A first-ever spinal cord imaging meeting was sponsored by the International Spinal Research Trust and the Wings for Life Foundation with the aim of identifying the current state-of-the-art of spinal ...cord imaging, the current greatest challenges, and greatest needs for future development. This meeting was attended by a small group of invited experts spanning all aspects of spinal cord imaging from basic research to clinical practice. The greatest current challenges for spinal cord imaging were identified as arising from the imaging environment itself; difficult imaging environment created by the bone surrounding the spinal canal, physiological motion of the cord and adjacent tissues, and small cross-sectional dimensions of the spinal cord, exacerbated by metallic implants often present in injured patients. Challenges were also identified as a result of a lack of “critical mass” of researchers taking on the development of spinal cord imaging, affecting both the rate of progress in the field, and the demand for equipment and software to manufacturers to produce the necessary tools. Here we define the current state-of-the-art of spinal cord imaging, discuss the underlying theory and challenges, and present the evidence for the current and potential power of these methods. In two review papers (part I and part II), we propose that the challenges can be overcome with advances in methods, improving availability and effectiveness of methods, and linking existing researchers to create the necessary scientific and clinical network to advance the rate of progress and impact of the research.
•Methodological challenges encountered in imaging of the spinal cord are presented.•Techniques to overcome these challenges for fMRI and DTI are presented.•Methods for spinal cord MRI (fMRI, DTI, MWF, MTR), MRS, and PET are presented.•Post-processing methods to improve spinal cord MRI are discussed.•We discuss the future directions, and current needs, for spinal cord imaging.
A first-ever spinal cord imaging meeting was sponsored by the International Spinal Research Trust and the Wings for Life Foundation with the aim of identifying the current state-of-the-art of spinal ...cord imaging, the current greatest challenges, and greatest needs for future development. This meeting was attended by a small group of invited experts spanning all aspects of spinal cord imaging from basic research to clinical practice. The greatest current challenges for spinal cord imaging were identified as arising from the imaging environment itself; difficult imaging environment created by the bone surrounding the spinal canal, physiological motion of the cord and adjacent tissues, and small crosssectional dimensions of the spinal cord, exacerbated by metallic implants often present in injured patients. Challenges were also identified as a result of a lack of “critical mass” of researchers taking on the development of spinal cord imaging, affecting both the rate of progress in the field, and the demand for equipment and software to manufacturers to produce the necessary tools. Here we define the current state-of-the-art of spinal cord imaging, discuss the underlying theory and challenges, and present the evidence for the current and potential power of these methods. In two review papers (part I and part II), we propose that the challenges can be overcome with advances in methods, improving availability and effectiveness of methods, and linking existing researchers to create the necessary scientific and clinical network to advance the rate of progress and impact of the research.
•Clinical challenges encountered in imaging of the spinal cord are presented.•Description of functional MRI of the spinal cord applications•Description of diffusion tensor imaging of the spinal cord applications•Specific findings in spinal cord pathologies
Image-based brachytherapy is increasingly used for gynecologic malignancies. We report early outcomes of magnetic resonance imaging (MRI)-guided brachytherapy.
Consecutive patient cases with FIGO ...stage IB1 to IVA cervical cancer treated at a single institution were retrospectively reviewed. All patients received concurrent cisplatin with external beam radiation therapy along with interdigitated high-dose-rate intracavitary brachytherapy. Computed tomography or MRI was completed after each application, the latter acquired for at least 1 fraction. High-risk clinical target volume (HRCTV) and organs at risk were identified by Groupe Européen de Curiethérapie and European SocieTy for Radiotherapy and Oncology guidelines. Doses were converted to equivalent 2-Gy doses (EQD2) with planned HRCTV doses of 75 to 85 Gy.
From 2007 to 2013, 128 patients, median 52 years of age, were treated. Predominant characteristics included stage IIB disease (58.6%) with a median tumor size of 5 cm, squamous histology (82.8%), and no radiographic nodal involvement (53.1%). Most patients (67.2%) received intensity modulated radiation therapy (IMRT) at a median dose of 45 Gy, followed by a median brachytherapy dose of 27.5 Gy (range, 25-30 Gy) in 5 fractions. At a median follow up of 24.4 months (range, 2.1-77.2 months), estimated 2-year local control, disease-free survival, and cancer-specific survival rates were 91.6%, 81.8%, and 87.6%, respectively. Predictors of local failure included adenocarcinoma histology (P<.01) and clinical response at 3 months (P<.01). Among the adenocarcinoma subset, receiving HRCTV D90 EQD2 ≥84 Gy was associated with improved local control (2-year local control rate 100% vs 54.5%, P=.03). Grade 3 or greater gastrointestinal or genitourinary late toxicity occurred at a 2-year actuarial rate of 0.9%.
This study constitutes one of the largest reported series of MRI-guided brachytherapy in North America, demonstrating excellent local control with acceptable morbidity. Dose escalation may be warranted when feasible for adenocarcinomas to offset the risk of local failure.
