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Background: Previous implementation of risk-stratified pancreatectomy clinical pathways (RSPCPs) decreased length of stay (LOS) following pancreaticoduodenectomy (PD). This study's primary aim was to measure the association of iterative RSPCP revisions with accelerated discharge and early postoperative outcomes.Methods: This is a retrospective cohort study of a prospectively maintained surgical database (10/2016-9/2020). In February 2019, revised RSPCPs were implemented with earlier nasogastric tube (NGT) removal (postoperative day [POD] 1 for low risk; POD 2 for high risk) and updated drain fluid amylase cutoffs for POD 1/POD 3 removal. Perioperative outcomes between original and revised pathways were compared. Predictors of accelerated discharge (defined as ≤ POD 5 for low risk; ≤ POD 6 for high risk) were identified.Results: There were 233 (36% high risk) patients in original and 131 (32% high risk) in revised RSPCPs. After revision, the rate of POD 1 NGT removal was higher while POD ≤ 3 drain removal was similar. Median LOS decreased for low risk (5 vs. 6 days, p = 0.011) and high risk (6 vs. 9 days, p = 0.005) with no increase in delayed gastric emptying, postoperative pancreatic fistula, or readmissions. With POD 1 NGT removal, diet tolerance was earlier without increased NGT reinsertions. In low-risk patients, younger age, POD 1 NGT removal, and POD ≤ 3 drain removal were independent predictors of accelerated discharge. In high-risk patients, POD 1 NGT removal and POD ≤ 3 drain removal were independent predictors of accelerated discharge.Conclusions: Following iterative revisions in RSPCPs, LOS after PD decreased further without increasing readmissions, and NGTs were removed earlier without increased reinsertions. Early NGT and drain removal are modifiable practices within RSPCPs that are associated with accelerated discharge. [ABSTRACT FROM AUTHOR]

At high latitudes and altitudes one of the main controls on hydrological and biogeochemical processes is the breakup and freeze-up of lake and river ice. This study uses 3510 time series from across 678 Northern Hemisphere lakes and rivers to explore historical patterns in lake and river ice phenology across five overlapping time periods (1931–1960, 1946–1975, 1961–1990, 1976–2005, and 1931–2005). These time series show that the number of annual open-water days increased by 0.63 d per decade from 1931–2005 across the Northern Hemisphere, with trends for breakup and, to a lesser extent, freeze-up closely correlating with regionally averaged temperature. Breakup and freeze-up trends display a spatiotemporally complex evolution and reveal considerable caveats with interpreting the implications of ice phenology changes at lake and river sites that may only have breakup or freeze-up data, rather than both. These results provide an important contribution by showing regional variation in ice phenology trends through time that can be hidden by longer-term trends. The overlapping 30-year time periods also show evidence for an acceleration in warming trends through time. Understanding the changes on both long- and short-term timescales will be important for determining the causes of this change, the underlying biogeochemical processes associated with it, and the wider climatological significance as global temperatures rise. [ABSTRACT FROM AUTHOR]

Purpose: Current methods of assessing disease burden in gastric adenocarcinoma are imperfect. Improved visualization during surgery with intraoperative molecular imaging (IMI) could improve gastric adenocarcinoma staging and guide surgical decision-making. The goal of this study was to evaluate if IMI with a folate receptor-targeted near-infrared fluorescent agent, OTL38, could identify gastric adenocarcinomas during surgery. Procedures: Five patients were enrolled in an IMI clinical trial. Patients received a folate receptor-targeted near-infrared dye (OTL38) 1.5–6 h prior to surgery. During staging laparoscopy and gastric resection, IMI was utilized to identify the primary tumor and any fluorescent lymph nodes. Resected tumors were analyzed for folate receptor alpha (FRα) and CD68 expression using immunohistochemistry. Microscopic OTL38 accumulation was examined with immunofluorescence. Results: Four out of five patients underwent total or subtotal gastrectomy; one had a staging laparoscopy only. All four patients who underwent gastric resection had invasive gastric adenocarcinoma; three had fluorescent tumors, mean tumor to background ratio (TBR) 4.1 ± 2.9. The one patient with a non-fluorescent tumor had a T1a tumor with two 0.4 cm tumor foci within a larger polyp. In each case with a fluorescent tumor, the fluorescence was evident from the exterior of the stomach. Two of the fluorescent tumors had modest FRα expression and no CD68 expression. One fluorescent tumor had high CD68 expression and no FRα expression. Conclusions: Intraoperative molecular imaging of gastric adenocarcinoma with OTL38 is feasible. Further studies should evaluate the clinical utility of this technique. [ABSTRACT FROM AUTHOR]

