Proceedings of the Comprehensive Oncology Network Evaluating Rare CNS Tumors (NCI-CONNECT) Oligodendroglioma Workshop.

Background: Oligodendroglioma is a rare primary central nervous system (CNS) tumor with highly variable outcome and for which therapy is usually not curative. At present, little is known regarding the pathways involved with progression of oligodendrogliomas or optimal biomarkers for stratifying risk. Developing new therapies for this rare cancer is especially challenging. To overcome these challenges, the neuro-oncology community must be particularly innovative, seeking multi-institutional and international collaborations, and establishing partnerships with patients and advocacy groups thereby ensuring that each patient enrolled in a study is as informative as possible. Methods: The mission of the National Cancer Institute\u27s NCI-CONNECT program is to address the challenges and unmet needs in rare CNS cancer research and treatment by connecting patients, health care providers, researchers, and advocacy organizations to work in partnership. On November 19, 2018, the program convened a workshop on oligodendroglioma, one of the 12 rare CNS cancers included in its initial portfolio. The purpose of this workshop was to discuss scientific progress and regulatory challenges in oligodendroglioma research and develop a call to action to advance research and treatment for this cancer. Results: The recommendations of the workshop include a multifaceted and interrelated approach covering: biology and preclinical models, data sharing and advanced molecular diagnosis and imaging; clinical trial design; and patient outreach and engagement. Conclusions: The NCI-CONNECT program is well positioned to address challenges in oligodendroglioma care and research in collaboration with other stakeholders and is developing a list of action items for future initiatives

Cashew cultivation in Guinea-Bissau – risks and challenges of the success of a cash crop

In recent decades a boom in cashew (Anacardium occidentale)cultivation has taken place in Guinea-Bissau, leading to the replacement of traditional slash-and-burn agriculture by a cash crop. As a result, the country is currently one of the world’s largest producers of raw cashew nuts and the cashew sector has acquired enormous importance in Guinea-Bissau’s economy. Changes induced by the cashew boom at social and environmental levels are yet to be analyzed and understood. The present study provides an account of the process of cashew expansion in Guinea-Bissau, reviews the current situation and discusses its future prospects. The cashew tree was introduced into the country by the Portuguese in the XIXth century, but only effectively expanded in the mid-1980s. It is largely cultivated by small farmers around villages and also plays a role in land ownership, since land tenure practices are linked to the planting of trees. The effects of this cashew boom on habitat fragmentation, fire regimes and biodiversity are still to be assessed. On the other hand, the spread of pests and diseases is becoming a problem. Strong dependence on a single cash crop also renders the country vulnerable to market fluctuations, entailing risks to local producers and the national economy. In the medium term, losses of export earnings can occur, which may impact the living standards and food security of Bissau-Guineans both in urban and rural areas

In vivo hippocampal subfield volumes in bipolar disorder—A mega-analysis from The Enhancing Neuro Imaging Genetics through Meta-Analysis Bipolar Disorder Working Group

The hippocampus consists of anatomically and functionally distinct subfields that may be differentially involved in the pathophysiology of bipolar disorder (BD). Here we, the Enhancing NeuroImaging Genetics through Meta‐Analysis Bipolar Disorder workinggroup, study hippocampal subfield volumetry in BD. T1‐weighted magnetic resonance imaging scans from 4,698 individuals (BD = 1,472, healthy controls [HC] = 3,226) from 23 sites worldwide were processed with FreeSurfer. We used linear mixed‐effects models and mega‐analysis to investigate differences in hippocampal subfield volumes between BD and HC, followed by analyses of clinical characteristics and medication use. BD showed significantly smaller volumes of the whole hippocampus (Cohen's d = −0.20), cornu ammonis (CA)1 (d = −0.18), CA2/3 (d = −0.11), CA4 (d = −0.19), molecular layer (d = −0.21), granule cell layer of dentate gyrus (d = −0.21), hippocampal tail (d = −0.10), subiculum (d = −0.15), presubiculum (d = −0.18), and hippocampal amygdala transition area (d = −0.17) compared to HC. Lithium users did not show volume differences compared to HC, while non‐users did. Antipsychotics or antiepileptic use was associated with smaller volumes. In this largest study of hippocampal subfields in BD to date, we show widespread reductions in nine of 12 subfields studied. The associations were modulated by medication use and specifically the lack of differences between lithium users and HC supports a possible protective role of lithium in BD

Selective augmentation of striatal functional connectivity following NMDA receptor antagonism: implications for psychosis

The psychotomimetic effect of the N-methyl-D-aspartate receptor (NMDAR) antagonist ketamine is thought to arise from a functional modulation of the brain's fronto-striato-thalamic (FST) circuits. Animal models suggest a pronounced effect on ventral ‘limbic' FST systems, although recent work in patients with psychosis and high-risk individuals suggests specific alterations of dorsal ‘associative' FST circuits. Here, we used functional magnetic resonance imaging to investigate the effects of a subanesthetic dose of ketamine on measures of functional connectivity as indexed by the temporal coherence of spontaneous neural activity in both dorsal and ventral FST circuits, as well as their symptom correlates. We adopted a placebo-controlled, double-blind, randomized, repeated-measures design in which 19 healthy participants received either an intravenous saline infusion or a racemic mixture of ketamine (100 ng/ml) separated by at least 1 week. Compared with placebo, ketamine increased functional connectivity between the dorsal caudate and both the thalamus and midbrain bilaterally. Ketamine additionally increased functional connectivity of the ventral striatum/nucleus accumbens and ventromedial prefrontal cortex. Both connectivity increases significantly correlated with the psychosis-like and dissociative symptoms under ketamine. Importantly, dorsal caudate connectivity with the ventrolateral thalamus and subthalamic nucleus showed inverse correlation with ketamine-induced symptomatology, pointing to a possible resilience role to disturbances in FST circuits. Although consistent with the role of FST in mediating psychosis, these findings contrast with previous research in clinical samples by suggesting that acute NMDAR antagonism may lead to psychosis-like experiences via a mechanism that is distinct from that implicated in frank psychotic illness

