Utility of Surgeon-Performed Ultrasound Assessment of the Lateral Neck for Metastatic Papillary Thyroid Cancer

Ultrasound is the recommended staging modality for papillary thyroid cancer. Surgeons proficient in US assessment of the neck and experienced in the management of papillary thyroid cancer (PTC) appear uniquely qualified to assess the lateral cervical lymph nodes for metastatic disease. Of 310 patients treated for PTC between 2000 and 2008, 109 underwent surgeon-performed ultrasound (SUS) of the lateral neck preoperatively. Fine needle aspiration was performed on suspicious lateral lymph nodes. SUS findings were compared with FNA cytology and results of postoperative imaging studies. The sensitivity and negative predictive value of SUS were 88% and 97%, respectively. Four patients were found to have missed metastatic disease within 6 months. No patient underwent a nontherapeutic neck dissection. SUS combined with US-guided FNA of suspicious lymph nodes can accurately stage PTC to reliably direct surgical management

Shadow Banning in Browser-based Volunteering Computing

Browser-based volunteering computing projects are mainly used to perform scientific computations in heterogeneous clusters at a low cost. As for every community-driven approach, saboteurs can try to cheat the system for various reasons. In this paper, we propose to study whether such solutions could improve their performance and resilience by using shadow banning instead of a classic ban scheme. To do so, we have built a framework simulating a real system and studied the impact of shadow banning in relation with task types, saboteur rates, and detection techniques such as majority, m-first and credibility-based voting. Results show that shadow banning is overall more resilient, reducing the number of errors of detection by more than 33.5% in average. It also improves the server-side performance in a significant manner for saboteur rates between 0 and 20%

External validation of novel clinical likelihood models to predict obstructive coronary artery disease and prognosis

Objectives The risk factor-weighted and coronary artery calcium score-weighted clinical likelihood (RF-CL and CACS-CL, respectively) models improve discrimination of patients with suspected obstructive coronary artery disease (CAD). However, external validation is warranted. Compared to the 2019 European Society of Cardiology pretest probability (ESC-PTP) model, the aims were (1) to validate the RF-CL and CACS-CL models for identification of obstructive CAD and revascularisation, and (2) to investigate prognosis by CL thresholds. Methods Stable de novo chest pain patients (n=1585) undergoing coronary CT angiography (CTA) were investigated. Obstructive CAD was defined as &gt;70% diameter stenosis in a major epicardial vessel on CTA. Decision of revascularisation within 120 days was based on onsite judgement. The endpoint was non-fatal myocardial infarction or cardiovascular death. The ESC-PTP was calculated based on age, sex and symptom typicality, the RF-CL additionally included number of risk factors, and the CACS-CL incorporated CACS to the RF-CL. Results Obstructive CAD was present in 386/1585 (24.4%) patients, and 91/1585 (5.7%) patients underwent revascularisation. Both the RF-CL and CACS-CL classified more patients to very-low CL (&lt;5%) of obstructive CAD compared with the ESC-PTP model (41.4% and 52.2% vs 19.2%, p&lt;0.001). In very-low CL patients, obstructive CAD and revascularisation prevalences (≤6% and &lt;1%) remained similar combined with low event risk during 5.0 years follow-up. Conclusion In an external validation cohort, the novel RF-CL and CACS-CL models improve categorisation to a very-low CL group with preserved prevalences of obstructive CAD, revascularisation and favourable prognosis.</p

Large eddy simulation of urban features for Copenhagen metropolitan area

International audienceThe large eddy simulations employing the SUBMESO model with the urban soil layer model SM2-U were performed for the model domain covering the Danish Island of Sealand and including the Copenhagen metropolitan area. Monthly and diurnal cycle variability were studied for the net radiation, sensible and storage heat fluxes, surface's temperatures, and others. These were evaluated for selected urban vs. non urban related types of covers/surfaces and urban districts such as city center, high buildings, industrial, and residential. Results showed strong effects of urban features on temporal and spatial variability. They are useful and applicable for verification of numerical weather prediction models and development of urban canopy parameterizations

Extracellular matrix mechanical cues regulate lipid metabolism through Lipin-1 and SREBP