The airborne lunar spectral irradiance mission is an inter-agency partnership between the US National Aeronautics and Space Administration and the US National Institute of Standards and Technology that aims to make SI-traceable measurements of lunar spectral irradiance at visible to near-infrared wavelengths with unprecedented accuracy. This information is vital to using the Moon as a calibration source for Earth observing satellites. To minimize uncertainty, the lunar measurements are made above 90% of the Earth's atmosphere from an Earth Resources 2 aircraft, a civilian descendant of the U-2 spy plane. Situated in a large wing pod, a custom-designed telescope automatically tracks the Moon and the measurements are fed into a spectrometer. This information is being used to develop an extremely accurate model that can be used to calibrate satellites. An Engineering Flight Campaign was completed in August 2018 and a Demonstration Flight Campaign in November 2019, which demonstrated autonomous lunar acquisition and tracking as well as measurements of the Moon's spectral irradiance from an altitude of approximately 21 km. This article presents the simplified double gimbal control system design that was used to manipulate the telescope, and was capable of targeting the Moon with a root mean squared tracking error of about 0. 1 ∘ . • This paper presents the results of a robotic system used for NASA science flights. • Robotic system autonomously tracks the Moon to obtain lunar spectral measurements. • Information is used by NASA and NIST to calibrate Earth-observing satellites. • Operates in extremely low pressures and temperatures at an altitude of 21 km. • Capable of targeting the Moon with a root mean squared error under 0.11 degrees. [ABSTRACT FROM AUTHOR]

Ice streams provide a fundamental control on ice sheet discharge and depositional patterns along glaciated margins. This paper investigates ancient ice streams by presenting the first 3D seismic geomorphological analysis of a major glacigenic succession offshore Greenland. In Melville Bugt, northwest Greenland, six sets of landforms (five buried and one on the seafloor) have been interpreted as mega-scale glacial lineations (MSGLs) that provide evidence for extensive ice streams on outer palaeo-shelves. A gradual change in mean MSGL orientation and associated depocentres through time suggests that the palaeo-ice flow and sediment transport pathways migrated in response to the evolving submarine topography through each glacial–interglacial cycle. The stratigraphy and available chronology show that the MSGLs are confined to separate stratigraphic units and were most likely formed after the onset of the Middle Pleistocene Transition at ∼1.3 Ma. The MSGL record in Melville Bugt suggests that since ∼1.3 Ma, ice streams have regularly advanced across the continental shelf during glacial stages. High-resolution buried 3D landform records such as these have not been previously observed anywhere on the Greenland continental shelf margin and provide a crucial benchmark for testing how accurately numerical models are able to recreate past configurations of the Greenland Ice Sheet. [ABSTRACT FROM AUTHOR]

Introduction: Current methods of intraoperative margin assessment in breast conserving surgery are impractical, unreliable, or time consuming. We hypothesized that intraoperative near-infrared (NIR) imaging with an FDA-approved NIR optical contrast agent could identify canine mammary tumors, a spontaneous large animal model of human breast cancer, during surgery. Methods: Dogs with mammary tumors underwent a standard of care lumpectomy or mastectomy with wide surgical margins 20 hours after indocyanine green administration (3 mg/kg IV). During surgery, NIR imaging was performed on tumors and wound margins in situ and tumors and lymph nodes ex vivo. Following resection, the wound bed was examined for residual fluorescence. Fluorescence intensity was determined by signal-to-background ratio (SBR). All tumors, areas of residual fluorescence, and lymph nodes underwent histopathologic analysis. Results: There were 41 mammary tumors in 16 female dogs. Twenty tumors were malignant and 21 were benign. Twenty-eight tumors were fluorescent (mean SBR 1.5±0.2). Sensitivity of fluorescence for all malignant tumors was 80% (16/20) and 93.3% (14/15) for malignant tumors > 2 cm. Specificity for malignancy was low (< 2cm = 55%; > 2cm = 30%). Tumors > 2 cm were more likely to be fluorescent (OR 6.05, 95% CI 1.50–24.44, P = 0.011) but not more likely to be malignant (OR 3.09, 95% CI 0.86–11.14, P = 0.085) than tumors ≤ 2 cm. Four out of seven inguinal lymph nodes excised in the mastectomy specimen fluoresced. All four drained malignant tumors; however only 2/4 contained metastatic disease. Conclusion: Systemic ICG accumulates reliably in malignant canine mammary tumors > 2 cm. Although no tumor margins fluoresced, a wider margin of normal tissue is removed in canine mastectomy, making direct comparisons with breast conserving surgery difficult. Targeted NIR imaging agents are likely required to improve detection of smaller tumors and improve the specificity of NIR imaging for residual disease and metastatic lymph node detection. [ABSTRACT FROM AUTHOR]

