Sellar Remodeling after Surgery for Nonfunctioning Pituitary Adenoma: Intercarotid Distance as a Predictor of Recurrence

Introduction  As they grow, pituitary adenoma can remodel the sella turcica and alter anatomical relationships with adjacent structures. The intercarotid distance (ICD) at the level of the sella is a measure of sella width. The purpose of this study was to (1) assess how ICD changes after transsphenoidal surgery and (2) explore whether the extent of ICD change is associated with tumor recurrence. Methods  A retrospective analysis of preoperative and postoperative coronal magnetic resonance imaging (MRI) scans was carried out by two independent assessors on patients who underwent transsphenoidal surgery for nonfunctioning pituitary macroadenomas. Preoperative tumor volume and any change in ICD following surgery were recorded and compared between groups. Logistic regression models of recurrence were generated. Results  In 36 of 42 patients, ICD fell after surgery (mean = 1.8 mm) and six cases were static. At time of follow-up (mean = 77 months), 25 had not required further intervention and 17 had undergone second surgery or radiosurgery. In patients in whom no further intervention has yet been necessary, the postoperative reduction in ICD was significantly smaller than in those who required repeat intervention (1.1 vs. 2.7 mm respectively, p  < 0.01). ICD decrease was weakly correlated with tumor volume ( r  = 0.35). ICD decrease was a significant predictor of recurrence (odds ratio [OR] = 3.15; 95% confidence interval [CI]: 1.44–6.87), largely independent of tumor volume. Conclusion  For most patients, ICD falls following surgical excision of a nonfunctioning pituitary macroadenoma. A greater reduction in ICD postsurgery appears to predict recurrence. Change in ICD shows promise as a radiographic tool for prognosticating clinical course after surgery

Ignition and combustion of single particles of coal and biomass

Co-firing technology at large power plants can contribute to reducing emissions and maintaining stable and secure electricity supplies. Due to the higher reactivity of biomass, a larger particle size range is generally used for biomass fuels compared with pulverized coal. A single particle apparatus has been developed for rapid heating and combustion of individual fuel particles. This wire mesh apparatus is used as a heating element to heat the particle by radiation while optical access allows particle combustion characterization by high speed camera recording. A woody biomass and a bituminous coal were used in this study. Both fuels showed a sequential combustion of volatile matter followed by char combustion. High speed video image analysis showed differences in ignition and devolatilization behaviour. The biomass volatile flame was smooth along the overall particle, while coal volatile matter release was delivered by jets. Times for the volatile matter combustion were much shorter for the coal while pyrolysis seemed to be the dominant step for around half of total combustion time. During devolatilization, the bituminous coal showed a significant swelling that was not seen in the biomass. As particle mass increased the overall times required for drying, devolatilization and burnout increased for both samples, and this was the dominant parameter to predict burnout time. Impact of particle size and mass was much higher in coal, with a dramatic increase in burnout times for particles above 300 µm, while biomass particle size can have a greater range of sizes for the same burnout times. During biomass particle combustion, the results showed that the surface tension on the biomass char particle plays a significant role due to partial melting of the char particle. This effect modifies the char particle shape during its combustion, with particles becoming more spherical even for the initial fibrous shape of the woody biomass particles

