Prognostic factors in patients with acute mesenteric ischemia-novel tools for determining patient outcomes

BACKGROUND Acute mesenteric ischemia (AMI) is a devastating disease with poor prognosis. Due to the multitude of underlying factors, prediction of outcomes remains poor. We aimed to identify factors governing diagnosis and survival in AMI and develop novel prognostic tools. METHODS This monocentric retrospective study analyzed patients with suspected AMI undergoing imaging between January 2014 and December 2019. Subgroup analyses were performed for patients with confirmed AMI undergoing surgery. Nomograms were calculated based on multivariable logistic regression models. RESULTS Five hundred and thirty-nine patients underwent imaging for clinically suspected AMI, with 216 examinations showing radiological indication of AMI. Intestinal necrosis (IN) was confirmed in 125 undergoing surgery, 58 of which survived and 67 died (median 9 days after diagnosis, IQR 22). Increasing age, ASA score, pneumatosis intestinalis, and dilated bowel loops were significantly associated with presence of IN upon radiological suspicion. In contrast, decreased pH, elevated creatinine, radiological atherosclerosis, vascular occlusion (versus non-occlusive AMI), and colonic affection (compared to small bowel ischemia only) were associated with impaired survival in patients undergoing surgery. Based on the identified factors, we developed two nomograms to aid in prediction of IN upon radiological suspicion (C-Index = 0.726) and survival in patients undergoing surgery for IN (C-Index = 0.791). CONCLUSION As AMI remains a condition with high mortality, we identified factors predicting occurrence of IN with suspected AMI and survival when undergoing surgery for IN. We provide two new tools, which combine these parameters and might prove helpful in treatment of patients with AMI

Infomorphic networks: Locally learning neural networks derived from partial information decomposition

Understanding the intricate cooperation among individual neurons in performing complex tasks remains a challenge to this date. In this paper, we propose a novel type of model neuron that emulates the functional characteristics of biological neurons by optimizing an abstract local information processing goal. We have previously formulated such a goal function based on principles from partial information decomposition (PID). Here, we present a corresponding parametric local learning rule which serves as the foundation of "infomorphic networks" as a novel concrete model of neural networks. We demonstrate the versatility of these networks to perform tasks from supervised, unsupervised and memory learning. By leveraging the explanatory power and interpretable nature of the PID framework, these infomorphic networks represent a valuable tool to advance our understanding of cortical function.Comment: 31 pages, 5 figure

Quality of Life and Independent Factors Associated with Poor Digestive Function after Ivor Lewis Esophagectomy

Transthoracic esophagectomy results in a radical change in foregut anatomy with multiple consequences for digestive physiology. The aim of this study was to identify factors associated with poor functional outcomes by assessing multiple dimensions of digestive performance and health-related quality of life (HRQL). Patients with cancer-free survival after Ivor Lewis esophagectomy were included. Four functional syndromes (dysphagia, gastroesophageal reflux disease (GERD), delayed gastric conduit emptying (DGCE), and dumping syndrome (DS)) and HRQL were assessed using specifically designed questionnaires. Patient outcomes were compared with healthy controls. Independent factors associated with poor digestive performance were identified through multivariable analysis. Sixty-five postoperative patients and 50 healthy volunteers participated in this study. Compared with controls, patients had worse outcomes for dysphagia, GERD, DS, and HRQL, but not for DGCE. A multivariate analysis showed a significant correlation of reduced digestive performance with ASA score, squamous cell carcinoma, open or hybrid surgical approach, and (neo)adjuvant therapy. In contrast, no individual patient factor was found to be associated with dumping syndrome. Digestive function and HRQL are substantially impaired after Ivor Lewis esophagectomy for cancer. Comorbid patients undergoing multimodal treatment and open access surgery for squamous cell carcinoma have the highest risk of poor functional outcome

Tumor grafts grown on the chicken chorioallantoic membrane are distinctively characterized by MRI under functional gas challenge