This paper presents a robust, fault tolerant, tube-based nonlinear model predictive controller for systems with additive external disturbances and actuator faults. The design exploits the sliding mode control design embedded in the auxiliary controller to create a lumped disturbance upper bound that represents the worst-case contribution of both faults and disturbances. In this way, the proposed design is shown to maintain robust control invariance in the presence of both forms of uncertainty. The design is expanded in two ways which utilize a double boundary layer for the sliding surface to create a blended tube design, permitting the control to take advantage of disturbance-based and lumped disturbance-based tubes. The proposed designs are implemented on the attitude control of a nanosatellite system in both simulation and experimentation, where performance is evaluated with average root mean square values on the attitude and input variables. Simulation results reveal the proposed fault-tolerant technique maintains robust control invariance in the presence of faults, unlike its nominal counterpart. Additionally, use of a double boundary layer and blended tube significantly improved tracking performance at little increase in control effort while still maintaining robust control invariance. Experimental results establish the validity of the fault-tolerant technique in practice on a model nanosatellite. [ABSTRACT FROM AUTHOR]

Background: Near-infrared (NIR) imaging using the second time window of indocyanine green (ICG) allows localization of pulmonary, pleural, and mediastinal malignancies during surgery. Based on empirical evidence, we hypothesized that different histologic tumor types fluoresce optimally at different ICG doses.Study Design: Patients with thoracic tumors biopsy-proven or suspicious for malignancy were enrolled in an NIR imaging clinical trial. Patients received a range of ICG doses 1 day before surgery: 1 mg/kg (n = 8), 2 mg/kg (n = 8), 3 mg/kg (n = 13), 4 mg/kg (n = 8), and 5 mg/kg (n = 8). Intraoperatively, NIR imaging was performed. The endpoint was to identify the highest tumor-to-background fluorescence ratio (TBR) for each tumor type at each dose. Final pathology confirmed tumor histology.Results: Of 45 patients, 41 had malignancies (18 non-small cell lung cancers [NSCLC], 3 pulmonary neuroendocrine tumors, 13 thoracic metastases, 4 thymomas, 3 mesotheliomas). At doses of 4 to 5 mg/kg, the TBR from primary NSCLC vs other malignancies was no different (2.70 vs 3.21, p = 1.00). At doses of 1 to 3 mg/kg, the TBR was greater for the NSCLCs (3.19 vs 1.49, p = 0.0006). Background fluorescence from the heart or ribs was observed in 1 of 16 cases at 1 to 2 mg/kg, 5 of 13 cases at 3 mg/kg, and 14 of 16 cases at 4 to 5 mg/kg; this was a major determinant of dose optimization.Conclusions: This is the first study to demonstrate that the optimal NIR contrast agent dose varies by tumor histology. Lower dose ICG (2 to 3 mg/kg) is superior for nonprimary lung cancers, and high dose ICG (4 to 5 mg/kg) is superior for lung cancers. This will have major implications as more intraoperative imaging trials surface in other specialties, will significantly reduce costs and may facilitate wider application. [ABSTRACT FROM AUTHOR]

The article cites a research study that reports on geometries of Early Pleistocene ice sheets in northwest Europe. It presents a multiproxy data set for the North Sea, which demonstrates spatially extensive glaciation of the basin from the earliest Pleistocene from 2.5 million years ago. Ice sheets repeatedly entered the North Sea and subsequently grounded in the center of the basin.

Pulmonary metastasectomy for osteosarcoma provides a select group of patients an opportunity for long-term survival and possible cure. Unfortunately, a complete metastasectomy is challenging due an inability to accurately identify lesions that lay below the threshold of preoperative imaging or intraoperative visual and tactile inspection. Growing evidence suggests that osteosarcomas express a number of unique molecular markers, including the folate receptor alpha. In this case report, we describe the application of a folate receptor-targeted, near-infrared optical contrast agent (OTL38) to improve osteosarcoma localization during minimally invasive pulmonary resection. In addition to localizing preoperatively identified lesions, this technology helped identify additional disease that was undetected on preoperative imaging or with traditional intraoperative techniques. This report marks the first successful utilization of a molecular imaging probe useful for osteosarcomas. This technology may provide a unique approach to improve pulmonary metastasectomy of osteosarcomas. [ABSTRACT FROM AUTHOR]