Crop Updates 2009 - Genetically Modified Crops, Nutrition, Soils, & Others

This session covers fifteen papers from different authors: 1. Performance of Canola Breeders Roundup Ready® canola hybrid CHYB-166 in 2008, Wallace Cowling, Canola Breeders Western Australia Pty Ltd 2. The implications of GM glyphosate resistant lupin, Art Diggle, Caroline Peek, Frank D’Emden, Fiona Evans, Bob French, Rob Grima, Sam Harburg, Abul Hashem,, John Holmes, Jeremy Lemon, Peter Newman, Janet Paterson, Steve Penny,Department of Agriculture and Food, Peter Portmann, Agriconnect 3. Nufarm Roundup Ready® Canola Systems Trials— 2008 Mark Slatter, Research and Development Officer, Victoria, Nufarm (0438 064 845) Angus MacLennan, Business Development Manager, New South Wales, Nufarm (0408 358 024) Cooperators: Monsanto, Nuseed, Pacific Seeds, Pioneer Seeds 4. Roundup Ready® canola—2008 Limited Commercial Release. Getting the system right, Andrew Wells and Mark Slatter, Nufarm Australia Limited (Reprint from 2008 GRDC Cropping Updates with Introductory note) NUTRITION 5. Fertilising in a changing price environment, Bill Bowden1, Wayne Pluske2 and Jeremy Lemon1, 1Department of Agriculture and Food, 2Back Paddock Company 6. Making better fertiliser for Western Australian cropping systems, Wen Chen1 2, Geoff Anderson1, Ross Brennan1and Richard Bell2 1Department of Agriculture and Food, 2School of Environmental Science, Murdoch University 7. The nitrogen fertiliser replacement value of biosolids from wastewater treatment, Hannah Rigby1, Deborah Pritchard1, David Collins1, Katrina Walton2, David Allen2 and Nancy Penney31School of Agriculture and Environment,Curtin University of Technology, Muresk Campus, 2Chemistry Centre of Western Australia 3Water Corporation of Western Australia 8. Fertilising to soil type (usually) pays, Michael Robertson, Bill Bowden and Roger Lawes, CSIRO, Floreat and Department of Agriculture and Food SOILS 9. Management of subsoil acidity and compaction using a combination of lime, deep ripping and controlled traffic, Stephen Davies, Chris Gazey, Breanne Best and David Gartner, Department of Agriculture and Food 10. Optimising gypsum applications through remote sensing and Variable Rate Technology, Frank D’Emden, Department of Agriculture and Food and Quenten Knight,Precision Agronomics Australia 11. Case study of a 17 year agricultural lime trial, Chris Gazey1, Joel Andrew2and Ryan Pearce3 1Department of Agriculture and Food; 2Precision SoilTech; 3ConsultAg 12. Soil organic carbon in WA agricultural soils, FC Hoyle and A Bennett, Department of Agriculture and Food OTHER 13. Is the no-till revolution complete in WA? Frank D’Emden1, Rick Llewellyn2 and Ken Flower3 1Department of Agriculture and Food, 2CSIRO Sustainable Ecosystems, 3University of Western Australia 14. Progression Planning (The Concept), Julian Krieg and Owen Catto, Wheatbelt Men’s Health 15. Is the Department of Agriculture and Food still a primary source of cropping information? Cindy Parsons, Department of Agriculture and Foo

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

A multidisciplinary team case management approach reduces the burden of frequent asthma admissions

Up to 10% of asthmatics have "difficult asthma"; however, they account for 80% of asthma-related expenditure and run the highest risk of acute severe exacerbations. An estimated 75% of admissions for asthma are avoidable. Guidelines advise that these patients be managed by an experienced specialist multidisciplinary team (MDT). We aimed to assess the impact of a case management strategy delivered via specialist MDTs on acute healthcare utilisation of patients with frequent asthma admissions. An MDT (consultant, specialist nurse, physiotherapist and psychologist) case management strategy was introduced in 2010 at University Hospital Southampton Foundation Trust (Southampton, UK) to support patients with frequent asthma admissions during admission and then in clinic. To assess efficacy, we systematically searched the hospital database for patients acutely admitted for asthma on two or more occasions in 2010, 2011 and 2012. Data were collected retrospectively covering patient demographics, admission details, asthma severity and comorbidity. From 2010 to 2012, 84 patients were admitted on two or more occasions per year (80% female, mean body mass index 31 kg·m-2 and 55% psychological comorbidity). After introducing an MDT approach repeat asthma admissions fell by 33% from 127 in 2010 to 84 in 2012 (p=0.0004). In addition, bed days fell by 52% from 895 in 2010 to 430 in 2010 (p=0.015). An MDT case management approach significantly reduces hospitalisation in difficult asthma patients with prior frequent admission.</p

VirA+EmiC project: Evaluating real-world effectiveness and sustainability of integrated routine opportunistic hepatitis B and C testing in a large urban emergency department.

Innovative testing approaches and care pathways are required to meet global hepatitis B virus (HBV) and hepatitis C virus (HCV) elimination goals. Routine blood-borne virus (BBV) testing in emergency departments (EDs) in high-prevalence areas is suggested by the European Centre for Disease Prevention and Control (ECDC) but there is limited evidence for this. Universal HIV testing in our ED according to UK guidance has been operational since 2015. We conducted a real-world service evaluation of a modified electronic patient record (EPR) system to include opportunistic opt-out HBV/reflex-HCV tests for any routine blood test orders for ED attendees aged ≥16 years. Reactive laboratory results were communicated directly to specialist clinical teams. Our model for contacting patients requiring linkage to care (new diagnoses/known but disengaged) evolved from initially primarily hospital-led to collaborating with regional health and community service networks. Over 11 months, 81,088 patients attended the ED; 36,865 (45.5%) had a blood test. Overall uptake for both HBV and HCV testing was 75%. Seroprevalence was 0.9% for hepatitis B surface antigen (HBsAg) and 0.9% for HCV antigen (HCV-Ag). 79% of 140 successfully contacted HBsAg+patients required linkage to care, of which 87% engaged. 76% of 130 contactable HCV-Ag+patients required linkage, 52% engaged. Our results demonstrate effectiveness and sustainability of universal ED EPR opt-out HBV/HCV testing combined with comprehensive linkage to care pathways, allowing care provision particularly for marginalized at-risk groups with limited healthcare access. The findings support the ECDC BBV testing guidance and may inform future UK hepatitis testing guidance