Automatic pedicle screw planning using atlas-based registration of anatomy and reference trajectories

An algorithm for automatic spinal pedicle screw planning is reported and evaluated in simulation and first clinical studies. A statistical atlas of the lumbar spine (N  =  40 members) was constructed for active shape model (ASM) registration of target vertebrae to an unsegmented patient CT. The atlas was augmented to include 'reference' trajectories through the pedicles as defined by a spinal neurosurgeon. Following ASM registration, the trajectories are transformed to the patient CT and accumulated to define a patient-specific screw trajectory, diameter, and length. The algorithm was evaluated in leave-one-out analysis (N  =  40 members) and for the first time in a clinical study (N  =  5 patients undergoing cone-beam CT (CBCT) guided spine surgery), and in simulated low-dose CBCT images. ASM registration achieved (2.0  ±  0.5) mm root-mean-square-error (RMSE) in surface registration in 96% of cases, with outliers owing to limitations in CT image quality (high noise/slice thickness). Trajectory centerlines were conformant to the pedicle in 95% of cases. For all non-breaching trajectories, automatically defined screw diameter and length were similarly conformant to the pedicle and vertebral body (98.7%, Grade A/B). The algorithm performed similarly in CBCT clinical studies (93% centerline and screw conformance) and was consistent at the lowest dose levels tested. Average runtime in planning five-level (lumbar) bilateral screws (ten trajectories) was (312.1  ±  104.0) s. The runtime per level for ASM registration was (41.2  ±  39.9) s, and the runtime per trajectory was (4.1  ±  0.8) s, suggesting a runtime of ~(45.3  ±  39.9) s with a more fully parallelized implementation. The algorithm demonstrated accurate, automatic definition of pedicle screw trajectories, diameter, and length in CT images of the spine without segmentation. The studies support translation to clinical studies in free-hand or robot-assisted spine surgery, quality assurance, and data analytics in which fast trajectory definition is a benefit to workflow.

[Repair effect of adipose-derived mesenchymal stem cells on lung injury in rats exposed to silica]

Objective: To observe the repairing effect of adipose mesenchymal stem cells (ADSCs) on lung injury induced by silica in rats. Methods: Primary ADSCs-GFP was obtained from rats. ADSCs-GFP was injected into tail vein of silicosis model rats. The expression of green fluorescence in lungs was observed regularly to determine the homing ability of ADSCs. Primary ADSCs of rats were obtained and randomly divided into control group, exposure group, vehicle group and ADSCs group. Silicosis rat model was established by non-exposed tracheal drip method. 24 hours after silica exposure, rats in ADSCs group were injected with ADSCs of 1×10(6)/kg body weight through tail vein, and the pathological changes of lung tissue were observed and evaluated 28 days after intervention. To explore the early intervention mechanism of ADSCs on pulmonary fibrosis in silicosis model rats, apoptosis-related proteins were detected by immunohistochemistry. Results: 28 days after exposure to silica, rats in the exposure group showed obvious pulmonary fibrosis. Compared with exposure group and vehicle group, ADSCs group showed less pulmonary inflammation, less silica nodules and less collagen deposition area. Immunohistochemical results showed that the expression of Caspase-3 and cytochrome C protein decreased and Bcl-2 protein increased after ADSCs transplantation. Conclusion: ADSCs infusion has an obvious intervention effect on postponing early silicosis fibrosis in rats exposed to silica, and its mechanism is related to the regulation of apoptotic process.

Beam Energy and Centrality Dependence of Direct-Photon Emission from Ultrarelativistic Heavy-Ion Collisions

The PHENIX collaboration presents first measurements of low-momentum (0.4<p_{T}<3  GeV/c) direct-photon yields from Au+Au collisions at sqrt[s_{NN}]=39 and 62.4 GeV. For both beam energies the direct-photon yields are substantially enhanced with respect to expectations from prompt processes, similar to the yields observed in Au+Au collisions at sqrt[s_{NN}]=200. Analyzing the photon yield as a function of the experimental observable dN_{ch}/dη reveals that the low-momentum (>1  GeV/c) direct-photon yield dN_{γ}^{dir}/dη is a smooth function of dN_{ch}/dη and can be well described as proportional to (dN_{ch}/dη)^{α} with α≈1.25. This scaling behavior holds for a wide range of beam energies at the Relativistic Heavy Ion Collider and the Large Hadron Collider, for centrality selected samples, as well as for different A+A collision systems. At a given beam energy, the scaling also holds for high p_{T} (>5  GeV/c), but when results from different collision energies are compared, an additional sqrt[s_{NN}]-dependent multiplicative factor is needed to describe the integrated-direct-photon yield.

[Study on occupational exposure limits of tributyl phosphate in the workplace air]

Objective: To put forward the suggestion of the occupational contact limit of tributyl phosphate in the air of the workplace. Methods: Data of production and usage, workers' basic information, occupational history, and physical examinations were collected, and the environmental and individual levels of exposure were monitored using fixed-point and individual sampling. The results of the questionnaire and health examination were statistically analyzed using exact probability method of Fisher in the workers exposed to tributyl phosphate and the control group. Results: The results showed that tributyl phosphate was widely distributed in the workplace of production and using enterprises, and the concentration of tributyl phosphate in packaging area was highest at 2.47 mg/m(3), and in feeder nose was highest at 2.13 mg/m(3). The discomfort symptoms were classified and results showed that tributyl phosphate exposure group of 136 people, all symptoms of 128 people, accounting for 94.44% of the total, the remaining 5.56% of the staff report had psychiatric symptoms or lethargy and irritability skin itching, the control group had no symptoms. There is or not discomfort symptoms in the tributyl phosphate exposure group and the control group was compared with the exact probability of Fisher, and the difference was statistically significant (P<0.05) . The results of healthy physical examination of workers exposed to tributyl phosphate and control group were statistically analyzed by the exact probability method of Fisher. The results showed that there was no significant difference in the results of routine internal medical examination, nervous system examination, skin examination, five senses examination, blood routine, urine routine, lung ventilation, and X ray chest fluoroscopy between the tributyl phosphate exposure group and the control group (P<0.05) . Conclusion: The workplace permissible time-weighted tributyl phosphate and short-term exposure limit concentrations in China were set at 2.5 mg/m(3) and 5 mg/m(3), respectively.