Contemporary climate change has resulted in great uncertainty in how glaciers and ice sheets around the Earth might evolve. It has long been appreciated that the contemporary West Antarctic Ice Sheet (WAIS) shares many similarities with the former Barents Sea Ice Sheet (BSIS). Therefore, an increasing number of studies have sought to investigate the Barents Sea glacial record to better understand marine-based glaciation. This paper reports the analysis of a new high-resolution bathymetric survey covering ~ 55,000 km 2 in the central Barents Sea. The relative chronologies of newly-mapped glacial landforms such as mega-scale glacial lineations, grounding-zone wedges, moraines, and crevasse-squeeze ridges are used to reconstruct the ice sheet dynamics in the central Barents Sea. Our results show that the ice sheet responded dynamically with different periods of retreat, advance, and stagnation observed. These new landform records have been integrated with other geomorphological records in order to reconstruct the retreat pattern of the BSIS between 17–14 ka, when the Fennoscandian Ice Sheet is thought to have uncoupled from the BSIS. Our data shows that the dynamic drawdown of the ice sheet saddle by ice streams was probably the primary mechanism in separating the two ice sheets. After the ice sheets uncoupled, the BSIS is shown to have retreated episodically with several periods of relative stability. Geomorphological records such as those from the BSIS can be used to constrain ice sheet modelling and will help to develop a clearer understanding of marine-based glaciation and the role of ice streams in driving ice sheet evolution. [ABSTRACT FROM AUTHOR]

Glaciation in the Southern Hemisphere is limited by the availability of land from which to seed ice sheets. The extents of the Antarctic, Patagonian, and New Zealand Ice Sheets at the Last Glacial Maximum (LGM) are relatively well known, although the rates and styles of their retreat after the LGM are poorly constrained, particularly in Antarctica. Offshore records of glaciation are relatively sparse in the Southern Hemisphere despite the potential ocean-climate insights that can be gained from records of glaciation that are preserved offshore. In this study, we document the occurrence of iceberg scours and accompanying pits within the North Falkland Basin (c. 50° S) and discuss their origin. The cross-sectional shapes of scours are u- to v-shaped and occur in present-day water depths of 280 to 460 m. Individual scours are up to 38 km long, 1 km wide, and up to ~ 10 m deep. The scours are observed as erosional linear to curvilinear depressions, showing only one point of contact between the iceberg and seafloor, often with raised berms, composed of excavated material, identified either side of the main depression. Undulating width of scours is interpreted as an effect of rotation of the iceberg keel during scour excavation. The elongate morphology of the scours differentiates them from asymmetrical pits, interpreted to represent iceberg impact pits, and symmetrical pockmarks, interpreted to form due to fluid expulsion. In cross-section the differentiation is highly interpretative, but the 3D bathymetric expression is unequivocal. The sinusoidal character of the scours suggests the interaction between local tidal currents and the East Falkland/Malvinas Currents in the North Falkland Basin at the time of formation. Offshore and onshore landscape analysis is used to determine potential sources of icebergs and suggests that they were most likely sourced from the Antarctic Peninsula. These results inform our understanding of Southern Hemisphere ocean-climate interactions during the last glacial cycle and suggest that the East Falklands/Malvinas Current, a key current in the Southern Hemisphere bringing cold, low-salinity Antarctic-derived waters into the South Atlantic, was in operation during the last glacial cycle. The accumulation of icebergs west of the Falkland Islands would also result in further cooling from fresh, meltwater perturbations, enhancing the development of a potential ice-bridge along the Argentinian coast. [ABSTRACT FROM AUTHOR]

Glomus tumors are rare neoplasms that typically occur within the dermis or subcutis of the subungual space. Primary glomus tumors of the thorax are exceedingly uncommon, thus standard-of-care management is lacking. In this report we describe the management of a patient presenting with a symptomatic glomus tumor of the posterior trachea, and provide a comprehensive review including all documented tracheal glomus tumor reports. [ABSTRACT FROM AUTHOR]

Sarcomas are rare malignancies that are generally treated with multimodal therapy protocols incorporating complete local resection, chemotherapy and radiation. Unfortunately, even with this aggressive approach, local recurrences are common. Near-infrared intraoperative imaging is a novel technology that provides real-time visual feedback that can improve identification of disease during resection. The presented study describes utilization of a near-infrared agent (indocyanine green) during resection of an anterior mediastinal sarcoma. Real-time fluorescent feedback provided visual information that helped the surgeon during tumor localization, margin assessment and dissection from mediastinal structures. This rapidly evolving technology may prove useful in patients with primary sarcomas arising from other locations or with other mediastinal neoplasms. [ABSTRACT FROM AUTHOR]

