Looking into cognitive impairment in primary-progressive multiple sclerosis

BACKGROUND AND PURPOSE

Cognitive impairment in primary-progressive multiple sclerosis (PP-MS) is correlated with global brain atrophy. Unfortunately, brain volume computation requires processing resources that are not widely available in clinical practice. Therefore, we decided to test the predictive role of retinal atrophy metrics on cognitive decline, applying them as a proxy of gray matter atrophy in PP-MS.

METHODS

Twenty-five patients with PP-MS completed the Brief International Cognitive Assessment for Multiple Sclerosis and underwent spectral-domain optical coherence tomography (OCT) and 3.0-T magnetic resonance imaging. We tested, through a stepwise logistic regression, whether OCT metrics [retinal nerve fiber layer, ganglion cell + inner plexiform layer (GCIPL) and total macular volume] predicted cognitive impairment and explored the role of gray matter atrophy in mediating these correlations.

RESULTS

Among OCT metrics, only GCIPL was associated with cognitive impairment (r_p = 0.448, P = 0.036) and predictive of objective cognitive impairment (Wald [1] = 4.40, P = 0.036). Controlling for demographics, normalized brain volume and thalamic volume were correlated with GCIPL (r_p = 0.427, P = 0.047 and r_p = 0.674, P = 0.001, respectively) and cognitive scores (r_p = 0.593, P = 0.004 and r_p = 0.501, P = 0.017, respectively), with thalamic volume nearly mediating the association between GCIPL and cognition (Sobel z = 1.86, P = 0.063).

CONCLUSIONS

The GCIPL thickness is a suitable measure of neurodegeneration. In comparison with brain atrophy, GCIPL offers higher histopathological specificity, being a pure correlate of neuronal loss, and may be a non-invasive, easy-to-perform way to quantitatively evaluate and monitor neuronal loss related to cognitive impairment in PP-MS.

Clinicopathologic characteristics associated with long-term survival in advanced epithelial ovarian cancer: an NRG Oncology/Gynecologic Oncology Group ancillary data study

OBJECTIVE

To identify clinicopathologic factors associated with 10-year overall survival in epithelial ovarian cancer (EOC) and primary peritoneal cancer (PPC), and to develop a predictive model identifying long-term survivors.

METHODS

Demographic, surgical, and clinicopathologic data were abstracted from GOG 182 records. The association between clinical variables and long-term survival (LTS) (>10years) was assessed using multivariable regression analysis. Bootstrap methods were used to develop predictive models from known prognostic clinical factors and predictive accuracy was quantified using optimism-adjusted area under the receiver operating characteristic curve (AUC).

RESULTS

The analysis dataset included 3010 evaluable patients, of whom 195 survived greater than ten years. These patients were more likely to have better performance status, endometrioid histology, stage III (rather than stage IV) disease, absence of ascites, less extensive preoperative disease distribution, microscopic disease residual following cyoreduction (R0), and decreased complexity of surgery (p<0.01). Multivariable regression analysis revealed that lower CA-125 levels, absence of ascites, stage, and R0 were significant independent predictors of LTS. A predictive model created using these variables had an AUC=0.729, which outperformed any of the individual predictors.

CONCLUSIONS

The absence of ascites, a low CA-125, stage, and R0 at the time of cytoreduction are factors associated with LTS when controlling for other confounders. An extensively annotated clinicopathologic prediction model for LTS fell short of clinical utility suggesting that prognostic molecular profiles are needed to better predict which patients are likely to be long-term survivors.

Study of neutron fields around an intense neutron generator

Neutron fields in the vicinity of the newly built neutron facility, at the University of Ontario Institute of Technology (UOIT), have been investigated in a series of Monte Carlo simulations and measurements. The facility hosts a P-385 neutron generator based on a deuterium-deuterium fusion reaction. The neutron fluence at different locations around the neutron generator facility has been simulated using MCNPX 2.7E Monte Carlo particle transport program. To characterize neutron fields, three neutron sources were modeled with distributions corresponding to different incident deuteron energies of 90kV, 110kV, and 130kV. Measurements have been carried out to determine the dose rate at locations adjacent to the generator using bubble detectors (BDs). The neutron intensity was evaluated and the total dose rates corresponding to different applied acceleration potentials were estimated at various locations.

