Inner and outer retinal morphology were quantified in vivo for 6 nonglaucomatous and 10 glaucomatous optic neuropathy patients. Custom, ultrahigh-resolution imaging modalities were used to evaluate ...segmented retinal layer thickness in 3D volumes (Fourier-domain optical coherence tomography), cone photoreceptor density (adaptive optics fundus camera), and the length of inner and outer segments of cone photoreceptors (adaptive optics-optical coherence tomography). Quantitative comparisons were made with age-matched controls, or by comparing affected and nonaffected retinal areas defined by changes in visual fields. The integrity of outer retinal layers on optical coherence tomography B-scans and density of cone photoreceptors were correlated with visual field sensitivity at corresponding retinal locations following reductions in inner retinal thickness. The photoreceptor outer segments were shorter and exhibited greater variability in retinal areas associated with visual field losses compared with normal or less affected areas of the same patient's visual field. These results demonstrate that nonglaucomatous and glaucomatous optic neuropathies are associated with outer retinal changes following long-term inner retinal pathology.
Context. The interstellar and intra-cluster medium (ICM) in giant elliptical galaxies and clusters of galaxies is often assumed to be in hydrostatic equilibrium. Numerical simulations, however, show ...that about 5–30% of the pressure in a cluster is provided by turbulence induced by, for example, the central active galactic nucleus (AGN) and merger activity. Aims. We aim to put constraints on the turbulent velocities and the turbulent pressure in the ICM of the giant elliptical galaxies NGC 5044 and NGC 5813 using XMM-Newton reflection grating spectrometer (RGS) observations. Methods. The magnitude of the turbulence is estimated using the Fe xvii lines at 15.01 Å, 17.05 Å, and 17.10 Å in the RGS spectra. At low turbulent velocities, the gas becomes optically thick in the 15.01 Å line due to resonant scattering, while the 17 Å lines remain optically thin. By comparing the (I17.05 + I17.10)/I15.01 line ratio from RGS with simulated line ratios for different Mach numbers, the level of turbulence is constrained. The measurement is, however, limited by the systematic uncertainty in the line ratio for an optically thin plasma, which is about 20–30%. Results. We find that the (I17.05 + I17.10)/I15.01 line ratio in NGC 5813 is significantly higher than in NGC 5044. This difference can be explained by a higher level of turbulence in NGC 5044. The best estimates for the turbulent velocities using resonant scattering and upper limits from the line widths, are 320 < Vturb < 720 km s-1 for NGC 5044 and 140 < Vturb < 540 km s-1 for NGC 5813 at the 90% confidence limit. Conclusions. The high turbulent velocities and the fraction of the turbulent pressure support of >40% in NGC 5044, assuming isotropic turbulence, confirm that it is a highly disturbed system, probably due to an off-axis merger. The turbulent pressure support in NGC 5813 is more modest at 15–45%. The (I17.05 + I17.10)/I15.01 line ratio in an optically thin plasma, calculated using AtomDB v2.0.1, is 2σ above the ratio measured in NGC 5044, which cannot be explained by resonant scattering. This shows that the discrepancies between theoretical, laboratory, and astrophysical data on Fe xvii lines need to be reduced to improve the accuracy of the determination of turbulent velocities using resonant scattering.
Relative scotopic spectral sensitivity depends only on the rhodopsin photopigment and ocular media absorption spectra. Rhodopsin is well characterised so the relative scotopic spectral sensitivity ...function can be calculated for intraocular lenses (IOLs) of known spectral density. In a recent perspective, Mainster and Sparrow concluded that an IOL with short wave absorbing chromophores would provide more retinal protection than conventional IOLs, but the practical consequences for scotopic vision are unclear. This paper uses published experiments to examine the implications for scotopic vision of the IOLs analysed by Mainster and Sparrow. A 14.6% reduction in scotopic sensitivity is expected for a SN60AT (AcrySof Natural) compared to a SA60AT (Conventional AcrySof) IOL under broadband illumination (equal quantum spectrum). This effect (0.07 log unit) is visually insignificant in relation to the ∼4.0 log unit range of scotopic sensitivity. More importantly, it is expected that scotopic contrast sensitivity would be reduced by only ∼0.01 log unit. It is thus improbable that a difference in scotopic vision between observers with the Natural and Conventional IOLs could be reliably detected using broadband stimuli.
