The role of positron-emission tomography in the diagnosis of giant cell arteritis

Abstract Background: Giant cell arteritis (GCA) is an inflammatory disease of the larger vessels, typically affecting the temporal arteries, but involvement of the carotid and thoracic arteries is not uncommon. Serious complications such as blindness can occur if the disease is left untreated. Currently, the gold standard test for GCA is a temporal biopsy, but this invasive technique is not without risks and frequently inaccurate. We investigate the use of 18-fluoro-desoxyglucose (18F-FDG) positron emission tomography (PET) as a new diagnostic means in GCA. Methods: We performed a literature search in the MEDLINE database for original research articles written in the English language that discussed the use of PET in diagnosing GCA. After applying selection criteria, 9 articles were included for literature review and 4 of these were incorporated in a meta-analysis. Results: 18-FDG uptake in the extracranial arteries is correlated to the presence GCA within patients suspected for vasculitis. In our meta-analysis we found the following results: sensitivity 85% (95% CI; 74-92%, I2=0.0%), specificity 91% (95% CI; 82-96%, I2=31.2%), positive likelihood ratio 7.18 (95% CI; 3.43-15.06, I2 =10.1%) and negative likelihood ratio 0.19 (95% CI; 0.11-0.33, I2= 0.0%). Discussion: 18F-FDG-PET cannot replace temporal artery biopsy at the present time, because of its limited ability to visualise the cranial arteries. However, PET may be provide valuable information when extracranial involvement is suspected, specifically in biopsy-negative patients who are strongly suspected of having GCA

Seeing the smart city on Twitter: Colour and the affective territories of becoming smart

This paper pays attention to the immense and febrile field of digital image files which picture the smart city as they circulate on the social media platform Twitter. The paper considers tweeted images as an affective field in which flow and colour are especially generative. This luminescent field is territorialised into different, emergent forms of becoming ‘smart’. The paper identifies these territorialisations in two ways: firstly, by using the data visualisation software ImagePlot to create a visualisation of 9030 tweeted images related to smart cities; and secondly, by responding to the affective pushes of the image files thus visualised. It identifies two colours and three ways of affectively becoming smart: participating in smart, learning about smart, and anticipating smart, which are enacted with different distributions of mostly orange and blue images. The paper thus argues that debates about the power relations embedded in the smart city should consider the particular affective enactment of being smart that happens via social media. More generally, the paper concludes that geographers must pay more attention to the diverse and productive vitalities of social media platforms in urban life and that this will require experiment with methods that are responsive to specific digital qualities

Growth mode, magnetic and magneto-optical properties of pulsed-laser-deposited Au/Co/Au(111) trilayers

The growth mode, magnetic and magneto-optical properties of epitaxial Au/Co/Au(111) ultrathin trilayers grown by pulsed-laser deposition (PLD) under ultra-high vacuum are presented. Sapphire wafers buffered with a single-crystalline Mo(110) bilayer were used as substrates. Owing to PLD-induced interfacial intermixing at the lower Co/Au(111) interface, a layer-by-layer growth mode is promoted. Surprisingly, despite this intermixing, ferromagnetic behavior is found at room temperature for coverings starting at 1 atomic layer (AL). The films display perpendicular magnetization with anisotropy constants reduced by 50% compared to TD-grown or electrodeposited films, and with a coercivity more than one order of magnitude lower ($\lesssim$ 5 mT). The magneto-optical (MO) response in the low Co thickness range is dominated by Au/Co interface contributions. For thicknesses starting at 3 AL Co, the MO response has a linear dependence with the Co thickness, indicative of a continuous-film-like MO behavior

Expression of oncoproteins and the amount of eosinophilic and lymphocytic infiltrates can be used as prognostic factors in gastric cancer. Dutch Gastric Cancer Group (DGCG).

Preoperative staging of gastric cancer is difficult. Several molecular markers associated with initiation and progression of cancer seem promising for obtaining preoperative prognostic information. To investigate whether these markers are indicative especially for the presence of lymph node metastases in patients with gastric cancer, we have examined primary tumour specimens from 105 patients with primary adenocarcinoma of the stomach entered in a surgical trial. In this trial, lymph node status was determined by strictly quality-controlled lymph node dissection and examination. The selected markers were growth regulators (p53, Rb and myc), metastasis-suppressor gene product (nm23), adhesion molecules (Ep-CAM, E-cadherin, CD44v5 and CD44v6) and urokinase-type plasminogen activator (u-PA). Also, the amount of eosinophilic and lymphocytic infiltrates available post-operatively was analysed with respect to its prognostic value for lymph node status. Moreover, the association of these parameters with survival and disease-free period (DFP) was evaluated. Of all molecular markers investigated, only Rb expression had a significant association with the presence of lymph node metastasis in both univariate and multivariate analysis. For curative resectability, a significant association was found with Rb and E-cadherin expression, while in multivariate analysis Rb and myc were selected as the combination with additional independent prognostic value, and E-cadherin had no additional independent value. For overall survival in univariate analysis, the amount of both eosinophilic and lymphocytic infiltrates and Rb and myc expression were of significant prognostic value. Only the amount of lymphocytic infiltrate had a prognostic significance for DFP. In stepwise multivariate analysis, TNM stage (I + II) and marked lymphocytic infiltrate were associated with better overall survival and longer DFP. We conclude that, if these results are confirmed in a larger series of patients, molecular markers can provide useful prognostic information