Background: During minimally invasive pulmonary resection, both limited visualization and tactile feedback can make localization of pulmonary nodules and assessment for synchronous disease challenging. Intraoperative molecular imaging is an emerging technology that can enhance a surgeon's ability to detect cancers at the time of resection.Case Presentation: In this report, we describe the application of a folate receptor-targeted, near infrared optical contrast agent (OTL38) for the detection of an invasive pulmonary adenocarcinoma. During molecular imaging, an otherwise undetectable synchronous nodule was also identified. This finding resulted in intraoperative upstaging and operative plan modifications.Conclusion: This report marks the first successful utilization of a targeted, near infrared intraoperative molecular imaging probe useful for thoracic malignancies. This rapidly evolving technology may enhance the surgeon's ability to perform a number of oncologic procedures including tumor localization, margin assessment and intraoperative staging. [ABSTRACT FROM AUTHOR]

L8047 --> 961.11 --> BACKGROUND: Caffeine and creatine nitrate are two purported supplements that may alter cognitive function. The primary purpose was to examine the impacts of each supplement ingested individually and co‐ingested on cognitive performance. A secondary purpose was to explore the effects of caffeine and creatine nitrate alone and co‐ingested on subjective feelings of readiness and sleep quality. METHODS: In a double‐blind, randomized, placebo‐controlled cross over study, 12 resistance‐trained participants (22±1 y; 180.0±9.5 cm; 85.9±15.1 kg) completed 4 conditions in random order: creatine nitrate (CN: 5 g/day + 0.675 g/day of maltodextrin), caffeine (CAF: 400 mg/day + 5 g/day of maltodextrin), CN+CAF (5 g/day of creatine nitrate + 400 mg/day of caffeine), and placebo (PL: 5.4 g/day of maltodextrin). Supplements were ingested for 7 days with a 7‐day washout period between conditions. Before and after supplementation, participants completed a Stroop color‐word test, in addition to a readiness to perform a visual analog scale and a sleep quality questionnaire (sleep latency and duration). The readiness to perform the questionnaire assessed sleep, vigor, optimism, energy, appetite, and soreness. Data were analyzed using a two‐way (within‐within) analysis of variance (p≤0.05) with a Tukey's post hoc when appropriate. RESULTS: There was a significant interaction for the Stroop color‐word interference (p=0.049), with the post hoc revealing that CN+CAF was superior to CN alone (CN+CAF: 65.9 ± 17.3; CN: 56.8 ± 10.8, p=0.007); however, no other conditions were significantly different. There was no interaction or main effects for the readiness to perform questionnaire or sleep quality (p>0.05). CONCLUSION: CAF+CN appears to be superior for cognitive performance compared to CN alone. Overall, neither supplement ingested individually or together altered subjective readiness to perform or sleep quality. [ABSTRACT FROM AUTHOR]

Malignant pleural mesothelioma is a deadly disease. Complete surgical resection provides patients with the best opportunity for long-term survival. Unfortunately, identification of disease during resection can be challenging. In this report, we describe successful intraoperative utilization of the near-infrared imaging agent, indocyanine green, to help the surgeon identify malignant disease in a patient with malignant pleural mesothelioma who had previously received neoadjuvant chemotherapy. This technology may ultimately enhance the thoracic surgeon’s ability to identify small disease deposits at the time of resection. [ABSTRACT FROM AUTHOR]

Self organization is invoked as a paradigm to explore the processes governing the evolution of shear flows. By examining the probability density function (PDF) of the local flow gradient (shear), we show that shear flows reach a quasi-equilibrium state as its growth of shear is balanced by shear relaxation. Specifically, the PDFs of the local shear are calculated numerically and analytically in reduced 1D and 0D models, where the PDFs are shown to converge to a bimodal distribution in the case of finite correlated temporal forcing. This bimodal PDF is then shown to be reproduced in nonlinear simulation of 2D hydrodynamic turbulence. Furthermore, the bimodal PDF is demonstrated to result from a self-organizing shear flow with linear profile. Similar bimodal structure and linear profile of the shear flow are observed in gulf stream, suggesting self-organization. [ABSTRACT FROM AUTHOR]