In this paper, we present a timing calibration technique for time-of-flight positron emission tomography (TOF PET) that eliminates the need for a specialized data acquisition. By eliminating the ...acquisition, the process becomes fully automated, and can be performed with any clinical data set and whenever computing resources are available. It also can be applied retroactively to datasets for which a TOF offset calibration is missing or suboptimal. Since the method can use an arbitrary data set to perform a calibration prior to a TOF reconstruction, possibly of the same data set, one also can view this as reconstruction from uncalibrated data. We present a performance comparison with existing calibration techniques.
European starlings are an invasive bird species in North America that are known to cause damage to commercial dairies through the consumption of total mixed rations (TMR) destined for dairy cows. We ...hypothesized that large foraging flocks of starlings alter the physical composition of TMR, and that this change may be significant enough to affect milk production. To better determine if production losses could potentially occur in commercial dairies as a consequence of feed consumption by foraging flocks of starlings, we conducted controlled feeding experiments using a TMR sourced from a commercial dairy that is chronically plagued with seasonal starling damage. European starlings selected the high-energy fraction of the TMR and reduced starch and crude fat availability. Using the dairy National Research Council production model equations, the nutritional changes measured in the controlled feeding experiments could potentially reduce the productivity of dairies. Model output suggests that for Holsteins producing 32 kg of milk/d, total required net energy intake (NEI) was 31.5 Mcal/d. Within the reference TMR, NEI supplied was 29.3 Mcal/d, whereas within the starling-consumed TMR NEI supplied was 27.7 Mcal/d. Following our nutrition experiments, we assessed the efficacy of pelleted feed as a deterrent strategy for bird damage management in commercial dairies. Six different pelleted feed treatments of differing diameter were offered to starlings. All pellets of 0.95 cm diameter or larger inhibited starling consumption by ≥79%.
Savannah-type ecosystems account for 26-30% of global gross primary productivity GPP, with water being one of the major driving factors. In Europe, savannah-type woodlands cover an area of about 1.5 ...million ha. Here, the recent past has shown a significant decrease in precipitation P in winter and spring as well as a decrease in total annual precipitation. Strong effects on local water balance and carbon sink strength have thus been reported due to changes in precipitation regime. The objective of this study is to quantify the impact of the extreme drought event in 2012 on the water balance, gross primary productivity and carbon sink strength of a typical Portuguese cork-oak woodland (montado) compared to the wet year of 2011. Physiological responses of the dominant tree species Quercus suber (L.) are disentangled employing combined photosynthesis and stomatal conductance modelling. Precipitation effectiveness ET/P increased from 86% in 2011 to 122% in the 2012 dry year due to deep soil or groundwater access of the Q. suber trees leaving no water for groundwater replenishment. Understorey and overstorey GPP were strongly reduced, by 53 and 28%, respectively, in 2012 compared to 2011, due to the late onset of the autumn rains in 2011 and an additional severe winter/spring drought. However, the ecosystem was still a carbon sink in both years, but with a 38% reduced sink strength under extreme drought in 2012 compared to 2011. The combined photosynthesis-stomatal conductance model yielded the best results if it was allowed to adjust photosynthetic and stomatal parameters simultaneously. If stomatal response was modelled with the Leuning approach, which allows for a different sensitivity to vapour pressure deficit, the stomatal model parameters were highly coupled. A change in either of the parameters needed to be compensated by the other to guarantee a stable sensitivity of stomatal conductance to assimilation, independent of variations in vapour pressure deficit. The Q. suber trees showed a 37% reduced stomatal conductance during the drought period of 2012 compared to 2011, due to water supply limitations. In response to reduced leaf-internal CO2 availability, the trees strongly reduced the apparent maximum carboxylation rate by 43% in 2012 compared to 2011. Unexpectedly, the optimum temperature Topt of the maximum electron transport rate decreased during the drought period, enhancing the susceptibility of the trees to high temperature stress during the summer. Our results suggest that, if the trend of decreasing annual precipitation and changed precipitation patterns on the Iberian Peninsula continues, sustained effects on local groundwater reservoirs, understorey species composition and tree mortality have to be expected in the long term. To model the effect of drought on the montado ecosystem successfully, variable apparent maximum carboxylation rate Vc,max, stomatal conductance parameter m and vapour pressure deficit sensitivity parameter D0 need to be incorporated into photosynthesis-stomatal conductance modelling.
By combining large-scale mosaics of ROSAT PSPC, XMM-Newton, and Suzaku X-ray observations, we present evidence for large-scale motions in the intracluster medium of the nearby, X-ray bright Perseus ...Cluster. These motions are suggested by several alternating and interleaved X-ray bright, low-temperature, low-entropy arcs located along the east-west axis, at radii ranging from ~ 10 kpc to over a Mpc. Thermodynamic features qualitatively similar to these have previously been observed in the centers of cool-core clusters, and were successfully modeled as a consequence of the gas sloshing/swirling motions induced by minor mergers. Our observations indicate that such sloshing/swirling can extend out to larger radii than previously thought, on scales approaching the virial radius.
