A computational tool for simulation and design of tangential multi-energy soft x-ray pin-hole cameras for tokamak plasmas

A new tool has been developed to calculate the spectral, spatial, and temporal responses of multi-energy soft x-ray (ME-SXR) pinhole cameras for arbitrary plasma densities (n _e,D), temperature (T _e), and impurity densities (n _Z). ME-SXR imaging provides a unique opportunity for obtaining important plasma properties (e.g., T _e, n _Z, and Z _eff) by measuring both continuum and line emission in multiple energy ranges. This technique employs a pixelated x-ray detector in which the lower energy threshold for photon detection can be adjusted independently. Simulations assuming a tangential geometry and DIII-D-like plasmas (e.g., n _e,0 ≈ 8 × 10¹⁹ m^-3 and T _e,0 ≈ 2.8 keV) for various impurity (e.g., C, O, Ar, Ni, and Mo) density profiles have been performed. The computed brightnesses range from few 10² counts pixel^-1 ms^-1 depending on the cut-off energy thresholds, while the maximum allowable count rate is 10⁴ counts pixel^-1 ms^-1. The typical spatial resolution in the mid-plane is ≈0.5 cm with a photon-energy resolution of 500 eV at a 500 Hz frame rate.

Simulation, design, and first test of a multi-energy soft x-ray (SXR) pinhole camera in the Madison Symmetric Torus (MST)

A multi-energy soft x-ray pinhole camera has been designed and built for the Madison Symmetric Torus reversed field pinch to aid the study of particle and thermal-transport, as well as MHD stability physics. This novel imaging diagnostic technique combines the best features from both pulse-height-analysis and multi-foil methods employing a PILATUS3 x-ray detector in which the lower energy threshold for photon detection can be adjusted independently on each pixel. Further improvements implemented on the new cooled systems allow a maximum count rate of 10 MHz per pixel and sensitivity to the strong Al and Ar emission between 1.5 and 4 keV. The local x-ray emissivity will be measured in multiple energy ranges simultaneously, from which it is possible to infer 1D and 2D simultaneous profile measurements of core electron temperature and impurity density profiles with no a priori assumptions of plasma profiles, magnetic field reconstruction constraints, high-density limitations, or need of shot-to-shot reproducibility. The expected time and space resolutions will be 2 ms and <1 cm, respectively.

From stability to dynamics: understanding molecular mechanisms of regulatory T cells through Foxp3 transcriptional dynamics

Studies on regulatory T cells (T_reg) have focused on thymic T_reg as a stable lineage of immunosuppressive T cells, the differentiation of which is controlled by the transcription factor forkhead box protein 3 (Foxp3). This lineage perspective, however, may constrain hypotheses regarding the role of Foxp3 and T_regin vivo, particularly in clinical settings and immunotherapy development. In this review, we synthesize a new perspective on the role of Foxp3 as a dynamically expressed gene, and thereby revisit the molecular mechanisms for the transcriptional regulation of Foxp3. In particular, we introduce a recent advancement in the study of Foxp3‐mediated T cell regulation through the development of the Timer of cell kinetics and activity (Tocky) system, and show that the investigation of Foxp3 transcriptional dynamics can reveal temporal changes in the differentiation and function of T_regin vivo. We highlight the role of Foxp3 as a gene downstream of T cell receptor (TCR) signalling and show that temporally persistent TCR signals initiate Foxp3 transcription in self‐reactive thymocytes. In addition, we feature the autoregulatory transcriptional circuit for the Foxp3 gene as a mechanism for consolidating T_reg differentiation and activating their suppressive functions. Furthermore, we explore the potential mechanisms behind the dynamic regulation of epigenetic modifications and chromatin architecture for Foxp3 transcription. Lastly, we discuss the clinical relevance of temporal changes in the differentiation and activation of T_reg.

Defining oliguria during cardiopulmonary bypass and its relationship with cardiac surgery-associated acute kidney injury

BACKGROUND

While urine flow rate ≤0.5 ml kg^-1 h^-1 is believed to define oliguria during cardiopulmonary bypass (CPB), it is unclear whether this definition identifies risk for acute kidney injury (AKI) . The purpose of this retrospective study was to evaluate if urine flow rate during CPB is associated with AKI.

