP). However, VIT treatment potentially reduced the detrimental effects of Cd in the kidney of rats. In conclusion, our study indicated that the VIT could attenuate the Cd-induced renal toxicity in rats.

Mitigation of cisplatin induced nephrotoxicity by casticin in male albino rats

Cisplatin (CP) is a commonly used, powerful antineoplastic drug, having numerous side effects. Casticin (CAS) is considered as a free radical scavenger and a potent antioxidant. The present research was planned to assess the curative potential of CAS on CP persuaded renal injury in male albino rats. Twenty four male albino rats were distributed into four equal groups. Group-1 was considered as a control group. Animals of Group-2 were injected with 5mg/kg of CP intraperitoneally. Group-3 was co-treated with CAS (50mg/kg) orally and injection of CP (5mg/kg). Group-4 was treated with CAS (50mg/kg) orally throughout the experiment. CP administration substantially reduced the activities of catalase (CAT), superoxide dismutase (SOD), peroxidase (POD), glutathione S-transferase (GST), glutathione reductase (GSR), glutathione (GSH) content while increased thiobarbituric acid reactive substances (TBARS), and hydrogen peroxide (H2O2) levels. Urea, urinary creatinine, urobilinogen, urinary proteins, kidney injury molecule-1 (KIM-1), and neutrophil gelatinase-associated lipocalin (NGAL) levels were substantially increased. In contrast, albumin and creatinine clearance was significantly reduced in CP treated group. The results demonstrated that CP significantly increased the inflammation indicators including nuclear factor kappa-B (NF-κB), tumor necrosis factor-α (TNF-α), Interleukin-1β (IL-1β), Interleukin-6 (IL-6) levels and cyclooxygenase-2 (COX-2) activity and histopathological damages. However, the administration of CAS displayed a palliative effect against CP-generated renal toxicity and recovered all parameters by bringing them to a normal level. These results revealed that the CAS is an effective compound having the curative potential to counter the CP-induced renal damage.

Toxicological effects of thimerosal on rat kidney: a histological and biochemical study

Thimerosal is an organomercurial compound, which is used in the preparation of intramuscular immunoglobulin, antivenoms, tattoo inks, skin test antigens, nasal products, ophthalmic drops, and vaccines as a preservative. In most of animal species and humans, the kidney is one of the main sites for mercurial compounds deposition and target organs for toxicity. So, the current research was intended to assess the thimerosal induced nephrotoxicity in male rats. Twenty-four adult male albino rats were categorized into four groups. The first group was a control group. Rats of Group-II, Group-III, and Group-IV were administered with 0.5µg/kg, 10µg/kg, and 50µg/kg of thimerosal once a day, respectively. Thimerosal administration significantly decreased the activities of catalase (CAT), superoxide dismutase (SOD), peroxidase (POD), glutathione reductase (GR), glutathione (GSH), and protein content while increased the thiobarbituric acid reactive substances (TBARS) and hydrogen peroxide (H2O2) levels dose-dependently. Blood urea nitrogen (BUN), creatinine, urobilinogen, urinary proteins, kidney injury molecule-1 (KIM-1), and neutrophil gelatinase-associated lipocalin (NGAL) levels were substantially increased. In contrast, urinary albumin and creatinine clearance was reduced dose-dependently in thimerosal treated groups. The results demonstrated that thimerosal significantly increased the inflammation indicators including nuclear factor kappaB (NF-κB), tumor necrosis factor-α (TNF-α), Interleukin-1β (IL-1β), Interleukin-6 (IL-6) levels and cyclooxygenase-2 (COX-2) activities, DNA and histopathological damages dose-dependently. So, the present findings ascertained that thimerosal exerted nephrotoxicity in male albino rats.

Molecular Phylogenetics of Physa acuta (Pulmonata: Basommatophora): an Invasive species in Central Punjab Pakistan

Physids belong to Class Gastropoda; belong to Phylum Mollusca and being bioindicators, intermediate hosts of parasites and pests hold a key position in the ecosystem. There are three species of Genus Physa i.e. P. fontinalis, Physa acuta and P. gyrina water bodies of Central Punjab and were characterized on the basis of molecular markers High level of genetic diversity was revealed by polymorphic RAPD, however SSR markers were not amplified. The multivariate analysis revealed polymorphism ranging from 9.09 percent to 50 percent among the three Physid species. Total number of 79 loci were observed for the three species under study and 24 loci were observed to be polymorphic. These RAPD fragment(s) can be developed into co dominant markers (SCAR) by cloning and can be further sequenced for the development of the Physa species specific markers to identify the introduced and native species in Pakistan.

