The Frequency of Focal Thyroid Incidental Findings and Risk of Malignancy Detected by 18F-Fluorodeoxyglucose Positron Emission Tomography in an Iodine Deficient Population

Incidental focal uptake of 18F-fluorodeoxyglucose (FDG) in the thyroid on positron emission tomography (PET/CT) is rare but often associated with malignancy. The epidemiology of thyroid incidentalomas has only to some extent been described in countries with iodine deficiency. Here we report data from Denmark, a country with known iodine deficiency and wide access to PET/CT. All FDG PET/CT comprising the head and neck region, during 2014, were retrospectively reviewed, and patients with focal FDG uptake in the thyroid gland were identified. A total of 2451 patients had an FDG PET/CT of which 59 (2.4%) patients presented with FDG-avid focal lesions in the thyroid gland. Among the 59 patients with FDG-avid lesions, 33 patients (56%) received work up with ultrasound, thyroid technetium scintigraphy, fine needle aspiration, and/or histology of which 20 patients had a conclusive pathology report. Ten patients with FDG-avid lesions were identified with thyroid malignancy. The risk of thyroid malignancy was 16.9% among patient with incidental FDG-avid thyroid lesions. Our findings indicated a similar frequency of FDG thyroid incidentalomas and malignancy rates in an iodine deficient population compared to summary data from prior studies, studies mostly performed in geographical areas of normal or excess iodine supplementation

Anhydrite‐Assisted Hydrothermal Metal Transport to the Ocean Floor—Insights From Thermo‐Hydro‐Chemical Modeling

High‐temperature hydrothermal venting has been discovered on all modern mid‐ocean ridges at all spreading rates. Although significant strides have been made in understanding the underlying processes that shape such systems, several first‐order discrepancies between model predictions and observations remain. One key paradox is that numerical experiments consistently show entrainment of cold ambient seawater in shallow high permeability ocean crust causing a temperature drop that is difficult to reconcile with high vent temperatures. We investigate this conundrum using a thermo‐hydro‐chemical model that couples hydrothermal fluid flow with anhydrite‐ and pyrite‐forming reactions in the shallow subseafloor. The models show that precipitation of anhydrite in warming seawater and in cooling hydrothermal fluids during mixing results in the formation of a chimney‐like subseafloor structure around the upwelling, high‐temperature plume. The establishment of such anhydrite‐sealed zones reduces mixing between the hydrothermal fluid and seawater and results in an increase in vent temperature. Pyrite subsequently precipitates close to the seafloor within the anhydrite chimney. Although anhydrite thus formed may be dissolved when colder seawater circulates through the crust away from the spreading axis, the inside pyrite walls would be preserved as veins in present‐day metal deposits, thereby preserving the history of hydrothermal circulation through shallow oceanic crust

Modeling fluid flow in sedimentary basins with sill intrusions: Implications for hydrothermal venting and climate change

Large volumes of magma emplaced within sedimentary basins have been linked to multiple climate change events due to release of greenhouse gases such as CH4. Basin-scale estimates of thermogenic methane generation show that this process alone could generate enough greenhouse gases to trigger global incidents. However, the rates at which these gases are transported and released into the atmosphere are quantitatively unknown. We use a 2D, hybrid FEM/FVM model that solves for fully compressible fluid flow to quantify the thermogenic release and transport of methane and to evaluate flow patterns within these systems. Our results show that the methane generation potential in systems with fluid flow does not significantly differ from that estimated in diffusive systems. The values diverge when vigorous convection occurs with a maximum variation of about 50%. The fluid migration pattern around a cooling, impermeable sill alone generates hydrothermal plumes without the need for other processes such as boiling and/or explosive degassing. These fluid pathways are rooted at the edges of the outer sills consistent with seismic imaging. Methane venting at the surface occurs in three distinct stages and can last for hundreds of thousands of years. Our simulations suggest that although the quantity of methane potentially generated within the contact aureole can cause catastrophic climate change, the rate at which this methane is released into the atmosphere is too slow to trigger, by itself, some of the negative δ13C excursions observed in the fossil record over short time scales (< 10,000 years)

Controls of faulting and reaction kinetics on serpentinization and double Benioff zones

