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ided biopsy of omental disease suspected on CT is safe and effective for tissue diagnosis. Though omental disease commonly appears on US as diffuse infiltrative thickening without a discrete target, sampling based on pre-biopsy CT landmarks is diagnostic in the large majority of cases. Clinical Impact US should be considered the first-line modality for omental biopsy guidance when feasible.Background Acute exacerbation (AE) is a life-threatening complication of interstitial pneumonia (IP). Thoracic surgery may trigger AE. Objective To explore the role of preoperative CT findings for predicting postoperative AE in patients with IP and lung cancer. Methods This retrospective case-control study included patients from 22 institutions with IP who underwent thoracic surgery for lung cancer. AE was diagnosed based on symptoms and imaging findings within 30 days after surgery and absence of alternate causes. For each case of AE, two control cases without AE were identified. After exclusions, 92 patients (78 men, 14 women; mean age 72 years; 31 with AE, 61 without AE) were included. Two radiologists independently reviewed preoperative thin-slice CT examinations for pulmonary findings and resolved differences by consensus. AE and no-AE groups were compared using Fisher's exact and Mann-Whitney U tests. Multivariable logistic regression was performed. Interreader agreement was assessed by kappa coefficiennt on preoperative CT predict AE in patients with IP undergoing lung cancer surgery. Clinical Impact Patients with IP and lung cancer should be carefully managed in the presence of the predictive CT features. Wedge resection, if possible, may help reduce AE risk in these patients.Background Multiple commercial and open-source software applications are available for texture analysis. Nonstandard techniques can cause undesirable variability that impedes result reproducibility and limits clinical utility. Objective The purpose of this study is to measure agreement of texture metrics extracted by 6 software packages. Methods This retrospective study included 40 renal cell carcinomas with contrast-enhanced CT from The Cancer Genome Atlas and Imaging Archive. Images were analyzed by 7 readers at 6 sites. Each reader used 1 of 6 software packages to extract commonly studied texture features. Inter and intra-reader agreement for segmentation was assessed with intra-class correlation coefficients. First-order (available in 6 packages) and second-order (available in 3 packages) texture features were compared between software pairs using Pearson correlation. Results Inter- and intra-reader agreement was excellent (ICC 0.93-1). First-order feature correlations were strong (r>0.8, p less then 0.001) between 75% (21/28) of software pairs for mean and standard deviation, 48% (10/21) for entropy, 29% (8/28) for skewness, and 25% (7/28) for kurtosis. Of 15 second-order features, only co-occurrence matrix correlation, grey-level non-uniformity, and run-length non-uniformity showed strong correlation between software packages (0.90-1, p less then 0.001). Conclusion Variability in first and second order texture features was common across software configurations and produced inconsistent results. Standardized algorithms and reporting methods are needed before texture data can be reliably used for clinical applications. Clinical Impact It is important to be aware of variability related to texture software processing and configuration when reporting and comparing outputs.

The increasing prevalence of diabetes mellitus and advances in endovascular therapies continue to have an impact on the epidemiology and management of lower extremity arterial disease. This study describes trends in lower extremity revascularisation and major lower limb amputation in NHS England over the past two decades (2000-2019).

Numbers of lower extremity endovascular interventions, open surgical procedures and major lower limb amputations performed in NHS England between 2000 and 2019 were extracted from publicly available hospital admitted patient care activity reports. Trends in intervention were assessed with linear regression models and chi-square tests for trend.

Over this period, 527,131 revascularisations and 92,053 amputations were performed. The mean age of patients was 67.5 years (standard deviation 1.6 years) and 65.3% were male. The number of lower limb revascularisation procedures increased by 402.4 units/year (95% confidence interval, CI, 290.1-514.6,

 < 0.001). selleck kinase inhibitor The number of endovascular interventions rose by 43.5% (10,912 in 2000 vs 15,657 in 2019; β = 359.5.0, 95% CI 279.3-439.8,

 < 0.001) compared with no significant increase in the number of open surgical procedures (8,483 in 2000 vs 7,872 in 2019; β = 42.8, 95% CI -8.3 to 94.0,

 = 0.095). The number of major lower limb amputations has decreased by 9.4% (5,418 in 2000 vs 4,907 in 2019; β = -31.0; 95% CI -49.6 to -12.5, R

 = 0.42,

 = 0.003).

There has been a significant increase in the rate of lower limb revascularisation procedures associated with decreased numbers of major lower limb amputations over the past two decades. These changes in overall trends may affect both service provision and vascular surgery training planning.

There has been a significant increase in the rate of lower limb revascularisation procedures associated with decreased numbers of major lower limb amputations over the past two decades. These changes in overall trends may affect both service provision and vascular surgery training planning.There is considerable interest in the development of hybrid organic-inorganic materials because of the potential for harvesting the unique capabilities that each system has to offer. Proteins are an especially attractive organic component owing to the high amount of chemical information encoded in their amino acid sequence, their amenability to molecular and computational (re)design, and the many structures and functions they specify. Genetic installation of solid-binding peptides (SBPs) within protein frameworks affords control over the position and orientation of adhesive and morphogenetic segments, and a path toward predictive synthesis and assembly of functional materials and devices, all while harnessing the built-in properties of the host scaffold. Here, we review the current understanding of the mechanisms through which SBPs bind to technologically relevant interfaces, with an emphasis on the variables that influence the process, and highlight the last decade of progress in the use of solid-binding proteins for hybrid and hierarchical materials synthesis.