Use of High-Resolution Ultrasound to Guide Alcohol Neurolysis for Chronic Pain

BACKGROUND: The diagnosis and treatment of neuropathic pain is often clinically challenging, with many patients requiring treatments beyond oral medications. To improve our percutaneous treatments, we established a clinical pathway that utilized ultrasound (US) guidance for steroid injection and alcohol ablation for patients with painful neuropathy. OBJECTIVES: To describe a collaborative neuropathy treatment pathway developed by a neurosurgeon, pain physicians, and a sonologist, describing early clinical experiences and patient-reported outcomes. STUDY DESIGN: A retrospective case series was performed. METHODS: Patients that received percutaneous alcohol ablation with US guidance for neuropathy were identified through a retrospective review of a single provider\u27s case log. Demographics and treatment information were collected from the electronic medical record. Patients were surveyed about their symptoms and treatment efficacy. Descriptive statistics were expressed as medians and the interquartile range ([IQR]; 25th and 75th data percentiles). Differences in the median follow-up pain scores were assessed using a Wilcoxon signed-rank test. RESULTS: Thirty-five patients underwent US-guided alcohol ablation, with the average patient receiving one treatment (range: 1 to 2), having a median duration of 4.8 months until reinjection (IQR: 2.9 to 13.1). The median number of steroid injections that individuals received before US-guided alcohol ablation was 2 (IQR: 1 to 3), and the median interval between steroid injections was 3.7 months (IQR: 2.0 to 9.6). Most (20/35 [57%]) patients responded to the survey, and the median pain scores decreased by 3 units (median: -3, IQR: -6 to 0; P \u3c 0.001) one week following the alcohol ablation. This pain reduction remained significant at one month (P \u3c 0.001) and one year (P = 0.002) following ablation. Most (12/20 [60%]) patients reported that alcohol ablation was more effective in improving their pain than oral pain medications. LIMITATIONS: Given the small sample size, treatment efficacy for alcohol neurolysis cannot be generalized to the broader population. CONCLUSIONS: US-guided percutaneous treatments for neuropathic pain present a growing opportunity for interprofessional collaboration between neurosurgery, clinicians who treat chronic pain, and sonologists. US can provide valuable diagnostic information and guide accurate percutaneous treatments in skilled hands. Further studies are warranted to determine whether a US-guided treatment pathway can prevent unnecessary open surgical management

Searching For Dark Matter with Plasma Haloscopes

We summarise the recent progress of the Axion Longitudinal Plasma HAloscope (ALPHA) Consortium, a new experimental collaboration to build a plasma haloscope to search for axions and dark photons. The plasma haloscope is a novel method for the detection of the resonant conversion of light dark matter to photons. ALPHA will be sensitive to QCD axions over almost a decade of parameter space, potentially discovering dark matter and resolving the Strong CP problem. Unlike traditional cavity haloscopes, which are generally limited in volume by the Compton wavelength of the dark matter, plasma haloscopes use a wire metamaterial to create a tuneable artificial plasma frequency, decoupling the wavelength of light from the Compton wavelength and allowing for much stronger signals. We develop the theoretical foundations of plasma haloscopes and discuss recent experimental progress. Finally, we outline a baseline design for ALPHA and show that a full-scale experiment could discover QCD axions over almost a decade of parameter space.Comment: Endorsers: Jens Dilling, Michael Febbraro, Stefan Knirck, and Claire Marvinney. 26 pages, 17 figures, version accepted in Physical Review

Hybrid Models Identified a 12-Gene Signature for Lung Cancer Prognosis and Chemoresponse Prediction

Lung cancer remains the leading cause of cancer-related deaths worldwide. The recurrence rate ranges from 35-50% among early stage non-small cell lung cancer patients. To date, there is no fully-validated and clinically applied prognostic gene signature for personalized treatment.From genome-wide mRNA expression profiles generated on 256 lung adenocarcinoma patients, a 12-gene signature was identified using combinatorial gene selection methods, and a risk score algorithm was developed with Naïve Bayes. The 12-gene model generates significant patient stratification in the training cohort HLM & UM (n = 256; log-rank P = 6.96e-7) and two independent validation sets, MSK (n = 104; log-rank P = 9.88e-4) and DFCI (n = 82; log-rank P = 2.57e-4), using Kaplan-Meier analyses. This gene signature also stratifies stage I and IB lung adenocarcinoma patients into two distinct survival groups (log-rank P<0.04). The 12-gene risk score is more significant (hazard ratio = 4.19, 95% CI: [2.08, 8.46]) than other commonly used clinical factors except tumor stage (III vs. I) in multivariate Cox analyses. The 12-gene model is more accurate than previously published lung cancer gene signatures on the same datasets. Furthermore, this signature accurately predicts chemoresistance/chemosensitivity to Cisplatin, Carboplatin, Paclitaxel, Etoposide, Erlotinib, and Gefitinib in NCI-60 cancer cell lines (P<0.017). The identified 12 genes exhibit curated interactions with major lung cancer signaling hallmarks in functional pathway analysis. The expression patterns of the signature genes have been confirmed in RT-PCR analyses of independent tumor samples.The results demonstrate the clinical utility of the identified gene signature in prognostic categorization. With this 12-gene risk score algorithm, early stage patients at high risk for tumor recurrence could be identified for adjuvant chemotherapy; whereas stage I and II patients at low risk could be spared the toxic side effects of chemotherapeutic drugs

