We present a three-dimensional (3-D) computational method to detect soft tissue sarcomas with the goal of automatic surgical margin assessment based on optical coherence tomography (OCT) images. ...Three parameters are investigated and quantified from OCT images as the indicators for the tissue diagnosis including the signal attenuation (A-line slope), the standard deviation of the signal fluctuations (speckles), and the exponential decay coefficient of its spatial frequency spectrum. The detection of soft tissue sarcomas relies on the combination of these three parameters, which are related to the optical attenuation characteristics and the structural features of the tissue. Pilot experiments were performed on ex vivo human tissue samples with homogeneous pieces (both normal and abnormal) and tumor margins. Our results demonstrate the feasibility of this computational method in the differentiation of soft tissue sarcomas from normal tissues. The features of A-line-based detection and 3-D quantitative analysis yield promise for a computer-aided technique capable of accurately and automatically identifying resection margins of soft tissue sarcomas during surgical treatment.
We report the discovery by the HATSouth survey of HATS-4b, an extrasolar planet transiting a V = 13.46 mag G star. HATS-4b has a period of P approximately 2.5167 days, mass of M sub(p) approximately ...1.32 M sub(Jup), radius of R sub(p) approximately 1.02 R sub(Jup), and density of rho sub(p) = 1.55 + or - 0.16 g cm super(-3) approximately 1.24 rho sub(Jup). The host star has a mass of 1.00 M sub(odot), a radius of 0.92 R sub(odot), and a very high metallicity Fe/H = 0.43 + or - 0.08. HATS-4b is among the densest known planets with masses between 1 and 2 M sub(J) and is thus likely to have a significant content of heavy elements of the order of 75 M sub(+ in circle). In this paper we present the data reduction, radial velocity measurements, and stellar classification techniques adopted by the HATSouth survey for the CORALIE spectrograph. We also detail a technique for simultaneously estimating v sin i and macroturbulence using high resolution spectra.
We describe the discovery of HAT-P-4b, a low-density extrasolar planet transiting BD + 36 2593, a upsilon = 11.2 mag slightly evolved metal-rich late F star. The planet's orbital period is 3.056536 ...plus or minus 0.000057 days with a midtransit epoch of 2,454, 245.8154 plus or minus 0.0003 (HJD). Based on high-precision photometric and spectroscopic data, and by using transit light curve modeling, spectrum analysis, and evolutionary models, we derive the following planet parameters: unk = 0.68 plus or minus 0.04 unk, unk = 1.27 plus or minus 0.05 unk, unk= 0.41 plus or minus 0.06 sub(g)cm super(-3), and unk= 0.0446 plus or minus 0.0012 AU. Because of its relatively large radius, together with its assumed high metallicity (that of its parent star), this planet adds to the theoretical challenges of explaining inflated extrasolar planets.
Sleep-related factors, such as snoring or sleep duration may be causes for or consequence of nocturia. The purpose of this study was to evaluate the associations between sleep-related factors and ...nocturia in the absence of sleep disorders.
Using the National Health and Nutrition Examination Survey (NHANES) database from 2005/06 to 2017/18, we analyzed respondents who completed the kidney conditions and sleep disorders questionnaires. Respondents who reported a physician-diagnosed sleep disorder, did not provide an answer to this sleep disorder question, or had other conditions impacting nocturia were excluded. After sample weighing, the prevalence of nocturia for responses to sleep-related factors (hours of sleep, work schedule, snoring, snorting or stopping breathing, and sleepiness) was analyzed using chi-square analysis and the association of sleep-related factors to nocturia, accounting for age, gender, race, and BMI, was determined using univariate and multivariate regression.
From the 2005/06–2017/18 NHANES database, 23,895 respondents (11,672 males and 12,223 females; mean age, SD = 45.2, 20.1 years) were included. For sleep-related factors, greatest nocturia prevalence was seen in those sleeping <6 h (38.4%) or >8 h (38.0%), snoring ≥5 nights per week (33.4%), snorting or stopping breathing ≥5 nights per week (38.7%), and feeling sleepy 16–30 times per month (44.7%). Work schedule differences (morning, evening/night, rotating) showed no differences in nocturia prevalence (21.1–22.5%) or significant odds of nocturia. On univariate analysis, nocturia was associated with age (OR = 1.035, p < 0.001), BMI (OR = 1.038, p < 0.001), sleeping <6 h (OR = 1.603, p < 0.001) or >8 h (OR = 1.673, p < 0.001), snoring ≥5 nights per week (OR = 1.192, p = 0.004), snorting or stopping breathing 3–4 nights (OR = 1.425, p < 0.001) to ≥5 nights per week (OR = 1.528, p < 0.001), and feeling sleepy 5–15 times (OR = 1.579, p < 0.001) to 16–30 times per month (OR = 1.970, p < 0.001). On multivariate analysis, only age (OR = 1.035, p < 0.001), BMI (OR = 1.032, p < 0.001), and sleepiness (OR = 1.169, p < 0.001) showed an association with nocturia.
While most sleep-related factors showed increasing prevalence of nocturia at their extremes, only sleepiness showed an association to nocturia on multivariate analysis. Further examination of sleep issues related to nocturia elucidating causality are warranted.
