Lobe Size Research Articles

Assessment of Right Liver Lobe Size / Serum Albumin Ratio as a New Non-Invasive Predictor for the Presence of Oesophageal Varices in Egyptian Patients with HCV Related Liver Cirrhosis

Background: Oesophageal varices are the most critical porto-systemic shunts that develop secondary to portal hypertension, which is considered the main complication of liver cirrhosis. Many studies recommend the screening of all cirrhotic patients by endoscopy, but repeated endoscopic examinations are unpleasant for patients and have a high- cost impact and burden on endoscopic units. Objective: This study aimed to evaluate the accuracy of using the right liver lobe size/serum albumin ratio as a non-invasive predictor of esophageal varices in patients with HCV-related liver cirrhosis. Patients Methods: This prospective study included 30 patients with liver cirrhosis and 30 patients who underwent upper gastrointestinal endoscopy for any causes other than liver cirrhosis. All studied subjects underwent a detailed history and clinical examination, biochemical workup, upper gastrointestinal endoscopy, and abdominal ultrasound. The right liver lobe/serum albumin ratio was calculated for all patients. Results: There was a statistically significant difference between the control and the study subgroups as regards the Right lobe of the Liver/Albumin ratio (p-value 0.007). The diagnostic accuracy of the Right lobe of the Liver/Albumin ratio was assessed using the ROC curve which revealed a sensitivity of 86.67% and specificity of 73.33% at cut-off value >3.88, with an acceptable discriminative accuracy of 79.9%. Conclusion: The use of Right liver lobe/serum albumin ratio can help physicians by restricting the use of endoscopic screening only to patients presenting a high probability of esophageal varices. This is especially useful in clinical settings where resources are limited, and endoscopic facilities are not present in all areas.

Assessment of Right Liver Lobe Size / Serum Albumin Ratio as a New Non-Invasive Predictor for the Presence of Oesophageal Varices in Egyptian Patients with HCV Related Liver Cirrhosis

Background: Oesophageal varices are the most critical porto-systemic shunts that develop secondary to portal hypertension, which is considered the main complication of liver cirrhosis. Many studies recommend the screening of all cirrhotic patients by endoscopy, but repeated endoscopic examinations are unpleasant for patients and have a high- cost impact and burden on endoscopic units. Objective: This study aimed to evaluate the accuracy of using the right liver lobe size/serum albumin ratio as a non-invasive predictor of esophageal varices in patients with HCV-related liver cirrhosis. Patients Methods: This prospective study included 30 patients with liver cirrhosis and 30 patients who underwent upper gastrointestinal endoscopy for any causes other than liver cirrhosis. All studied subjects underwent a detailed history and clinical examination, biochemical workup, upper gastrointestinal endoscopy, and abdominal ultrasound. The right liver lobe/serum albumin ratio was calculated for all patients. Results: There was a statistically significant difference between the control and the study subgroups as regards the Right lobe of the Liver/Albumin ratio (p-value 0.007). The diagnostic accuracy of the Right lobe of the Liver/Albumin ratio was assessed using the ROC curve which revealed a sensitivity of 86.67% and specificity of 73.33% at cut-off value >3.88, with an acceptable discriminative accuracy of 79.9%. Conclusion: The use of Right liver lobe/serum albumin ratio can help physicians by restricting the use of endoscopic screening only to patients presenting a high probability of esophageal varices. This is especially useful in clinical settings where resources are limited, and endoscopic facilities are not present in all areas.

Temporal lobe evolution in Javanese Homo erectus and African Homo ergaster: Inferences from the cranial base