METHODS

Urine flow rate was calculated in 503 patients during CPB. AKI in the first 48 h after surgery was defined by the Kidney Disease: Improving Global Outcomes classification. Adjusted risk factors associated with AKI and urine flow rate were assessed.

RESULTS

Patients with AKI [n=149 (29.5%)] had lower urine flow rate than those without AKI (P<0.001). The relationship between urine flow and AKI risk was non-linear, with an inflection point at 1.5 ml kg^-1 h^-1 Among patients with urine flow <1.5 ml kg^-1 h^-1, every 0.5 ml kg^-1 h^-1 higher urine flow reduced the adjusted risk of AKI by 26% (95% CI 13-37; P<0.001). Urine flow rate during CPB was independently associated with the risk for AKI. Age up to 80 years and preoperative diuretic use were inversely associated with urine flow rate; mean arterial pressure on CPB (when <87 mmHg) and CPB flow were positively associated with urine flow rate.

CONCLUSIONS

Urine flow rate during CPB <1.5 ml kg^-1 h^-1 identifies patients at risk for cardiac surgery-associated AKI. Careful monitoring of urine flow rate and optimizing mean arterial pressure and CPB flow might be a means to ensure renal perfusion during CPB.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov NCT00769691 and NCT00981474.

Multicenter observational study on functional bowel disorders diagnosed using Rome III diagnostic criteria in Japan

BACKGROUND

The Rome III diagnostic criteria had been used to diagnose functional gastrointestinal disorders (FGIDs) world wide, and functional bowel disorders (FBDs) including irritable bowel syndrome (IBS) have recently attracted the attention of Japanese physicians. However, there have been few reports on the prevalence of FBDs diagnosed by the Rome III diagnostic criteria.

AIMS

The aim of this study was to determine the prevalence of FBDs diagnosed according to the diagnostic criteria of Rome III in Japan.

PATIENTS AND METHODS

All patients who were booked for colonoscopy were enrolled from eight institutions in Japan. This study was a prospective observational study in the period from April 2013 to December 2013. Patients filled out FGID questionnaires of Rome III when they were waiting for colonoscopy.

RESULTS

Data for 1200 patients who underwent colonoscopy were analyzed. A total of 547 patients (45.6%) were diagnosed with FBDs. Out of those patients, 9.1% had IBS. According to the Rome III diagnostic criteria, 134 patients (11.2%) had functional bloating (FB), 73 (6.1%) had functional constipation (FC), 40 (3.3%) had functional diarrhea (FD), and 191 (15.9%) had unspecified functional bowel disorder (UFBD). Patients with FBDs had significantly higher rates of almost all symptoms (abdominal pain, hard or lumpy stools, loose or watery stools, and bloating) than those in the controls.

CONCLUSIONS

In Japan, the prevalence of FBDs and IBS is high, similar to that in the US. Many patients with FBDs have multiple symptoms.

Hysteresis Relation between Turbulence and Temperature Modulation during the Heat Pulse Propagation into a Magnetic Island in DIII-D

The hysteresis relation between turbulence and temperature modulation during the heat pulse propagation into a magnetic island is studied for the first time in toroidal plasmas. Lissajous curves of the density fluctuation (n[over ˜]/n) and the electron temperature (T_{e}) modulation show that the (n[over ˜]/n) propagation is faster than the heat pulse propagation near the O point of the magnetic island. This faster n[over ˜]/n propagation is experimental evidence of the turbulence spreading from the X point to the O point of the magnetic island.

