Potato (Solanum tuberosum L.) is a worldwide food staple, but substantial waste accompanies the cultivation of this crop due to wounding of the outer skin and subsequent unfavorable healing conditions. Motivated by both economic and nutritional considerations, this metabolite profiling study aims to improve understanding of closing layer and wound periderm formation and guide the development of new methods to ensure faster and more complete healing after skin breakage. The polar metabolites of wound-healing tissues from four potato cultivars with differing patterns of tuber skin russeting (Norkotah Russet, Atlantic, Chipeta, and Yukon Gold) were analyzed at three and seven days after wounding, during suberized closing layer formation and nascent wound periderm development, respectively. The polar extracts were assessed using LC-MS and NMR spectroscopic methods, including multivariate analysis and tentative identification of 22 of the 24 biomarkers that discriminate among the cultivars at a given wound-healing time point or between developmental stages. Differences among the metabolites that could be identified from NMR- and MS-derived biomarkers highlight the strengths and limitations of each method, also demonstrating the complementarity of these approaches in terms of assembling a complete molecular picture of the tissue extracts. Both methods revealed that differences among the cultivar metabolite profiles diminish as healing proceeds during the period following wounding. The biomarkers included polyphenolic amines, flavonoid glycosides, phenolic acids and glycoalkaloids. Because wound healing is associated with oxidative stress, the free radical scavenging activities of the extracts from different cultivars were measured at each wounding time point, revealing significantly higher scavenging activity of the Yukon Gold periderm especially after 7 days of wounding.

Background and Purpose: Distal medium vessel occlusions (DMVOs) are increasingly considered for endovascular thrombectomy but are difficult to detect on computed tomography angiography (CTA). We aimed to determine whether time-to-maximum of tissue residue function ( Tmax ) maps, derived from CT perfusion, can be used as a triage screening tool to accurately and rapidly identify patients with DMVOs. Methods: Consecutive code stroke patients who underwent multimodal CT were screened retrospectively. Two experienced readers evaluated all patients’ Tmax maps in consensus for presence of delay in an arterial territory (territorial Tmax delay). The diagnostic accuracy of this surrogate for identifying DMVOs was determined using receiver-operating characteristic analysis. CTA, interpreted by 2 experienced neuroradiologists with access to all imaging data, served as the reference standard. Diagnostic performance of 4 other readers with different levels of experience for identifying DMVOs on Tmax versus CTA was also assessed. These readers independently assessed patients’ Tmax maps and CTAs in 2 separate timed sessions, and areas under the receiver-operating characteristic curves were compared using the DeLong algorithm. The Wilcoxon signed-rank test was used to comparatively assess diagnostic speed. Results: Three hundred seventy-three code stroke patients (median age, 70 years; 56% male, 70 with a DMVO) were included. Territorial Tmax delay had a sensitivity of 100% (CI 95 , 94.9%–100%) and specificity of 87.8% (CI 95 , 83.6%–91.3%) for presence of a DMVO, yielding an area under the receiver-operating characteristic curves of 0.939 (CI 95 , 0.920–0.957). All 4 readers achieved sensitivity >95% and specificity >84% for detecting DMVOs using Tmax maps, with diagnostic accuracy (area under the receiver-operating characteristic curves) and speed that were significantly ( P <0.001) higher than on CTA. Conclusions: Territorial Tmax delay had perfect sensitivity and high specificity for a DMVO. Tmax maps were accurately and rapidly interpreted by even inexperienced readers, and causes of false positives are easy to recognize and dismiss. These findings encourage the use of Tmax to identify patients with DMVOs.

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BACKGROUND AND PURPOSE: Detecting intracranial distal arterial occlusions on CTA is challenging but increasingly relevant to clinical decision-making. Our purpose was to determine whether the use of CTP-derived time-to-maximum of the tissue residue function maps improves diagnostic performance for detecting these occlusions. MATERIALS AND METHODS:Seventy consecutive patients with a distal arterial occlusion and 70 randomly selected controls who underwent multimodal CT with CTA and CTP for a suspected acute ischemic stroke were included in this retrospective study. Four readers with different levels of experience independently read the CTAs in 2 separate sessions, with and without time-to-maximum of the tissue residue function maps, recording the presence or absence of an occlusion, diagnostic confidence, and interpretation time. Accuracy for detecting distal occlusions was assessed using receiver operating characteristic analysis, and areas under curves were compared to assess whether accuracy improved with use of time-to-maximum of the tissue residue function. Changes in diagnostic confidence and interpretation time were assessed using the Wilcoxon signed rank test. RESULTS:Mean sensitivity for detecting occlusions on CTA increased from 70.7% to 90.4% with use of time-to-maximum of the tissue residue function maps. Diagnostic accuracy improved significantly for the 4 readers (P , .001), with areas under the receiver operating characteristic curves increasing by 0.186, 0.136, 0.114, and 0.121, respectively. Diagnostic confidence and speed also significantly increased. CONCLUSIONS:All assessed metrics of diagnostic performance for detecting distal arterial occlusions improved with the use of time-to-maximum of the tissue residue function maps, encouraging their use to aid in interpretation of CTA by both experienced and inexperienced readers. These findings show the added diagnostic value of including CTP in the acute stroke imaging protocol. ABBREVIATIONS: ACA ¼ anterior cerebral artery; AUC ¼ area under the curve; DVO ¼ distal vessel occlusion; EVT ¼ endovascular thrombectomy; NECT ¼ nonenhanced CT; PCA ¼ posterior cerebral artery; ROC ¼ receiver operating characteristic; Tmax ¼ time to maximum of the tissue residue function; SCA ¼ Superior Cerebellar Artery