Combined skin and muscle vaccination differentially impact the quality of effector T cell functions: the CUTHIVAC-001 randomized trial

Targeting of different tissues via transcutaneous (TC), intradermal (ID) and intramuscular (IM) injection has the potential to tailor the immune response to DNA vaccination. In this Phase I randomised controlled clinical trial in HIV-1 negative volunteers we investigate whether the site and mode of DNA vaccination influences the quality of the cellular immune responses. We adopted a strategy of concurrent immunization combining IM injection with either ID or TC administration. As a third arm we assessed the response to IM injection administered with electroporation (EP). The DNA plasmid encoded a MultiHIV B clade fusion protein designed to induce cellular immunity. The vaccine and regimens were well tolerated. We observed differential shaping of vaccine induced virus-specific CD4 + and CD8 + cell-mediated immune responses. DNA given by IM + EP promoted strong IFN-γ responses and potent viral inhibition. ID + IM without EP resulted in a similar pattern of response but of lower magnitude. By contrast TC + IM (without EP) shifted responses towards a more Th-17 dominated phenotype, associated with mucosal and epidermal protection. Whilst preliminary, these results offer new perspectives for differential shaping of desired cellular immunity required to fight the wide range of complex and diverse infectious diseases and cancers.

A large-diameter hollow-shaft cryogenic motor based on a superconducting magnetic bearing for millimeter-wave polarimetry

In this paper, we present the design and measured performance of a novel cryogenic motor based on a superconducting magnetic bearing (SMB). The motor is tailored for use in millimeter-wave half-wave plate (HWP) polarimeters, where a HWP is rapidly rotated in front of a polarization analyzer or polarization-sensitive detector. This polarimetry technique is commonly used in cosmic microwave background polarization studies. The SMB we use is composed of fourteen yttrium barium copper oxide (YBCO) disks and a contiguous neodymium iron boron (NdFeB) ring magnet. The motor is a hollow-shaft motor because the HWP is ultimately installed in the rotor. The motor presented here has a 100 mm diameter rotor aperture. However, the design can be scaled up to rotor aperture diameters of approximately 500 mm. Our motor system is composed of four primary subsystems: (i) the rotor assembly, which includes the NdFeB ring magnet, (ii) the stator assembly, which includes the YBCO disks, (iii) an incremental encoder, and (iv) the drive electronics. While the YBCO is cooling through its superconducting transition, the rotor is held above the stator by a novel hold and release mechanism. The encoder subsystem consists of a custom-built encoder disk read out by two fiber optic readout sensors. For the demonstration described in this paper, we ran the motor at 50 K and tested rotation frequencies up to approximately 10 Hz. The feedback system was able to stabilize the rotation speed to approximately 0.4%, and the measured rotor orientation angle uncertainty is less than 0.15°. Lower temperature operation will require additional development activities, which we will discuss.

High somatic mutation and neoantigen burden are correlated with decreased progression-free survival in multiple myeloma

Tumor-specific mutations can result in immunogenic neoantigens, both of which have been correlated with responsiveness to immune checkpoint inhibitors in highly mutagenic cancers. However, early results of single-agent checkpoint inhibitors in multiple myeloma (MM) have been underwhelming. Therefore, we sought to understand the relationship between mutation and neoantigen landscape of MM patients and responsiveness to therapies. Somatic mutation burden, neoantigen load, and response to therapy were determined using interim data from the MMRF CoMMpass study (NCT01454297) on 664 MM patients. In this population, the mean somatic and missense mutation loads were 405.84(s=608.55) and 63.90(s=95.88) mutations per patient, respectively. There was a positive linear relationship between mutation and neoantigen burdens (R²=0.862). The average predicted neoantigen load was 23.52(s=52.14) neoantigens with an average of 9.40(s=26.97) expressed neoantigens. Survival analysis revealed significantly shorter progression-free survival (PFS) in patients with greater than average somatic missense mutation load (N=163, 0.493 vs 0.726 2-year PFS, P=0.0023) and predicted expressed neoantigen load (N=214, 0.555 vs 0.729 2-year PFS, P=0.0028). This pattern is maintained when stratified by disease stage and cytogenetic abnormalities. Therefore, high mutation and neoantigen load are clinically relevant risk factors that negatively impact survival of MM patients under current standards of care.

Social interactions in different environments impacts and motivates reproductive displays in college students

Social environments can have an impact on the interactions between the sexes, specifically pre-courtship behaviors. Sexual selection theory may explain social interactions of the sexes, where males display and attract mates more than females. These behaviors may intensify in a sexual environment. It was hypothesized that individuals would display more in a sexualized environment compared to a non-sexualized location. This research sampled N = 880 participants at a university in a southern state in North America and asked which unisex sunglasses they preferred. While the most popular non-showy sunglasses were selected the most, showy new arrival sunglasses were selected more often when the surveyor’s behavior was flirty, compared to normal behavior and dressing sexy. Thus, social interactions such as flirting between the sexes impacted the behaviors of others and increased the intensity of reproductive displays. At the location with sexualized behaviors and dress, individuals selected the non-showy sunglasses, possibly to draw attention to their bodies in swimsuits, whereas at the non-sexy location, new arrivals were chosen at a higher frequency, possibly to stand out when wearing normal clothes. The sexes chose to stand out at equal frequencies as did single participants and people in a relationship, suggesting that all individuals are trying to display and attract mates equally. Social environments impacted display behaviors and the motivation to display is discussed.