Identification and initial characterization of novel neural immediate early genes possibly differentially contributing to foraging-related learning and memory processes in the honeybee

Despite possessing a limited number of neurones compared to vertebrates, honeybees show remarkable learning and memory performance, an example being 'dance communication'. In this phenomenon, foraging honeybees learn the location of a newly discovered food source and transmit the information to nestmates by symbolic abdomen vibrating behaviour, leading to navigation of nestmates to the new food source. As an initial step toward understanding the detailed molecular mechanisms underlying the sophisticated learning and memory performance of the honeybee, we focused on the neural immediate early genes (IEGs), which are specific genes quickly transcribed after neural activity without de novo protein synthesis. Although these have been reported to play an essential role in learning and memory processes in vertebrates, far fewer studies have been performed in insects in this regard. From RNA-sequencing analysis and subsequent assays, we identified three genes, Src homology 3 (SH3) domain binding kinase, family with sequence similarity 46 and GB47136, as novel neural IEGs in the honeybee. Foragers and/or orientating bees, which fly around their hives to memorize the positional information, showed induced expression of these IEGs in the mushroom body, a higher-order centre essential for learning and memory, indicating a possible role for the novel IEGs in foraging-related learning and memory processes in the honeybee.

Abstract P3-01-05: A feasibility study of sentinel lymph node detection and analysis of safety to omit axillary lymph node dissection in clinically node-negative breast cancer patients after neoadjuvant chemotherapy

Background: Concerns still remain about lower sentinel node (SN) detection and higher false-negative rates (FNR) in breast cancer patients treated with neoadjuvant chemotherapy (NAC), especially those who are clinically node-positive before NAC. It is necessary to analyze the validity of sentinel node biopsy (SNB) after NAC and evaluate whether the SN identification rate and FNR for clinically N0 (cN0) patients after NAC would be acceptable or not in order to omit axillary lymph node dissection (ALND).

Objectives and methods: We identified SN by radioisotopic methods followed by completion of ALND in cN0 patients after NAC from 2013 to 2016 as part of a clinical research study (SNB group, N=68) to analyze the accuracy of SNB, and retrospectively investigated the prognosis of patients treated with NAC from 2006 to 2012 (control group, N=92) to evaluate whether the validity of SNB would be acceptable or not.

Results: Mean patient ages in the SNB group and control group were 51.0 years and 49.5 years, respectively (p=0.17), and the distribution of intrinsic subtypes was not significantly different between the two groups. The numbers of cN1≤ before NAC in the SNB group and control group were 85.5% (57/68) and 80.4% (74/92), respectively (p=0.58), and the pathological complete response rates were 25.0% (17/68) and 19.6% (18/92), respectively (p=0.41). Lymphoscintigraphy using 99mTc-phytate acid was performed in the SNB group, and hot spots were detected at the ipsilateral axilla in 62 of 68 (91.2%) patients, in all of whom SNs could be identified by using a gamma-probe. The FNR, which indicates no metastasis in SNs and metastasis in non-SN, was 5.9% (4/68). Among these four patients, three were of the luminal type while one was triple negative. The number of patients without metastasis in both SN and non-SN, which are candidates for omission of ALND, was 26 of 68 (38.2%). They included eight of nine HER2-enriched patients and six of 13 luminal-HER2 patients. Conversely, there were no false-negative cases in these subtypes. Moreover, all SNs were identified even if there were metastases in SNs. Regarding the prognosis of the control group, the 10-year disease free survival of post-NAC N0 (ypN0) (52/92, 56.5%) and ypN1≤ (40/92, 43.5%) were 80.7% and 61.2%, respectively (p=0.08); in addition, the 10-year overall survival of yN0 and ypN1≤ were 90.4% and 72.6% (p=0.26). Thus, the prognosis of ypN1≤ was not significantly inferior to that of ypN0. If omission of ALND were performed for false negative cases, then the risk of axillary relapse would be a concern. However, these data indicate the possibility that 5.9% of FNR as shown in the SNB group would not have much influence on prognosis.

Conclusion: The accuracy of SN detection by radioisotopic methods for cN0 breast cancer after NAC was not maintained like that for -early breast cancer although it was better than the results of previous studies. However, there were no false-negative cases in HER2-enriched and luminal-HER2 subtypes, which could be potential candidates for omission of ALND. In addition, omission of ALND for false-negative patients would have less influence on the prognosis.

Citation Format: Maeno K, Yamamoto K, Ono M, Oba T, Iesato A, Ono K, Ito T, Kanai T, Ito K-I. A feasibility study of sentinel lymph node detection and analysis of safety to omit axillary lymph node dissection in clinically node-negative breast cancer patients after neoadjuvant chemotherapy [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-01-05.