Large area CMOS active pixel sensor x‐ray imager for digital breast tomosynthesis: Analysis, modeling, and characterization

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134791/1/mp2368.pd

Response to “Comment on ‘Large area CMOS active pixel sensor x‐ray imager for digital breast tomosynthesis: Analysis, modeling, and characterization’ ” [Med. Phys. 43, 1578–1579 (2016)]

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135038/1/mp5041_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135038/2/mp5041.pd

Mediastinitis complicating a percutaneous endoscopic gastrostomy: a case report

BACKGROUND: Since its introduction in the early 1980s, percutaneous endoscopic gastrostomy has become the most popular method for performing a gastrostomy for long-term enteral feeding. It has been associated, however, with a lot of minor and major complications. CASE PRESENTATION: A case of mediastinitis with concominant sepsis caused by a masked esophageal perforation after percutaneous endoscopic gastrostomy in a multi-traumatized, brain-injured patient is presented. Ten – fourteen days after the procedure, the patient became febrile and gradually septic with tenderness of the sternum and upper abdomen. Computerized tomography of the thorax revealed mediastinitis. An urgent left thoracotomy and laparotomy were performed for drainage of the mediastinum, removal of the gastrostomy and insertion of a jejunostomy tube. The patient improved soon after the surgery. He was successfully weaned off the ventilator and was discharged from the Intensive Care Unit. CONCLUSION: Perforating mediastinitis is a rare but potentially lethal complication of percutaneous endoscopic gastrostomy. When diagnosed and properly treated it may have a favourable outcome

Rare Copy Number Variants in \u3cem\u3eNRXN1\u3c/em\u3e and \u3cem\u3eCNTN6\u3c/em\u3e Increase Risk for Tourette Syndrome

Tourette syndrome (TS) is a model neuropsychiatric disorder thought to arise from abnormal development and/or maintenance of cortico-striato-thalamo-cortical circuits. TS is highly heritable, but its underlying genetic causes are still elusive, and no genome-wide significant loci have been discovered to date. We analyzed a European ancestry sample of 2,434 TS cases and 4,093 ancestry-matched controls for rare (\u3c 1% frequency) copy-number variants (CNVs) using SNP microarray data. We observed an enrichment of global CNV burden that was prominent for large (\u3e 1 Mb), singleton events (OR = 2.28, 95% CI [1.39–3.79], p = 1.2 × 10−3) and known, pathogenic CNVs (OR = 3.03 [1.85–5.07], p = 1.5 × 10−5). We also identified two individual, genome-wide significant loci, each conferring a substantial increase in TS risk (NRXN1 deletions, OR = 20.3, 95% CI [2.6–156.2]; CNTN6 duplications, OR = 10.1, 95% CI [2.3–45.4]). Approximately 1% of TS cases carry one of these CNVs, indicating that rare structural variation contributes significantly to the genetic architecture of TS

Synaptic processes and immune-related pathways implicated in Tourette syndrome

Tourette syndrome (TS) is a neuropsychiatric disorder of complex genetic architecture involving multiple interacting genes. Here, we sought to elucidate the pathways that underlie the neurobiology of the disorder through genome-wide analysis. We analyzed genome-wide genotypic data of 3581 individuals with TS and 7682 ancestry-matched controls and investigated associations of TS with sets of genes that are expressed in particular cell types and operate in specific neuronal and glial functions. We employed a self-contained, set-based association method (SBA) as well as a competitive gene set method (MAGMA) using individual-level genotype data to perform a comprehensive investigation of the biological background of TS. Our SBA analysis identified three significant gene sets after Bonferroni correction, implicating ligand-gated ion channel signaling, lymphocytic, and cell adhesion and transsynaptic signaling processes. MAGMA analysis further supported the involvement of the cell adhesion and trans-synaptic signaling gene set. The lymphocytic gene set was driven by variants in FLT3, raising an intriguing hypothesis for the involvement of a neuroinflammatory element in TS pathogenesis. The indications of involvement of ligand-gated ion channel signaling reinforce the role of GABA in TS, while the association of cell adhesion and trans-synaptic signaling gene set provides additional support for the role of adhesion molecules in neuropsychiatric disorders. This study reinforces previous findings but also provides new insights into the neurobiology of TS

Genomic Relationships, Novel Loci, and Pleiotropic Mechanisms across Eight Psychiatric Disorders

Genetic influences on psychiatric disorders transcend diagnostic boundaries, suggesting substantial pleiotropy of contributing loci. However, the nature and mechanisms of these pleiotropic effects remain unclear. We performed analyses of 232,964 cases and 494,162 controls from genome-wide studies of anorexia nervosa, attention-deficit/hyper-activity disorder, autism spectrum disorder, bipolar disorder, major depression, obsessive-compulsive disorder, schizophrenia, and Tourette syndrome. Genetic correlation analyses revealed a meaningful structure within the eight disorders, identifying three groups of inter-related disorders. Meta-analysis across these eight disorders detected 109 loci associated with at least two psychiatric disorders, including 23 loci with pleiotropic effects on four or more disorders and 11 loci with antagonistic effects on multiple disorders. The pleiotropic loci are located within genes that show heightened expression in the brain throughout the lifespan, beginning prenatally in the second trimester, and play prominent roles in neurodevelopmental processes. These findings have important implications for psychiatric nosology, drug development, and risk prediction.Peer reviewe

X-ray performance evaluation of the dexela cmos aps x-ray detector using monochromatic synchrotron radiation in the mammographic energy range

Digital detectors based on complementary metal-oxide-semiconductors (CMOS) active pixel sensor (APS) technology have been introduced recently in many scientific applications. This work is focused on the X-ray performance evaluation of a novel CMOS APS detector in low energy medical imaging applications using monochromatic synchrotron radiation (i.e., 17-35 keV), which also allows studying how the performance varies with energy. The CMOS sensor was coupled to a Thallium-activated structured cesium iodide (CsI:Tl) scintillator and the detector's X-ray performance evaluation was carried out in terms of sensitivity, presampling modulation transfer function (pMTF), normalized noise power spectrum (NNPS) and the resulting detective quantum efficiency (DQE). A Monte Carlo simulation was used to validate the experimentally measured low frequency DQE. Finally, the effect of iodine's secondary generated K-fluorescence X-rays on pMTF and DQE results was evaluated. Good agreement (within 5%) was observed between the Monte Carlo and experimentally measured low frequency DQE results. A CMOS APS detector was characterized for the first time over a wide range of low energies covering the mammographic spectra. The detector's performance is limited mainly by the detectability of the scintillator. Finally, we show that the current data could be used to calculate the detector's pMTF, NNPS and DQE for any mammographic spectral shape within the investigated energies