To study the risk factors for the development of moyamoya syndrome after cranial irradiation for primary brain tumors in children.
We reviewed neuroimaging studies and dosimetry data for 456 children ...who were treated with radiation for a primary brain tumor and who were prospectively evaluated with serial neuroimaging studies and neurologic evaluations. A total of 345 patients had both adequate neuroimaging and radiation dosimetry data for further analysis. We used survival analysis techniques to examine the relationship of clinically important variables as risk factors for the development of moyamoya over time.
Overall, 12 patients (3.5%) developed evidence of moyamoya. The onset of moyamoya was more rapid for patients with neurofibromatosis type 1 (NF1) (median of 38 vs 55 months) and for patients who received >5,000 cGy of radiation (median of 42 vs 67 months). In a multiple Cox proportional hazards regression analysis controlling for age at start of radiation, each 100-cGy increase in radiation dose increased the rate of moyamoya by 7% (hazard ratio HR = 1.07, 95% CI: 1.02 to 1.13, p = 0.01) and the presence of NF1 increased the rate of moyamoya threefold (HR = 3.07, 95% CI: 0.90 to 10.46, p = 0.07).
Moyamoya syndrome is a potentially serious complication of cranial irradiation in children, particularly for those patients with tumors in close proximity to the circle of Willis, such as optic pathway glioma. Patients who received higher doses of radiation to the circle of Willis and with neurofibromatosis type 1 have increased risk of the development of moyamoya syndrome.
Objective
Spectral CT differs from dual-energy CT by using a conventional X-ray tube and a photon-counting detector. We wished to produce 3D spectroscopic images of mice that distinguished calcium, ...iodine and barium.
Methods
We developed a desktop spectral CT, dubbed MARS, based around the Medipix2 photon-counting energy-discriminating detector. The single conventional X-ray tube operated at constant voltage (75 kVp) and constant current (150 µA). We anaesthetised with ketamine six black mice (C57BL/6). We introduced iodinated contrast material and barium sulphate into the vascular system, alimentary tract and respiratory tract as we euthanised them. The mice were preserved in resin and imaged at four detector energy levels from 12 keV to 42 keV to include the K-edges of iodine (33.0 keV) and barium (37.4 keV). Principal component analysis was applied to reconstructed images to identify components with independent energy response, then displayed in 2D and 3D.
Results
Iodinated and barium contrast material was spectrally distinct from soft tissue and bone in all six mice. Calcium, iodine and barium were displayed as separate channels on 3D colour images at <55 µm isotropic voxels.
Conclusion
Spectral CT distinguishes contrast agents with K-edges only 4 keV apart. Multi-contrast imaging and molecular CT are potential future applications.
Little is known about the relative importance of monocyte and tissue-resident macrophages in the development of lung fibrosis. We show that specific genetic deletion of monocyte-derived alveolar ...macrophages after their recruitment to the lung ameliorated lung fibrosis, whereas tissue-resident alveolar macrophages did not contribute to fibrosis. Using transcriptomic profiling of flow-sorted cells, we found that monocyte to alveolar macrophage differentiation unfolds continuously over the course of fibrosis and its resolution. During the fibrotic phase, monocyte-derived alveolar macrophages differ significantly from tissue-resident alveolar macrophages in their expression of profibrotic genes. A population of monocyte-derived alveolar macrophages persisted in the lung for one year after the resolution of fibrosis, where they became increasingly similar to tissue-resident alveolar macrophages. Human homologues of profibrotic genes expressed by mouse monocyte-derived alveolar macrophages during fibrosis were up-regulated in human alveolar macrophages from fibrotic compared with normal lungs. Our findings suggest that selectively targeting alveolar macrophage differentiation within the lung may ameliorate fibrosis without the adverse consequences associated with global monocyte or tissue-resident alveolar macrophage depletion.
Aim
Radiologically assessed muscle mass has been suggested as a surrogate marker of functional status and frailty and may predict patients at risk of postoperative complications. We hypothesize that ...sarcopenia negatively impacts on postoperative recovery and is predictive of complications.
Method
One hundred patients undergoing elective resection for colorectal carcinoma were included in this study. Lean muscle mass was estimated by measuring the cross‐sectional area of the psoas muscle at the level of the third lumbar vertebra identified on a preoperative CT scan, normalizing for patient height. Perioperative morbidity was scored according to the Clavien–Dindo classification. All statistical data analyses were carried out using the Statistical Package for the Social Sciences (SPSS) version 20.0.