Increased brain size is a characteristic of the Homo erectus hypodigm compared to early fossil hominins with changes in cerebral reorganization of evolutionary importance for the genus Homo. The close spatial proximity of the temporal lobes of the brain to the cranial base, specifically, the middle cranial fossa (MCF), provides inference of temporal lobe evolution. To date, differences in MCF proportions and relative scaling in the H. erectus hypodigm compared to extant Homo sapiens is unknown. A total sample (n = 51) of cranial Computed Tomography scans (CT) from extant H. sapiens and fossil specimens attributed to African Homo ergaster and Javanese H. erectus were generated into three-dimensional (3D) virtual models with three linear metrics digitally measured on the MCF and two metrics to approximate cranial size. Reduced Major Axis (RMA) log-log regressions and resampling with permutations determined if relative MCF scaling in the fossil sample was greater than observed among extant H. sapiens. An increase or decrease in MCF proportions in the fossil sample compared to extant H. sapiens was used to determine potential changes in temporal lobe size. There were no differences in the allometric trend of relative MCF scaling with no statistically significant differences suggesting that the fossil sample were beyond the range observed for extant H. sapiens, but the effects of the small fossil sample size could not be excluded. However, relative MCF proportions showed extant H. sapiens had a larger MCF to relative to cranial size, while specimens attributed to Javanese H. erectus which had a relatively longer and wider MCF compared to African H. ergaster. These findings indicate that despite sampling limitations, the fossil sample did not show differences in allometric scaling compared to extant H. sapiens, but these specimens attributed to Javanese H. erectus and African H. ergaster share the same total cranial size but had different MCF proportions relative to cranial size. The paleoneurological implications are that these specimens attributed to Javanese H. erectus had longer and wider temporal lobes relative to total brain size compared to African H. ergaster suggesting different patterns of cerebrocranial organization within the Homo erectus hypodigm.

Abstract 2113: Discrimination of benign breast disease from normal lobules using an automated computational pathology algorithm

Abstract Background: Biopsy diagnosis of benign breast disease (BBD) based on the most severe lesion in a sample predicts future breast cancer risk and has implications for screening and management. Lobules are the functional unit of the breast and the structures from which BBD arises. We developed and preliminarily validated an automated computational pathology algorithm to discriminate normal from BBD breast lobules as a step toward automated comprehensive characterization of benign biopsies. Methods: 152 BBD biopsies (27 training, 125 validation) from the Mayo Clinic were examined using scanned digital images of H&E stained sections. For each image, a pathologist annotated up to 10 representative lobules as normal or BBD using standard pathology criteria. A deep learning algorithm to quantify lobular features was developed using 129 lobules from 27 subjects. Nine features were identified that discriminate normal vs BBD lobules, expressing lobule size, acini size and number, acinar lumen size, proportion of lobular stroma, and capillaries. Here, we validate their performance to discriminate normal vs BBD lobules in a set of 1250 lobules from 125 subjects using area under the ROC curve (AUC) analysis. Random forest analysis was used for multivariable modeling; model performance was assessed with a tenfold cross-validation approach. Results: Median subject age was 52 years. Among the 125 validation subjects, BBD findings were nonproliferative in 39%, proliferative in 45%, and atypical hyperplasia in 16%. Sections included 552 (44%) normal lobules and 698 BBD (56%) lobules, with representation of both lobule types on each section. In univariate analyses, four individual features showed good discrimination between normal vs. BBD lobules, yielding the following AUCs: lobule size= 0.74, mean acini size= 0.75, epithelial area= 0.75, and number of acini with large lumens= 0.76. Lobule size and epithelial area were highly correlated (Spearman rank correlation r = 0.95), but both of these features showed lower correlation with mean acini size and number of acini with large lumens (each r < 0.5). With random forest modeling, number of acini with large lumens was the strongest discriminating feature, followed by mean acini size, lobule size, and epithelial area. With ten-fold cross validation of the multivariable random forest model, the overall AUC was 0.82 (95% CI: 0.79-0.85). Conclusion: Our validation showed that automated quantitative computational pathology assessment of breast lobules can discriminate normal versus BBD on a per lobule basis. This finding supports the feasibility of developing automated algorithms to classify every lesion in breast biopsies, expanding beyond visual assessment. Further studies using deep learning may reveal novel pathology features for classifying BBD biopsies with the potential to strengthen estimation of breast cancer risk. Citation Format: Amy C. Degnim, Thomas de Bel, Mark E. Sherman, Derek C. Radisky, Stacey J. Winham, Tanya L. Hoskin, Melody L. Stallings Mann, Marlene Frost, Robert A. Vierkant, Brendan T. Broderick, Ethan P. Heinzen, Rushin Brahmbhatt, Muhammad Arshad, Celine M. Vachon, Jodi M. Carter, Lori A. Denison, Daniel W. Visscher, Jeroen van der Laak. Discrimination of benign breast disease from normal lobules using an automated computational pathology algorithm [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 2113.

