The Effect of Left- Versus Right-Sided Contrast Infusion on Attenuation in Chest CT Angiograms

THE EFFECT OF LEFT- VERSUS RIGHT-SIDED CONTRAST INFUSION ON ATTENUATION IN CHEST CT ANGIOGRAMS Lars J. Grimm, Daniel Cornfeld, Hamid R. Mojibian. Department of Diagnostic Radiology, Yale University, School of Medicine, New Haven, CT. This study assesses if the arm of contrast infusion influences attenuation of the main pulmonary artery in CT angiograms to evaluate for pulmonary emboli. With IRB approval, 407 consecutive CT angiograms performed to exclude pulmonary emboli were reviewed. Patient characteristics, study details, and interpretation results were collected. After exclusion criteria were applied, 100 studies from each of our three scanners (4, 16, and 64 slice) remained. A reader, blinded to injection side, reviewed the images and recorded the attenuation of the main pulmonary artery. The average post-contrast attenuation in the main pulmonary artery was similar if infused through the right (275.4 HU) or left (275.0 HU) arm when controlling for confounders with a multiple regression analysis (p = 0.82). There was no statistical difference (p \u3e 0.05) in the number of scans with attenuation less than 250 (45.9% right, 42.9% left), 200 (25.0% right, 29.0% left), or 150 HU (11.6% right, 12.3% left) and no difference in the number of scans interpreted as indeterminate (1% right, 4% left) or non-diagnostic (3% right, 3% left). Main pulmonary artery attenuation is not dependent on the arm of infusion when evaluating mean attenuation, attenuation beneath thresholds of 250, 200, or 150 HU, or indeterminate or non-diagnostic interpretations for patients undergoing a CT angiogram of the chest to rule out pulmonary emboli

A novel ion channel formed by interaction of TRPML3 with TRPV5.

TRPML3 and TRPV5 are members of the mucolipin (TRPML) and TRPV subfamilies of transient receptor potential (TRP) cation channels. Based on sequence similarities of the pore forming regions and on structure-function evidence, we hypothesized that the pore forming domains of TRPML and TRPV5/TRPV6 channels have similarities that indicate possible functional interactions between these TRP channel subfamilies. Here we show that TRPML3 and TRPV5 associate to form a novel heteromeric ion channel. This novel conductance is detectable under conditions that do not activate either TRPML3 or TRPV5. It has pharmacological similarity with TRPML3 and requires functional TRPML3 as well as functional TRPV5. Single channel analyses revealed that TRPML3 and TRPV5 heteromers have different features than the respective homomers, and furthermore, that they occur in potentially distinct stoichiometric configurations. Based on overlapping expression of TRPML3 and TRPV5 in the kidney and the inner ear, we propose that TRPML3 and TRPV5 heteromers could have a biological function in these organs

A Tractable Multi-Leader Multi-Follower Peak-Load-Pricing Model with Strategic Interaction

While single-level Nash equilibrium problems are quite well understood nowadays, less is known about multi-leader multi-follower games. However, these have important applications, e.g., in the analysis of electricity and gas markets, where often a limited number of firms interacts on various subsequent markets. In this paper, we consider a special class of two-level multi-leader multi-follower games that can be applied, e.g., to model strategic booking decisions in the European entry-exit gas market. For this nontrivial class of games, we develop a solution algorithm that is able to compute the complete set of Nash equilibria instead of just individual solutions or a bigger set of stationary points. Additionally, we prove that for this class of games, the solution set is finite and provide examples for instances without any Nash equilibria in pure strategies. We apply the algorithm to a case study in which we compute strategic booking and nomination decisions in a model of the European entry-exit gas market system. Finally, we use our algorithm to provide a publicly available test library for the considered class of multi-leader multi-follower games. This library contains problem instances with different economic and mathematical properties so that other researchers in the field can test and benchmark newly developed methods for this challenging class of problems

Evaluation of a structured treatment discontinuation in patients with inoperable alveolar echinococcosis on long-term benzimidazole therapy: A retrospective cohort study.