Results
Fifteen per cent of patients were identified as sarcopenic. There were no deaths in the study group. Sarcopenia was associated with a significantly increased risk of developing major complications (Grade 3 or greater, OR = 5.41, 95% CI: 1.45–20.15, P = 0.01). Sarcopenia did not predict length of stay, critical care dependency or time to mobilization.
Conclusion
Sarcopenia, as a marker of frailty, is an important risk factor in surgical patients but difficult to estimate using bedside testing. CT scans, performed for preoperative staging, provide an opportunity to quantify lean muscle mass without additional cost or exposure to radiation and eliminate the inconvenience of further investigations.
We present the final Sloan Digital Sky Survey IV (SDSS-IV) quasar catalog from Data Release 16 of the extended Baryon Oscillation Spectroscopic Survey (eBOSS). This catalog comprises the largest ...selection of spectroscopically confirmed quasars to date. The full catalog includes two subcatalogs (the current versions are DR16Q_v4 and DR16Q_Superset_v3 at https://data.sdss.org/sas/dr16/eboss/qso/DR16Q/): a "superset" of all SDSS-IV/eBOSS objects targeted as quasars containing 1,440,615 observations and a quasar-only catalog containing 750,414 quasars, including 225,082 new quasars appearing in an SDSS data release for the first time, as well as known quasars from SDSS-I/II/III. We present automated identification and redshift information for these quasars alongside data from visual inspections for 320,161 spectra. The quasar-only catalog is estimated to be 99.8% complete with 0.3%-1.3% contamination. Automated and visual inspection redshifts are supplemented by redshifts derived via principal component analysis and emission lines. We include emission-line redshifts for H , Hβ, Mg ii, C iii, C iv, and Ly . Identification and key characteristics generated by automated algorithms are presented for 99,856 broad absorption-line quasars and 35,686 damped Lyman alpha quasars. In addition to SDSS photometric data, we also present multiwavelength data for quasars from the Galaxy Evolution Explorer, UKIDSS, the Wide-field Infrared Survey Explorer, FIRST, ROSAT/2RXS, XMM-Newton, and Gaia. Calibrated digital optical spectra for these quasars can be obtained from the SDSS Science Archive Server.
Fixating a small dot is a universal technique for stabilizing gaze in vision and eye movement research, and for clinical imaging of normal and diseased retinae. During fixation, microsaccades and ...drifts occur that presumably benefit vision, yet microsaccades compromise image stability and usurp task attention. Previous work suggested that microsaccades and smooth pursuit catch-up saccades are controlled by similar mechanisms. This, and other previous work showing fewer catch-up saccades during smooth pursuit of peripheral targets suggested that a peripheral target might similarly mitigate microsaccades. Here, human observers fixated one of three stimuli: a small central dot, the center of a peripheral, circular array of small dots, or a central/peripheral stimulus created by combining the two. The microsaccade rate was significantly lower with the peripheral array than with the dot. However, inserting the dot into the array increased the microsaccade rate to single-dot levels. Drift speed also decreased with the peripheral array, both with and without the central dot. Eye position variability was higher with the array than with the composite stimulus. The results suggest that analogous to the foveal pursuit, foveating a stationary target engages the saccadic system likely compromising retinal-image stability. In contrast, fixating a peripheral stimulus improves stability, thereby affording better retinal imaging and releasing attention for experimental tasks.
Measuring factors influencing time to presentation is important in developing and evaluating interventions to promote timely cancer diagnosis, yet there is a lack of validated, culturally relevant ...measurement tools. This study aimed to develop and validate the African Women Awareness of CANcer (AWACAN) tool to measure awareness of breast and cervical cancer in Sub-Saharan Africa (SSA).
Development of the AWACAN tool followed 4 steps: 1) Item generation based on existing measures and relevant literature. 2) Refinement of items via assessment of content and face validity using cancer experts' ratings and think aloud interviews with community participants in Uganda and South Africa. 3) Administration of the tool to community participants, university staff and cancer experts for assessment of validity using test-retest reliability (using Intra-Class Correlation (ICC) and adjusted Kappa coefficients), construct validity (comparing expert and community participant responses using t-tests) and internal reliability (using the Kuder-Richarson (KR-20) coefficient). 4) Translation of the final AWACAN tool into isiXhosa and Acholi.
