The role of stereotactic radiosurgery in the multimodal management of growth hormone–secreting pituitary adenomas

Growth hormone (GH)–secreting pituitary adenomas represent a common source of GH excess in patients with acromegaly. Whereas surgical extirpation of the culprit lesion is considered first-line treatment, as many as 19% of patients develop recurrent symptoms due to regrowth of previously resected adenomatous tissue or to continued growth of the surgically inaccessible tumor. Although medical therapies that suppress GH production can be effective in the management of primary and recurrent acromegaly, these therapies are not curative, and lifelong treatment is required for hormonal control. Stereotactic radiosurgery has emerged as an effective adjunctive treatment modality, and is an appealing alternative to conventional fractionated radiation therapy. The authors reviewed the growing body of literature concerning the role of radiosurgical procedures in the treatment armamentarium of acromegaly, and identified more than 1350 patients across 45 case series. In this review, the authors report that radiosurgery offers true hormonal normalization in 17% to 82% of patients and tumor growth control in 37% to 100% of cases across all series, while minimizing adverse complications. As a result, stereotactic radiosurgery represents a safe and effective treatment option in the multimodal management of primary or recurrent acromegaly secondary to GH-secreting pituitary adenomas

The alchemy of ideas

This article presents an assessment of the power of ideas and their role in initiating change and progress. The enormous potential cascade effect is illustrated by examining the movement of Modernism in the arts. Next, the immense scope and capabilities of the modern scientific endeavor—with robotic space exploration at the scale of 10⁹ meters at one extreme and the wonders of nanoscience at the scale of 10⁻⁹ m at the other—are examined. The attitudes and philosophies of neurological surgery are related to those involved in the Modernist movement and placed on the defined scale of contemporary scientific activity

Content Based Image Retrieval by Convolutional Neural Networks

Hamreras S., Benítez-Rochel R., Boucheham B., Molina-Cabello M.A., López-Rubio E. (2019) Content Based Image Retrieval by Convolutional Neural Networks. In: Ferrández Vicente J., Álvarez-Sánchez J., de la Paz López F., Toledo Moreo J., Adeli H. (eds) From Bioinspired Systems and Biomedical Applications to Machine Learning. IWINAC 2019. Lecture Notes in Computer Science, vol 11487. Springer.In this paper, we present a Convolutional Neural Network (CNN) for feature extraction in Content based Image Retrieval (CBIR). The proposed CNN aims at reducing the semantic gap between low level and high-level features. Thus, improving retrieval results. Our CNN is the result of a transfer learning technique using Alexnet pretrained network. It learns how to extract representative features from a learning database and then uses this knowledge in query feature extraction. Experimentations performed on Wang (Corel 1K) database show a significant improvement in terms of precision over the state of the art classic approaches.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Interregional competition and prospective shifts in the location of livestock slaughter

Future prospects of growth in livestock production and meat consumption impose new patterns of adjustment upon our livestock marketing institutions. Historically, our livestock and meat markets have adjusted to changing patterns of production. and consumption by gradually modifying, expanding or relocating existing facilities and by adopting new methods of livestock procurement and distribution. Sharp changes in these historical patterns of marketing and distribution may occur in future years. These changes involve the entire marketing process. Retailers, for example, are more insistent now than ever before about buying a prescribed quality of product in adequate volume and at the lowest possible price. Wholesalers and packers are seeking means of reducing short-term variability in supplies and prices through programming of procurement and slaughter activities based on improved market outlook information. Producers are adopting new production practices and methods of marketing to increase their income position and to obtain a more precise valuation of their outputs

Utility and lower limits of frequency detection in surface electrode stimulation for somatosensory brain-computer interface in humans

Objective: Stimulation of the primary somatosensory cortex (S1) has been successful in evoking artificial somatosensation in both humans and animals, but much is unknown about the optimal stimulation parameters needed to generate robust percepts of somatosensation. In this study, the authors investigated frequency as an adjustable stimulation parameter for artificial somatosensation in a closed-loop brain-computer interface (BCI) system. Methods: Three epilepsy patients with subdural mini-electrocorticography grids over the hand area of S1 were asked to compare the percepts elicited with different stimulation frequencies. Amplitude, pulse width, and duration were held constant across all trials. In each trial, subjects experienced 2 stimuli and reported which they thought was given at a higher stimulation frequency. Two paradigms were used: first, 50 versus 100 Hz to establish the utility of comparing frequencies, and then 2, 5, 10, 20, 50, or 100 Hz were pseudorandomly compared. Results: As the magnitude of the stimulation frequency was increased, subjects described percepts that were “more intense” or “faster.” Cumulatively, the participants achieved 98.0% accuracy when comparing stimulation at 50 and 100 Hz. In the second paradigm, the corresponding overall accuracy was 73.3%. If both tested frequencies were less than or equal to 10 Hz, accuracy was 41.7% and increased to 79.4% when one frequency was greater than 10 Hz (p = 0.01). When both stimulation frequencies were 20 Hz or less, accuracy was 40.7% compared with 91.7% when one frequency was greater than 20 Hz (p < 0.001). Accuracy was 85% in trials in which 50 Hz was the higher stimulation frequency. Therefore, the lower limit of detection occurred at 20 Hz, and accuracy decreased significantly when lower frequencies were tested. In trials testing 10 Hz versus 20 Hz, accuracy was 16.7% compared with 85.7% in trials testing 20 Hz versus 50 Hz (p < 0.05). Accuracy was greater than chance at frequency differences greater than or equal to 30 Hz. Conclusions: Frequencies greater than 20 Hz may be used as an adjustable parameter to elicit distinguishable percepts. These findings may be useful in informing the settings and the degrees of freedom achievable in future BCI systems

Graft harvesting for revascularization in the head and neck.

The techniques for revascularization in the neurocranium, skull base, and neck continue to evolve at an exciting pace. In this body of literature, however, techniques for harvesting radial artery and saphenous vein grafts are mainly reported using traditional open techniques. Minimally invasive procedures are fast becoming an alternative to open techniques in many fields and have the potential to become the standard of care. The cardiovascular literature is replete with reports of endoscopically harvested vascular grafts. This article reviews both methods, since the current state of the art involves knowledge of open and endoscopic harvesting techniques