The role of antimicrobial sutures in preventing surgical site infection

INTRODUCTION Healthcare associated infections (HCAIs) are falling following widespread and enforced introduction of guidelines, particularly those that have addressed antibiotic resistant pathogens such as methicillin resistant Staphylococcus aureus or emergent pathogens such as Clostridium difficile, but no such decline has been seen in the incidence of surgical site infection (SSI), either in the UK, the EU or the US. SSI is one of the HCAIs, which are all avoidable complications of a surgical patient's pathway through both nosocomial and community care. METHODS This report is based on a meeting held at The Royal College of Surgeons of England on 21 July 2016. Using PubMed, members of the panel reviewed the current use of antiseptics and antimicrobial sutures in their specialties to prevent SSI. FINDINGS The group agreed that wider use of antiseptics in surgical practice may help in reducing reliance on antibiotics in infection prevention and control, especially in the perioperative period of open elective colorectal, hepatobiliary and cardiac operative procedures. The wider use of antiseptics includes preoperative showering, promotion of hand hygiene, (including the appropriate use of surgical gloves), preoperative skin preparation (including management of hair removal), antimicrobial sutures and the management of dehisced surgical wounds after infection. The meeting placed emphasis on the level I evidence that supports the use of antimicrobial sutures, particularly in surgical procedures after which the SSI rate is high (colorectal and hepatobiliary surgery) or when a SSI can be life threatening even when the rate of SSI is low (cardiac surgery).

GW170104: Observation of a 50-Solar-Mass Binary Black Hole Coalescence at Redshift 0.2

We describe the observation of GW170104, a gravitational-wave signal produced by the coalescence of a pair of stellar-mass black holes. The signal was measured on January 4, 2017 at 10∶11:58.6 UTC by the twin advanced detectors of the Laser Interferometer Gravitational-Wave Observatory during their second observing run, with a network signal-to-noise ratio of 13 and a false alarm rate less than 1 in 70 000 years. The inferred component black hole masses are 31.2_{-6.0}^{+8.4}M_{⊙} and 19.4_{-5.9}^{+5.3}M_{⊙} (at the 90% credible level). The black hole spins are best constrained through measurement of the effective inspiral spin parameter, a mass-weighted combination of the spin components perpendicular to the orbital plane, χ_{eff}=-0.12_{-0.30}^{+0.21}. This result implies that spin configurations with both component spins positively aligned with the orbital angular momentum are disfavored. The source luminosity distance is 880_{-390}^{+450}  Mpc corresponding to a redshift of z=0.18_{-0.07}^{+0.08}. We constrain the magnitude of modifications to the gravitational-wave dispersion relation and perform null tests of general relativity. Assuming that gravitons are dispersed in vacuum like massive particles, we bound the graviton mass to m_{g}≤7.7×10^{-23}  eV/c^{2}. In all cases, we find that GW170104 is consistent with general relativity.

Predicting Water Resource Impacts of Unconventional Gas Using Simple Analytical Equations

The rapid expansion in unconventional gas development over the past two decades has led to concerns over the potential impacts on groundwater resources. Although numerical models are invaluable for assessing likelihood of impacts at particular sites, simpler analytical models are also useful because they help develop hydrological understanding. Analytical approaches are also valuable for preliminary assessments and to determine where more complex models are warranted. In this article, we present simple analytical solutions that can be used to predict: (1) the spatial extent of drawdown from horizontal wells drilled into the gas-bearing formation, and rate of recovery after gas production ceases; (2) the potential for upward transport of contaminants from the gas-bearing formation to shallow aquifers during hydraulic fracturing operations when pressures in the gas-bearing formation are greatly increased; and (3) the potential downward leakage of water from shallow aquifers during depressurization of gas-bearing formations. In particular, we show that the recovery of pressure after production ceases from gas-bearing shale formations may take several hundred years, and we present critical hydraulic conductivity values for intervening aquitards, below which the impact on shallow aquifers will be negligible. The simplifying assumptions inherent in these solutions will limit their predictive accuracy for site-specific assessments, compared to numerical models that incorporate knowledge of spatial variations in formation properties and which may include processes not considered in the simpler solutions.