Two new species of Phialiphora (Spermacoceae, Rubiaceae) exemplify drought adaptations in western Madagascar

Background – Phialiphora (Spermacoceae, Rubiaceae) is a herbaceous genus restricted to unconsolidated white sands in open spaces in dry forests in northwestern Madagascar. The genus is characterized by the semi-succulent nature of its leaves and stems, its basal leaf rosette, its head-like inflorescences subtended by large leaf-like involucrate bracts and its isostylous flowers. Hitherto, only two species were described.Methods – Classical methods of herbarium taxonomy are followed.Key results – Two new Phialiphora species, P. glabrata De Block and P. valida De Block, are described, which brings the number of species in the genus to four. The two new species differ from the two previously described species by their glabrous branches, bracts, ovaries, calyces and fruits. They are easily distinguished from each other by the shape and size of the calyx lobes. A detailed description, illustration, distribution map and preliminary conservation assessment is given for the new species, which are assessed as critically endangered. We also present a key for the genus and discuss in detail the typical branching system, the capsules and the dispersal mechanism of Phialiphora. The description of these two new species exemplifies the uniqueness of the dry vegetations on unconsolidated white sands in western Madagascar, which are characterized by a high level of endemicity.

Study on anatomy and postnatal development of sublingual salivary glands in Black Bengal goat

There are three pairs of salivary glands in Black Bengal goat namely parotid, mandibular and sublingual salivary gland. Information regarding the sublingual salivary gland is very limited and confined in adult goat only, no reports available concerning the postnatal development of the goat sublingual gland to date. Present study is carried out to fill up the gap of information regarding this gland. In day old kid the sublingual gland is measured 2.5 ± 0.30 cm in length, 0.25 ± 0.08 cm in breadth, 0.15 ± 0.01 cm in thickness and 0.09 ±0.01 g in weight which became little more than double in each parameter in adult. The main sublingual duct is formed by the union of 5-7 radicles from monostomatic part of the gland and opened at sublingual caruncle. 26-30 small tortuous ducts arise from the polystomatic part and opened independently in a row of microscopic orifices of the sublingual fold. Gradual histological development shows the glandular units composed of tubule-alveolar acini which are mostly mucous in type. The mucous acini composed of pyramidal shape cells resting on a basement membrane. In day old kid, the acini have distinct lumen. The cells contain rounded nuclei at their basal part and lack of zymogenic granules indicating less functional state of the glands. Along the advancement of age the size of lobes and lobules are increased, the lumens of the mucous acini reduced in size, nuclei of the cells became flattened the zymogenic granules increased gradually. Mixed acini are more than the serous acini where a serous demilune is attached on a mucous acinus. The serous acini were less in number.
 Asian J. Med. Biol. Res. June 2020, 6(2): 328-333

An Integrated Spatial Dynamics-Pharmacokinetic Model Explaining Poor Penetration of Anti-retroviral Drugs in Lymph Nodes.