Characterization of the species of genus Physa on the basis of typological species concept from Central Punjab

Physids belong to Class Gastropoda; Phylum Mollusca have important position in food web and act as bio indicators, pests and intermediate host. Being resistant these are called cockroaches of malacology. Physid snails were collected from different water bodies of Faisalabad (Punjab) and were identified up to species using morphological markers. The morphometry of the specimens was carried out with the help of a digital Vernier caliper in millimeters (mm) using linear measurement of shell characters. Linear regression analysis of the AL/SW ratio vs AL and SL/SW ratio vs AL indicated that allometric growth exists only in Physa acuta when compared with P.gyrina and P. fontinalis. This study will lead to assess the status of the Physid species in Central Punjab. The Principal component analysis shows that the Component 1 (Shell Length) and component 2 (Shell Width) are the most prolific components and nearly 80 percent of the identification. The distance between P. acuta and P. fontinalis is 5.4699, P. acuta and P. gyrina is 7.6411, P. fontinalis and P. gyrina is 16.6080 showing that P. acuta resembles with P. fontinalis, and both these specimens donot resemble with P. gyrina. P.acuta is an invasive species and shows bioactivity making it a potent candidate for bioactive substances.

Single π 0 production off neutrons bound in deuteron with linearly polarized photons

The quasifree γ → d → π 0 n ( p ) photon beam asymmetry, Σ , has been measured at photon energies, E γ , from 390 to 610 MeV, corresponding to center of mass energy from 1.271 to 1.424 GeV, for the first time. The data were collected in the A2 hall of the MAMI electron beam facility with the Crystal Ball and TAPS calorimeters covering pion center-of-mass angles from 49 ∘ to 148 ∘ . In this kinematic region, polarization observables are sensitive to contributions from the Δ ( 1232 ) and N(1440) resonances. The extracted values of Σ have been compared to predictions based on partial-wave analyses (PWAs) of the existing pion photoproduction database. Our comparison includes the SAID, MAID and Bonn-Gatchina analyses; while a revised SAID fit, including the new Σ measurements, has also been performed. In addition, isospin symmetry is examined as a way to predict π 0 n photoproduction observables, based on fits to published data in the channels π 0 p , π + n and π - p .

Seasonal analysis of food items and feeding habits of endangered riverine catfish Rita rita (Hamilton, 1822)

This investigation presents the food and feeding activity of and endangered riverine catfish Rita rita, during February 2017-January 2018. A total of 225 fish individuals was analyzed for stomach contents by characterizing the dominant food items and morphometric features. The results divulged ten major food items consumed, preferably fish scales and eggs, teleost fishes, copepods, cladocerans, rotifers, and mollusks. Total length and body weight of fish varied between 9-34 cm (20.53 ± 6.90 cm) and 10-400 g (9125.94 ± 102.07 g), respectively. The index of relative importance (IRI%) showed the importance of rotifers over the other food items. Morisita's index of diet overlap indicated seasonal variations in catfish diets with summer and monsoon displaying the least overlap, while maximum overlap during monsoon and winter seasons. The non-metric multidimensional scaling (nMDS) indicated the close association between the food items available during summer and winter seasons with a significant difference among the seasons (ANOSIM, R = 0.638, P = 0.013). Levin's niche breadth index arranged in the order of 0.88>0.81>0.78>0.63>0.43 for the size classes of V, IV, III, II and I, respectively. The PCA explained 95.39% of the total variance among the food items and fish size groups. Small-sized fish individuals displayed a greater correlation with food items suitable for their mouth size. In conclusion, the variety and frequency of food items recorded indicated considerable feeding plasticity and opportunistic feeding behavior with a shift from carnivorous to omnivorous feeding nature. This study could render useful information on the food and feeding habits of R. rita and provide background for preparing its diet for future aquaculture practices.

