Application of RNS in refractory epilepsy: Targeting insula.

Although responsive neurostimulation (RNS) is approved for treatment of resistant focal epilepsy in adults, little is known about response to treatment of specific cortical targets. We describe the experience of RNS targeting the insular lobe. We identified patients who had RNS implantation with at least one electrode within the insula between April 2014 and October 2015. We performed a retrospective review of preoperative clinical features, imaging, electrocardiogram (EEG), intraoperative electrocorticography (ECoG), and postoperative seizure outcome. Eight patients with at least 6 months of postimplant follow-up were identified. Ictal localization was inconclusive with MRI or scalp EEG findings. Intracranial EEG monitoring or intraoperative ECoG demonstrated clear ictal onsets and/or frequent interictal discharges in the insula. Four patients demonstrated overall 50-75% reduction in seizure frequency. Two patients did not show appreciable seizure improvement. One patient has experienced a 75% reduction of seizure frequency, and another is nearly seizure free postoperatively. There were no reported direct complications of insular RNS electrode placement or stimulation, though two patients had postoperative complications thought to be related to craniotomy (hydrocephalus and late infection). Our study suggests that insular RNS electrode placement in selected patients is relatively safe and that RNS treatment may benefit selected patients with insular epilepsy

My funky genetics : BRCA1/2 mutation carriers\u27 understanding of genetic inheritance and reproductive merger in the context of new reprogenetic technologies

Deleterious mutations in the BRCA1/BRCA2 genes elevate lifetime risk of breast and ovarian cancer. Each child of a mutation-positive parent has a 50% chance of inheriting it. Preimplantation genetic diagnosis (PGD) permits prospective parents to avoid the birth of a BRCA-mutation-positive child, introducing predictability into a process historically defined by chance. This investigation explored how BRCA1/2 mutation carriers understand genetic inheritance and consider a child\u27s inheritance of a BRCA1/2 mutation, given the opportunities that exist to pursue PGD. Thirty-nine female and male BRCA1/2 mutation carriers of reproductive age were recruited from urban cancer and reproductive medical centers. Participants completed a standardized educational presentation on PGD and prenatal diagnosis, with pre-and posttest assessments. An interdisciplinary team of qualitative researchers analyzed data using grounded theory techniques. Participants expressed the belief that reproduction yields children with unique genetic strengths and challenges, including the BRCA1/2 mutation, family traits for which predictive tests do not exist, and hypothetical genetic risks. Participants expressed preference for biologically related children, yet stated their genetically well partner\u27s lineage would be marred through reproductive merger, requiring the well partner to assume the burden of the BRCA1/2 mutation via their children. Participants expressed diverse views of genetically well partners\u27 participation in family planning and risk management decisions. Pressure to use reprogenetic technology may grow as genetic susceptibility testing becomes more widely available. Work with individuals and couples across the disease spectrum must be attuned to the ways beliefs about genetic inheritance play into reproductive decision-making. (PsycINFO Database Record (c) 2012 APA, all rights reserved) © 2012 American Psychological Association

Analysis of the MOST light curve of the heavily spotted K2IV component of the single-line spectroscopic binary II Pegasi

Continuous photometric observations of the visible component of the single-line, K2IV spectroscopic binary II Peg carried out by the MOST satellite during 31 consecutive days in 2008 have been analyzed. On top of spot-induced brightness modulation, eleven flares were detected of three distinct types characterized by different values of rise, decay and duration times. The flares showed a preference for occurrence at rotation phases when the most spotted hemisphere is directed to the observer, confirming previous similar reports. An attempt to detect a grazing primary minimum caused by the secondary component transiting in front of the visible star gave a negative result. The brightness variability caused by spots has been interpreted within a cold spot model. An assumption of differential rotation of the primary component gave a better fit to the light curve than a solid-body rotation model.Comment: Accepteed to MNRA

Quantum correlated twin atomic beams via photo-dissociation of a molecular Bose-Einstein condensate

We study the process of photo-dissociation of a molecular Bose-Einstein condensate as a potential source of strongly correlated twin atomic beams. We show that the two beams can possess nearly perfect quantum squeezing in their relative numbers.Comment: Corrected LaTeX file layou

Notch signaling regulates metabolic heterogeneity in glioblastoma stem cells.