Although combined anti-retroviral therapy (cART) suppresses plasma HIV viremia below the limit of detection in a majority of HIV patients, evidence is emerging that the distribution of the anti-retroviral drugs is heterogeneous in tissue. Clinical studies measuring antiretroviral drug concentrations in lymph nodes (LNs) revealed lower concentrations compared to peripheral blood levels suggesting poor drug penetration properties. Our current study is an attempt to understand this poor anti-retroviral drug penetration inside lymph node lobules through integrating known pharmacokinetic and pharmacodynamic (PK/PD) parameters of the anti-retroviral drugs into a spatial model of reaction and transport dynamics within a solid lymph node lobule. Simulated drug penetration values were compared against experimental results whenever available or matched with data that is available for other drugs in a similar class. Our integrated spatial dynamics pharmacokinetic model reproduced the experimentally observed exclusion of antivirals from lymphoid sites. The strongest predictor of drug exclusion from the lymphoid lobule, independent of drug class, was lobule size; large lobules (high inflammation) exhibited high levels of drug exclusion. PK/PD characteristics associated with poor lymphoid penetration include high cellular uptake rates and low intracellular half-lives. To determine whether this exclusion might lead to ongoing replication, target CD4+ T cell, infected CD4+ T cell, free virus, and intracellular IC50 values of anti-retroviral drugs were incorporated into the model. Notably, for median estimates of PK/PD parameters and lobule diameters consistent with low to moderate inflammation, the model predicts no ongoing viral replication, despite substantial exclusion of the drugs from the lymphoid site. Monte-Carlo studies drawn from the prior distributions of the PK/PD parameters predicts increases in site-specific HIV replication in a small fraction of the patient population for lobule diameters greater than 0.2 mm; this fraction increases as the site diameter/ inflammation level increases. The model shows that cART consisting of two nRTIs and one PI is the most likely treatment combination to support formation of a sanctuary site, a finding that is consistent with clinical observations.

SAT-268 Thyrotropin Secreting Pituitary Adenoma Initially Misdiagnosed as Primary Hyperthyroidism in a Taiwanese Man

Background:TSH (Thyrotropin) secreting pituitary adenoma (TSHoma) account for less than 1% of all causes of hyperthyroidism and 1% of all functioning pituitary tumors. Definite diagnosis and treatment of TSHoma are clinical challenges in practice. Here we report laboratory data, imaging findings, endocrine dynamic test, and treatment outcomes in a 50-year-old Taiwanese man with pituitary plurihormonal adenoma secreting TSH and LH.Clinical case:The patient was initially diagnosed as goiter with primary hyperthyroidism and DM while medical check-up by primary care physician in 2014. He had no significant hyperthyroidism symptoms and signs except goiter and mild palpitation. He received propylthiouracil and Metformin. Two years later, he visited to Endocrinologist’s clinic for poor glycemic control. Central hyperthyroidism was diagnosed due to measurable TSH level in the presence of increased serum thyroid hormone level. Moreover sella MRI revealed left sided pituitary lesion. He was referred to Taipei Veteran General Hospital for further management. There was no family history of thyroid disease. Physical examination was not remarkable except diffuse grade 3 goiter and tachycardia (HR 100~115 bpm). Follow up laboratory data showed TSH 4.89; range 0.4~4.0 uIU/ml, free T4: 3.05; range 0.9~1.8 ng/dl, T4: 16.02; range 4.50~12.50 μg/dl, T3: 249; range 58~159 ng/dl, free T3: 8.0; range 2.3~4.3 pg/ml. Two times of TRH stimulation test showed blunted TSH response. Normal limit of thyroid autoantibodies level were found. Thyroid sonography revealed heterogenous echogenicity with increased size and vascularity of both lobes. I-131 uptake was homogenous uptake (94%). Other pituitary hormones level were within normal limit except mild elevation of testosterone 12.69 ng/ml. Sella MRI with contrast showed macroadenoma (size 10x10x7.6 mm) at left pituitary gland. Taken together, he was diagnosed as central hyperthyroidism related to left sided pituitary macroadenoma. Surgery was performed after one year of definite diagnosis due to personal reason. TSH level returned to normal ranges (0.799 uIU/ml) in 1st post operative day. Histologically, the pituitary mass was compatible with plurihormonal adenoma and immunohistochemistry showed positivity for TSH (4+) and LH (3+). Post operative condition was well. Antithyroid agent was discontinued after operation. His blood glucose became well controlled after operation.Clinical lessons:A biochemical hallmark of TSHoma is an escape of TSH from the feedback loop that is detectable TSH levels in the presence of increased serum thyroid hormone level. Diagnosis of TSHoma was frequently unrecognized and thus much delayed despite its relatively straightforward. Physician should keep in mind that the importance interpretation of simple laboratory tests to avoid delay diagnosis and unnecessary treatments.

