Positron Emission Tomography-Computed Tomography Compared with Invasive Mediastinal Staging in Non-small Cell Lung Cancer: Results of Mediastinal Staging in the Early Lung Positron Emission Tomography Trial

IntroductionPatients with non-small cell lung cancer (NSCLC) require careful preoperative staging to define resectability for potential cure. 18Fluorodeoxyglucose positron emission tomography combined with computed tomography (18FDG PET-CT) is widely used to stage NSCLC. If the mediastinum is positive on PET-CT examination, some practitioners conclude that the patient is inoperable and refer the patient for nonsurgical treatment.MethodsIn this analysis of a previously reported trial comparing PET-CT with conventional imaging in the diagnostic work-up of patients with clinical stage I, II, or IIIA NSCLC, we determined the accuracy of PET-CT in mediastinal staging compared with invasive mediastinal staging either by mediastinoscopy alone or by mediastinoscopy combined with thoracotomy.ResultsAll 149 patients had mediastinal nodal staging at mediastinoscopy alone (14), thoracotomy alone (64), or both (71). The sensitivity of PET-CT was 70% (95% confidence interval [CI], 48–85%), and specificity was 94% (95% CI, 88–97%). Of 22 patients with a PET-CT interpreted as positive for mediastinal nodes, 8 did not have tumor. The positive predictive value and negative predictive value were 64% (95% CI, 43–80%) and 95% (95% CI, 90–98%), respectively. Based on PET-CT alone, eight patients would have been denied potentially curative surgery if the mediastinal abnormalities detected by PET-CT had not been evaluated with an invasive mediastinal procedure.ConclusionsPET-CT assessment of the mediastinum is associated with a clinically relevant false-positive result. Our study confirms the need for pathologic confirmation of mediastinal lymph node abnormalities detected by PET-CT

Factors associated with syphilis incidence in the HIV-infected in the era of highly active antiretrovirals.

After several years of steady decline, syphilis is reemerging globally as a public health hazard, especially among people living with human immunodeficiency virus (HIV). Syphilis resurgence is observed mainly in men who have sex with men (MSM), yet other transmission groups are affected too. In this manuscript, we study the factors associated with syphilis incidence in the Swiss HIV cohort study in the era of highly effective antiretrovirals. Using parametric interval censored models with fixed and time-varying covariates, we studied the immunological, behavioral, and treatment-related elements associated with syphilis incidence in 3 transmission groups: MSM, heterosexuals, and intravenous drug users. Syphilis incidence has been increasing annually since 2005, with up to 74 incident cases per 1000 person-years in 2013, with MSM being the population with the highest burden (92% of cases). While antiretroviral treatment (ART) in general did not affect syphilis incidence, nevirapine (NVP) was associated with a lower hazard of syphilis incidence (multivariable hazard ratio 0.5, 95% confidence interval 0.2-1.0). We observed that condomless sex and younger age were associated with higher syphilis incidence. Moreover, time-updated CD4, nadir CD4, and CD8 cell counts were not associated with syphilis incidence. Finally, testing frequency higher than the recommended once a year routine testing was associated with a 2-fold higher risk of acquiring syphilis. Condomless sex is the main driver of syphilis resurgence in the Swiss HIV Cohort study; ART and immune reconstitution provide no protection against syphilis. This entails targeted interventions and frequent screening of high-risk populations. There is no known effect of NVP on syphilis; therefore, further clinical, epidemiological, and microbiological investigation is necessary to validate our observation

Next Generation Very Large Array Memo No. 9 Science Working Group 4: Time Domain, Fundamental Physics, and Cosmology

We report here on key science topics for the Next Generation Very Large Array in the areas of time domain, fundamental physics, and cosmology. Key science cases considered are pulsars in orbit around the Galactic Center massive black hole, Sagittarius A*, electromagnetic counterparts to gravitational waves, and astrometric cosmology. These areas all have the potential for ground-breaking and transformative discovery. Numerous other topics were discussed during the preparation of this report and some of those discussions are summarized here, as well. There is no doubt that further investigation of the science case will reveal rich and compelling opportunities

Next Generation Very Large Array Memo No. 9 Science Working Group 4: Time Domain, Fundamental Physics, and Cosmology

We report here on key science topics for the Next Generation Very Large Array in the areas of time domain, fundamental physics, and cosmology. Key science cases considered are pulsars in orbit around the Galactic Center massive black hole, Sagittarius A*, electromagnetic counterparts to gravitational waves, and astrometric cosmology. These areas all have the potential for ground-breaking and transformative discovery. Numerous other topics were discussed during the preparation of this report and some of those discussions are summarized here, as well. There is no doubt that further investigation of the science case will reveal rich and compelling opportunities

The IASLC Lung Cancer Staging Project: A Renewed Call to Participation

Over the past two decades, the International Association for the Study of Lung Cancer (IASLC) Staging Project has been a steady source of evidence-based recommendations for the TNM classification for lung cancer published by the Union for International Cancer Control and the American Joint Committee on Cancer. The Staging and Prognostic Factors Committee of the IASLC is now issuing a call for participation in the next phase of the project, which is designed to inform the ninth edition of the TNM classification for lung cancer. Following the case recruitment model for the eighth edition database, volunteer site participants are asked to submit data on patients whose lung cancer was diagnosed between January 1, 2011, and December 31, 2019, to the project by means of a secure, electronic data capture system provided by Cancer Research And Biostatistics in Seattle, Washington. Alternatively, participants may transfer existing data sets. The continued success of the IASLC Staging Project in achieving its objectives will depend on the extent of international participation, the degree to which cases are entered directly into the electronic data capture system, and how closely externally submitted cases conform to the data elements for the project

The KarmetiK NotomotoN: A New Breed of Musical Robot for Teaching and Performance

This paper describes the KarmetiK NotomotoN, a new musical robotic system for performance and education. A long time goal of the authors has been to provide users with plug-andplay, highly expressive musical robot system with a high degree of portability. This paper describes the technical details of the NotomotoN, and discusses its use in performance and educational scenarios. Detailed tests performed to optimize technical aspects of the NotomotoN are described to highlight usability and performance specifications for electronic musicians and educators

Long-term survival of humpback whales radio-tagged in Alaska from 1976 through 1978

Invasive tags designed to provide information on animal movements through radio or satellite monitoring have tremendous potential for the study of whales and other cetaceans. However, to date there have been no published studies on the survival of tagged animals over periods of years or decades. Researchers from the National Marine Mammal Laboratory and the Woods Hole Oceanographic Institution tracked five humpback whales with implanted radio tags in southeastern Alaska in August 1976 and July 1977, and tracked two humpback whales in Prince William Sound, Alaska, in June 1978. All seven of these individually identified humpback whales were resighted at least 20 yr after first being tagged, and five of the seven have been observed for more than 30 yr; some of them are among the most resighted humpback whales in the North Pacific. Photos of tagging sites taken during and subsequent to tagging operations show persistent but superficial scarring and no indication of infection