[Particulate matter pollution and allergic rhinitis]

Summary Outdoor air pollution has become a major environmental health problem throughout the world. In particular, exposure to particulate matter(PM) has been associated with the development and exacerbation of allergic rhinitis（AR）. Although the adverse health effects of PM have been demonstrated for many years, the underlying mechanisms have not been fully identified. In this review, we refer to recently published literature to describe the composition of PM, the epidemiological evidence of PM-induced AR, and the possible immune mechanisms of PM-induced AR.

Bacterial population dynamics after foliar fertilization of almond leaves

AIMS

To describe the effects of foliar fertilizer application on the bacterial populations of almond tree leaves.

METHODS AND RESULTS

We applied a commercially available foliar fertilizer or a water control onto the leaves of almond trees and collected leaves after 1, 7, 14 and 56 days and examined their bacterial populations by 16S rRNA gene sequence analysis. After 1 day, we observed significant differences in 3 of the 4 predominant bacterial phyla, and 5 of the 13 predominant bacterial families. After 7 days, we observed significant differences in all of the predominant phyla, and 8 of the 13 predominant families. After 14 days, the number of significant differences decreased, and after 56 days only 2 of the 13 predominant families differed significantly.

CONCLUSIONS

Foliar fertilization significantly altered the bacterial population structure of almond leaves as compared to the water control. While most of the observed perturbation was transient, significant differences remained after 56 days.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first report describing the effects of foliar fertilization on the bacterial populations of almond leaves and provides new insights as to how this process alters the leaf bacterial population structure.

Real-time, image-based slice-to-volume registration for ultrasound-guided spinal intervention

Real-time fusion of magnetic resonance (MR) and ultrasound (US) images could facilitate safe and accurate needle placement in spinal interventions. We develop an entirely image-based registration method (independent of or complementary to surgical trackers) that includes an efficient US probe pose initialization algorithm. The registration enables the simultaneous display of 2D ultrasound image slices relative to 3D pre-procedure MR images for navigation. A dictionary-based 3D-2D pose initialization algorithm was developed in which likely probe positions are predefined in a dictionary with feature encoding by Haar wavelet filters. Feature vectors representing the 2D US image are computed by scaling and translating multiple Haar basis filters to capture scale, location, and relative intensity patterns of distinct anatomical features. Following pose initialization, fast 3D-2D registration was performed by optimizing normalized cross-correlation between intra- and pre-procedure images using Powell's method. Experiments were performed using a lumbar puncture phantom and a fresh cadaver specimen presenting realistic image quality in spinal US imaging. Accuracy was quantified by comparing registration transforms to ground truth motion imparted by a computer-controlled motion system and calculating target registration error (TRE) in anatomical landmarks. Initialization using a 315-length feature vector yielded median translation accuracy of 2.7 mm (3.4 mm interquartile range, IQR) in the phantom and 2.1 mm (2.5 mm IQR) in the cadaver. By comparison, storing the entire image set in the dictionary and optimizing correlation yielded a comparable median accuracy of 2.1 mm (2.8 mm IQR) in the phantom and 2.9 mm (3.5 mm IQR) in the cadaver. However, the dictionary-based method reduced memory requirements by 47×  compared to storing the entire image set. The overall 3D error after registration measured using 3D landmarks was 3.2 mm (1.8 mm IQR) mm in the phantom and 3.0 mm (2.3 mm IQR) mm in the cadaver. The system was implemented in a 3D Slicer interface to facilitate translation to clinical studies. Haar feature based initialization provided accuracy and robustness at a level that was sufficient for real-time registration using an entirely image-based method for ultrasound navigation. Such an approach could improve the accuracy and safety of spinal interventions in broad utilization, since it is entirely software-based and can operate free from the cost and workflow requirements of surgical trackers.

A momentum-based diffeomorphic demons framework for deformable MR-CT image registration

Neuro-navigated procedures require a high degree of geometric accuracy but are subject to geometric error from complex deformation in the deep brain-e.g. regions about the ventricles due to egress of cerebrospinal fluid (CSF) upon neuroendoscopic approach or placement of a ventricular shunt. We report a multi-modality, diffeomorphic, deformable registration method using momentum-based acceleration of the Demons algorithm to solve the transformation relating preoperative MRI and intraoperative CT as a basis for high-precision guidance. The registration method (pMI-Demons) extends the mono-modality, diffeomorphic form of the Demons algorithm to multi-modality registration using pointwise mutual information (pMI) as a similarity metric. The method incorporates a preprocessing step to nonlinearly stretch CT image values and incorporates a momentum-based approach to accelerate convergence. Registration performance was evaluated in phantom and patient images: first, the sensitivity of performance to algorithm parameter selection (including update and displacement field smoothing, histogram stretch, and the momentum term) was analyzed in a phantom study over a range of simulated deformations; and second, the algorithm was applied to registration of MR and CT images for four patients undergoing minimally invasive neurosurgery. Performance was compared to two previously reported methods (free-form deformation using mutual information (MI-FFD) and symmetric normalization using mutual information (MI-SyN)) in terms of target registration error (TRE), Jacobian determinant (J), and runtime. The phantom study identified optimal or nominal settings of algorithm parameters for translation to clinical studies. In the phantom study, the pMI-Demons method achieved comparable registration accuracy to the reference methods and strongly reduced outliers in TRE (p [Formula: see text] 0.001 in Kolmogorov-Smirnov test). Similarly, in the clinical study: median TRE  =  1.54 mm (0.83-1.66 mm interquartile range, IQR) for pMI-Demons compared to 1.40 mm (1.02-1.67 mm IQR) for MI-FFD and 1.64 mm (0.90-1.92 mm IQR) for MI-SyN. The pMI-Demons and MI-SyN methods yielded diffeomorphic transformations (J  >  0) that preserved topology, whereas MI-FFD yielded unrealistic (J  <  0) deformations subject to tissue folding and tearing. Momentum-based acceleration gave a ~35% speedup of the pMI-Demons method, providing registration runtime of 10.5 min (reduced to 2.2 min on GPU), compared to 15.5 min for MI-FFD and 34.7 min for MI-SyN. The pMI-Demons method achieved registration accuracy comparable to MI-FFD and MI-SyN, maintained diffeomorphic transformation similar to MI-SyN, and accelerated runtime in a manner that facilitates translation to image-guided neurosurgery.