Nano-crystals of c-diamond, n-diamond and i-carbon grown in carbon-ion implanted fused quartz

Combined high-resolution transmission electron microscopy, selected area electron diffraction and parallel electron energy loss spectroscopy are used to characterise carbon nano-phases found embedded in fused quartz. These appear after implantation of 1 MeV carbon ions, followed by annealing in argon, oxygen and forming gas for 1 hour at 1100°C. For Ar, virtually all of the carbon diffuses out of the substrate with no observable carbon clusters for all doses studied. After annealing in oxygen, a crystalline COx phase is identified at the end of range, following a dose of 5 1017 C/cm2. Three nano-crystalline carbon phases, including diamond, appear after annealing in forming gas: these form a layer 170 nm beneath the fused quartz surface for all ion doses. The average size of these clusters and the corresponding phases depend on the ion dose; the smallest size of 5-7 nm diameter crystallise as fcc Fdm diamond following a dose of 0.5 1017 C/cm2, whereas clusters of 8-13 nm diameter, for a higher dose of 2 1017 C/cm2, have a Fmm modified phase of diamond known as n-diamond. The largest clusters, diameter 15-40 nm, for a dose of 5 1017 C/cm2, have the cubic P213 (or P4232) structure known as i-carbon. These buried layered diamond and diamond-related materials may have applications for field emission and optical waveguide type devices

Growth of c-diamond, n-diamond and i-carbon nanophases in carbon-ion-implanted fused quartz

Combined high-resolution transmission electron microscopy, selected-area electron diffraction and parallel electron-energy-loss spectroscopy are used to characterize nanophases of carbon found embedded in fused quartz. These appear after implantation of 1 MeV carbon ions, followed by annealing in argon, oxygenand forming gas for lh at 1100°C. For argon, virtually all the carbon diffuses out of the substrate with no observable carbon clusters for all doses studied. After annealing in oxygen, acrystalline COxphase is identified at the end of range, following a dose of 5 × 1017 carbon ions cm−2. Three nanocrystalline carbon phases, including diamond, appear after annealing in forming gas; these formalayer 170 nm beneath the fused quartz surface for all ion doses.The average size of these clusters and the corresponding phases depend on the ion dose; the smallest clusters of 5-7 nm diametercrystallize as fcc Fd3m diamond following a dose of 0.5 × 1017 carbon ions cm−2, whereas clusters of 8–13 nm diameter, for a higher dose of 2 × 1017 carbon ionscm−2, have a Fm3mmodified phase of diamond known as n-diamond. The largest clusters (diameter, 15–40nm) for a dose of 5 × 10 17 carbon ions cm−2, have thecubic P213 (or P4232) structure known as i-carbon. These buried layered diamond-related materials may have applications for field emission devices

Outpatient management of urinary tract infections by medical officers in Nairobi, Kenya: lack of benefit from audit and feedback on adherence to treatment guidelines

Abstract Introduction Acute uncomplicated urinary tract infections are common in outpatient settings but are not treated optimally. Few studies of the outpatient use of antibiotics for specific diagnoses have been done in sub-Saharan Africa, so little is known about the prescribing patterns of medical officers in the region. Methods Aga Khan University has 16 outpatient clinics throughout the Nairobi metro area with a medical officer specifically assigned to that clinic. A baseline assessment of evaluation and treatment of suspected UTI was performed from medical records in these clinics. Then the medical officer from each of the 16 clinics was recruited from each clinic was recruited with eight each randomized to control vs. feedback groups. Both groups were given a multimodal educational session including locally adapted UTI guidelines and emphasis on problems identified in the baseline assessment Each record was scored using a scoring system that was developed for the study according to adequacy of history, physical examination, clinical diagnosis matching recorded data, diagnostic workup and treatment. Three audits were done for both groups; baseline (audit 1), post-CME (audit 2), and a final audit, which was after feedback for the feedback group (audit 3). The primary analysis assessed overall guideline adherence in the feedback group versus the CME only group. Results The overall scores in both groups showed significant improvement after the CME in comparison to baseline and for each group, the scores in most domains also improved. However, audit 3 showed persistence of the gains attained after the CME but no additional benefit from the feedback. Some deficiencies that persisted throughout the study included lack of workup of possible STI and excess use of non-UTI laboratory tests such as CBC, stool culture and H. pylori Ag. After the CME, the use of nitrofurantoin rose from only 4% to 8% and cephalosporin use increased from 49 to 67%, accompanied by a drop in quinolone use. Conclusion The CME led to modest improvements in patient care in the categories of history taking, treatment and investigations, but feedback had no additional effect. Future studies should consider an enforcement element or a more intensive feedback approach

Producing optimized ensembles of nitrogen-vacancy color centers for quantum information applications

Quantum information applications place stringent demands on the development of platforms that can host them. Color centers in diamond have been identified as important media for quantum information processing. Accordingly, the photoluminescence properties of nitrogen-vacancy (N-V) centers in diamond created by implantation and annealing are studied at cryogenic temperatures (below 10 K). We examine high pressure high temperature and chemical vapor deposition synthetic diamonds with varying nitrogen concentration and present an accurate method to estimate the concentration of the (N-V) centers created by ion implantation. The ion irradiation route produced up to 6 ppm of optically active (N-V) centers, while nitrogen implantation yielded up to 3 ppm of optically active (N-V) with 8% conversion efficiency. However, a broadening of the (N-V) - zero phonon line was observed in all sample