The subduction of partially serpentinized oceanic mantle may potentially be the key geologic process leading to the regassing of Earth's mantle and also has important consequences for subduction zone processes such as element cycling, slab deformation, and intermediate-depth seismicity. However, little is known about the quantity of water that is retained in the slab during mantle serpentinization and the pattern of serpentinization that may occur during bending-related faulting; an initial state that is essential for quantifying subsequent dehydration processes. We present a 2-D reactive-flow model simulating hydration processes in the presence of faulting at the trench outer-rise. We find that the temperature dependence of the serpentinization rate in conjunction with outer-rise faulting results in plate age and speed dependent patterns of hydration. Serpentinization also results in a reduction in surface heat flux toward the trench caused by advective downflow of seawater into the reaction region. Observed heat flow reductions are larger than the reduction due to the minimum-water downflow needed for partial serpentinization, predicting that active hydrothermal vents and chemosynthetic communities should also be associated with bend-fault serpentinization. Our model results agree with previous studies that the lower plane of double Benioff zones can be generated due to dehydration of serpentinized mantle at depth. More importantly, the depth-dependent pattern of serpentinization including reaction kinetics predicts a separation between the two Benioff planes consistent with seismic observations

The Diversity and Variability of Star Formation Histories in Models of Galaxy Evolution

Understanding the variability of galaxy star formation histories (SFHs) across a range of timescales provides insight into the underlying physical processes that regulate star formation within galaxies. We compile the SFHs of galaxies at $z=0$ from an extensive set of models, ranging from cosmological hydrodynamical simulations (Illustris, IllustrisTNG, Mufasa, Simba, EAGLE), zoom simulations (FIRE-2, g14, and Marvel/Justice League), semi-analytic models (Santa Cruz SAM) and empirical models (UniverseMachine), and quantify the variability of these SFHs on different timescales using the power spectral density (PSD) formalism. We find that the PSDs are well described by broken power-laws, and variability on long timescales ($\gtrsim1$ Gyr) accounts for most of the power in galaxy SFHs. Most hydrodynamical models show increased variability on shorter timescales ($\lesssim300$ Myr) with decreasing stellar mass. Quenching can induce $\sim0.4-1$ dex of additional power on timescales $>1$ Gyr. The dark matter accretion histories of galaxies have remarkably self-similar PSDs and are coherent with the in-situ star formation on timescales $>3$ Gyr. There is considerable diversity among the different models in their (i) power due to SFR variability at a given timescale, (ii) amount of correlation with adjacent timescales (PSD slope), (iii) evolution of median PSDs with stellar mass, and (iv) presence and locations of breaks in the PSDs. The PSD framework is a useful space to study the SFHs of galaxies since model predictions vary widely. Observational constraints in this space will help constrain the relative strengths of the physical processes responsible for this variability.Comment: 31 pages, 17 figures (+ appendix). Resubmitted to MNRAS after responding to referee's comments. Comments are welcome

Controls of bathymetric relief on hydrothermal fluid flow at mid-ocean ridges

We present quantitative modeling results for the effects of surface relief on hydrothermal convection at ocean-spreading centers investigating how vent site locations and subsurface flow patterns are affected by bathymetry induced sub-seafloor pressure variations. The model is based on a 2-D FEM solver for fluid flow in porous media and is used to simulate hydrothermal convection systematically in 375 synthetic studies. The results of these studies show that bathymetric relief has a profound effect on hydrothermal flow: bathymetric highs induce subsurface pressure variations that can deviate upwelling zones and favor venting at structural highs. The deviation angle from vertical upwelling can be expressed by a single linear dependence relating deviation angle to bathymetric slope and depth of the heat source. These findings are confirmed in two case studies for the East Pacific Rise at 9°30′N and Lucky Strike hydrothermal fields. In both cases, it is possible to predict the observed vent field locations only if bathymetry is taken into account. Our results thereby show that bathymetric relief should be considered in simulations of submarine hydrothermal systems and plays a key role especially in focusing venting of across axis hydrothermal flow onto the ridge axis of fast spreading ridges

Interrelation between rifting, faulting, sedimentation, and mantle serpentinization during continental margin formation-including examples from the Norwegian Sea

The conditions permitting mantle serpentinization during continental rifting are explored within 2-D thermotectonostratigraphic basin models, which track the rheological evolution of the continental crust, account for sediment blanketing effects, and allow for kinetically controlled mantle serpentinization processes. The basic idea is that the entire extending continental crust has to be brittle for crustal scale faulting and mantle serpentinization to occur. The isostatic and latent heat effects of the reaction are fully coupled to the structural and thermal solutions. A systematic parameter study shows that a critical stretching factor exists for which complete crustal embrittlement and serpentinization occurs. Increased sedimentation rates shift this critical stretching factor to higher values as sediment blanketing effects result in higher crustal temperatures. Sediment supply has therefore, through the temperature-dependence of the viscous flow laws, strong control on crustal strength and mantle serpentinization reactions are only likely when sedimentation rates are low and stretching factors high. In a case study for the Norwegian margin, we test whether the inner lower crustal bodies (LCB) imaged beneath the Møre and Vøring margin could be serpentinized mantle. Multiple 2-D transects have been reconstructed through the 3-D data set by Scheck-Wenderoth and Maystrenko (2011). We find that serpentinization reactions are possible and likely during the Jurassic rift phase. Predicted thicknesses and locations of partially serpentinized mantle rocks fit to information on LCBs from seismic and gravity data. We conclude that some of the inner LCBs beneath the Norwegian margin may be partially serpentinized mantle