Histone/protein deacetylase inhibitor therapy for enhancement of Foxp3+ T-regulatory cell function posttransplantation

T-regulatory (Treg) cells are like other cells present throughout the body in being subject to biochemical modifications in response to extracellular signals. An important component of these responses involves changes in posttranslational modifications (PTMs) of histones and many nonhistone proteins, including phosphorylation/dephosphorylation, ubiquitination/deubiquitination, and acetylation/deacetylation. Foxp3, the key transcription factor of Tregs, is constantly being rapidly turned over, and a number of these PTMs determine its level of expression and activity. Of interest in the transplant setting, modulation of the acetylation or deacetylation of key lysine residues in Foxp3 can promote the stability and function, leading to increased Treg production and increased Treg suppressive activity. This mini-review focuses on recent data concerning the roles that histone/protein deacetylases (HDACs) play in control of Treg function, and how small molecule HDAC inhibitors can be used to promote Treg-dependent allograft survival in experimental models. These data are discussed in the light of increasing interest in the identification and clinical evaluation of isoform-selective HDAC inhibitors, and their potential application as tools to modulate Foxp3+ Treg cell numbers and function in transplant recipients.

[Cause analysis of one case multiply misdiagnosed patient with hypopharyngeal carcinoma]

The clinical manifestations were pharyngalgia anddysphagia. Physical examination found that the size of a mobilizable and hard lymph node in the area of the right neck Ⅱ was about 2.0 cm×2.0 cm. Ultrasound examination demonstrated abnormal lymphadenopathy in bilateral neck which was considered metastatic cancer. Neck CT showed occupation of the hypopharynx, thickening bilateral aryepiglottic folds and false vocal cords, and enlargement lymph node in the bilateral neck Ⅱ area. Upper gastrointestinal radiography: The mucosa from the lower border of right pear-shaped fossa to the entrance of the esophagus was disrupted, and the partial lumen was narrowed. There were no abnormalities in the remaining segments. Pathologicalexamination of postoperative: hypopharyngealmoderately differentiated squamous cell carcinoma,invasion of the muscularis propria, lymph node cancerometastasis in the left cervical Ⅱ, Ⅲ, and Ⅳ regions (1/19); lymph node cancerometastasis in the right cervical Ⅱ, Ⅲ, and Ⅳ regions (6/12).

LHX6 inhibits the proliferation, invasion and migration of breast cancer cells by modulating the PI3K/Akt/mTOR signaling pathway

OBJECTIVE

LIM homeobox domain 6 (LHX6) is emerging as a critical regulator in carcinogenesis and tumor progression. The previous study has reported the expression and function of LHX6 in breast cancer (BC). However, its mechanism underlying BC metastasis remains largely unclear. This study aimed to investigate the related mechanisms of the tumor-suppressive role of LHX6 in BC.

PATIENTS AND METHODS

Quantitative Real-time PCR (qRT-PCR) and Western blotting were used to determine LHX6 mRNA levels and protein expressions in BC tissues and cell lines. LHX6 protein expression was also analyzed in BC tissues and matched normal breast tissues using immunohistochemistry (IHC). The biologic functions of LHX6 in BC were explored by CCK-8 assay, colony formation assay, and transwell assays in vitro. Finally, we investigated the effect of LHX6 up-regulation on PI3K/AKT/mTOR pathway by Western blot.

RESULTS

Our results showed that LHX6 was lowly expressed at the mRNA and protein level in BC cancer tissues and cell lines. Ectopic expression of LHX6 in MDA-MB-231 and T-47D suppressed cell growth, migration, and invasion. Mechanistically, our further investigations revealed that the upregulation of LHX6 inhibited the activation of the PI3K/Akt/mTOR signaling pathway.

CONCLUSIONS

We firstly provided evidence that LHX6 exerted its anti-tumor function on BC via suppressing activation of the PI3K/Akt/mTOR signaling, which eventually inhibited the progression of BC.