<p><strong><em>Vincetoxicum</em></strong><strong> <em>strigosum</em> (Asclepiadoideae, Apocynaceae), a new species from northeastern Thailand</strong></p>

A new slender twining herb, Vincetoxicum strigosum A. Kidyoo, from northeastern Thailand is described and illustrated. This species is morphologically similar to V. kerrii (Craib) A. Kidyoo, but can be distinguished by several morphological, anatomical, and ultrastructural characters, i.e. leaf indumentum, inflorescence architecture, shape and size of calyx lobes, stipe of gynostegium, apex of corona lobes, and shape of corpusculum.

The effect of different doses of probiotic feed additives on hematologic indices and morphological structure of individual pig internal organs

In order to improve the digestibility and absorption of feed, metabolic processes, growth and development of animals, increase the resistance of the body immunomodulatory agents, probiotics, prebiotics, combined enzyme-probiotic feed additives are widely used. The purpose of our work was to conduct comparative clinical trials of the effectiveness of the probiotic feed additive Probion-forte in terms of productivity, blood indices and histological structure of individual internal pigs organs during fattening. The researches were carried out on 120 piglets of big white breed at the age of 28 days, which were divided into 4 groups with 30 units in each one. The probiotics were added to feed in different concentrations in order to determine their efficiency and examine influence on piglets organism: the first group was given probiotic Probion-forte in dose of 1.0 g/kg (10 weeks); the second one – Probion in dose of 1.0 g/kg (6 weeks) and 0.5 g/kg (4 weeks); the third one was given probiotic Bio Plus 2B in dose of 0.4 g/kg for 10 weeks; and the fourth one was a control group. The compound feed was provided according to norms recommended for big white breed taking into account age. On the 42nd day (6 weeks) and on the 70th day of test 10 units were selected for haematological, pathomorphological and microbiological tests. The productivity of animals of all studied groups was evaluated by the average daily gains, safety, feed conversion and slaughter output. The stabilized with EDTA piglets’ blood was used for morphological studies, and blood serum – for biochemical studies. The clinical trials have shown that the application of Probion-forte, as a feed additive for fattening of piglets within 10 weeks after weaning, did not cause adverse reactions, was well tolerated by animals and contributed to the improvement of the processes of erythropoiesis and leucopoiesis, increased of serum total protein content. The increasing activity of serum transaminases indicated more intense metabolic processes in experimental animals’ organism, which was confirmed by increase in average daily weight gains and slaughter output compared to control. In the microscopic examination of the thymus, spleen, lymph nodes, intestines, liver, the characteristic histological structure of the organs was preserved and indicated their active morphofunctional state throughout the study period. Morphometrically the increase in the height of the villi in the duodenum and the size of the thymus lobes in piglets, which were fed with probiotic feed additives was established. The efficiency and appropriateness of the application of these products was confirmed in the first and second experimental groups. However, the most significant difference was observed in piglets fed with Probion-forte for 10 weeks at a dose of 1.0 g/kg of feed.

Size of portally deprived liver lobe after portal vein ligation and additional partial hepatectomy: Result of balancing proliferation and apoptosis

The liver has the ability to maintain its total size by adjusting the size of the individual liver lobes differently in response to regeneration- and atrophy-stimuli. Portal vein ligation (PVL) drives the ligated lobe to undergo atrophy whereas partial hepatectomy (PHx) drives the total remnant liver to regenerate. We hypothesize that the size of the PVL-lobe is dependent on the balance between the extent of PVL and the extent of PHx inducing a complex interplay between hepatocyte proliferation, apoptosis and autophagy. Lewis-rats were subjected to either 20%PVL + 70%PHx or 70%PVL + 20%PHx. Control groups consisted of 20%PVL and 70%PVL. Liver lobe weight, BrdU-proliferation-index, proliferating-cell-nuclear-antigen-mRNA-expression level, apoptotic density and autophagy-related-proteins were investigated. The PVL-liver lobe adjusted its weight differently, increasing by 40% after 20%PVL + 70%PHx, but decreasing by 25% after 70%PVL + 20%PHx. Additional resection induced a low, but substantial size-dependent hepatocyte proliferation rate (maximal 6.3% and 3.6% vs. 0.3% and significantly suppressed apoptotic density in the deportalized-liver-lobe (3 and 14 cells/mm2 comparing with above 26 cells/mm2, p < 0.01). Autophagy was more activated in PVL-liver lobe after simultaneous PHx than after PVL only. In summary, atrophy of the PVL-liver lobe after simultaneous PHx was counteracted by promoting hepatocyte proliferation, inducing autophagy and suppressing apoptosis in a PHx-extent-dependent manner.

