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o provided. This article is protected by copyright. All rights reserved.OBJECTIVES To assess the feasibility of retrieval of intact human fetal hearts after first trimester surgical termination of pregnancy (TOP) and subsequent anatomical assessment by postmortem micro-computed tomography (micro-CT). METHODS In a cohort of consenting women undergoing surgical TOP between 8 and 13 weeks' gestation, we attempted the retrieval of the fetal heart from the suction material. Specimens were immersion fixed in 10% formaldehyde, scanned by Iodine enhanced micro-CT and cardiac anatomy assessed by a multidisciplinary team using 3D-multiplanar analysis. RESULTS The median gestational age at TOP was 10.7weeks (range 8.3-12.9). In 57 (95.0%) out of 60 suction specimens, the heart could be retrieved. The median cardiac length was 5mm (range 2-8mm), in three (5.3%), the heart was too damaged to assess cardiac anatomy and in five (8.7%) only the four chambers could be examined. In the remaining 49 (86.0%) cases, a detailed assessment of cardiac anatomy was possible, showing a major defect in two (4.1%) and a minor defect in four (8.2%). CONCLUSIONS Fetal hearts can be retrieved after first trimester TOP being intact in the vast majority of cases. Iodine enhanced, post-mortem micro-CT can be used to assess cardiac anatomy from as early as 8 weeks and to describe heart abnormalities. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Diabetes is an increasingly common diagnosis among pregnant women. Pregestational diabetes is associated with an increase in many adverse pregnancy outcomes, which impact both on the woman and her fetus. The models of pregnancy care for women with diabetes are based largely on observational data or consensus opinion. Strategies for aneuploidy screening and monitoring for fetal wellbeing should be modified in women with diabetes. There is an increasing understanding of the mechanisms by which congenital anomalies and disorders of fetal growth occur, involving epigenetic modifications, changes in gene expression in critical developmental pathways, and oxidative stress. This knowledge may lead to pathways for improved care for these high risk pregnancies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.In many European countries the number of asylum seekers has increased in parallel with increasing numbers of migrants and refugees. Recent experiences in providing medical assessment, care and corroborating evidence for people seeking asylum in France motivated us to review the basic principles of forensic dermatology, an essential skill for the attribution of skin lesions to different mechanisms of torture and for proposing appropriate diagnosis. This article is protected by copyright. All rights reserved.INTRODUCTION The aim of the study was to determine the association of body mass index (BMI), self-reported symptoms or diagnosis of polycystic ovary syndrome (PCOS), and hyperandrogenaemia with the occurrence of gestational diabetes mellitus (GDM) through reproductive life. MATERIAL AND METHODS A cohort of women born in 1966 were investigated at ages 14, 31, and 46. Women with self-reported PCOS-symptoms (presence of both oligo-amenorrhoea and hirsutism) at age 31 or with formally diagnosed polycystic ovaries (PCO)/PCOS by age 46 formed the group of self-reported PCOS (srPCOS, N=222) and were compared with women without self-reported PCOS symptoms or diagnosis (N=1357We investigated also the association of hyperandrogenism (hirsutism or biochemical hyperandrogenism) at age 31 with the occurrence of GDM throughout reproductive life. RESULTS srPCOS alone was not a risk factor for GDM but combined with overweight at age 31 (OR 2.43 [95% CI1.22 to 4.86]) or 46 (OR 3.04 [95% CI1.58 to 5.83]) srPCOS was associated with GDM when compared with normal-weight controls. The association disappeared when comparing overweight srPCOS women to overweight controls. However, hyperandrogenaemia at age 31, but not hirsutism, was associated with GDM even after adjustment for BMI. CONCLUSIONS The increased risk of GDM in women with srPCOS was mostly attributed to overweight or obesity. Importantly, normal weight women with srPCOS seem not to be at increased risk for developing GDM. However, hyperandrogenaemia was associated with GDM even after adjustment for BMI. These findings strengthen the importance of weight management in reproductive-age women and suggest a noteworthy role of hyperandrogenaemia in the pathophysiology of GDM. This article is protected by copyright. All rights reserved.PURPOSE Identification of tube thoracostomy insertion location is currently performed using a blind, landmark based approach at either the fifth intercostal space (ICS) or inframammary crease in the midaxillary line. A significant percentage of thoracostomies at this site result in complications. This pilot study aimed to assess whether bedside ultrasound could aid in identifying safer tube thoracostomy insertion sites in emergency department patients. METHODS Fifty emergency department patients were enrolled in this study. Right and left hemidiaphragms were evaluated with ultrasound at the fifth ICS. Observations were made on if the diaphragm was below, above, or crossed the fifth ICS during an entire respiratory cycle. RESULTS Eighty-one (95% confidence interval 72-82) of the diaphragms were below, 13 (95% confidence interval 8-21) of the diaphragms were at, and 6 (95% confidence interval 3-12) of the diaphragms were above the location marked using traditional landmark techniques. On the right and left hemidiaphragms, 20% (95% confidence interval 19.9%-20.1%) and 18% (95% confidence interval 17.9%-18.1%) of diaphragms were above or crossing the fifth ICS, respectively CONCLUSIONS Ultrasound identified a significant number of potential chest tube insertion sites at the fifth ICS that would result in subdiaphragmatic insertion or diaphragmatic injury. Based on this data ultrasound can be used to identify safer insertion sites and reduce thoracostomy complications. © 2020 Wiley Periodicals, Inc.Shiga toxin-producing E. coli is carried in the intestine of ruminant animals, and outbreaks have occurred after contact with ruminant animals or their environment. The presence of STEC virulence genes in the environment was investigated along recreational walking paths in the North West and East Anglia regions of England. 