Multi-center, prospective, cohort study.
To assess the validity and reliability of the Spinal Cord Independence Measure (SCIM III) in measuring functional ability in persons with spinal cord injury ...(SCI).
Inpatient rehabilitation hospitals in the United States (US).
Functional ability was measured with the SCIM III during the first week of admittance into inpatient acute rehabilitation and within one week of discharge from the same rehabilitation program. Motor and sensory neurologic impairment was measured with the American Spinal Injury Association Impairment Scale. The Functional Independence Measure (FIM), the default functional measure currently used in most US hospitals, was used as a comparison standard for the SCIM III. Statistical analyses were used to test the validity and reliability of the SCIM III.
Total agreement between raters was above 70% on most SCIM III tasks and all κ-coefficients were statistically significant (P<0.001). The coefficients of Pearson correlation between the paired raters were above 0.81 and intraclass correlation coefficients were above 0.81. Cronbach's-α was above 0.7, with the exception of the respiration task. The coefficient of Pearson correlation between the FIM and SCIM III was 0.8 (P<0.001). For the respiration and sphincter management subscale, the SCIM III was more responsive to change, than the FIM (P<0.0001).
Overall, the SCIM III is a reliable and valid measure of functional change in SCI. However, improved scoring instructions and a few modifications to the scoring categories may reduce variability between raters and enhance clinical utility.
Chronic myelomonocytic leukemia (CMML) is a hematologic malignancy nearly confined to the elderly. Previous studies to determine incidence and prognostic significance of somatic mutations in CMML ...have relied on candidate gene sequencing, although an unbiased mutational search has not been conducted. As many of the genes commonly mutated in CMML were recently associated with age-related clonal hematopoiesis (ARCH) and aged hematopoiesis is characterized by a myelomonocytic differentiation bias, we hypothesized that CMML and aged hematopoiesis may be closely related. We initially established the somatic mutation landscape of CMML by whole exome sequencing followed by gene-targeted validation. Genes mutated in ⩾10% of patients were SRSF2, TET2, ASXL1, RUNX1, SETBP1, KRAS, EZH2, CBL and NRAS, as well as the novel CMML genes FAT4, ARIH1, DNAH2 and CSMD1. Most CMML patients (71%) had mutations in ⩾2 ARCH genes and 52% had ⩾7 mutations overall. Higher mutation burden was associated with shorter survival. Age-adjusted population incidence and reported ARCH mutation rates are consistent with a model in which clinical CMML ensues when a sufficient number of stochastically acquired age-related mutations has accumulated, suggesting that CMML represents the leukemic conversion of the myelomonocytic-lineage-biased aged hematopoietic system.
Background Major depressive disorder (MDD) is characterized by abnormalities in structure, function, and connectivity in several brain regions. Few studies have examined how these regions are ...organized in the brain or investigated network-level structural aberrations that might be associated with depression. Methods We used graph analysis to examine the gray matter structural networks of individuals diagnosed with MDD ( n = 93) and a demographically similar healthy comparison group ( n = 151) with no history of psychopathology. The efficiency of structural networks for processing information was determined by quantifying local interconnectivity (clustering) and global integration (path length). We also compared the groups on the contributions of high-degree nodes (i.e., hubs) and regional network measures, including degree (number of connections in a node) and betweenness (fraction of short path connections in a node). Results Depressed participants had significantly decreased clustering in their brain networks across a range of network densities. Compared with control subjects, depressed participants had fewer hubs primarily in medial frontal and medial temporal areas, had higher degree in the left supramarginal gyrus and right gyrus rectus, and had higher betweenness in the right amygdala and left medial orbitofrontal gyrus. Conclusions Networks of depressed individuals are characterized by a less efficient organization involving decreased regional connectivity compared with control subjects. Regional connections in the amygdala and medial prefrontal cortex may play a role in maintaining or adapting to depressive pathology. This is the first report of anomalous large-scale gray matter structural networks in MDD and provides new insights concerning the neurobiological mechanisms associated with this disorder.
•We show results from a Spitzer mid-IR survey of Jupiter-family (JF) comets.•We present 89 new radii and 57 new beaming parameters for the nuclei.•Mean beaming parameter is 1.03±0.11, so ensemble ...thermal inertia is low.•Our independent cumulative size distribution is similar to earlier work.•There are likely low-perihelion, large JF nuclei still undiscovered.