Janus Magnetic-Plasmonic Nanoparticles for Magnetically Guided and Thermally Activated Cancer Therapy.

Progress of thermal tumor therapies and their translation into clinical practice are limited by insufficient nanoparticle concentration to release therapeutic heating at the tumor site after systemic administration. Herein, the use of Janus magneto-plasmonic nanoparticles, made of gold nanostars and iron oxide nanospheres, as efficient therapeutic nanoheaters whose on-site delivery can be improved by magnetic targeting, is proposed. Single and combined magneto- and photo-thermal heating properties of Janus nanoparticles render them as compelling heating elements, depending on the nanoparticle dose, magnetic lobe size, and milieu conditions. In cancer cells, a much more effective effect is observed for photothermia compared to magnetic hyperthermia, while combination of the two modalities into a magneto-photothermal treatment results in a synergistic cytotoxic effect in vitro. The high potential of the Janus nanoparticles for magnetic guiding confirms them to be excellent nanostructures for in vivo magnetically enhanced photothermal therapy, leading to efficient tumor growth inhibition.

An ultrasound-based referential of body height-adjusted normal liver organometry in school children from Bokito in rural Cameroon

The grading system for ultrasonographic assessment of Schistosoma mansoni morbidity is crucial for evaluation of control programs. This requires prior definition of normal liver organometric ranges in the population from the endemic area. A cross-sectional study was conducted in a S. mansoni endemic area in rural Cameroon. 1002 Participants were screened and 234 of them, free from all common liver-affecting diseases in the area (schistosomiasis, malaria, hepatitis B and C) and with no ultrasonographic signs of liver disease were selected and their liver parameters measured by ultrasonography. All statistics were considered significant for p-values < 0.05. Normal dimensions of livers lobe sizes, portal vein wall thickness and portal vein diameters are reported. The liver organometric data are presented for the entire study population as a whole and separately for males and females as prediction plots, with observed values and fitted regression line with 95% confidence. Reference ranges for liver parameters (size, portal vein thickness and diameter) adjusted for body height established in the current study are novel for Cameroon. The prediction plots generated should improve the accuracy of the assessment of liver morbidity by ultrasonography in the region.

Back to the light, coevolution between vision and olfaction in the "Dark-flies" (Drosophila melanogaster).

Trade-off between vision and olfaction, the fact that investment in one correlates with decreased investment in the other, has been demonstrated by a wealth of comparative studies. However, there is still no empirical evidence suggesting how these two sensory systems coevolve, i.e. simultaneously or alternatively. The "Dark-flies" (Drosophila melanogaster) constitute a unique model to investigate such relation since they have been reared in the dark since 1954, approximately 60 years (~1500 generations). To observe how vision and olfaction evolve, populations of Dark-flies were reared in normal lighting conditions for 1 (DF1G) and 65 (DF65G) generations. We measured the sizes of the visual (optic lobes, OLs) and olfactory (antennal lobes, ALs) primary centres, as well as the rest of the brain, and compared the results with the original and its genetically most similar strain (Oregon flies). We found that, whereas the ALs decreased in size, the OLs (together with the brain) increased in size in the Dark-flies returned back to the light, both in the DF1G and DF65G. These results experimentally show that trade-off between vision and olfaction occurs simultaneously, and suggests that there are possible genetic and epigenetic processes regulating the size of both optic and antennal lobes. Furthermore, although the Dark-flies were able to mate and survive in the dark with a reduced neural investment, individuals being returned to the light seem to have been selected with reinvestment in visual capabilities despite a potential higher energetic cost.