Turbulence regulation by large-scale shear flows is crucial for a predictive modeling of transport in plasma. In this paper the suppression of turbulent transport by large-scale flows is studied numerically by measuring the turbulent diffusion Dt and scalar amplitude of decaying passive scalar fields n′ advected by various turbulent flows. Both uniform flows and shear flows are shown to suppress turbulence causing the quenching in transport and turbulence amplitude. The uniform flows U0=Λy with the advection rate Λ in the case of a finite correlated forcing with τF=1 gives rise to the advection/sweeping effect which suppresses Dt, and as ∝Λ-2 for Λ>>τF-1. In contrast, no influence of the uniform flow is found in the case of a short correlated forcing τF→0 due to Galilean invariance. For the shear flow U0=Ωsinxy (Ω= constant shearing rate) with the appropriate choice of the forcing (τF→0) the nature of transport suppression is shown to crucially depend on the properties of the turbulence. Specifically, for prescribed turbulence with a short correlation time τc=τF<Ω-1, the turbulence statistics scale as Dt∝Ω-0.02, ∝Ω-0.62 and cross-phase cosθ∝Ω0.29. For consistently evolved turbulence with a finite correlation time τc≥Ω-1, turbulence statistics are suppressed more strongly as Dt∝Ω-1.75, ∝Ω-2.41, ∝Ω-0.65 and <ω′2>∝Ω-0.50. A novel renormalization scheme is then introduced to rescale our results into the regime within which the kinetic energy and enstrophy are unchanged by shear flow. This allows our numerical results to closely match previous analytical predictions [E. Kim, Mod. Phys. Lett. B 18, 1 (2004)] and to understand different experimental scalings observed in laboratory plasmas. Furthermore, Dt is found to be related to by ∝Dt/DΩ, where DΩ∝Ω2/3 is the shear accelerated diffusion of n′ with an interesting scaling cosθ∝DtDΩ. [ABSTRACT FROM AUTHOR]

This article draws on a recent study that examined the impact of target hardening on domestic burglary in the City of Liverpool, England, between July 2005 and December 2007. Individual property-level data, from a range of sources, were collated for each residential property in the City enabling details about burglaries (timing, location, modus operandi) to be linked to data on the nature, timing, and location of target-hardening activity. Properties were grouped according to the presence or absence of burglary and/or target hardening at each address and the sequence of events. Groups included properties burgled, target hardened, and not subsequently burgled; no prior burglary, target hardened, subsequent burglary; burgled, never target hardened, and other combinations. The results suggest that property-level data give a richer picture of the relationship between burglary and target hardening than is possible using aggregate data at an area level. [ABSTRACT FROM AUTHOR]

The effect of oscillatory shear flows on turbulent transport of passive scalar fields is studied by numerical computations based on the results provided by E. Kim [Physics of Plasmas 13, 022308 (2006)]. Turbulent diffusion is found to depend crucially on the competition between suppression due to shearing and enhancement due to resonances, depending on the characteristic time and length scales of shear flow and turbulence. Enhancements in transport occur for turbulence with finite memory time either due to Doppler or parametric resonances. Scalings of turbulence amplitude and transport are provided in different parameter spaces. The results suggest that oscillatory shear flows are not only less efficient in regulating turbulence, but also can enhance the value of turbulent diffusion, accelerating turbulent transport. [ABSTRACT FROM AUTHOR]

The article introduces the foundations of patent law, which includes the history of the willful infringement doctrine, the duty of due care and the origin of the adverse inference doctrine. In addition, it addresses the Knorr-Bremse Systeme Fuer Nutzfahrzeuge GmbH versus Dana Corp. case decision. It also describes the practical effect of the case as well as dicusses the impact and complications of the Patent Reform Act of 2005. Lastly, the paper then proposes solutions for patent reform.

Large knots (>100 individuals) of adult horsehair worms (Gordius difficilis) were collected in several spring-fed habitats in Wisconsin and Minnesota. These aggregations were dominated numerically by males. Although distributions of length and diameter of males and females overlapped, females tended to be significantly longer and wider than males. Moreover, at any given length, females were wider than males. These findings confirm and add statistical support to previously published reports. [ABSTRACT FROM AUTHOR]

3D seismic reflection data have been used to map 784 enigmatic ridge-furrow structures in water depths of 0.8–1.7 km offshore Angola. The structures are characterised by asymmetric ridges with intervening furrows, typically <0.5–5.5 km long, with a sinuous to bifurcating planform. The furrows are well-imaged on seismic profiles, and range from 60 to 80 m in width, up to 10 m in amplitude, and 0.1–1 km in wavelength. The furrow sets aggrade in a downslope direction and occur in arrays that have an internally consistent direction that is either parallel, or slightly diverging or converging. Two alternative origins are considered: (1) furrows that are dominantly erosional scours formed from seafloor-incising currents flowing parallel to the furrows, with the ridges a by-product of the erosion, or (2) the ridge-furrows are bottom-current generated dune-type sediment waves. The latter interpretation allows us to reconstruct a key component of the deepwater bottom-currents regime along this continental margin from the Middle Pleistocene to the present-day. The most likely transport agent responsible for the interpreted sediment waves is a palaeo-bottom-current regime with a flow direction toward the west-southwest/south-southwest, the same direction of the sediment wave migration. The palaeo-bottom currents would then be expected to have a very specific flow regime with 1 < Fr max < 2 and may originate from longshore currents cascading off the shelf, Congo Canyon distal overflows, breaking internal waves or a combination of these processes. [ABSTRACT FROM AUTHOR]