Live phylogeny with polytomies: Finding the most compact parsimonious trees

Construction of phylogenetic trees has traditionally focused on binary trees where all species appear on leaves, a problem for which numerous efficient solutions have been developed. Certain application domains though, such as viral evolution and transmission, paleontology, linguistics, and phylogenetic stemmatics, often require phylogeny inference that involves placing input species on ancestral tree nodes (live phylogeny), and polytomies. These requirements, despite their prevalence, lead to computationally harder algorithmic solutions and have been sparsely examined in the literature to date. In this article we prove some unique properties of most parsimonious live phylogenetic trees with polytomies, and their mapping to traditional binary phylogenetic trees. We show that our problem reduces to finding the most compact parsimonious tree for n species, and describe a novel efficient algorithm to find such trees without resorting to exhaustive enumeration of all possible tree topologies.

Upper Limits on the Stochastic Gravitational-Wave Background from Advanced LIGO's First Observing Run

A wide variety of astrophysical and cosmological sources are expected to contribute to a stochastic gravitational-wave background. Following the observations of GW150914 and GW151226, the rate and mass of coalescing binary black holes appear to be greater than many previous expectations. As a result, the stochastic background from unresolved compact binary coalescences is expected to be particularly loud. We perform a search for the isotropic stochastic gravitational-wave background using data from Advanced Laser Interferometer Gravitational Wave Observatory's (aLIGO) first observing run. The data display no evidence of a stochastic gravitational-wave signal. We constrain the dimensionless energy density of gravitational waves to be Ω_{0}<1.7×10^{-7} with 95% confidence, assuming a flat energy density spectrum in the most sensitive part of the LIGO band (20-86 Hz). This is a factor of ∼33 times more sensitive than previous measurements. We also constrain arbitrary power-law spectra. Finally, we investigate the implications of this search for the background of binary black holes using an astrophysical model for the background.

Directional Limits on Persistent Gravitational Waves from Advanced LIGO's First Observing Run

We employ gravitational-wave radiometry to map the stochastic gravitational wave background expected from a variety of contributing mechanisms and test the assumption of isotropy using data from the Advanced Laser Interferometer Gravitational Wave Observatory's (aLIGO) first observing run. We also search for persistent gravitational waves from point sources with only minimal assumptions over the 20-1726 Hz frequency band. Finding no evidence of gravitational waves from either point sources or a stochastic background, we set limits at 90% confidence. For broadband point sources, we report upper limits on the gravitational wave energy flux per unit frequency in the range F_{α,Θ}(f)<(0.1-56)×10^{-8}    erg cm^{-2} s^{-1} Hz^{-1}(f/25  Hz)^{α-1} depending on the sky location Θ and the spectral power index α. For extended sources, we report upper limits on the fractional gravitational wave energy density required to close the Universe of Ω(f,Θ)<(0.39-7.6)×10^{-8}  sr^{-1}(f/25  Hz)^{α} depending on Θ and α. Directed searches for narrowband gravitational waves from astrophysically interesting objects (Scorpius X-1, Supernova 1987 A, and the Galactic Center) yield median frequency-dependent limits on strain amplitude of h_{0}<(6.7,5.5,  and  7.0)×10^{-25}, respectively, at the most sensitive detector frequencies between 130-175 Hz. This represents a mean improvement of a factor of 2 across the band compared to previous searches of this kind for these sky locations, considering the different quantities of strain constrained in each case.

A case study in institutional repository content curation

Purpose

The purpose of this case study is to illustrate how a university library collaborated with a specific college to preserve scholarship with a sustainable approach. The practical process described is recommended for increasing content submissions in a newly established institutional repository. Of the eight colleges at Middle Tennessee State University (MTSU), the Honors College was selected as a case study for a library–college collaboration on content curation for the institutional repository that is maintained by MTSU’s Walker Library.

Design/methodology/approach

Concept of shared and divided responsibilities for the upload, maintenance and sustainability of institutional repository submissions based on a particular case study and aided with literature on data management, digital publishing, library publishing and preservation research.

Findings

The partner approach, the sharing and division of responsibilities, is instrumental to the growth and sustainability of a library publishing program and for the preservation of university scholarship.

Practical implications

The (college) partner approach not only educates campus units about a new resource (e.g. institutional repository), but also encourages campus units to rethink other current and outdated practices that need to adapt to technological changes that support the unit and its students. This approach will help the library with campus outreach after an institutional repository is implemented and offers guidance on a collaborative approach to repository submission growth.

Originality/value

This paper suggests a (college) partner approach that mutually benefits the College and its students, departments and the library that maintains the institutional repository on behalf of the university. During the implementation process of this case study, an Americans with Disabilities Act (ADA)/accessibility compliance issue of repository items surfaced and allowed for a new course of action to be taken campus wide which adds to the originality of this case study.