PR-957 mediates neuroprotection by inhibiting Th17 differentiation and modulating cytokine production in a mouse model of ischaemic stroke

Acute ischaemic stroke can induce secondary brain injury by activating an inflammatory response that contributes to clinical impairment. As a specific inhibitor of the immunoproteasome subunit low molecular weight polypeptide 7 (LMP7), PR-957 may participate in regulating pathophysiological and inflammatory responses in multiple diseases of the central nervous system (CNS). We investigated the neuroprotective properties of PR-957 in a mouse model of stroke, induced by middle cerebral artery occlusion (MCAO). After MCAO and injections of PR-957 or vehicle, we evaluated mice behaviourally using modified Neurological Severity Scores (mNSS) and sensorimotor tests, including the adhesive-removal test, a foot-fault test and an inclined plane test. Infarct volume was measured 24 and 72 h after MCAO. Infiltration by different lymphocyte subpopulations was evaluated by flow cytometry and immunofluorescent staining of brain tissue from the penumbral area. Quantitative real-time polymerase chain reaction analysis and enzyme-linked immunosorbent assay were used to measure the expression of proinflammatory cytokines: interkeukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, IL-10, IL-12, IL-17A, interferon (IFN)-γ, tumour necrosis factor (TNF)-α, granulocyte colony-stimulating factor (GCSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF). Expression of phosphorylated signal transducer and activator of transcription 3 (pSTAT-3) protein levels in brain was measured by immunoblot. MCAO mice treated with PR-957 showed a significant decrease in infarct volume and had mild neurological deficits compared to vehicle-treated mice. PR-957 administration also significantly decreased IL-1β, IL-6, IL-12, IL-17A and TNF-α. PR-957 provides neuroprotection via inhibiting T lymphocyte infiltration and decreasing T helper type 17 (Th17) cell differentiation in MCAO mice, which may result from the reduced expression of pSTAT-3. The neuroprotective effect of PR-957 indicates its potential utility as anti-inflammatory therapy for ischaemic stroke.

Inhibition of RhoA reduces propofol-mediated growth cone collapse, axonal transport impairment, loss of synaptic connectivity, and behavioural deficits

BACKGROUND

Exposure of the developing brain to propofol results in cognitive deficits. Recent data suggest that inhibition of neuronal apoptosis does not prevent cognitive defects, suggesting mechanisms other than neuronal apoptosis play a role in anaesthetic neurotoxicity. Proper neuronal growth during development is dependent upon growth cone morphology and axonal transport. Propofol modulates actin dynamics in developing neurones, causes RhoA-dependent depolymerisation of actin, and reduces dendritic spines and synapses. We hypothesised that RhoA inhibition prevents synaptic loss and subsequent cognitive deficits. The present study tested whether RhoA inhibition with the botulinum toxin C3 (TAT-C3) prevents propofol-induced synapse and neurite loss, and preserves cognitive function.

METHODS

RhoA activation, growth cone morphology, and axonal transport were measured in neonatal rat neurones (5-7 days in vitro) exposed to propofol. Synapse counts (electron microscopy), dendritic arborisation (Golgi-Cox), and network connectivity were measured in mice (age 28 days) previously exposed to propofol at postnatal day 5-7. Memory was assessed in adult mice (age 3 months) previously exposed to propofol at postnatal day 5-7.

RESULTS

Propofol increased RhoA activation, collapsed growth cones, and impaired retrograde axonal transport of quantum dot-labelled brain-derived neurotrophic factor, all of which were prevented with TAT-C3. Adult mice previously treated with propofol had decreased numbers of total hippocampal synapses and presynaptic vesicles, reduced hippocampal dendritic arborisation, and infrapyramidal mossy fibres. These mice also exhibited decreased hippocampal-dependent contextual fear memory recall. All anatomical and behavioural changes were prevented with TAT-C3 pre-treatment.

CONCLUSION

Inhibition of RhoA prevents propofol-mediated hippocampal neurotoxicity and associated cognitive deficits.

A line fiducial method for geometric calibration of cone-beam CT systems with diverse scan trajectories

Modern cone-beam CT systems, especially C-arms, are capable of diverse source-detector orbits. However, geometric calibration of these systems using conventional configurations of spherical fiducials (BBs) may be challenged for novel source-detector orbits and system geometries. In part, this is because the BB configurations are designed with careful forethought regarding the intended orbit so that BB marker projections do not overlap in projection views. Examples include helical arrangements of BBs (Rougee et al 1993 Proc. SPIE 1897 161-9) such that markers do not overlap in projections acquired from a circular orbit and circular arrangements of BBs (Cho et al 2005 Med. Phys. 32 968-83). As a more general alternative, this work proposes a calibration method based on an array of line-shaped, radio-opaque wire segments. With this method, geometric parameter estimation is accomplished by relating the 3D line equations representing the wires to the 2D line equations of their projections. The use of line fiducials simplifies many challenges with fiducial recognition and extraction in an orbit-independent manner. For example, their projections can overlap only mildly, for any gantry pose, as long as the wires are mutually non-coplanar in 3D. The method was tested in application to circular and non-circular trajectories in simulation and in real orbits executed using a mobile C-arm prototype for cone-beam CT. Results indicated high calibration accuracy, as measured by forward and backprojection/triangulation error metrics. Triangulation errors on the order of microns and backprojected ray deviations uniformly less than 0.2 mm were observed in both real and simulated orbits. Mean forward projection errors less than 0.1 mm were observed in a comprehensive sweep of different C-arm gantry angulations. Finally, successful integration of the method into a CT imaging chain was demonstrated in head phantom scans.

[Treatment of recurrent chylous leakage after neck dissection for one case with thyroid carcinoma]

The incidence of chylous leakage which is one of serious complications after neck dissection is low. The recurrent chylous leakage is even rare. One patient with recurrent chylous leakage after the operation of thyroid papillary carcinoma is reported to investigate the pathogenesis and effective treatment of recurrent chylous leakage after neck surgery.