OBJECTIVES Alveolar echinococcosis (AE) is an orphan zoonosis of increasing concern in endemic areas, including Europe. It frequently presents in an advanced, inoperable stage, that requires life-long parasitostatic benzimidazole therapy. In some patients, long-term therapy leads to negative anti-Em18 antibody ELISA and PET. It is disputed, whether these patients are truly cured and treatment can be safely discontinued. Our aim was to retrospectively assess long-term outcome of 34 patients with inoperable AE who participated in a previous study to determine feasibility of benzimidazole treatment cessation. METHODS Retrospective analysis of medical charts was undertaken in all 34 AE patients who participated in our previous study. Of particular interest were AE recurrence or other reasons for re-treatment in patients who stopped benzimidazole therapy and whether baseline clinical and laboratory parameters help identify of patients that might qualifiy for treatment cessation. Additionally, volumetric measurement of AE lesions on contrast-enhanced cross-sectional imaging was performed at baseline and last follow-up in order to quantify treatment response. RESULTS 12 of 34 patients stopped benzimidazole therapy for a median of 131 months. 11 of these patients showed stable or regressive AE lesions as determined by volumetric measurement. One patient developed progressive lesions with persistently negative anti-Em18 antibody ELISA but slight FDG-uptake in repeated PET imaging. At baseline, patients who met criteria for treatment cessation demonstrated higher lymphocyte count and lower total IgE. CONCLUSION Treatment cessation is feasible in inoperable AE patients, who demonstrate negative anti-Em18 antibody ELISA and PET on follow-up. Close monitoring including sectional imaging is strongly advised

Phonon spectra of pure and acceptor doped BaZrO3 investigated with visible and UV Raman spectroscopy

We report results from visible and UV Raman spectroscopy studies of the phonon spectra of a polycrystalline sample of the prototypical perovskite type oxide BaZrO3 and a 500 nm thick film of its Y-doped, proton conducting, counterpart BaZr0.8Y0.2O2.9. Analysis of the Raman spectra measured using different excitation energies (between 3.44 eV and 5.17 eV) reveals the activation of strong resonance Raman effects involving all lattice vibrational modes. Specifically, two characteristic energies were identified for BaZrO3, one around 5 eV and one at higher energy, respectively, and one for BaZr0.8Y0.2O2.9, above 5 eV. Apart from the large difference in spectral intensity between the non-resonant and resonant conditions, the spectra are overall similar to each other, suggesting that the vibrational spectra of the perovskites are stable when investigated using an UV laser as excitation source. These results encourage further use of UV Raman spectroscopy as a novel approach for the study of lattice vibrational dynamics and local structure in proton conducting perovskites, and open up for, e.g., time-resolved experiments on thin films targeted at understanding the role of lattice vibrations in proton transport in these kinds of materials

Visualization of causation in social-ecological systems

In social-ecological systems (SES), where social and ecological processes are intertwined, phenomena are usually complex and involve multiple interdependent causes. Figuring out causal relationships is thus challenging but needed to better understand and then affect or manage such systems. One important and widely used tool to identify and communicate causal relationships is visualization. Here, we present several common visualization types: diagrams of objects and arrows, X-Y plots, and X-Y-Z plots, and discuss them in view of the particular challenges of visualizing causation in complex systems such as SES. We use a simple demonstration model to create and compare exemplary visualizations and add more elaborate examples from the literature. This highlights implicit strengths and limitations of widely used visualization types and facilitates adequate choices when visualizing causation in SES. Thereupon, we recommend further suitable ways to account for complex causation, such as figures with multiple panels, or merging different visualization types in one figure. This provides caveats against oversimplifications. Yet, any single figure can rarely capture all relevant causal relationships in an SES. We therefore need to focus on specific questions, phenomena, or subsystems, and often also on specific causes and effects that shall be visualized. Our recommendations allow for selecting and combining visualizations such that they complement each other, support comprehensive understanding, and do justice to the existing complexity in SES. This lets visualizations realize their potential and play an important role in identifying and communicating causation.Peer reviewe

A tractable multi-leader multi-follower peak-load-pricing model with strategic interaction

While single-level Nash equilibrium problems are quite well understood nowadays, less is known about multi-leader multi-follower games. However, these have important applications, e.g., in the analysis of electricity and gas markets, where often a limited number of firms interacts on various subsequent markets. In this paper, we consider a special class of two-level multi-leader multi-follower games that can be applied, e.g., to model strategic booking decisions in the European entry-exit gas market. For this nontrivial class of games, we develop a solution algorithm that is able to compute the complete set of Nash equilibria instead of just individual solutions or a bigger set of stationary points. Additionally, we prove that for this class of games, the solution set is finite and provide examples for instances without any Nash equilibria in pure strategies. We apply the algorithm to a case study in which we compute strategic booking and nomination decisions in a model of the European entry-exit gas market system. Finally, we use our algorithm to provide a publicly available test library for the considered class of multi-leader multi-follower games. This library contains problem instances with different economic and mathematical properties so that other researchers in the field can test and benchmark newly developed methods for this challenging class of problems