Growth performance, intestinal histomorphology, gut microflora and ghrelin gene expression analysis of broiler by supplementing natural growth promoters: A nutrigenomics approach

In an epoch of escalating number of antibiotic-resistance bacteria, there is a dire need to develop efficient and novel feeding strategies for animal nutrition as alternatives to antibiotics. Here, implicating nutrigenomic approach, phytobiotics and organic acids were used to evaluate ghrelin gene expression levels, gut microflora composition, performance parameters and intestinal histomorphological changes in broiler chickens. One-day-old chicks (n = 315) were reared for 42 days and distributed randomly into five experimental groups; each with three replicates (21 birds per replicate). Experimental groups were control: basal diet only, antimicrobial growth promoter: 40 g/metric ton of basal diet (virginiamycin), organic acids: 4 kg/metric ton of basal diet, phytobiotics: 3 kg/metric ton of basal diet, combination: 7 kg/metric ton of basal diet (organic acids 4 kg and phytobiotics 3 kg metric ton of feed). Growth performance, histological and ghrelin gene expression analysis were executed on 21 and 42 days while, quantitative bacterial analysis of cecum and ileum was performed on day 42. Increased feed intake and body weight (p < 0.05) were noticed in phytobiotics group. Addition of phytobiotics significantly improved (p < 0.05) villus height and ratio of villus height/crypt depth in ileum, jejunum, and duodenum and down-regulated ghrelin gene expression levels. Total coliform and Escherichia coli in cecal and ileal digesta were decreased significantly (p < 0.05) in organic acids group. Correlation analysis revealed Lactobacillus spp. were positively correlated to villus height/crypt depth ration in duodenum. The findings indicated the importance of gene-nutrient-microbiota interactions based on nutrigenomics approach. Hence, phytobiotics and organic acids might be suitable alternatives to antibiotics for improved performance and immunity, along with healthier meat production in poultry.

"Real-world" radiomics from multi-vendor MRI: an original retrospective study on the prediction of nodal status and disease survival in breast cancer, as an exemplar to promote discussion of the wider issues

BACKGROUND

Most MRI radiomics studies to date, even multi-centre ones, have used "pure" datasets deliberately accrued from single-vendor, single-field-strength scanners. This does not reflect aspirations for the ultimate generalisability of AI models. We therefore investigated the development of a radiomics signature from heterogeneous data originating on six different imaging platforms, for a breast cancer exemplar, in order to provide input into future discussions of the viability of radiomics in "real-world" scenarios where image data are not controlled by specific trial protocols but reflective of routine clinical practice.

METHODS

One hundred fifty-six patients with pathologically proven breast cancer underwent multi-contrast MRI prior to neoadjuvant chemotherapy and/or surgery. From these, 92 patients were identified for whom T2-weighted, diffusion-weighted and contrast-enhanced T1-weighted sequences were available, as well as key clinicopathological variables. Regions-of-interest were drawn on the above image types and, from these, semantic and calculated radiomics features were derived. Classification models using a variety of methods, both with and without recursive feature elimination, were developed to predict pathological nodal status. Separately, we applied the same methods to analyse the information carried by the radiomic features regarding the originating scanner type and field strength. Repeated, ten-fold cross-validation was employed to verify the results. In parallel work, survival modelling was performed using random survival forests.

RESULTS

Prediction of nodal status yielded mean cross-validated AUC values of 0.735 ± 0.15 (SD) for clinical variables alone, 0.673 ± 0.16 (SD) for radiomic features only, and 0.764 ± 0.16 (SD) for radiomics and clinical features together. Prediction of scanner platform from the radiomics features yielded extremely high values of AUC between 0.91 and 1 for the different classes examined indicating the presence of confounding features for the nodal status classification task. Survival analysis, gave out-of-bag prediction errors of 19.3% (clinical features only), 36.9-51.8% (radiomic features from different combinations of image contrasts), and 26.7-35.6% (clinical plus radiomics features).

CONCLUSIONS

Radiomic classification models whose predictive ability was consistent with previous single-vendor, single-field strength studies have been obtained from multi-vendor, multi-field-strength data, despite clear confounding information being present. However, our sample size was too small to obtain useful survival modelling results.