Planning, guidance, and quality assurance of pelvic screw placement using deformable image registration

Percutaneous pelvic screw placement is challenging due to narrow bone corridors surrounded by vulnerable structures and difficult visual interpretation of complex anatomical shapes in 2D x-ray projection images. To address these challenges, a system for planning, guidance, and quality assurance (QA) is presented, providing functionality analogous to surgical navigation, but based on robust 3D-2D image registration techniques using fluoroscopy images already acquired in routine workflow. Two novel aspects of the system are investigated: automatic planning of pelvic screw trajectories and the ability to account for deformation of surgical devices (K-wire deflection). Atlas-based registration is used to calculate a patient-specific plan of screw trajectories in preoperative CT. 3D-2D registration aligns the patient to CT within the projective geometry of intraoperative fluoroscopy. Deformable known-component registration (dKC-Reg) localizes the surgical device, and the combination of plan and device location is used to provide guidance and QA. A leave-one-out analysis evaluated the accuracy of automatic planning, and a cadaver experiment compared the accuracy of dKC-Reg to rigid approaches (e.g. optical tracking). Surgical plans conformed within the bone cortex by 3-4 mm for the narrowest corridor (superior pubic ramus) and  >5 mm for the widest corridor (tear drop). The dKC-Reg algorithm localized the K-wire tip within 1.1 mm and 1.4° and was consistently more accurate than rigid-body tracking (errors up to 9 mm). The system was shown to automatically compute reliable screw trajectories and accurately localize deformed surgical devices (K-wires). Such capability could improve guidance and QA in orthopaedic surgery, where workflow is impeded by manual planning, conventional tool trackers add complexity and cost, rigid tool assumptions are often inaccurate, and qualitative interpretation of complex anatomy from 2D projections is prone to trial-and-error with extended fluoroscopy time.

Effects of Teriparatide on Joint Erosions in Rheumatoid Arthritis: A Randomized Controlled Trial

OBJECTIVE

Articular erosions correlate with disability in rheumatoid arthritis (RA). Biologic agents reduce erosion progression in RA, but erosion healing occurs infrequently. This study was undertaken to assess the effects of the anabolic agent teriparatide on joint erosion volume in RA patients treated with a tumor necrosis factor inhibitor (TNFi).

METHODS

We conducted a randomized controlled trial in 24 patients with erosive RA, osteopenia, and disease activity controlled by TNFi treatment for at least 3 months. Half were randomized to receive teriparatide for 1 year and the others constituted a wait-list control group. Subjects and primary rheumatologists were not blinded with regard to treatment assignment, but all outcomes were assessed in a blinded manner. The primary outcome measure was change in erosion volume determined by computed tomography at 6 anatomic sites. Significance within each hand and anatomic site was based on a 2-tailed test, with P values less than 0.05 considered significant.

RESULTS

Baseline characteristics of the treatment groups were well balanced. After 52 weeks, the median change in erosion volume in the teriparatide group was -0.4 mm³ (interquartile range [IQR] -34.5, 29.6) and did not differ significantly from that in controls (median change +9.1 mm³ [IQR -29.6, 26.4]) (P = 0.28). No significant difference in change in erosion volume was noted at the radius, ulna, or metacarpophalangeal joints. Bone mineral density improved at the femoral neck and lumbar spine in the teriparatide group.

CONCLUSION

Our findings indicate that teriparatide treatment for 1 year does not significantly reduce erosion volume in the hands or wrists of patients with established RA with disease activity controlled by TNFi treatment.

[Prevalence of hearing disorders in China: a population-based survey in four provinces of China]

Objective: To investigate the prevalence, severity of hearing disorders and demographics of people with hearing disorders based on the whole population in Jilin, Guangdong, Shannxi and Gansu provinces in China. Methods: According to " WHO Ear and Hearing Disorders Survey Protocol" , 144 clusters were chosen with probability proportional sampling(PPS) method from the four provinces covering 194, 688, 061 residents. Audiological test, otological examination and questionnaire surveying were conducted for all samples from August, 2014 to September, 2015. The hearing disorders were classified according to WHO criteria and classification. Results: Among 47 511 targeted residents, 45, 052 individuals (94.82% response rate) participated in the survey. The standardized prevalence rates of hearing disorders and disabling hearing disorders were 15.84 % and 5.17 % respectively. Almost 50% of people with hearing disorders had no awareness of it or its starting time. There was significant difference in the prevalence among people of different ages, genders, occupations, provinces, marital status and education levels. The prevalence of hearing disorders increased significantly as age grew. People above 60 years old occupied 55.31% of the total hearing disorders. The prevalence of hearing disorders among male, people of low education and those who lost husband or wife, as well as workers and farmers was relatively higher. Conclusions: The prevalence of hearing disorders is high, and hearing disorders are " invisible" . Demographics and socioeconomic factors significantly influence the prevalence of hearing disorders.

An analysis of the polymorphisms of the GLUT1 gene in urothelial cell carcinomas of the bladder and its correlation with p53, Ki67 and GLUT1 expressions

Frequencies of two glucose transporter 1 (GLUT1) single-nucleotide polymorphisms (SNPs) (XbaI G>T and HaeIII T>C) were studied with urothelial cell carcinomas of the bladder (UCC) and 204 normal persons. And the expression of the p53, Ki67 and GLUT1 was assayed by immunohistochemistry. The frequency of the TT genotype and T allele of the XbaI G>T SNP was decreased in the patients with UCC. The frequency of the CC genotype and C allele of the HaeIII T>C SNP was decreased in the patients with UCC. The GLUT1 XbaI genotype GG was more frequent in higher tumor stage and higher tumor grade patients. In the XbaI G>T SNP, the GG genotype was significantly related to higher Remmele immunoreactive score (IRS) of Ki67 and higher IRS of GLUT1. In conclusion, the TT genotype in XbaI G>T SNP and CC genotype of HaeIII T>C SNP may have protective effect in the carcinogenesis process of UCC. In the XbaI G>T SNP, the GG genotype of was positively related to tumor proliferation, glucose metabolism, tumor grade and stage. Therefore, the variant might become a possible proliferation-related prognostic factor for UCC.