ICC scores indicated good test-retest reliability (≥ 0.7) for all breast cancer knowledge domains and cervical cancer risk factor and lay belief domains. Experts had higher knowledge of breast cancer risk factors (p < 0.001), and cervical cancer risk factors (p = 0.003) and symptoms (p = 0.001) than community participants, but similar knowledge of breast cancer symptoms (p = 0.066). Internal reliability for breast cancer risk factors, lay beliefs and symptom and cervical cancer symptom subscales was good with KR-20 values > 0.7, and lower (0.6) for the cervical cancer risk subscale.
The final AWACAN tool includes items on socio-demographic details; breast and cervical cancer symptom awareness, risk factor awareness, lay beliefs, anticipated help-seeking behaviour; and barriers to seeking care. The tools showed evidence of content, face, construct and internal validity and test-retrest reliability and are available for use in SSA in three languages.
We present the discovery and characterization of two sub-Neptunes in close orbits, as well as a tentative outer planet of a similar size, orbiting TOI-1260 – a low metallicity K6 V dwarf star. ...Photometry from Transiting Exoplanet Survey Satellite(TESS) yields radii of R(b) = 2.33 ± 0.10 and R(c) = 2.82 ± 0.15 Rꚛ, and periods of 3.13 and 7.49 d for TOI-1260 b and TOI-1260 c, respectively. We combined the TESS data with a series of ground-based follow-up observations to characterize the planetary system. From HARPS-N high-precision radial velocities we obtain M(b) = 8.6(+1.4,−1.5) and M(c) = 11.8(+3.4,−3.2) Mꚛ. The star is moderately active with a complex activity pattern, which necessitated the use of Gaussian process regression for both the light-curve detrending and the radial velocity modelling, in the latter case guided by suitable activity indicators. We successfully disentangle the stellar-induced signal from the planetary signals, underlining the importance and usefulness of the Gaussian process approach. We test the system’s stability against atmospheric photoevaporation and find that the TOI-1260 planets are classic examples of the structure and composition ambiguity typical for the 2–3 Rꚛ range.
The change in resistance of a material in a magnetic field reflects its electronic state. In metals with weakly- or non-interacting electrons, the resistance typically increases upon the application ...of a magnetic field. In contrast, negative magnetoresistance may appear under some circumstances, e.g., in metals with anisotropic Fermi surfaces or with spin-disorder scattering and semimetals with Dirac or Weyl electronic structures. Here we show that the non-magnetic semimetal TaAs2 possesses a very large negative magnetoresistance, with an unknown scattering mechanism. Density functional calculations find that TaAs2 is a new topological semimetal ℤ2 invariant (0;111) without Dirac dispersion, demonstrating that a negative magnetoresistance in non-magnetic semimetals cannot be attributed uniquely to the Adler-Bell-Jackiw chiral anomaly of bulk Dirac/Weyl fermions.
Purpose
Transforaminal endoscopic discectomy (TED) minimises paraspinal muscle damage. The aim of this trial was to compare clinical outcomes of TED to Microdiscectomy (Micro).
Methods
143 patients, ...age 25–70 years and <115 kg, with single level lumbar prolapse and radiculopathy, were recruited and randomised. 70 received TED under conscious sedation and 70 Micro under general anaesthesia. Oswestry Disability Index (ODI), visual analogue scores (VAS) of back and leg pain, and Short Form Health Survey indices (SF-36) were measured preoperatively and at 3, 12 and 24 months.
Results
All outcome measures improved significantly in both groups (
p
< 0.001). Affected side leg pain was lower in the TED group at 2 years (1.9 ± 2.6 vs 3.5 ± 3.1,
p
= 0.002). Hospital stay was shorter following TED (0.7 ± 0.7 vs 1.4 ± 1.3 days,
p
< 0.001). Two Micro patients and five TED patients required revision giving a relative risk of revision for TED of 2.62 (95% CI 0.49–14.0).
Conclusions
Functional improvements were maintained at 2 years in both groups with less ongoing sciatica after TED. A greater revision rate after TED was offset by a more rapid recovery.
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