Ruling out Color Transparency in Quasielastic ^{12}C(e,e^{'}p) up to Q^{2} of 14.2 (GeV/c)^{2}

Quasielastic ^{12}C(e,e^{'}p) scattering was measured at spacelike 4-momentum transfer squared Q^{2}=8, 9.4, 11.4, and 14.2  (GeV/c)^{2}, the highest ever achieved to date. Nuclear transparency for this reaction was extracted by comparing the measured yield to that expected from a plane-wave impulse approximation calculation without any final state interactions. The measured transparency was consistent with no Q^{2} dependence, up to proton momenta of 8.5  GeV/c, ruling out the quantum chromodynamics effect of color transparency at the measured Q^{2} scales in exclusive (e,e^{'}p) reactions. These results impose strict constraints on models of color transparency for protons.

Effect of capsaicin supplementation on lactational and reproductive performance of Holstein cows during summer

Context Summer ambient temperature and humidity are major factors negatively influencing the physiology and the productive and reproductive efficiency of dairy cows. Various management and breeding approaches may be useful for maintaining productivity in dairy cows during summer to minimise these effects. Aims The experiment was designed to test a natural phytochemical supplementation of capsaicin (CPS), followed by a specific oestrus synchronisation protocol as a means to maintain productivity and reproductive performance of Chinese Holstein cows during summer in Hubei province, China. Methods Lactating Chinese Holstein cows (n = 109) were randomly divided into four groups and supplemented with 0 (control, n = 27), 20 (CPS-20, n = 26), 40 (CPS-40, n = 28) and 60 (CPS-60, n = 28) mg of capsaicin (CPS) per kg of total mixed ration respectively for continuous 30 days initiated on 10 July 2018. Milk production and composition were measured over 45 days from the start of CPS supplementation. After CPS supplementation, all cows were synchronised through a modified Ovsynch oestrus synchronisation protocol, and reproductive variables were recorded. Metabolic parameters were measured on the days before CPS supplementation, artificial insemination (AI) and 50 days post-AI. Key results Highest (P &lt; 0.05) milk production were found in the CPS-40 group, and highest total solids and milk fat in the CPS-20 and CPS-40 groups. Milk urea nitrogen and milk fat were generally increased in CPS supplemented cows compared with the control group. Significant increases (P &lt; 0.05) in oestrus response, ovulatory follicle size, ovulation rate and pregnancy rates were observed in the CPS-40 group compared with other groups. Glucose, lipoprotein esterase and aspartate aminotransferase were increased (P &lt; 0.05) in CPS-40 and CPS-60 supplemented groups at the time of AI and 50 days post-AI. Conclusions CPS supplementation has the capacity to maintain milk yield, milk composition and serum metabolites in Chinese Holstein dairy cows during summer. The synergistic effect of CPS and the modified oestrus synchronisation protocol also improved reproductive variables of the cows. Implications Adoption of CPS as a supplement along with oestrus synchronisation could be a useful and economical strategy for dairy herd keepers to improve herd performance during summer.

Probing the Deuteron at Very Large Internal Momenta

We measure ^{2}H(e,e^{'}p)n cross sections at 4-momentum transfers of Q^{2}=4.5±0.5  (GeV/c)^{2} over a range of neutron recoil momenta p_{r}, reaching up to ∼1.0  GeV/c. We obtain data at fixed neutron recoil angles θ_{nq}=35°, 45°, and 75° with respect to the 3-momentum transfer q[over →]. The new data agree well with previous data, which reached p_{r}∼500  MeV/c. At θ_{nq}=35° and 45°, final state interactions, meson exchange currents, and isobar currents are suppressed and the plane wave impulse approximation provides the dominant cross section contribution. We compare the new data to recent theoretical calculations, where we observe a significant discrepancy for recoil momenta p_{r}>700  MeV/c.

Endocrine dysfunction in psychology during social distancing measures

OBJECTIVES

To determine the psychological impact of the social distancing measures in place due to the coronavirus pandemic.