Quantification of Perinodular Emphysema in High-risk Patients Offers No Benefit in Lung Nodule Risk-Stratification of Malignancy Potential.

Pulmonary nodules, found either incidentally or on lung cancer screening, are common. Evaluating the benign or malignant nature of these nodules is costly in terms of patient risk and expense. The presence of both global and regional emphysema has been linked to increased lung cancer risk. We sought to determine whether the measurement of emphysema directly adjacent to a lung nodule could inform the likelihood of a nodule being malignant. Within a population of Veterans at high risk for lung cancer, 58 subjects with malignant nodules found on computerized tomographic chest scans were matched by lobe and nodule size to 58 controls. Lung densitometry was measured via determination of the low attenuation area percentage at -950 Hounsfield units (LAA950) and the Hounsfield unit (HU) value at which 15% of lung voxels have a lower lung density (Perc15), at predefined lung volumes that encompassed the nodule to evaluate both perinodular and regional lung fields. The association between measured lung density and malignancy was investigated using conditional logistic regression models, with densitometry measurements used as the primary predictor, adjusting for age alone, or age and computerized tomographic scan characteristics. No significant differences in emphysema measurements between malignant and benign nodules were identified at lung volumes encompassing both perinodular and regional emphysema. Furthermore, emphysema quantification remained stable across lung volumes within individuals. In this study, quantifying the degree of perinodular or regional emphysema did not offer any benefit in the risk stratification of lung nodules.

The 2017 Nishinoshima eruption: combined analysis using Himawari-8 and multiple high-resolution satellite images

Nishinoshima volcano suddenly resumed eruptive activity in April 2017 after about 1.5 years of dormancy since its previous activity in 2013–2015. Nishinoshima is an uninhabited isolated island. We analyzed the eruption sequence and the eruptive process of the 2017 eruption (17 April–10 August: 116 days) by combining high-temporal-resolution images from Himawari-8 and high-spatial-resolution images from the ALOS-2, Landsat-8, and Pleiades satellites. We used these data to discuss how temporal variations in the lava effusion rate affected the flow formations and topographical features of the effused lava. The total effused volume was estimated to be 1.6 × 107 m3, and the average effusion rate was 1.5 × 105 m3/day (1.7 m3/s). Based on variations in the thermal anomalies in the 1.6-μm band of Himawari-8, which roughly coincided with that of the lava effusion rate estimated by ALOS-2, the activity was segmented into five stages. In Stage 1 (17–30 April: 14 days), the lava effusion rate was the highest, and lava flowed to the west and southwest. Stage 2 (1 May–5 June: 36 days) showed a uniform decrease in flow, and lava flowed to the southwest and formed the southwestern lava delta. During Stage 3 (6–15 June: 10 days), the lava effusion rate increased in a pulsed manner, the flow direction changed from southwestward to westward, and a narrow lava flow effused from the southern slope of the cone. In Stage 4 (16 June–31 July: 46 days), the lava effusion rate decreased and lava flowed westward through lava tubes, enlarging the western lava delta. Around the end of July, lava effusion mostly stopped. Finally, in Stage 5 (1–10 August: 10 days), explosive eruptions occurred sporadically. The variation in lava effusion rate seemed to play an important role in forming different flow patterns of lava on Nishinoshima. In Stages 1 and 3, lava flowed in multiple directions, while in Stages 2 and 4, it flowed in single direction, probably because the effusion rate was lower. A pulsed increase in the lava effusion rate during Stage 3 caused new breaks and disturbances of the lava passages near the vents, which resulted in changes in flow directions. Differences in the size of lava lobes between the southwestern and western deltas are also considered to result from differences in the lava effusion rate.

Clinical application of lobulated transplantation of free anterolateral thigh perforator flap in the treatment of electric burns of limbs

Clinical application of lobulated transplantation of free anterolateral thigh perforator flap in the treatment of electric burns of limbs

Thyroid lobe size predicts risk of postoperative temporary recurrent laryngeal nerve paralysis.