Background Healthcare waste contributes substantially to the world’s carbon footprint. Our aims are to review the current knowledge of Interventional Radiology (IR) waste generation and ways of reducing waste in practice, to quantify the environmental and financial impact of waste generated and address green initiatives to improve IR waste management. Methods A systematic literature search was conducted in July 2022 using the Medline and Embase literature databases. The scope of the search included the field of IR as well as operating theatre literature, where relevant to IR practice. Results One-hundred articles were reviewed and 68 studies met the inclusion criteria. Greening initiatives include reducing, reusing and recycling waste, as well as strict waste segregation. Interventional radiologists can engage with suppliers to reformulate procedure packs to minimize unnecessary items and packaging. Opened but unused equipment can be prevented if there is better communication within the team and increased staff awareness of wasted equipment cost. Incentives to use soon-to-expire equipment can be offered. Power consumption can be reduced by powering down operating room lights and workstations when not in use, changing to Light Emitting Diode (LED) and motion sensor lightings. Surgical hand wash can be replaced with alcohol-based hand rubs to reduce water usage. Common barriers to improving waste management include the lack of leadership, misconceptions regarding infectious risk, lack of data, concerns about increased workload, negative staff attitudes and resistance to change. Education remains a top priority to engage all staff in sustainable healthcare practices. Conclusion Interventional radiologists have a crucial role to play in improving healthcare sustainability. By implementing small, iterative changes to our practice, financial savings, greater efficiency and improved environmental sustainability can be achieved.

Intussusception is a rare condition in adulthood and, unlike in children, is usually caused by an identifiable underlying lesion, most commonly a gastrointestinal tumour. The clinical presentation is non-specific and often there are intermittent symptoms making the diagnosis difficult based solely on history and examination. Plain radiography may reveal signs of bowel obstruction, however, CT is the gold standard to diagnose and localise an intussusception in adults. We present an unusual case of adult ileocolic intussusception caused by an ileal leiomyoma. This case highlights the important radiological findings of intussusception presenting with a high-grade obstruction and discusses the potential causes which should be considered.

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Objective: Since the introduction of endovascular technology to treat thoracic and abdominal aortic aneurysms, there has been a global research effort focused on assessing the effectiveness of treatment. A bibliometric analysis is used to identify the scientific impact of an article, impactful authors, institutions, and collaborative groups. Our objective was to identify and to analyze the 100 most cited articles in the field of endovascular treatment of thoracic and abdominal aortic aneurysms. Methods: We performed a retrospective bibliometric analysis in April 2018. Articles were searched on the Science Citation Index Expanded database using Web of Science to identify the most cited articles in endovascular therapy for thoracic and aortic aneurysms since 1945. Use of selected key terms ("AAA," "aortic aneurysm," "thoracic aneurysm," "abdominal aneurysm," "endovascular," "endoluminal," "stent," "graft," "repair," "EVAR," and "TEVAR") yielded a total of 23,354 articles. The top 100 articles were identified and analyzed to extract relevant information including year of publication, citation count, journal, authorship country of origin, and article type. Results: The earliest articles were published in 1991, with the majority being published in the 2000s (n ¼ 59). The number of citations for the top 100 articles ranged from 151 to 1142, with a median citation count of 212. All articles were cited an average of 22.4 times per year. Almost half (n ¼ 46) of the top 100 articles were published in the Journal of Vascular Surgery. Thirty-nine authors contributed four or more articles, with two being credited on 10 papers to make the list. The majority (n ¼ 62) of the articles arose from the United States, while the United Kingdom contributed 11 articles. There were 7 guidelines and 12 randomized controlled trials, and the majority constituted level III or level IV evidence. Conclusions: This study provides a comprehensive and informative analysis of the most cited and impactful research undertaken in the field of endovascular treatment of abdominal and thoracic aortic aneurysms. By quantitatively assessing the 100 most cited articles in the field, we recognize the contributions of key authors, institutions, and collaborative groups and develop an understanding of the strengths of past research and the requirements for future global efforts.