Recently, a tumor model based on the chorioallantoic membrane (CAM) was characterized structurally with Magnetic Resonance Imaging (MRI). Yet, capability of MRI to assess vascular functional reserve and potential of oxygenation-sensitive MRI remain largely unexplored in this model. For this purpose, we compared MC-38 colon and A549 lung adenocarcinoma cell grafts grown on the CAM, using quantitative T1 and T2* MRI readouts as imaging markers. These are associated with vascular functionality and oxygenation status when compared between periods of air and carbogen exposure. Our data show that in A549 lung adenocarcinoma cell grafts T2* values increased significantly upon carbogen exposure (p < 0.004, Wilcoxon test; no change in T1), while MC-38 grafts displayed no changes in T1 and T2*), indicating that the grafts differ in their vascular response. Heterogeneity with regard to T1 and T2* distribution within the grafts was noted. MC-38 grafts displayed larger T1 and T2* in the graft centre, while in A549 they were distributed more towards the graft surface. Finally, qualitative assessment of gadolinium-enhancement suggests that A549 grafts display more prominent enhancement compared to MC-38 grafts. Furthermore, MC-38 grafts had 65% larger volumes than A549 grafts. Histology revealed distinct underlying phenotypes of the two tumor grafts, pertaining to the proliferative status (Ki-67) and cellularity (H&E). In sum, a functional gas challenge with carbogen is feasible through gas exchange on the CAM, and it affects MRI signals associated with vascular reactivity and oxygenation status of the tumor graft planted on the CAM. Different grafts based on A549 lung adenocarcinoma and MC-38 colon carcinoma cell lines, respectively, display distinct phenotypes that can be distinguished and characterized non-invasively in ovo using MRI in the living chicken embryo

Calcium and Potassium Channels in Experimental Subarachnoid Hemorrhage and Transient Global Ischemia

Healthy cerebrovascular myocytes express members of several different ion channel families which regulate resting membrane potential, vascular diameter, and vascular tone and are involved in cerebral autoregulation. In animal models, in response to subarachnoid blood, a dynamic transition of ion channel expression and function is initiated, with acute and long-term effects differing from each other. Initial hypoperfusion after exposure of cerebral vessels to oxyhemoglobin correlates with a suppression of voltage-gated potassium channel activity, whereas delayed cerebral vasospasm involves changes in other potassium channel and voltage-gated calcium channels expression and function. Furthermore, expression patterns and function of ion channels appear to differ between main and small peripheral vessels, which may be key in understanding mechanisms behind subarachnoid hemorrhage-induced vasospasm. Here, changes in calcium and potassium channel expression and function in animal models of subarachnoid hemorrhage and transient global ischemia are systematically reviewed and their clinical significance discussed

HAZMAT. VIII. A Spectroscopic Analysis of the Ultraviolet Evolution of K Stars: Additional Evidence for K Dwarf Rotational Stalling in the First Gigayear

Efforts to discover and characterize habitable zone planets have primarily focused on Sun-like stars and M dwarfs. K stars, however, provide an appealing compromise between these two alternatives that has been relatively unexplored. Understanding the ultraviolet (UV) environment around such stars is critical to our understanding of their planets, as the UV can drastically alter the photochemistry of a planet's atmosphere. Here we present near-UV and far-UV \textit{Hubble Space Telescope}'s Cosmic Origins Spectrograph observations of 39 K stars at three distinct ages: 40 Myr, 650 Myr, and $\approx$5 Gyr. We find that the K star (0.6 -- 0.8 M$_{\odot}$) UV flux remains constant beyond 650 Myr before falling off by an order of magnitude by field age. This is distinct from early M stars (0.3 -- 0.6 M$_{\odot}$), which begin to decline after only a few hundred Myr. However, the rotation-UV activity relation for K stars is nearly identical to that of early M stars. These results may be a consequence of the spin-down stalling effect recently reported for K dwarfs, in which the spin-down of K stars halts for over a Gyr when their rotation periods reach $\approx$10 d, rather than the continuous spin down that G stars experience. These results imply that exoplanets orbiting K dwarfs may experience a stronger UV environment than thought, weakening the case for K stars as hosts of potential "super-habitable" planets.Comment: 18 pages, 7 figure