ObjectivesIn patients who had undergone thyroidectomy in Japan for benign tumor, we determined whether thyroid lobe size correlates with temporary recurrent laryngeal nerve paralysis (T‐RLNP).MethodsWe retrospectively collected medical record data on usage of intraoperative neuromonitoring, laterality of thyroidectomy, amount of bleeding during surgery, duration of surgery, and whether the surgeon was a board certified otorhinolaryngologist as determined by the Oto‐Rhino‐Laryngological Society of Japan. Thyroid size was measured in preoperative axial computed tomography (CT) images. Receiver operating characteristic (ROC) curve analysis was used to determine the thyroid size that predicted a high risk of T‐RLNP or permanent recurrent laryngeal nerve paralysis (P‐RLNP).ResultsOf the 146 eligible patients identified, 9 (6.2%) developed T‐RLNP and 2 (1.4%) developed P‐RLNP. The amount of bleeding during thyroidectomy was significantly greater in T‐RLNP patients than in P‐RLNP patients. Thyroid sizes in CT images were significantly larger in T‐RLNP patients compared to patients who did not develop RLNP (referred to hereafter as N‐RLNP). ROC analysis revealed that 1.3% of thyroid lobes with an area of less than 1000.0 mm2, and 9.9% of thyroid lobes with an area of greater than 1000.0 mm2 were at risk for T‐RLNP.ConclusionWe presented evidence that thyroid sizes, as measured on preoperative axial CT images, were larger in T‐RLNP patients than in N‐RLNP patients. Our results indicate a connection between benign thyroid tumor stretch injuries and T‐RLNP.Level of EvidenceIV.

Brain differences between social castes precede group formation in a primitively eusocial bee.

Social interactions may shape brain development. In primitively eusocial insects, the mushroom body (MB), an area of the brain associated with sensory integration and learning, is larger in queens than in workers. This may reflect a strategy of neural investment in queens or it may be a plastic response to social interactions in the nest. Here, we show that nest foundresses-the reproductive females who will become queens but are solitary until their first workers are born-have larger MBs than workers in the primitively eusocial sweat bee Augochlorella aurata. Whole brain size and optic lobe size do not differ between the two groups, but foundresses also have larger antennal lobes than workers. This shows that increased neural investment in MBs precedes social group formation. Larger MBs among foundresses may reflect the increased larval nutrition provisioned to future queens and the lack of social aggression from a dominant queen upon adult emergence.

The Hubble Space Telescope PanCET Program: Exospheric Mg ii and Fe ii in the Near-ultraviolet Transmission Spectrum of WASP-121b Using Jitter Decorrelation

Abstract We present Hubble Space Telescope (HST) near-ultraviolet (NUV) transits of the hot Jupiter WASP-121b, acquired as part of the PanCET program. Time-series spectra during two transit events were used to measure the transmission spectra between 2280 and 3070 Å at a resolution of 30,000. Using HST data from 61 Space Telescope Imaging Spectrograph visits, we show that data from HST’s Pointing Control System can be used to decorrelate the instrument systematic errors (jitter decorrelation), which we used to fit the WASP-121b light curves. The NUV spectra show very strong absorption features, with the NUV white light curve found to be larger than the average optical and near-infrared value at 6σ confidence. We identify and spectrally resolve absorption from the Mg ii doublet in the planetary exosphere at a 5.9σ confidence level. The Mg ii doublet is observed to reach altitudes of R pl/R star = 0.284 ± 0.037 for the 2796 Å line and 0.242 ± 0.0431 for the 2804 Å line, which exceeds the Roche lobe size as viewed in transit geometry (R eqRL/R star = 0.158). We also detect and resolve strong features of the Fe ii UV1 and UV2 multiplets, and observe the lines reaching altitudes of R pl/R star ≈ 0.3. At these high altitudes, the atmospheric Mg ii and Fe ii gas is not gravitationally bound to the planet, and these ionized species may be hydrodynamically escaping or could be magnetically confined. Refractory Mg and Fe atoms at high altitudes also indicate that these species are not trapped into condensate clouds at depth, which places constraints on the deep interior temperature.