We report the discovery of HAT-P-25b, a transiting extrasolar planet orbiting the V = 13.19 G5 dwarf star GSC 1788-01237, with a period P = 3.652836 + or - 0.000019 days, transit epoch Tc = ...2455176.85173 + or - 0.00047 (BJD-barycentric Julian dates throughout the paper are calculated from Coordinated Universal Time, UTC), and transit duration 0.1174 + or - 0.0017 days. The host star has amass of 1.01 + or - 0.03 M radius of (ProQuest: Formulae and/or non-USASCII text omitted) R effective temperature 5500 + or - 80 K, and metallicity Fe/H = +0.31 + or - 0.08. The planetary companion has a mass of 0.567 + or - 0.022 M sub(J) and radius of (ProQuest: Formulae and/or non-USASCII text omitted) R sub(J) yielding a mean density of 0.42 + or - 0.07 g cm super(-3).
Background With increased time and quality pressures, it may be more difficult for residents in cardiothoracic surgery residency programs to get independent operative experience. That may lead ...residents to inaccurately report their role as “surgeon” to meet American Board of Thoracic Surgery (ABTS) case requirements. Methods The 2013 In-Training Examination surveyed 312 cardiothoracic surgery residents and was used to contrast residents in traditional 2-year and 3-year cardiothoracic surgery residencies (traditional, n = 216) with those in 6-year integrated or 3+4-year programs (integrated, n = 96). Results Traditional program residents reported a higher percentage of cases that met the ABTS criteria of surgeon than did integrated program residents ( p = 0.05) but were less likely to meet requirements if all cases were logged accurately ( p = 0.03). The majority of residents in each program believed that their case log accurately reflected their experience as “surgeon.” Residents who tended to log cases incorrectly had lower self-reported 2012 In-Training Examination percentiles, were less likely to meet case requirements if logged properly, and felt less prepared for board examinations and eventual practice compared with residents who logged cases correctly (all p < 0.001). Residents who believed they would not meet case requirements if logged correctly cited limited surgical opportunities, poor case diversity, and a compromised training environment but not the 80-hour work week, excessive simulation, or disproportionate number of complex cases as causes. Conclusions Overall cardiothoracic surgery residents appear to be satisfied with their training. There were specific subsets of trainees in both traditional and Integrated programs that are misrepresenting their role on cases because they otherwise may not meet the requirements.
Introduction
Asymptomatic carotid artery stenosis (ACAS) may cause future stroke and therefore patients with ACAS require best medical treatment. Patients at high risk for stroke may opt for ...additional revascularization (either surgery or stenting) but the future stroke risk should outweigh the risk for peri/post‐operative stroke/death. Current risk stratification for patients with ACAS is largely based on outdated randomized‐controlled trials that lack the integration of improved medical therapies and risk factor control. Furthermore, recent circulating and imaging biomarkers for stroke have never been included in a risk stratification model. The TAXINOMISIS Project aims to develop a new risk stratification model for cerebrovascular complications in patients with ACAS and this will be tested through a prospective observational multicentre clinical trial performed in six major European vascular surgery centres.
Methods and analysis
The risk stratification model will compromise clinical, circulating, plaque and imaging biomarkers. The prospective multicentre observational study will include 300 patients with 50%‐99% ACAS. The primary endpoint is the three‐year incidence of cerebrovascular complications. Biomarkers will be retrieved from plasma samples, brain MRI, carotid MRA and duplex ultrasound. The TAXINOMISIS Project will serve as a platform for the development of new computer tools that assess plaque progression based on radiology images and a lab‐on‐chip with genetic variants that could predict medication response in individual patients.
Conclusion
Results from the TAXINOMISIS study could potentially improve future risk stratification in patients with ACAS to assist personalized evidence‐based treatment decision‐making.
Aims
Nocturnal polyuria syndrome (NPS) denotes nocturnal polyuria (NP) in the absence of identifiable contributory factors. The trajectory of nocturnal urine production (NUP; typically expressed as ...ml/hour) may be useful in delineating between NP patients with versus without NPS, but changes in absolute urine volume, the directly measured substrate for behavioral and pharmacologic interventions targeting nocturnal urine production, have not been well characterized. This study compares the ratio of the first nocturnal voided volume (FNVV) to the nocturnal average voided volume (NAVV) in patients with versus without NPS.
Methods
Secondary analysis of 24‐h voiding diaries from male patients greater than or equal to 18 years of age with two or more nocturnal voids and NP using two different criteria for NP: NUP greater than or equal to 90 ml/h and nocturnal polyuria index (NPi) greater than or equal to 0.33. Patients with diabetes insipidus and CPAP‐adherent obstructive sleep apnea (OSA) were excluded. Patients were divided into 2 groups: secondary NP (OSA, congestive heart failure, and chronic kidney disease) and NPS (absence of edema, diuretic use, and the aforementioned comorbidities). FNVV was defined as the volume of urine accompanying the first nocturic episode. NAVV was defined as nocturnal urine volume/(number of nocturnal voids + 1). The nocturnal urine trajectory ratio (NUTR) was defined as FNVV/NAVV.
Results
At NUP greater than or equal to 90 ml/h, NUTR was significantly greater in patients with (n = 73) versus without (n = 28) NPS (1.10 0.89–1.33 vs. 0.91 0.55–1.15, p = .012). At NPi greater than or equal to 0.33, NUTR was likewise significantly greater in patients with (n = 92) versus without (n = 32) NPS (1.09 0.90–1.33 vs. 0.91 0.57–1.17, p = .010).
Conclusions
The volume of urine produced in the early hours of sleep is central to identification of NPS in patients with nocturia.
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