Value of thrombus CT Characteristics in Patients with Acute Ischemic Stroke

BACKGROUND AND PURPOSE: Thrombus CT characteristics might be useful for patient selection for intra-arterial treatment. Our objective was to study the association of thrombus CT characteristics with outcome and treatment effect in patients with acute ischemic stroke. MATERIALS AND METHODS: We included 199 patients for whom thin-section NCCT and CTA within 30 minutes from each other were available in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute ischemic stroke in the Netherlands (MR CLEAN) study. We assessed the following thrombus characteristics: location, distance from ICA terminus to thrombus, length, volume, absolute and relative density

European training requirements in vascular surgery

The Union Europénne des Médecins Spécialistes (UEMS) is a non-governmental organization representing national associations of medical specialists (over 1.6 million) at the European level. It has strong links and relations with European institutions (Commission and Parliament), the other independent European medical or-ganizations and the European medical/scientific societies. With a current membership of 40 national associations and 43 specialist sections and European boards, the UEMS promotes the free movement of medical specialists across Europe while ensuring the highest level of training which will pave the way to the improvement of quality of care for the benefit of all European citizens. The UEMS areas of expertise notably encompass Continuing Medical Education, Post-Graduate Training and Quality Assurance. It is the UEMS conviction that the quality of medical care and expertise is directly linked to the quality of train-ing provided to the medical professionals. Therefore, the UEMS committed itself to contribute to the improvement of medical training at the European level through the de-velopment of European standards in the different medical disciplines. One of the added values of the UEMS is the development of new harmonized models for the training of the next generation of medical specialists, and of high standards of clinical practice, hence improved care for pa-tients throughout Europe. It is not important where doc-tors are trained, they should have at least the same core competencies.peer-reviewe

Rare and low-frequency coding variants alter human adult height

Height is a highly heritable, classic polygenic trait with ~700 common associated variants identified so far through genome - wide association studies . Here , we report 83 height - associated coding variants with lower minor allele frequenc ies ( range of 0.1 - 4.8% ) and effects of up to 2 16 cm /allele ( e.g. in IHH , STC2 , AR and CRISPLD2 ) , >10 times the average effect of common variants . In functional follow - up studies, rare height - increasing alleles of STC2 (+1 - 2 cm/allele) compromise d proteolytic inhibition of PAPP - A and increased cleavage of IGFBP - 4 in vitro , resulting in higher bioavailability of insulin - like growth factors . The se 83 height - associated variants overlap genes mutated in monogenic growth disorders and highlight new biological candidates ( e.g. ADAMTS3, IL11RA, NOX4 ) and pathways ( e.g . proteoglycan/ glycosaminoglycan synthesis ) involved in growth . Our results demonstrate that sufficiently large sample sizes can uncover rare and low - frequency variants of moderate to large effect associated with polygenic human phenotypes , and that these variants implicate relevant genes and pathways

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Reachability and Dexterity: Analysis and Applications for Space Robotics

The utility of a mobile manipulator largely depends on its kinematic structure and mounting point on the robot body. The reachable workspace of the robot can be obtained offline and modeled as a discretized map called Reachability map. A Capability map is obtained by including some quality measure for the local dexterity of the manipulator, which helps to identify good and bad regions for manipulation. Once the maps are obtained based on forward or inverse kinematic methods, they can be used for numerous analysis tasks such as robot kinematics and workspace quality assessment, robot mounting point analysis or redundancy and failure analysis. This paper covers basic aspects of the Reachability and Capability map generation and storage, and shows particular applications of the maps for space robotics

The OOS-SIM: An On-ground Simulation Facility For On-Orbit Servicing Robotic Operations

On-orbit servicing involves a new class of space missions in which a servicer spacecraft is launched into the orbit of a target spacecraft, the client. The servicer navigates to the client with the intention of manipulating it, using a robotic arm. Within this framework, this work presents a new robotic experimental facility which was recently built at the DLR to support the development and experimental validation of such orbital servicing robots. The facility allows reproducing a close-proximity scenario under realistic three-dimensional orbital dynamics conditions. Its salient features are described here, to include a fully actuated macro-micro system with multiple sensing capabilities, and analyses on its performance including the amount of space environment volume that can be simulated

Remote Collaboration, Decision Support, and On-Demand Medical Image Analysis for Acute Stroke Care

Part 2: Industry TrackInternational audienceAcute stroke is the leading cause of disabilities and the fourth cause of death worldwide. The treatment of stroke patients often requires fast collaboration between medical experts and fast analysis and sharing of large amounts of medical data, especially image data. In this situation, cloud technologies provide a potentially cost-effective way to optimize management of stroke patients and, consequently, improve patient outcome. This paper presents a cloud-based platform for Medical Distributed Utilization of Services & Applications (MEDUSA). This platform aims at improving current acute care settings by allowing fast medical data exchange, advanced processing of medical image data, automated decision support, and remote collaboration between physicians in a secure and responsive virtual space. We describe a prototype implemented in the MEDUSA platform for supporting the treatment of acute stroke patients. As the initial evaluation illustrates, this prototype improves several aspects of current stroke care and has the potential to play an important role in the care management of acute stroke patients

Recycling and refilling of transmitter quanta at the frog neuromuscular junction

Fluorescent dyes have been used at the frog neuromuscular junction to label synaptic vesicular membrane. Retrieved membrane is reformed into vesicles, which are released along with pre-existing vesicles. Consequently, if vesicular refilling with acetylcholine (ACh) is depressed by inhibitors, two sizes of quanta should be released: normal and smaller. As recycling continues the fraction of smaller size quanta should increase exponentially.We enhanced the rate of quantal release by elevating the K+ concentration. The principal inhibitors were (−)-vesamicol (VES), hemicholinium-3 (HC3), and NH4+. Quantal size measurements were fitted to one and to two cumulative lognormal probability distribution functions. When two fitted better, the statistical significance assessment took into account the three additional parameters used in calculating the fit.After recycling in the presence of inhibitor, many sets were fitted better by two lognormal functions. As recycling continued, the fraction of the miniature endplate potential voltage–time integrals (∫MEPPs) in the larger sub-population decreased exponentially.The size of the releasable pool was estimated by counting the quanta released by carbonyl cyanide m-chlorophenylhydrazone (CCCP). This was compared to pool sizes calculated from the inhibitor experiments. The two estimates of pool size were indistinguishable, with mean values ranging from about 170 000 to 270 000.With all of the treatments tested, the means of the sizes in the smaller sub-population of ∫MEPPs were about 1/3 those of the larger sub-populations.Recycling synaptic vesicles appear to be incorporated into the releasable pool from which they have roughly the same probability of release as the pre-existing vesicles

Remote Collaboration, Decision Support, and On-Demand Medical Image Analysis for Acute Stroke Care

Acute stroke is the leading cause of disabilities and the fourth cause of death worldwide. The treatment of stroke patients often requires fast collaboration between medical experts and fast analysis and sharing of large amounts of medical data, especially image data. In this situation, cloud technologies provide a potentially cost-effective way to optimize management of stroke patients and, consequently, improve patient outcome. This paper presents a cloud-based platform for Medical Distributed Utilization of Services & Applications (MEDUSA). This platform aims at improving current acute care settings by allowing fast medical data exchange, advanced processing of medical image data, automated decision support, and remote collaboration between physicians in a secure and responsive virtual space. We describe a prototype implemented in the MEDUSA platform for supporting the treatment of acute stroke patients. As the initial evaluation illustrates, this prototype improves several aspects of current stroke care and has the potential to play an important role in the care management of acute stroke patient