Implementing opportunistic spectrum access in LTE-Advanced

Long term evolution advanced (LTE-A) has emerged as a promising mobile broadband access technology aiming to cope with the increasing traffic demand in wireless networks. However, the enhanced spectral efficiency offered by LTE-A may become futile without a better management of scarce and overcrowded electromagnetic spectrum. In this sense, cognitive radio (CR) has been proposed as a potential solution to the problem of spectrum scarcity. Among all the mechanisms provided by CR, opportunistic spectrum access (OSA) aims at a dynamic and seamless use of certain licensed bands provided the licensee is not harmfully affected. This operation requires spectral awareness in order to avoid interferences with licensed systems. In spite of implementing some spectrum sensing mechanisms, LTE-A technology lacks other tools that are needed in order to improve the knowledge of the radio environment. This work studies the adoption of a Geo-located data base (Geo-DB) that cooperatively retrieves and maintains information regarding the location of unutilized portions of spectrum potentially available for OSA. Moreover, the potential benefit of this LTE-compliant OSA solution is evaluated using a calibrated simulation tool, by which numerical results allow us to optimally configure the system and show that the proposed opportunistic system is able to significantly improve its performance.The authors would like to thank the funding received from the Ministerio de Ciencia e Innovacion within the Project number TEC2011-27723-C02-02 and from the Ministerio de Industria, Turismo y Comercio TSI-020100-2011-266 funds. This article had been written in the framework of the CELTIC project CP08-001 COMMUNE. Study by X. Gelabert is funded by the BP-DGR 2010 scholarship (ref. 00192). The authors would like to acknowledge the contributions of their colleagues.Osa Ginés, V.; Herranz Claveras, C.; Monserrat Del Río, JF.; Gelabert, X. (2012). Implementing opportunistic spectrum access in LTE-Advanced. EURASIP Journal on Wireless Communications and Networking. 2012(99):1-17. https://doi.org/10.1186/1687-1499-2012-99S117201299Martín-Sacristán D, Monserrat JF, Cabrejas-Peñuelas J, Calabuig D, Garrigas S, Cardona N: On the way towards fourth-generation mobile: 3GPP LTE and LTE-Advanced. EURASIP J Wirel Commun Netw 2009, 2009: 1-10.Ratasuk R, Tolli D, Ghosh A: Carrier aggregation in LTE-Advanced. In IEEE 71st Vehicular Technology Conference (VTC 2010-Spring). Taipei; 2010:1-5.Wang H, Rosa C, Pedersen K: Performance of uplink carrier aggregation in LTE-advanced systems. In IEEE 72nd Vehicular Technology Conference Fall (VTC 2010-Fall). Ottawa; 2010:1-5.Tandra R, Sahai A, Mishra S: What is a spectrum hole and what does it take to recognize one? 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Random line graphs and a linear law for assortativity

For a fixed number N of nodes, the number of links L in the line graph H(N,L) can only appear in consecutive intervals, called a band of L. We prove that some consecutive integers can never represent the number of links L in H(N,L), and they are called a bandgap of L. We give the exact expressions of bands and bandgaps of L. We propose a model which can randomly generate simple graphs which are line graphs of other simple graphs. The essence of our model is to merge step by step a pair of nodes in cliques, which we use to construct line graphs. Obeying necessary rules to ensure that the resulting graphs are line graphs, two nodes to be merged are randomly chosen at each step. If the cliques are all of the same size, the assortativity of the line graphs in each step are close to 0, and the assortativity of the corresponding root graphs increases linearly from ?1 to 0 with the steps of the nodal merging process. If we dope the constructing elements of the line graphs—the cliques of the same size—with a relatively smaller number of cliques of different size, the characteristics of the assortativity of the line graphs is completely altered. We also generate line graphs with the cliques whose sizes follow a binomial distribution. The corresponding root graphs, with binomial degree distributions, zero assortativity, and semicircle eigenvalue distributions, are equivalent to Erd?s-Rényi random graphs.Electrical Engineering, Mathematics and Computer Scienc

A Novel Way to Measure and Predict Development: A Heuristic Approach to Facilitate the Early Detection of Neurodevelopmental Disorders.

Purpose of reviewSubstantial research exists focusing on the various aspects and domains of early human development. However, there is a clear blind spot in early postnatal development when dealing with neurodevelopmental disorders, especially those that manifest themselves clinically only in late infancy or even in childhood.Recent findingsThis early developmental period may represent an important timeframe to study these disorders but has historically received far less research attention. We believe that only a comprehensive interdisciplinary approach will enable us to detect and delineate specific parameters for specific neurodevelopmental disorders at a very early age to improve early detection/diagnosis, enable prospective studies and eventually facilitate randomised trials of early intervention. In this article, we propose a dynamic framework for characterising neurofunctional biomarkers associated with specific disorders in the development of infants and children. We have named this automated detection 'Fingerprint Model', suggesting one possible approach to accurately and early identify neurodevelopmental disorders