Extracellular matrix (ECM) mechanical cues have powerful effects on cell proliferation, differentiation and death. Here, starting from an unbiased metabolomics approach, we identify synthesis of neutral lipids as a general response to mechanical signals delivered by cell\u2013matrix adhesions. Extracellular physical cues reverberate on the mechanical properties of the Golgi apparatus and regulate the Lipin-1 phosphatidate phosphatase. Conditions of reduced actomyosin contractility lead to inhibition of Lipin-1, accumulation of SCAP/SREBP to the Golgi apparatus and activation of SREBP transcription factors, in turn driving lipid synthesis and accumulation. This occurs independently of YAP/TAZ, mTOR and AMPK, and in parallel to feedback control by sterols. Regulation of SREBP can be observed in a stiffened diseased tissue, and contributes to the pro-survival activity of ROCK inhibitors in pluripotent stem cells. We thus identify a general mechanism centered on Lipin-1 and SREBP that links the physical cell microenvironment to a key metabolic pathway

Engaging with Sustainability Issues in Metropolitan Chennai

Publication en ligne, City report series (Chance2Sustain) - ISSN 2309-8198Chennai is the largest metropolitan city in South India (8.7 million in 2011) and the provincial capital of the large state of Tamil Nadu (population 72 million in 2011). Before that, under British rule, the city was the capital of the Madras Presidency, and was known as Madras until 1996, when the name was officially changed to Chennai. Located on the east coast of India, on the Bay of Bengal, sea trade has been an important aspect of the regional economy since at least the colonial period. Still today, the city combines political functions with economic command functions for both manufacturing and services, reflecting the region's diversified economy. The Chennai metropolitan area has witnessed strong growth over the last 20 years in automobile manufacturing, software services, hardware manufacturing, healthcare and financial services (CDP 2009). However, it should be noted that only 30% of total employment in the city takes place in the formal sector i.e., is covered by contracts and labour laws, the remaining 70% falls in the informal sector. This underscores the importance of small and micro enterprises and self-employment for providing goods, services and livelihoods in the local economy

Characterization of acoustic materials at arbitrary incidence angle using sound field synthesis

Standardized methods for measuring sound absorption such as the impedance tube and reverberation chamber methods are limited to normal or diffuse incidence, respectively. Two research axes have been generally followed in the literature to develop alternative techniques, the first one focusing on the measurement part, that is from the two-microphone technique to the use of microphone arrays or pressure-velocity sensors. The second axis focuses on the excitation part with for instance the use of sound field synthesis techniques. Since acoustic impedance and sound absorption coefficient of materials are classically defined under normal and oblique plane wave excitation, synthesizing an “ideal” plane wave using a loudspeaker array would allow measuring these acoustics quantities using a simple microphone pair. In this article, the effect of the different parameters of a loudspeaker array on acoustic plane waves reproduction on a material’s surface is first numerically studied. Then, numerical and experimental results for the estimation of both impedance and absorption coefficients are reported. These results show that sound field synthesis allows to characterize a material for arbitrary incidence angles over a wide frequency range, thus offering an alternative method to standard techniques and an improvement over existing works

Clinical Study Utility of Surgeon-Performed Ultrasound Assessment of the Lateral Neck for Metastatic Papillary Thyroid Cancer

Ultrasound is the recommended staging modality for papillary thyroid cancer. Surgeons proficient in US assessment of the neck and experienced in the management of papillary thyroid cancer (PTC) appear uniquely qualified to assess the lateral cervical lymph nodes for metastatic disease. Of 310 patients treated for PTC between 2000 and 2008, 109 underwent surgeon-performed ultrasound (SUS) of the lateral neck preoperatively. Fine needle aspiration was performed on suspicious lateral lymph nodes. SUS findings were compared with FNA cytology and results of postoperative imaging studies. The sensitivity and negative predictive value of SUS were 88% and 97%, respectively. Four patients were found to have missed metastatic disease within 6 months. No patient underwent a nontherapeutic neck dissection. SUS combined with US-guided FNA of suspicious lymph nodes can accurately stage PTC to reliably direct surgical management