001) and maxillary sinus wall deformation (68% vs 2%, P less then 0.001) in infants and preschool children with CF compared to age-matched controls. Further, the extent of these abnormalities was also increased with a MRI sum score of 22.9±10.9 in CF compared to 4.5±7.6 in non-CF controls (P less then 0.001). CONCLUSIONS MRI detected normal dimensions of paranasal sinuses, and a high prevalence and severity of paranasal sinus abnormalities due to CRS in infants and preschool children with CF without radiation exposure. Our results support the development of MRI for sensitive non-invasive diagnosis and monitoring of CRS in young children with CF, and as outcome measure for clinical trials.OBJECTIVE Ultrasound elastography is increasingly used in the diagnosis of prostate cancer, however results are heterogeneous. We correlate in a large sample-size prospective study the accuracy of elastography, aiming to settle an accurate cut-off point for diagnosis and possibility of use as a screening tool. METHODS Prospective study that included 120 patients with mean age 59.5 ± 9.8 years, showing enlarged prostate by clinical examination with prostate-specific antigen >4 ng ml-1.The study was done using high frequency high resolution endorectal probe with real time tissue elastography.Grayscale ultrasound examination was done first with Doppler followed by elastography color-coded map and strain ratio measurement. Then, transrectal ultrasound-guided core biopsy was done from suspicious areas detected by elastography (totally or partly stiff by color-coded map or with relative increased strain ratio), besides standard six-quadrant core biopsy samples. RESULTS There was statistically significant difference (p less then 0.001) regarding strain ratio in benign and malignant lesions. Strain ratio showed significant proportionate correlation with prostate-specific antigen level and Gleason pathological score, while no significant correlation noted with the age or the prostatic volume. A strain ratio with a cut-off value of 1.9 showed a sensitivity of 100%, specificity 93.8%, positive predictive value of 79.3%, negative predictive value 100 and 95% accuracy in differentiating between malignant and benign lesions. CONCLUSION Strain ratio improves the detection of prostatic cancer with high sensitivity (100%) and high negative predictive value (100%). ADVANCES IN KNOWLEDGE Different prostatic lesions are mostly similar in grayscale ultrasound.Imaging plays an important role in differentiation of prostatic nodules.Ultrasound elastography may play an important role in distinguishing benign from malignant nodules.OBJECTIVES Assessment of the extent of variation in delineations and dose optimisation performed at multiple UK centres as a result of inter-observer variation and protocol differences. METHODS CT/MR images of two cervical cancer patients previously treated with External Beam Radiotherapy (EBRT) and Brachytherapy were distributed to eleven UK centres. Centres delineated structures and produced treatment plans following their local protocol. OAR delineations were assessed dosimetrically through application of the original treatment plan and target volume delineations were assessed in terms of variation in absolute volume and length, width and height. Treatment plan variation was assessed across all centres and across centres that followed EMBRACE II. Treatment plans were assessed using total EQD 2 delivered and were compared to EMBRACE II dose aims. Variation in combined intracavitary/interstitial Brachytherapy treatments was also assessed. RESULTS Brachytherapy target volume delineations contained variation due to differences in protocol used, window/level technique and differences in interpretations of grey zones. PTV delineations were varied due to protocol differences and extended parametrial tissue inclusion. All centres met EMBRACE II plan aims for PTV V 95 and CTV HR D 90 EQD 2, despite variation in prescription dose, fractionation and treatment technique. CONCLUSIONS Brachytherapy target volume delineations are varied due to differences in contouring guidelines and protocols used.  https://www.selleckchem.com/products/Chlorogenic-acid.html  PTV delineations are varied due to the uncertainties surrounding the extent of parametrial involvement. Dosimetric optimisation is sufficient across all centres to satisfy EMBRACE II planning aims despite significant variation in protocols used. ADVANCES IN KNOWLEDGE Previous multi-institutional audits of cervical cancer radiotherapy practices have been performed in Europe and the US. This study is the first of its kind to be performed in the UK.RATIONALE Aspirin-exacerbated respiratory disease is characterized by severe asthma, non-steroidal anti-inflammatory drug hypersensitivity, nasal polyposis, and leukotriene overproduction. Systemic corticosteroid therapy does not completely suppress lifelong aspirin-hypersensitivity. Omalizumab efficacy against aspirin-exacerbated respiratory disease has not been investigated in a randomized manner. OBJECTIVES To evaluate omalizumab efficacy against aspirin-hypersensitivity, leukotriene E4 overproduction, and symptoms during oral aspirin challenge in aspirin-exacerbated respiratory disease using a randomized design. METHODS We performed a double-blind, randomized, cross-over, placebo-controlled, single-centre study at Sagamihara National Hospital between August 2015 and December 2016. Atopic patients aged 20-79 years with aspirin-exacerbated respiratory disease diagnosed by systemic aspirin challenge were randomized (11) to 3-month treatment with omalizumab or placebo, followed by >18-week washout period (croistration available at https//www.umin.ac.jp/ctr/index.htm, ID UMIN000018777. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http//creativecommons.org/licenses/by-nc-nd/4.0/).BACKGROUND Uncontrolled blood pressure (BP) is a leading preventable cause of death that remains common in the US population despite the availability of effective medications. New technology and program innovation has high potential to improve BP but may be expensive and burdensome for patients, clinicians, health systems, and payers and may not produce desired results or reduce existing disparities in BP control. METHODS AND RESULTS The PCORnet Blood Pressure Control Laboratory is a platform designed to enable national surveillance and facilitate quality improvement and comparative effectiveness research. The platform uses PCORnet, the National Patient-Centered Clinical Research Network, for engagement of health systems and collection of electronic health record data, and the Eureka Research Platform for eConsent and collection of patient-reported outcomes and mHealth data from wearable devices and smartphones. Three demonstration projects are underway BP track will conduct national surveillance of BP control and related clinical processes by measuring theory-derived pragmatic BP control metrics using electronic health record data, with a focus on tracking disparities over time; BP MAP will conduct a cluster-randomized trial comparing effectiveness of 2 versions of a BP control quality improvement program; BP Home will conduct an individual patient-level randomized trial comparing effectiveness of smartphone-linked versus standard home BP monitoring.