Differential contributions of specimen types, culturing, and 16S rRNA sequencing in diagnosis of prosthetic joint infections

ABSTRACT Prosthetic joint failure is mainly caused by infection, aseptic failure (AF), and mechanical problems. Infection detection has been improved with modified culture methods and molecular diagnostics. However, comparisons between modified and conventional microbiology methods are difficult due to variations in specimen sampling. In this prospective, multidisciplinary study of hip or knee prosthetic failures, we assessed the contributions of different specimen types, extended culture incubations, and 16S rRNA sequencing for diagnosing prosthetic joint infections (PJI). Project specimens included joint fluid (JF), bone biopsy specimens (BB), soft-tissue biopsy specimens (STB), and swabs (SW) from the prosthesis, collected in situ , and sonication fluid collected from prosthetic components (PC). Specimens were cultured for 6 (conventional) or 14 days, and 16S rRNA sequencing was performed at study completion. Of the 156 patients enrolled, 111 underwent 114 surgical revisions (cases) due to indications of either PJI ( n = 43) or AF ( n = 71). Conventional tissue biopsy cultures confirmed PJI in 28/43 (65%) cases and refuted AF in 3/71 (4%) cases; one case was not evaluable. Based on these results, minor diagnostic adjustments were made. Fourteen-day cultures of JF, STB, and PC specimens confirmed PJI in 39/42 (93%) cases, and 16S rRNA sequencing confirmed PJI in 33/42 (83%) cases. One PJI case was confirmed with 16S rRNA sequencing alone and five with cultures of project specimens alone. These findings indicated that JF, STB, and PC specimen cultures qualified as an optimal diagnostic set. The contribution of sequencing to diagnosis of PJI may depend on patient selection; this hypothesis requires further investigation. </jats:p

Interobserver reliability of classification and characterization of proximal humeral fractures: a comparison of two and three-dimensional CT

Interobserver reliability for the classification of proximal humeral fractures is limited. The aim of this study was to test the null hypothesis that interobserver reliability of the AO classification of proximal humeral fractures, the preferred treatment, and fracture characteristics is the same for two-dimensional (2-D) and three-dimensional (3-D) computed tomography (CT). Members of the Science of Variation Group--fully trained practicing orthopaedic and trauma surgeons from around the world--were randomized to evaluate radiographs and either 2-D CT or 3-D CT images of fifteen proximal humeral fractures via a web-based survey and respond to the following four questions: (1) Is the greater tuberosity displaced? (2) Is the humeral head split? (3) Is the arterial supply compromised? (4) Is the glenohumeral joint dislocated? They also classified the fracture according to the AO system and indicated their preferred treatment of the fracture (operative or nonoperative). Agreement among observers was assessed with use of the multirater kappa (&kappa;) measure. Interobserver reliability of the AO classification, fracture characteristics, and preferred treatment generally ranged from &quot;slight&quot; to &quot;fair.&quot; A few small but statistically significant differences were found. Observers randomized to the 2-D CT group had slightly but significantly better agreement on displacement of the greater tuberosity (&kappa; = 0.35 compared with 0.30, p &lt; 0.001) and on the AO classification (&kappa; = 0.18 compared with 0.17, p = 0.018). A subgroup analysis of the AO classification results revealed that shoulder and elbow surgeons, orthopaedic trauma surgeons, and surgeons in the United States had slightly greater reliability on 2-D CT, whereas surgeons in practice for ten years or less and surgeons from other subspecialties had slightly greater reliability on 3-D CT. Proximal humeral fracture classifications may be helpful conceptually, but they have poor interobserver reliability even when 3-D rather than 2-D CT is utilized. This may contribute to the similarly poor interobserver reliability that was observed for selection of the treatment for proximal humeral fractures. The lack of a reliable classification confounds efforts to compare the outcomes of treatment methods among different clinical trials and reports