Dependence of Intramyocardial Pressure and Coronary Flow on Ventricular Loading and Contractility: A Model Study

The phasic coronary arterial inflow during the normal cardiac cycle has been explained with simple (waterfall, intramyocardial pump) models, emphasizing the role of ventricular pressure. To explain changes in isovolumic and low afterload beats, these models were extended with the effect of three-dimensional wall stress, nonlinear characteristics of the coronary bed, and extravascular fluid exchange. With the associated increase in the number of model parameters, a detailed parameter sensitivity analysis has become difficult. Therefore we investigated the primary relations between ventricular pressure and volume, wall stress, intramyocardial pressure and coronary blood flow, with a mathematical model with a limited number of parameters. The model replicates several experimental observations: the phasic character of coronary inflow is virtually independent of maximum ventricular pressure, the amplitude of the coronary flow signal varies about proportionally with cardiac contractility, and intramyocardial pressure in the ventricular wall may exceed ventricular pressure. A parameter sensitivity analysis shows that the normalized amplitude of coronary inflow is mainly determined by contractility, reflected in ventricular pressure and, at low ventricular volumes, radial wall stress. Normalized flow amplitude is less sensitive to myocardial coronary compliance and resistance, and to the relation between active fiber stress, time, and sarcomere shortening velocity

High-resolution, 3D radiative transfer modelling : IV. AGN-powered dust heating in NGC 1068

The star formation rate and the mass of interstellar medium (ISM) have a high predictive power for the future evolution of a galaxy. Nevertheless, deriving such properties is not straightforward. Dust emission, an important diagnostic of star formation and ISM mass throughout the Universe, can be powered by sources unrelated to ongoing star formation. In the framework of the DustPedia project we set out to disentangle the radiation of the ongoing star formation from that of the older stellar populations. This is done through detailed 3D radiative transfer simulations of face-on spiral galaxies. We take special care in modelling the morphological features present for each source of radiation. In this particular study, we focus on NGC 1068, which in addition contains an active galactic nucleus (AGN). The effect of diffuse dust heating by an AGN (beyond the torus) has so far only been investigated for quasars. This additional dust heating source further contaminates the broadband fluxes that are used by classic galaxy modelling tools to derive physical properties. We aim to fit a realistic model to the observations of NGC 1068 and quantify the contribution of the several dust-heating sources. Our model is able to reproduce the global spectral energy distribution of the galaxy. It matches the resolved optical and infrared images fairly well, but deviates in the UV and the submillimetre (submm). This is partly due to beam smearing effects, but also because the input dust distribution is not sufficiently peaked in the centre. We find that AGN contamination of the broadband fluxes has a strong dependency on wavelength. It peaks in the mid-infrared, drops in the far-infrared, and then rises again at submm wavelengths. We quantify the contribution of the dust-heating sources in each 3D dust cell and find a median value of 83% for the star formation component. The AGN contribution is measurable at the percentage level in the disc, but quickly increases in the inner few hundred parsecs, peaking above 90%. This is the first time the phenomenon of an AGN heating the diffuse dust beyond its torus is quantified in a nearby star-forming galaxy. NGC 1068 only contains a weak AGN, meaning this effect could be stronger in galaxies with a more luminous AGN. This could significantly impact the derived star formation rates and ISM masses for such systems

Deconvolution of Serum Cortisol Levels by Using Compressed Sensing

The pulsatile release of cortisol from the adrenal glands is controlled by a hierarchical system that involves corticotropin releasing hormone (CRH) from the hypothalamus, adrenocorticotropin hormone (ACTH) from the pituitary, and cortisol from the adrenal glands. Determining the number, timing, and amplitude of the cortisol secretory events and recovering the infusion and clearance rates from serial measurements of serum cortisol levels is a challenging problem. Despite many years of work on this problem, a complete satisfactory solution has been elusive. We formulate this question as a non-convex optimization problem, and solve it using a coordinate descent algorithm that has a principled combination of (i) compressed sensing for recovering the amplitude and timing of the secretory events, and (ii) generalized cross validation for choosing the regularization parameter. Using only the observed serum cortisol levels, we model cortisol secretion from the adrenal glands using a second-order linear differential equation with pulsatile inputs that represent cortisol pulses released in response to pulses of ACTH. Using our algorithm and the assumption that the number of pulses is between 15 to 22 pulses over 24 hours, we successfully deconvolve both simulated datasets and actual 24-hr serum cortisol datasets sampled every 10 minutes from 10 healthy women. Assuming a one-minute resolution for the secretory events, we obtain physiologically plausible timings and amplitudes of each cortisol secretory event with R[superscript 2] above 0.92. Identification of the amplitude and timing of pulsatile hormone release allows (i) quantifying of normal and abnormal secretion patterns towards the goal of understanding pathological neuroendocrine states, and (ii) potentially designing optimal approaches for treating hormonal disorders.National Science Foundation (U.S.). Graduate Research Fellowship ProgramNational Institutes of Health (U.S.) (NIH DP1 OD003646)National Science Foundation (U.S.) (0836720)National Science Foundation (U.S.). Office of Emerging Frontiers in Research and Innovation (EFRI-0735956