Background and aimThe International Cancer of the Pancreas Screening Consortium met in 2018 to update its consensus recommendations for the management of individuals with increased risk of pancreatic ...cancer based on family history or germline mutation status (high-risk individuals).MethodsA modified Delphi approach was employed to reach consensus among a multidisciplinary group of experts who voted on consensus statements. Consensus was considered reached if ≥75% agreed or disagreed.ResultsConsensus was reached on 55 statements. The main goals of surveillance (to identify high-grade dysplastic precursor lesions and T1N0M0 pancreatic cancer) remained unchanged. Experts agreed that for those with familial risk, surveillance should start no earlier than age 50 or 10 years earlier than the youngest relative with pancreatic cancer, but were split on whether to start at age 50 or 55. Germline ATM mutation carriers with one affected first-degree relative are now considered eligible for surveillance. Experts agreed that preferred surveillance tests are endoscopic ultrasound and MRI/magnetic retrograde cholangiopancreatography, but no consensus was reached on how to alternate these modalities. Annual surveillance is recommended in the absence of concerning lesions. Main areas of disagreement included if and how surveillance should be performed for hereditary pancreatitis, and the management of indeterminate lesions.ConclusionsPancreatic surveillance is recommended for selected high-risk individuals to detect early pancreatic cancer and its high-grade precursors, but should be performed in a research setting by multidisciplinary teams in centres with appropriate expertise. Until more evidence supporting these recommendations is available, the benefits, risks and costs of surveillance of pancreatic surveillance need additional evaluation.
A
bstract
Studying atmospheric neutrino oscillations in the few-GeV range with a multi-megaton detector promises to determine the neutrino mass hierarchy. This is the main science goal pursued by the ...future KM3NeT/ORCA water Cherenkov detector in the Mediterranean Sea. In this paper, the processes that limit the obtainable resolution in both energy and direction in charged-current neutrino events in the ORCA detector are investigated. These processes include the composition of the hadronic fragmentation products, the subsequent particle propagation and the photon-sampling fraction of the detector. GEANT simulations of neutrino interactions in seawater produced by GENIE are used to study the effects in the 1-20 GeV range. It is found that fluctuations in the hadronic cascade in conjunction with the variation of the inelasticity
y
are most detrimental to the resolutions. The effect of limited photon sampling in the detector is of significantly less importance. These results will therefore also be applicable to similar detectors/media, such as those in ice.
The KM3NeT research infrastructure is under construction in the Mediterranean Sea. It consists of two water Cherenkov neutrino detectors, ARCA and ORCA, aimed at neutrino astrophysics and oscillation ...research, respectively. Instrumenting a large volume of sea water with
∼
6200
optical modules comprising a total of
∼
200
,
000
photomultiplier tubes, KM3NeT will achieve sensitivity to
∼
10
MeV
neutrinos from Galactic and near-Galactic core-collapse supernovae through the observation of coincident hits in photomultipliers above the background. In this paper, the sensitivity of KM3NeT to a supernova explosion is estimated from detailed analyses of background data from the first KM3NeT detection units and simulations of the neutrino signal. The KM3NeT observational horizon (for a
5
σ
discovery) covers essentially the Milky-Way and for the most optimistic model, extends to the Small Magellanic Cloud (
∼
60
kpc
). Detailed studies of the time profile of the neutrino signal allow assessment of the KM3NeT capability to determine the arrival time of the neutrino burst with a few milliseconds precision for sources up to 5–8 kpc away, and detecting the peculiar signature of the
standing accretion shock instability
if the core-collapse supernova explosion happens closer than 3–5 kpc, depending on the progenitor mass. KM3NeT’s capability to measure the neutrino flux spectral parameters is also presented.
The results for sixty-two patients who had had a diagnosis of diabetes mellitus and lumbar disc disease or spinal stenosis and had been managed with a posterior decompressive procedure were compared, ...in a retrospective study, with those for sixty-two age and sex-matched non-diabetic (control) patients who had had similar operative procedures. Forty-four of the sixty-two diabetic patients and fifty-five of the non-diabetic patients were available for long-term follow-up (mean, five and seven years, respectively). Among the diabetic patients, there were high rates of postoperative infection and prolonged hospitalization compared with the rates for the control group. The long-term result was excellent or good for seventeen (39 per cent) of the forty-four patients who had diabetes mellitus and for fifty-two (95 per cent) of the fifty-five non-diabetic patients. The poor results in the diabetic patients may have been related to coexisting diabetic neuropathy, to the associated microvascular disease that affects the spinal nerve roots in diabetic patients, or to the failure of the nerve roots of these patients to recover after decompressive procedures.
Monodisperse magnetic nanoparticles conjugated with virus-surface-specific antibodies self-assemble in the presence of specific viral particles to create supramolecular structures with enhanced ...magnetic properties, as detected by magnetic resonance methods (NMR/MRI). The observed magnetic relaxation changes that occur upon viral-induced assembly allowed for highly sensitive and selective detection of a virus in complex biological media. The developed method was shown to specifically detect adenovirus-5 and herpes simplex virus-1 at concentrations of 5 viral particles/10 μL without the need of extensive sample preparation. The applications of this new method span from high-throughput NMR detection of viruses in biological samples to potential MR imaging of viral distribution in vivo.
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