METHODS

We conducted a cross-sectional study on the Pakistani population. Informed consent was taken from all the participants. The data was collected through an online questionnaire. Cronbach's alpha was used to assess the internal consistency of the questionnaire, and it was found to be 0.80. The data obtained was analyzed on IBM's statistical package for the social sciences (SPSS) version 26.

RESULTS

Out of 706 participants, 489 (69.26 %) were males and 217 (30.74 %) were females. The mean age of the participants was 35.24 ± 12.08 years. The majority of the participants were from Punjab (66.00 %).The mean time since quarantine measures had been established was 10.35 ± 5.09 days. The mean total score was 9.08 ± 2.38 points. A majority of the participants (25.64 %) were daily wage workers. t-test was significant when the time of quarantine was compared to the psychological impact. Significant results were also found when gender was compared to the impact.

CONCLUSIONS

Social distancing measures have an impact on psychology and endocrinology of people in general. The impact can take the shape of long-lasting consequences (Tab. 3, Ref. 19).

Helicity-Dependent Cross Sections for the Photoproduction of π^{0} Pairs from Nucleons

The double-polarization observable E and helicity-dependent cross sections σ_{1/2}, σ_{3/2} have been measured for the photoproduction of π^{0} pairs off quasifree protons and neutrons at the Mainz MAMI accelerator with the Crystal Ball/TAPS setup. A circularly polarized photon beam was produced by bremsstrahlung from longitudinally polarized electrons and impinged on a longitudinally polarized deuterated butanol target. The reaction products were detected with an almost 4π covering calorimeter. The results reveal for the first time the helicity- and isospin-dependent structure of the γN→Nπ^{0}π^{0} reaction. They are compared to predictions from reaction models in view of nucleon resonance contributions and also to a refit of one model that predicted results for the proton and for the neutron target. The comparison of the prediction and the refit demonstrates the large impact of the new data.

Knowledge, attitude, practice and perceived barriers among healthcare workers regarding COVID-19: a cross-sectional survey from Pakistan

A self-administered validated (Cronbach's alpha=0.077) questionnaire was used to assess knowledge, attitude and practice among healthcare workers (HCWs) in Pakistan regarding coronavirus disease 2019 (COVID-19). Findings showed that HCWs have good knowledge (93.2%, N=386), a positive attitude [mean 8.43 (standard deviation 1.78)] and good practice (88.7%, N=367) regarding COVID-19. HCWs perceived that limited infection control material (50.7%, N=210) and poor knowledge regarding transmission (40.6%, N=168) were the major barriers to infection control. Regression analysis indicated that pharmacists were more likely to demonstrate good practice than other HCWs (odds ratio 2.247, 95% confidence interval 1.11-4.55, P=0.025). This study found that HCWs in Pakistan have good knowledge, but there are gaps in specific aspects of knowledge and practice that warrant attention.

Knowledge, attitude, practice and perceived barriers among healthcare workers regarding COVID-19: a cross-sectional survey from Pakistan

A self-administered validated (Cronbach's alpha=0.077) questionnaire was used to assess knowledge, attitude and practice among healthcare workers (HCWs) in Pakistan regarding coronavirus disease 2019 (COVID-19). Findings showed that HCWs have good knowledge (93.2%, N=386), a positive attitude [mean 8.43 (standard deviation 1.78)] and good practice (88.7%, N=367) regarding COVID-19. HCWs perceived that limited infection control material (50.7%, N=210) and poor knowledge regarding transmission (40.6%, N=168) were the major barriers to infection control. Regression analysis indicated that pharmacists were more likely to demonstrate good practice than other HCWs (odds ratio 2.247, 95% confidence interval 1.11-4.55, P=0.025). This study found that HCWs in Pakistan have good knowledge, but there are gaps in specific aspects of knowledge and practice that warrant attention.