Fundamental limits of image registration performance: Effects of image noise and resolution in CT-guided interventions

PURPOSE

In image-guided procedures, image acquisition is often performed primarily for the task of geometrically registering information from another image dataset, rather than detection / visualization of a particular feature. While the ability to detect a particular feature in an image has been studied extensively with respect to image quality characteristics (noise, resolution) and is an ongoing, active area of research, comparatively little has been accomplished to relate such image quality characteristics to registration performance.

METHODS

To establish such a framework, we derived Cramer-Rao lower bounds (CRLB) for registration accuracy, revealing the underlying dependencies on image variance and gradient strength. The CRLB was analyzed as a function of image quality factors (in particular, dose) for various similarity metrics and compared to registration accuracy using CT images of an anthropomorphic head phantom at various simulated dose levels. Performance was evaluated in terms of root mean square error (RMSE) of the registration parameters.

RESULTS

Analysis of the CRLB shows two primary dependencies: 1) noise variance (related to dose); and 2) sum of squared image gradients (related to spatial resolution and image content). Comparison of the measured RMSE to the CRLB showed that the best registration method, RMSE achieved the CRLB to within an efficiency factor of 0.21, and optimal estimators followed the predicted inverse proportionality between registration performance and radiation dose.

CONCLUSIONS

Analysis of the CRLB for image registration is an important step toward understanding and evaluating an intraoperative imaging system with respect to a registration task. While the CRLB is optimistic in absolute performance, it reveals a basis for relating the performance of registration estimators as a function of noise content and may be used to guide acquisition parameter selection (e.g., dose) for purposes of intraoperative registration.

Increased Efficacy of Entomopathogenic Nematode-Insecticide Combinations Against Holotrichia oblita (Coleoptera: Scarabaeidae)

Combinations of entomopathogenic nematodes Steinernema longicaudum X-7 and Heterorhabditis bacteriophora H06 with chlorantraniliprole, diflubenzuron, and imidacloprid insecticides at different rates for the control of the white grub, Holotrichia oblita Faldermann (Coleoptera: Scarabaeidae), were evaluated both in the laboratory and in peanut fields. In the laboratory, the combinations had a synergistic or additive effect on the second-instar larvae of H. oblita and caused faster mortality than one nematode species or insecticide alone. Heterorhabditis bacteriophora-chlorantraniliprole and H. bacteriophora-imidacloprid showed synergistic effects on the larvae. When higher concentrations of the insecticides were combined with nematodes, the stronger synergistic effects were found. In peanut fields, S. longicaudum-imidacloprid, H. bacteriophora-imidacloprid, or H. bacteriophora-chlorantraniliprole also showed synergistic effects against the larvae. The three nematode-insecticide combinations produced similar percentage reductions of the grub larvae and less percentages of injured legumes, compared with the chlorpyrifos treatment. Cost-benefit analysis showed that H. bacteriophora 5.0 × 103 infective juveniles (IJs) per plant (equal to 7.5 × 108 IJ ha-1) combined with imidacloprid at the recommended concentration is a practical strategy for the practitioner to manage the white grubs in the peanut production.

[Salvage surgical treatment for local recurrent nasopharyngeal cancer]

The salvage radiation or surgery is the main choice for recurrent nasopharyngeal cancer now. However the recurrent tumor becomes radiation insensitive and meanwhile,morbidity and mortality become higher.Recently the endoscopic salvage surgery has been developed;the collective evidence from a number of such studies suggests that endoscopic nasopharyngectomy is a safe and effective procedure for the treatment of rNPC.This article reviewed related researches about the feasibility,methods, and current situation of endoscopic salvage surgery.

Limits on Active to Sterile Neutrino Oscillations from Disappearance Searches in the MINOS, Daya Bay, and Bugey-3 Experiments

Searches for a light sterile neutrino have been performed independently by the MINOS and the Daya Bay experiments using the muon (anti)neutrino and electron antineutrino disappearance channels, respectively. In this Letter, results from both experiments are combined with those from the Bugey-3 reactor neutrino experiment to constrain oscillations into light sterile neutrinos. The three experiments are sensitive to complementary regions of parameter space, enabling the combined analysis to probe regions allowed by the Liquid Scintillator Neutrino Detector (LSND) and MiniBooNE experiments in a minimally extended four-neutrino flavor framework. Stringent limits on sin^{2}2θ_{μe} are set over 6 orders of magnitude in the sterile mass-squared splitting Δm_{41}^{2}. The sterile-neutrino mixing phase space allowed by the LSND and MiniBooNE experiments is excluded for Δm_{41}^{2}<0.8  eV^{2} at 95%  CL_{s}.

Improved Search for a Light Sterile Neutrino with the Full Configuration of the Daya Bay Experiment

This Letter reports an improved search for light sterile neutrino mixing in the electron antineutrino disappearance channel with the full configuration of the Daya Bay Reactor Neutrino Experiment. With an additional 404 days of data collected in eight antineutrino detectors, this search benefits from 3.6 times the statistics available to the previous publication, as well as from improvements in energy calibration and background reduction. A relative comparison of the rate and energy spectrum of reactor antineutrinos in the three experimental halls yields no evidence of sterile neutrino mixing in the 2×10^{-4}≲|Δm_{41}^{2}|≲0.3  eV^{2} mass range. The resulting limits on sin^{2}2θ_{14} are improved by approx imately a factor of 2 over previous results and constitute the most stringent constraints to date in the |Δm_{41}^{2}|≲0.2  eV^{2} region.

Dexmedetomidine post-treatment induces neuroprotection via activation of extracellular signal-regulated kinase in rats with subarachnoid haemorrhage

BACKGROUND

Dexmedetomidine, a sedative agent, provides neuroprotection when administered during or before brain ischaemia. This study was designed to determine whether dexmedetomidine post-treatment induces neuroprotection against subarachnoid haemorrhage (SAH) and the mechanisms for this effect.