We present results from SEPPCoN, an on-going Survey of the Ensemble Physical Properties of Cometary Nuclei. In this report we discuss mid-infrared measurements of the thermal emission from 89 nuclei of Jupiter-family comets (JFCs). All data were obtained in 2006 and 2007 using imaging capabilities of the Spitzer Space Telescope. The comets were typically 4–5AU from the Sun when observed and most showed only a point-source with little or no extended emission from dust. For those comets showing dust, we used image processing to photometrically extract the nuclei. For all 89 comets, we present new effective radii, and for 57 comets we present beaming parameters. Thus our survey provides the largest compilation of radiometrically-derived physical properties of nuclei to date. We have six main conclusions: (a) The average beaming parameter of the JFC population is 1.03±0.11, consistent with unity; coupled with the large distance of the nuclei from the Sun, this indicates that most nuclei have Tempel 1-like thermal inertia. Only two of the 57 nuclei had outlying values (in a statistical sense) of infrared beaming. (b) The known JFC population is not complete even at 3km radius, and even for comets that approach to ∼2AU from the Sun and so ought to be more discoverable. Several recently-discovered comets in our survey have small perihelia and large (above ∼2km) radii. (c) With our radii, we derive an independent estimate of the JFC nuclear cumulative size distribution (CSD), and we find that it has a power-law slope of around −1.9, with the exact value depending on the bounds in radius. (d) This power-law is close to that derived by others from visible-wavelength observations that assume a fixed geometric albedo, suggesting that there is no strong dependence of geometric albedo with radius. (e) The observed CSD shows a hint of structure with an excess of comets with radii 3–6km. (f) Our CSD is consistent with the idea that the intrinsic size distribution of the JFC population is not a simple power-law and lacks many sub-kilometer objects.
Context. B-type asteroids constitute a peculiar spectral class within the C-complex. Previous work has pointed out the difference between the visible geometric albedos of B-types and those of the ...Pallas collisional family (PCF), whose few members with observed spectra are B-types (one exception out of eight objects). This has been interpreted as being due to compositional differences. However, the PCF members are typically smaller than the spectroscopically classified B-types, and the following possibilities have not been ruled out: the albedo differences might be related to a size-albedo dependence and/or to the generally larger errors of the WISE data and best-fitting values of the derived parameters expected for smaller objects. Aims. We compare albedos and beaming parameters of PCF members and B-types of similar sizes and re-examine our conclusion on the different composition of the PCF. Methods. By modelling their WISE/NEOWISE data, we derived sizes and albedos of all objects whose Sloan Digital Sky Survey reflectances are similar to the typical B-type reflectance spectra. In particular, we derived the so-called infrared beaming parameters (η), effective diameters (D), and corresponding visible geometric albedos (pV), and studied their value distributions. Results. We obtained the effective diameter and geometric visible albedo for ~600 B-type asteroids whose sizes range between 2 and 100 km, approximately half of which have fitted η-values that are inversely correlated to size. We found that the albedo distributions of the PCF is significantly different from that of other B-types in the same size range (2−20 km), and we rule out any size-albedo dependency or biases related to the lower quality of the pV-values of smaller objects. In addition, we also found differences between the η-value distribution of the PCF and the other similarly-sized B-types. Conclusions. The differences in the visible albedos of PCF members and the other B-types of similar sizes is a strong indication that their compositions are different. The trend between beaming parameter and size of the B-types (excluding the PCF) is consistent with the expectation that the surfaces of smaller asteroids have coarser rocks than do those of larger objects (D> 40 km), which are thought to be covered by a finer, more insulating layer of dust.
Stemflow has distinguishable effects on the hydrology and biogeochemistry of wooded ecosystems. Nonetheless, it is a relatively poorly understood hydrologic process. No known studies have ...investigated the temporal variability of stemflow volume at 5-min intervals in a beech-yellow poplar forest of eastern North America. The aim of this research is to compare the temporal variability of stemflow generation by
Fagus grandifolia Ehrh. (American beech) and
Liriodendron tulipifera L. (yellow poplar) in relation to tree species and size. Employing a dense network of tipping-bucket stemflow gages interfaced with a datalogger, a 5
min stemflow yield database was assembled and analyzed to better discern how stemflow production varies (temporally) with tree species and size. Results indicate that both tree species and size have detectable effects on the temporal variability of stemflow yield. Observational data, scientific analysis, and correspondence analysis reveals that stemflow yield: (1) is more similar within than between the two tree species with differences likely being attributable to differences in bark texture and water storage capacity; (2) tree size affects stemflow yield within species; (3) rain event characteristics affect stemflow yield; and (4) stemflow yield for particular trees and rain events is the result of a complex set of interactions among tree species, tree size, and meteorological conditions. These results suggest that the temporal variation in stemflow yield from co-occurring forest trees may play a significant role in subsurface drainage of wooded ecosystems during rain events.
The Great Recession increased income inequality by an average of 6%. We assesses the impact of that on subjective wellbeing (happiness, life satisfaction). Data: European Quality of Life survey, 25 ...representative national samples at three time points, over 70,000 respondents. Analysis: variance-components multi-level models controlling for GDP per capita (an essential point) and individual-level predictors. Findings: income inequality has no statistically significant impact before, during, or after the Great Recession. Instead (contrary to much previous research) a straightforward individualistic utilitarian–materialist understanding is supported: money does increase wellbeing but inequality itself—the gap between rich and poor—is irrelevant.
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