A Large, Uniform Sample of X-ray Emitting AGN from the ROSAT All-Sky and Sloan Digital Sky Surveys: the Data Release 5 Sample

We describe further results of a program aimed to yield ~10^4 fully characterized optical identifications of ROSAT X-ray sources. Our program employs X-ray data from the ROSAT All-Sky Survey (RASS), and both optical imaging and spectroscopic data from the Sloan Digital Sky Survey (SDSS). RASS/SDSS data from 5740 deg^2 of sky spectroscopically covered in SDSS Data Release 5 (DR5) provide an expanded catalog of 7000 confirmed quasars and other AGN that are probable RASS identifications. Again in our expanded catalog, the identifications as X-ray sources are statistically secure, with only a few percent of the SDSS AGN likely to be randomly superposed on unrelated RASS X-ray sources. Most identifications continue to be quasars and Seyfert 1s with 15<m<21 and 0.01<z<4; but the total sample size has grown to include very substantial numbers of even quite rare AGN, e.g., now including several hundreds of candidate X-ray emitting BL Lacs and narrow-line Seyfert 1 galaxies. In addition to exploring rare subpopulations, such a large total sample may be useful when considering correlations between the X-ray and the optical, and may also serve as a resource list from which to select the "best" object (e.g., X-ray brightest AGN of a certain subclass, at a preferred redshift or luminosity) for follow-on X-ray spectral or alternate detailed studies.Comment: Accepted for publication in AJ; 32 pages, including 11 figures, and 6 example table

Cataclysmic Variables from Sloan Digital Sky Survey. IV. The Fourth Year (2003)

This paper continues the series presenting cataclysmic variables identified during the fourth year (2003) of the Sloan Digital Sky Survey. We describe 44 close binary systems, of which 12 are the previously known systems EN Cet, EG Cnc, V844 Her, GG Leo, Leo 7, CY UMa, DV UMa, EK UMa, EV UMa, UMa 8, EUVE J0854+390, and RX J0859.1+0537 and 32 are new cataclysmic variables. As in the previous papers, the positions, colors, and spectra of all 44 systems are shown, along with follow-up spectroscopic, photometric, and/or polarimetric observations of 15 of the new systems. The new objects include one eclipsing system, eight with prominent He II emission (of which two are confirmed new polars), and 12 systems showing features of the underlying stars. Our spectropolarimetry also confirms EUVE J0854+390 as a polar

Stellar SEDs from 0.3 to 2.5 μm: Tracing the Stellar Locus and Searching for Color Outliers in the SDSS and 2MASS

The Sloan Digital Sky Survey (SDSS) and Two Micron All Sky Survey (2MASS) are rich resources for studying stellar astrophysics and the structure and formation history of the Galaxy. As new surveys and instruments adopt similar filter sets, it is increasingly important to understand the properties of the ugrizJHK_s stellar locus, both to inform studies of "normal" main-sequence stars and enable robust searches for point sources with unusual colors. Using a sample of ~600,000 point sources detected by SDSS and 2MASS, we tabulate the position and width of the ugrizJHK_s stellar locus as a function of g - i color, and provide accurate polynomial fits. We map the Morgan-Keenan spectral type sequence to the median stellar locus by using synthetic photometry of spectral standards and by analyzing 3000 SDSS stellar spectra with a custom spectral typing pipeline, described in the Appendix to this paper. We develop an algorithm to calculate a point source's minimum separation from the stellar locus in a seven-dimensional color space, and use it to robustly identify objects with unusual colors, as well as spurious SDSS/2MASS matches. Analysis of a final catalog of 2117 color outliers identifies 370 white-dwarf/M dwarf (WDMD) pairs, 93 QSOs, and 90 M giant/carbon star candidates, and demonstrates that WDMD pairs and QSOs can be distinguished on the basis of their J - K_s and r - z colors. We also identify a group of objects with correlated offsets in the u - g versus g - r and g - r versus r - i color-color spaces, but subsequent follow-up is required to reveal the nature of these objects. Future applications of this algorithm to a matched SDSS-UKIDSS catalog may well identify additional classes of objects with unusual colors by probing new areas of color-magnitude space