METHODS

Subarachnoid haemorrhage was induced by endovascular perforation to the junction of the right middle and anterior cerebral arteries in adult rats. Dexmedetomidine was applied immediately or 2 h after onset of SAH. Neurological outcome was evaluated 2 days after SAH. Right frontal cortex area 1 was harvested 24 h after SAH for western blotting.

RESULTS

Subarachnoid haemorrhage reduced neurological scores and increased brain oedema and blood-brain barrier permeability. These effects were attenuated by dexmedetomidine post-treatment. Neuroprotection by dexmedetomidine was abolished by PD98095, an inhibitor of extracellular signal-regulated kinase (ERK) activation. Phospho-ERK, the activated form of ERK, was increased by dexmedetomidine; this activation was inhibited by PD98095.

CONCLUSIONS

Dexmedetomidine post-treatment provides neuroprotection against SAH. This effect appears to be mediated by ERK.

ID: 77: FAST-SKELETAL MYOSIN BINDING PROTEIN-C REGULATES SKELETAL MUSCLE CALCIUM SENSITIVITY

Mutations in myosin binding protein-C (MyBP-C) cause both cardiac and skeletal muscle diseases, such as hypertrophic cardiomyopathy and distal arthrogryposis. There are three isoforms of MyBP-C: slow-skeletal, fast-skeletal, and cardiac (ssMyBP-C, fsMyBP-C, and cMyBP-C, respectively). These isoforms reside within the sarcomere, the functional unit of muscle contraction at the molecular level. However, the function of the three major MyBP-C isoforms remains unclear. The present study is the first to focus on the least characterized isoform, fsMyBP-C, which is expressed in fast- and mixed-type skeletal muscles. To determine the necessity of fsMyBP-C for regulation of contraction in the sarcomere, we generated a conventional fast-skeletal MyBP-C knockout (FSKO) mouse model. We analyzed both structural changes and regulatory function of skeletal muscles from heterozygous (FSKO−/+) and homozygous (FSKO−/−), compared to wild-type (WT) mice. Neither heterozygous nor homozygous FSKO mice exhibited changes in morbidity or mortality relative to WT mice. Molecular analyses revealed a complete knockout of fsMyBP-C in the FSKO−/− skeletal muscles compared to FSKO−/+ and WT mice. Histopathological analyses of both Extensor digitorum longus (EDL) and soleus muscles revealed no obvious abnormalities, such as fibrosis or calcification, in either heterozygous or homozygous FSKO mice. Though fiber structure is preserved, we demonstrated that EDL muscles from FSKO−/− mice increases Ca2+-sensitivity of force development, suggesting that fsMyBP-C regulates contraction at the molecular level by decreasing Ca2+-sensitivity. While others have previously proposed the role of cMyBP-C is to increase Ca2+-sensitivity to normalize a Ca2+ gradient imbalance in the heart, we propose that the role of fsMyBP-C in skeletal muscles is to reduce Ca2+-sensitivity of the thin filaments in order to normalize the reversed Ca2+ gradient imbalance. Despite opposite effects on Ca2+-sensitivity, MyBP-C share the same functional role in both cardiac and skeletal muscles. Thus, in addition to elucidating the role of fast-skeletal MyBP-C and its regulation of skeletal muscle contraction, the present study provides insight into the cardiac isoform and its regulation of cardiac contraction.

Centrality-Dependent Modification of Jet-Production Rates in Deuteron-Gold Collisions at √[s(NN)]=200 GeV

Jet production rates are measured in p+p and d+Au collisions at sqrt[s_{NN}]=200  GeV recorded in 2008 with the PHENIX detector at the Relativistic Heavy Ion Collider. Jets are reconstructed using the R=0.3 anti-k_{t} algorithm from energy deposits in the electromagnetic calorimeter and charged tracks in multiwire proportional chambers, and the jet transverse momentum (p_{T}) spectra are corrected for the detector response. Spectra are reported for jets with 12<p_{T}<50  GeV/c, within a pseudorapidity acceptance of |η|<0.3. The nuclear-modification factor (R_{dAu}) values for 0%-100% d+Au events are found to be consistent with unity, constraining the role of initial state effects on jet production. However, the centrality-selected R_{dAu} values and central-to-peripheral ratios (R_{CP}) show large, p_{T}-dependent deviations from unity, challenging the conventional models that relate hard-process rates and soft-particle production in collisions involving nuclei.

Measurement of the Reactor Antineutrino Flux and Spectrum at Daya Bay

This Letter reports a measurement of the flux and energy spectrum of electron antineutrinos from six 2.9 GWth nuclear reactors with six detectors deployed in two near (effective baselines 512 and 561 m) and one far (1579 m) underground experimental halls in the Daya Bay experiment. Using 217 days of data, 296 721 and 41 589 inverse β decay (IBD) candidates were detected in the near and far halls, respectively. The measured IBD yield is (1.55±0.04) ×10(-18)  cm(2) GW(-1) day(-1) or (5.92±0.14) ×10(-43)  cm(2) fission(-1). This flux measurement is consistent with previous short-baseline reactor antineutrino experiments and is 0.946±0.022 (0.991±0.023) relative to the flux predicted with the Huber-Mueller (ILL-Vogel) fissile antineutrino model. The measured IBD positron energy spectrum deviates from both spectral predictions by more than 2σ over the full energy range with a local significance of up to ∼4σ between 4-6 MeV. A reactor antineutrino spectrum of IBD reactions is extracted from the measured positron energy spectrum for model-independent predictions.