Trough mouth fans on glaciated margins are a common sedimentary feature that contain a record of ice sheet advance and retreat across the continental shelf. This study uses 2D and 3D seismic reflection data across the Melville Bugt Trough Mouth Fan (MB-TMF), offshore northwest Greenland, to document its stratigraphic architecture, glacigenic landforms, and marine deposits. The MB-TMF stratigraphy is characterised by rapid progradation of the continental shelf (over 100 km since ∼2.7 Ma) and heterogeneous truncation or subsidence of topset strata. The variable topset character relates to the repeated growth and retreat of the Greenland Ice Sheet across the shelf since ∼2.7 Ma. Seismic geomorphology and facies analysis of the prograding clinoforms show repeated sequences of debris flow deposits and gullies that are taken to infer gravity-driven processes and the presence of meltwater-related hyperpycnal flows in areas proximal to the ice sheet on the outer shelf. Several sets of mega-scale glacial lineations confirm the presence and flow pathways of successive ice streams since ∼1.3 Ma. Evolution of the MB-TMF can be summarised into four stages that were controlled by variations in ice sheet erosion, topographic forcing of ice stream flow, and changes in accommodation related to glacigenic deposition and tectonic subsidence. These results show that during the Middle Pleistocene Transition there is an apparent switch from a meltwater-dominated depositional regime, to one with greater emplacement of materials by ice directly at the palaeo-shelf edge. These results provide significant new detail about the large-scale glacigenic and marine depositional processes during the repeated fluctuations of the northwest Greenland Ice Sheet into Melville Bugt since ∼2.7 Ma. • First seismic geomorphology study across the Melville Bugt Trough Mouth Fan. • Glacial lineations, gullies, grounding-zone wedges and iceberg scours documented. • Landforms and stratigraphy reveal changes in ice sheet evolution since ∼2.7 Ma. [ABSTRACT FROM AUTHOR]

Ice low-switching, which can involve changes in ice flow velocity and direction, is crucial to a full understanding of ice masses and their response to climate change. A topographically controlled ice flow switch near a glacier margin was recently documented at Breiðamerkurjökull, southeast Iceland, where the central flow unit migrated eastward in response to variations in subglacial topography and the influence of Jökulsárlón glacial lagoon. This site provides an opportunity to study the geomorphic response to ice-margin reconfiguration. Investigating contemporary processes can offer valuable insights into analogous landforms created during the deglaciation of palaeo-ice sheets. The landform assemblage and topographic setting of our Icelandic study site is compared to a palaeo-example from Alberta, Canada, which was once covered by the Laurentide ice sheet. Uncrewed aerial vehicle-(UAV) derived data was used to assess the geomorphic response to this switching and related processes across a 1.5 km2 area of the central flow unit which deglaciated between 2010 and 2023. From 2010 to 2017, the landscape featured streamlined subglacial material, a stable subglacial esker system and proglacial lakes (Landsystem A), shifting to a spillway-dominated system between 2018 and 2023 (Landsystem B). Since 2018 this section of Breiðamerkurjökull has been retreating across a reverse slope bed, resulting in the formation of quasi-annual ice-marginal spillways. Meltwater impoundment at the ice margin, formed ice-contact lakes which eventually initiated ice-margin parallel spillways draining proglacial meltwater along the local land-surface gradient, towards Jökulsárlón. As the ice retreats, an ice-contact lake forms again at the new margin and initiates the erosion of the next ice-marginal spillway. The geomorphological signature demonstrates how subglacial topography and ice-flow switching can significantly influence ice and meltwater dynamics. Since the glacier flow-switch, part of the central unit is now lake-terminating with areas of the margin evolving into a stagnant system, as it is now cut off from the accumulation centre. Therefore, Landsystem B could be analogous to regions of ice stream shut down and where ice masses retreated across reverse slope beds. For example, the Pakowki Lake region of Southeastern Alberta displays a similar landform assemblage and is presented as a palaeo-example in this work. Such insights are important for assessing the efficacy of numerical models in reconstructing the finer scale dynamics of past ice sheets during retreat. • Landform mapping at Breiðamerkurjökull (Iceland) from UAV-derived data reveals two distinct landform assemblages. • Landsystem A (2010-2017): flat subglacial bed, subglacial eskers and proglacial lakes. • Landsystem B (2018-2023): reverse slope bed and ice-marginal spillways. • Landsystem B is analogous to SE Alberta, providing support for existing spillway reconstructions in the region. • The geomorphic response highlights the significance of subglacial topography on ice and meltwater dynamics. [ABSTRACT FROM AUTHOR]