The patients with unresectable perihilar cholangiocarcinoma require biliary drainage to relieve symptoms and allow for palliative systemic chemotherapy. The aim of this study was to establish the ...success, complication, and mortality rates of the initial biliary drainage in patients with unresectable perihilar cholangiocarcinoma at presentation.
In this retrospective multicenter study, patients with unresectable perihilar cholangiocarcinoma who underwent initial endoscopic or percutaneous transhepatic biliary drainage between 2002 and 2014 were included. The success of drainage was defined as a successful biliary stent or drain placement, no unscheduled reintervention within 14 days, and serum bilirubin levels <50 μmol/L (ie, 2.9 mg/dL) or a >50% decrease in serum bilirubin after 14 days. Severe complications, and 90-day mortality were recorded.
Included were 186 patients: 161 (87%) underwent initial endoscopic biliary drainage and 25 (13%) underwent initial percutaneous transhepatic biliary drainage. The success of initial drainage was observed in 73 patients (45%) after endoscopic biliary drainage and 6 (24%) after percutaneous transhepatic biliary drainage. The reasons for an unsuccessful initial drainage were: the failure to place a drain or stent in 39 patients (21%), an unplanned reintervention within 14 days in 52 patients (28%), and the bilirubin level >50 μmol/L (or not halved) after 14 days of initial drainage in 16 patients (9%). Severe drainage-related complications occurred in 19 patients (12%) after endoscopic biliary drainage and in 3 (12%) after percutaneous transhepatic biliary drainage. Overall, 66 patients (36%) died within 90 days after initial biliary drainage.
Initial biliary drainage in patients with unresectable perihilar cholangiocarcinoma had a success rate of 45% and a 90-day mortality rate of 36%. Future studies for patients with perihilar cholangiocarcinoma should focus on improving biliary drainage.
Guidelines are inconclusive on whether contrast-enhanced MRI using gadoxetic acid and diffusion-weighted imaging should be added routinely to CT in the investigation of patients with colorectal liver ...metastases who are scheduled for curative liver resection or thermal ablation, or both. Although contrast-enhanced MRI is reportedly superior than contrast-enhanced CT in the detection and characterisation of colorectal liver metastases, its effect on clinical patient management is unknown. We aimed to assess the clinical effect of an additional liver contrast-enhanced MRI on local treatment plan in patients with colorectal liver metastases amenable to local treatment, based on contrast-enhanced CT.
We did an international, multicentre, prospective, incremental diagnostic accuracy trial in 14 liver surgery centres in the Netherlands, Belgium, Norway, and Italy. Participants were aged 18 years or older with histological proof of colorectal cancer, a WHO performance status score of 0-4, and primary or recurrent colorectal liver metastases, who were scheduled for local therapy based on contrast-enhanced CT. All patients had contrast-enhanced CT and liver contrast-enhanced MRI including diffusion-weighted imaging and gadoxetic acid as a contrast agent before undergoing local therapy. The primary outcome was change in the local clinical treatment plan (decided by the individual clinics) on the basis of liver contrast-enhanced MRI findings, analysed in the intention-to-image population. The minimal clinically important difference in the proportion of patients who would have change in their local treatment plan due to an additional liver contrast-enhanced MRI was 10%. This study is closed and registered in the Netherlands Trial Register, NL8039.
Between Dec 17, 2019, and July 31, 2021, 325 patients with colorectal liver metastases were assessed for eligibility. 298 patients were enrolled and included in the intention-to-treat population, including 177 males (59%) and 121 females (41%) with planned local therapy based on contrast-enhanced CT. A change in the local treatment plan based on liver contrast-enhanced MRI findings was observed in 92 (31%; 95% CI 26-36) of 298 patients. Changes were made for 40 patients (13%) requiring more extensive local therapy, 11 patients (4%) requiring less extensive local therapy, and 34 patients (11%) in whom the indication for curative-intent local therapy was revoked, including 26 patients (9%) with too extensive disease and eight patients (3%) with benign lesions on liver contrast-enhanced MRI (confirmed by a median follow-up of 21·0 months IQR 17·5-24·0).
Liver contrast-enhanced MRI should be considered in all patients scheduled for local treatment for colorectal liver metastases on the basis of contrast-enhanced CT imaging.
The Dutch Cancer Society and Bayer AG - Pharmaceuticals.
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