Glioblastoma (GBM) stem cells (GSCs) reside in both hypoxic and vascular microenvironments within tumors. The molecular mechanisms that allow GSCs to occupy such contrasting niches are not understood. We used patient-derived GBM cultures to identify GSC subtypes with differential activation of Notch signaling, which co-exist in tumors but occupy distinct niches and match their metabolism accordingly. Multipotent GSCs with Notch pathway activation reside in perivascular niches, and are unable to entrain anaerobic glycolysis during hypoxia. In contrast, most CD133-expressing GSCs do not depend on canonical Notch signaling, populate tumors regardless of local vascularity and selectively utilize anaerobic glycolysis to expand in hypoxia. Ectopic activation of Notch signaling in CD133-expressing GSCs is sufficient to suppress anaerobic glycolysis and resistance to hypoxia. These findings demonstrate a novel role for Notch signaling in regulating GSC metabolism and suggest intratumoral GSC heterogeneity ensures metabolic adaptations to support tumor growth in diverse tumor microenvironments

Strong dipolar effects in a quantum ferrofluid

We report on the realization of a Chromium Bose-Einstein condensate (BEC) with strong dipolar interaction. By using a Feshbach resonance, we reduce the usual isotropic contact interaction, such that the anisotropic magnetic dipole-dipole interaction between 52Cr atoms becomes comparable in strength. This induces a change of the aspect ratio of the cloud, and, for strong dipolar interaction, the inversion of ellipticity during expansion - the usual "smoking gun" evidence for BEC - can even be suppressed. These effects are accounted for by taking into account the dipolar interaction in the superfluid hydrodynamic equations governing the dynamics of the gas, in the same way as classical ferrofluids can be described by including dipolar terms in the classical hydrodynamic equations. Our results are a first step in the exploration of the unique properties of quantum ferrofluids.Comment: Final, published versio

Reexamining treatment of high-grade T1 bladder cancer according to depth of lamina propria invasion: a prospective trial of 200 patients

BACKGROUND: Management of high-grade T1 (HGT1) bladder cancer represents a major challenge. We studied a treatment strategy according to substaging by depth of lamina propria invasion. METHODS: In this prospective observational cohort study, patients received initial transurethral resection (TUR), mitomycin-C, and BCG. Subjects with shallower lamina propria invasion (HGT1a) were followed without further surgery, whereas subjects with HGT1b received a second TUR. Association of clinical and histological features with outcomes (primary: progression; secondary: recurrence and cancer-specific survival) was assessed using Cox regression. RESULTS: Median age was 71 years; 89.5% were males, with 89 (44.5%) cases T1a and 111 (55.5%) T1b. At median follow-up of 71 months, disease progression was observed in 31 (15.5%) and in univariate analysis, substaging, carcinoma in situ, tumour size, and tumour pattern predicted progression. On multivariate analysis only substaging, associated carcinoma in situ, and tumour size remained significant for progression. CONCLUSIONS: In HGT1 bladder cancer, the strategy of performing a second TUR only in T1b cases results in a global low progression rate of 15.5%. Tumours deeply invading the lamina propria (HGT1b) showed a three-fold increase in risk of progression. Substaging should be routinely evaluated, with HGT1b cases being thoroughly evaluated for cystectomy. Inclusion in the TNM system should also be carefully considered

Projections in donor organs available for liver transplantation in the United States: 2014‐2025

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111759/1/lt24136.pd

New views on the emission and structure of the solar transition region

The Sun is the only star that we can spatially resolve and it can be regarded as a fundamental plasma laboratory of astrophysics. The solar transition region (TR), the layer between the solar chromosphere and corona, plays an important role in solar wind origin and coronal heating. Recent high-resolution observations made by SOHO, TRACE, and Hinode indicate that the TR is highly nonuniform and magnetically structured. Through a combination of spectroscopic observations and magnetic field extrapolations, the TR magnetic structures and plasma properties have been found to be different in coronal holes and in the quiet Sun. In active regions, the TR density and temperature structures also differ in sunspots and the surrounding plage regions. Although the TR is believed to be a dynamic layer, quasi-steady flows lasting from several hours to several days are often present in the quiet Sun, coronal holes, and active regions, indicating some kind of plasma circulation/convection in the TR and corona. The emission of hydrogen Lyman lines, which originates from the lower TR, has also been intensively investigated in the recent past. Observations show clearly that the flows and dynamics in the middle and upper TR can greatly modify the Lyman line profiles.Comment: This paper has been withdrawn by the authors. This is a repetition of another record in ADS: New Astronomy Reviews, Volume 54, Issue 1-2, p. 13-3

Prevalence and predictors of verbal aggression in a secure mental health service:use of the HCR-20

Despite evidence about the negative effects of verbal aggression in mental health wards there is little research about its prevalence or about the factors that predict the behaviour among inpatients. This study aimed to determine the prevalence of verbal aggression in a secure mental health service, and to examine the relationship of verbal aggression with risk factors for aggression in the risk assessment tool HCR-20 in order to establish whether, and with which factors, the behaviour can be predicted. Verbal aggression was measured using the Overt Aggression Scale (OAS) over a 3-month period across a heterogeneous patient group (n = 613). Over half the patients (n = 341, 56%) engaged in 1594 incidents of verbal aggression. The HCR-20 total, clinical, and risk management subscale scores predicted verbal aggression, though effect sizes were not large. Item-outcome analysis revealed that impulsivity, negative attitudes, and non-compliance with medication were the best predictors of verbal aggression and, therefore, should be targeted for intervention. There are key synergies between factors predicting verbal aggression and the core mental health nursing role. Nurses, therefore, are in a prime position to develop and implement interventions that may reduce verbal aggression in mental health inpatients