720 boot sock samples from walkers' shoes were collected between April 2013 and July 2014. Multiplex PCR was used to detect E. coli based on the amplification of the uidA gene and investigate STEC-associated virulence genes eaeA, stx1 and stx2. The eaeA virulence gene was detected in 45.5% of the samples while stx1 and/or stx2 was detected in 12.4% of samples. There was a difference between the two regions sampled, with the North West exhibiting a higher proportion of positive boot socks for stx compared to East Anglia. In univariate analysis, ground conditions, river flow and temperature were associated with positive boot socks. The detection of stx genes in the soil samples suggests that STEC is present in the English countryside and individuals may be at risk for infection after outdoor activities even if there is no direct contact with animals. This article is protected by copyright. All rights reserved.Superior vena cava syndrome (SVCS) often relates to malignant causes such as lung tumors, metastatic cancer, or lymphomas. While the diagnosis relies nowadays on the use of contrast-enhanced thoracic computed tomography, ultrasonography may have an important value as a first-line imaging technique, particularly when used in point-of-care office-based settings. Here, we report the case of a 67-year-old male presenting with SVCS in whom ultrasound contributed to diagnosis. © 2020 Wiley Periodicals, Inc.PURPOSE Stereotactic radiosurgery (SRS) serves as a standard of care of brain metastases (BMs), however, the BMs delineation in the SRS workflow can be time-consuming. The manual contouring can be a pronounced bottleneck in multiple BMs, but there is a lack of tools for automatic delineation and quantitative evaluation. In this study, based on our previous developed deep learning-based segmentation algorithms, we developed a web-based automated BMs segmentation and labeling platform to assist the SRS clinical workflow. METHOD This platform is developed based on the Django framework, including a web client and a back-end server. The web client enables interactions as database access, data import, image viewing. The server performs the segmentation and labeling tasks including (1) skull stripping; (2) deep learning-based BMs segmentation; (3) affine registration-based BMs labeling. Afterwards the client can display BMs contours with corresponding atlas labels, and allows further post-processing tasks including m can be a useful tool for assisting SRS treatment planning and treatment follow-up. This article is protected by copyright. All rights reserved.Membrane traffic between secretory and endosomal compartments is vesicle-mediated and must be tightly balanced to maintain a physiological compartment size. Vesicle formation is initiated by guanine nucleotide exchange factors (GEFs) that activate the ARF family of small GTPases. Regulatory mechanisms, including reversible phosphorylation, allow ARF-GEFs to support vesicle formation only at the right time and place in response to cellular needs. Here, we review current knowledge of how the GBF1/BIG family of ARF-GEFs is influenced by phosphorylation and use predictive paradigms to propose new regulatory paradigms. We describe a conserved cluster of phosphorylation sites within the N-terminal domains of the GBF1/BIG ARF-GEFs and suggest that these sites may respond to homeostatic signals related to cell growth and division. In the C-terminal region, GBF1 shows phosphorylation sites clustered differently as compared with the similar configuration found in both BIG1 and BIG2. Despite this similarity, BIG1 and BIG2 phosphorylation patterns are divergent in other domains. The different clustering of phosphorylation sites suggests that the non-conserved sites may represent distinct regulatory nodes and specify the function of GBF1, BIG1, and BIG2. This article is protected by copyright. All rights reserved.Oestrogen receptor β (ERβ) has been suggested to have anti-proliferative and anti-tumour effects in breast and prostate cancer cells, but other studies have indicated its tumour-promoting effects. Understanding the complex effects of this receptor in different contexts requires further study. We reported that high ERβ expression is independently associated with improved prognosis in female colorectal cancer (CRC) patients. Herein, we investigated the possible anti-tumour effect of ERβ and its selective agonist. CRC patients with high ERβ expression had significantly higher levels of membrane-associated β-catenin, cysteinyl leukotriene receptor 2 (CysLT2 R) and 15-hydroxyprostaglandin dehydrogenase (15-PGDH), which have anti-tumour effects, but lower levels of nuclear β-catenin, cysteinyl leukotriene receptor 1 (CysLT1 R) and cyclooxygenase-2 (COX-2), which have tumour-promoting effects. These interesting findings were further supported by two different publicly available CRC mRNA datasets that showed a significant positive correlation between ERβ expression and 15-PGDH and CysLT2 R expression and a negative correlation between ERβ expression and β-catenin, CysLT1 R and COX-2 expression.