Local injection of a hexametaphosphate formulation reduces heterotopic ossification in vivo

Heterotopic ossification (HO), the pathological formation of ectopic bone, is a debilitating condition which can cause chronic pain, limit joint movement, and prevent prosthetic limb fitting. The prevalence of this condition has risen in the military population, due to increased survivorship following blast injuries. Current prophylaxes, which aim to target the complex upstream biological pathways, are inconsistently effective ​and have a range of side-effects that make them unsuitable for combat-injured personnel. As such, many patients must undergo further surgery to remove the formed ectopic bone. In this study, a non-toxic, U.S. Food and Drug Administration (FDA) -approved calcium chelator, hexametaphosphate (HMP), is explored as a novel treatment paradigm for this condition, which targets the chemical, rather that biological, ​bone formation pathways. This approach allows not only prevention of pathological bone formation ​but also uniquely facilitates reversal, which current drugs cannot achieve. Targeted, minimally invasive delivery is achieved by loading HMP into an injectable colloidal alginate. These formulations significantly reduce ​the length of the ectopic bone formed in a rodent model of HO, with no effect on the adjacent skeletal bone. This study demonstrates the potential of localized dissolution as a new treatment ​and an alternative to surgery ​for pathological ossification and calcification conditions.

Signatures of the d^{*}(2380) Hexaquark in d(γ,pn[over →])

We report a measurement of the spin polarization of the recoiling neutron in deuterium photodisintegration, utilizing a new large acceptance polarimeter within the Crystal Ball at MAMI. The measured photon energy range of 300-700 MeV provides the first measurement of recoil neutron polarization at photon energies where the quark substructure of the deuteron plays a role, thereby providing important new constraints on photodisintegration mechanisms. A very high neutron polarization in a narrow structure centered around E_{γ}∼570  MeV is observed, which is inconsistent with current theoretical predictions employing nucleon resonance degrees of freedom. A Legendre polynomial decomposition suggests this behavior could be related to the excitation of the d^{*}(2380) hexaquark.

Broadband, millimeter-wave antireflection coatings for large-format, cryogenic aluminum oxide optics

We present two prescriptions for broadband ($ {\sim} 77 - 252\;{\rm GHz} $), millimeter-wave antireflection coatings for cryogenic, sintered polycrystalline aluminum oxide optics: one for large-format (700 mm diameter) planar and plano-convex elements, the other for densely packed arrays of quasi-optical elements-in our case, 5 mm diameter half-spheres (called "lenslets"). The coatings comprise three layers of commercially available, polytetrafluoroethylene-based, dielectric sheet material. The lenslet coating is molded to fit the 150 mm diameter arrays directly, while the large-diameter lenses are coated using a tiled approach. We review the fabrication processes for both prescriptions, then discuss laboratory measurements of their transmittance and reflectance. In addition, we present the inferred refractive indices and loss tangents for the coating materials and the aluminum oxide substrate. We find that at 150 GHz and 300 K the large-format coating sample achieves $ (97 \pm 2)\% $ transmittance, and the lenslet coating sample achieves $ (94 \pm 3)\% $ transmittance.

Analysis of bioactive composites and antiviral activity of Iresine herbstii extracts against Newcastle disease virus in ovo

The study was implemented to actuate the qualitative and quantitative phyto constituents of Iresine herbstii extracts and its antiviral efficacy against avian ND virus. Among four tested solvents, the ethanolic extract of Iresine herbstii revealed the presence of highest quantity of all tested phytochemicals while petroleum ether extract showed the least. Folin-Ciocalteu method assessed the range of TPC extended from 81.01 ± 0.67 to 126.35 ± 0.45 µg GAE/mg. Acetonic extract showed the highest amount among all extracts and petroleum ether possessed the lower quantity. TFC ranged from 54.37 ± 0.45 to 88.12 ± 0.26 µg QE/mg followed by colorimetric method. From all extract ethanolic extract showed highest quantity and petroleum ether revealed the lower. HPLC analysis of ethanolic extract of I. herbstii confesses the presence six bioactive components by using the HP5-MS column. To check the antiviral potential of plants, different prepared treatments of plant extract and live virus were inoculated at 9 days old SPF embryonated chicken eggs. Results exposed that all plant extracts produce antiviral activity against NDV in ovo according to their potential and phytochemical profile. The highest survival rate was observed in the ethanolic extract at 400 µg/mL and acetonic extract at 300 µg/mL as it controls the NDV activity completely, evidence of absence of embryo death and HA titre. Dichloromethane and petroleum ether could not inhibit the virus completely. 600 µg/mL concentration was proved as toxic in all extracts except petroleum ether extract which showed a dose dependent pattern.