Toward interfacing organic semiconductors with ferromagnetic transition metal substrates: enhanced stability via carboxylate anchoring

The controlled growth of chemically and structurally well-defined as well as thermally stable carboxylate-anchored self-assembled monolayers on ferromagnetic 3d transition metal substrates provides promising model systems for advanced studies of spin-dependent electron transport.

Apodized waveguide arrays induced by photorefractive nonlinear surface waves

A new type of nonlinear waveguides, photorefractive surface optical waveguides is suggested, which can be induced by photorefractive surface waves on the boundary of photorefractive crystal. The disturbed refractive index distribution of such waveguides behaves as a periodic lattice with apodized envelope, thus we call them photorefractive surface apodized waveguide arrays. Moreover, the dispersion relation and corresponding modes are analyzed. It is very interesting that the dispersion curves of index-guided modes and Bragg-guided modes couple and intertwine with each other, and anti-crossings instead of crossings between them hence generate some mini-gaps. Moreover there exists a type of extraordinary modes constituted by the splice of index-guided modes and Bragg-guided modes.

Measurements of Elliptic and Triangular Flow in High-Multiplicity 3He+Au Collisions at √(s(NN))=200 GeV

We present the first measurement of elliptic (v(2)) and triangular (v(3)) flow in high-multiplicity (3)He+Au collisions at √(s(NN))=200  GeV. Two-particle correlations, where the particles have a large separation in pseudorapidity, are compared in (3)He+Au and in p+p collisions and indicate that collective effects dominate the second and third Fourier components for the correlations observed in the (3)He+Au system. The collective behavior is quantified in terms of elliptic v(2) and triangular v(3) anisotropy coefficients measured with respect to their corresponding event planes. The v(2) values are comparable to those previously measured in d+Au collisions at the same nucleon-nucleon center-of-mass energy. Comparisons with various theoretical predictions are made, including to models where the hot spots created by the impact of the three (3)He nucleons on the Au nucleus expand hydrodynamically to generate the triangular flow. The agreement of these models with data may indicate the formation of low-viscosity quark-gluon plasma even in these small collision systems.

New measurement of antineutrino oscillation with the full detector configuration at Daya Bay

We report a new measurement of electron antineutrino disappearance using the fully constructed Daya Bay Reactor Neutrino Experiment. The final two of eight antineutrino detectors were installed in the summer of 2012. Including the 404 days of data collected from October 2012 to November 2013 resulted in a total exposure of 6.9×10^{5} GW_{th}  ton days, a 3.6 times increase over our previous results. Improvements in energy calibration limited variations between detectors to 0.2%. Removal of six ^{241}Am-^{13}C radioactive calibration sources reduced the background by a factor of 2 for the detectors in the experimental hall furthest from the reactors. Direct prediction of the antineutrino signal in the far detectors based on the measurements in the near detectors explicitly minimized the dependence of the measurement on models of reactor antineutrino emission. The uncertainties in our estimates of sin^{2}2θ_{13} and |Δm_{ee}^{2}| were halved as a result of these improvements. An analysis of the relative antineutrino rates and energy spectra between detectors gave sin^{2}2θ_{13}=0.084±0.005 and |Δm_{ee}^{2}|=(2.42±0.11)×10^{-3}  eV^{2} in the three-neutrino framework.

Measurement of Long-Range Angular Correlation and Quadrupole Anisotropy of Pions and (Anti)Protons in Central d+Au Collisions at sqrt[s_{NN}]=200 GeV

We present azimuthal angular correlations between charged hadrons and energy deposited in calorimeter towers in central d+Au and minimum bias p+p collisions at sqrt[s_{NN}]=200 GeV. The charged hadron is measured at midrapidity |η|<0.35, and the energy is measured at large rapidity (-3.7<η<-3.1, Au-going direction). An enhanced near-side angular correlation across |Δη|>2.75 is observed in d+Au collisions. Using the event plane method applied to the Au-going energy distribution, we extract the anisotropy strength v_{2} for inclusive charged hadrons at midrapidity up to p_{T}=4.5 GeV/c. We also present the measurement of v_{2} for identified π^{±} and (anti)protons in central d+Au collisions, and observe a mass-ordering pattern similar to that seen in heavy-ion collisions. These results are compared with viscous hydrodynamic calculations and measurements from p+Pb at sqrt[s_{NN}]=5.02 TeV. The magnitude of the mass ordering in d+Au is found to be smaller than that in p+Pb collisions, which may indicate smaller radial flow in lower energy d+Au collisions.

Class-specific histone/protein deacetylase inhibition protects against renal ischemia reperfusion injury and fibrosis formation

Renal ischemia-reperfusion injury (IRI) is a common cause of renal dysfunction and renal failure. Histone/protein deacetylases (HDACs) regulate gene accessibility and higher order protein structures and may alter cellular responses to a variety of stresses. We investigated whether use of pan- and class-specific HDAC inhibitors (HDACi) could improve IRI tolerance in the kidney. Using a model of unilateral renal IRI, we investigated early renal function after IRI, and calculated fibrosis after IRI using an automated scoring system. We found that pan-HDAC inhibition using trichostatin (TSA) yielded significant renal functional benefit at 24-96 hours (p < 0.001). Treated mice developed significantly less fibrosis at 30 days (p < 0.0004). Class I HDAC inhibition with MS-275 yielded similar effects. Protection from fibrosis formation was also noted in a cold ischemia transplant model (p < 0.008) with a trend toward improved cold ischemic survival in TSA-treated mice. These effects were not accompanied by induction of typical ischemic tolerance pathways or by priming of heat shock protein expression. In fact, heat shock protein 70 deletion or overexpression did not alter renal ischemia tolerance. Micro-RNA 21, known to be enhanced in vitro in renal tubular cells that survive stress, was enhanced by treatment with HDACi, pointing to possible mechanism.