The potential sea-level equivalent of the Greenland Ice Sheet (~7 m) has led to an ever-increasing interest in how the ice sheet has responded to warmer temperatures in the geological past. This has resulted in contrasting models where Greenland is thought to have been both nearly ice-free and persistently ice-covered. This contradiction is due to a lack of long-term geological or ice core records that go significantly beyond the last glacial cycle. Much of the Greenland margin is composed of thick sedimentary successions, including km-thick glaciogenic wedges. In this work, we first used a grid of high-quality 2D seismic reflection data offshore northwest Greenland to develop a large-scale model for the glaciogenic evolution of the Melville Bugt and Upernavik Trough Mouth Fans (TMF). This is constrained by a simple age model and provides insight into a major glacial outlet from the northwestern Greenland Ice Sheet over the last 2.7 million years. A number of progradational units are separated by onlapping surfaces that record eleven major cycles of ice sheet advance to the (palaeo-) shelf edge and subsequent retreat. The large-scale sedimentary architecture indicates that prior to the Middle Pleistocene Transition (MPT) deposition was evenly distributed along strike. After this, during the MPT, the depositional pattern was replaced by focusing and separation into two individual ice stream flows through the two contemporary cross-shelf troughs. This likely indicates a change in ice sheet geometry and dynamics through the MPT. In the second part of this study we investigated 3D seismic reflection data from the Melville Bugt TMF that capture ice sheet history through and after the MPT. Seismic geomorphological analysis provided further support for the transition to focused ice stream flow with the observation of five sets of buried mega-scale glacial lineations (MSGL). These landforms are indicative of ice streaming and demonstrate marine-based glaciation, palaeo-ice flow, and sediment transport pathways prior to the last glacial cycle. The age model suggests that the MSGL were formed during several glacial stages since the onset of the MPT. These observations provide the first 3D evidence for ice stream landforms anywhere along the Greenland continental margin prior to the Last Glacial Maximum. Such records supplement limited proxy data and are essential for constraining the spatio-temporal configuration and longevity of the Greenland Ice Sheet. [ABSTRACT FROM AUTHOR]

Background: The management of most solid tumors of the anterior mediastinum involves complete resection. Because of their location near mediastinal structures, wide resection is not possible; therefore, surgeons must use subjective visual and tactile cues to determine disease extent. This clinical trial explored intraoperative near-infrared (NIR) imaging as an approach to improving tumor delineation during mediastinal tumor resection.Methods: Twenty-five subjects with anterior mediastinal lesions suspicious for malignancy were enrolled in an open-label feasibility trial. Subjects were administered indocyanine green (ICG) at a dose of 5 mg/kg, 24 hours before resection (via a technique called TumorGlow). The NIR imaging systems included Artemis (Quest, Middenmeer, the Netherlands) and Iridium (VisionSense Corp, Philadelphia, Pennsylvania). Intratumoral ICG uptake was evaluated. The clinical value was determined via an assessment of the ability of NIR imaging to detect phrenic nerve involvement or incomplete resection. Clinical and histopathologic variables were analyzed to determine predictors of tumor fluorescence.Results: No drug-related toxicity was observed. Optical imaging added a mean of 10 minutes to case duration. Among the subjects with solid tumors, 19 of 20 accumulated ICG. Fluorescent tumors included thymomas (n = 13), thymic carcinomas (n = 4), and liposarcomas (n = 2). NIR feedback improved phrenic nerve dissection (n = 4) and identified residual disease (n = 2). There were no false-positives or false-negatives. ICG preferentially accumulated in solid tumors; this was independent of clinical and pathologic variables.Conclusions: NIR imaging for anterior mediastinal neoplasms is safe and feasible. This technology may provide a real-time tool capable of determining tumor extent and specifically identify phrenic nerve involvement and residual disease. [ABSTRACT FROM AUTHOR]

Objective: To assess whether discharging patients early after radical cystectomy (RC) is associated with an increased risk of readmission and post‐discharge complications. Materials and Methods: The National Surgical Quality Improvement Program database was queried to identify patients who underwent an elective RC from 2012 to 2015. Patients were stratified into two groups: those with a length of hospital stay (LOS) of 4–5 days (early‐discharge group) and those with an LOS of 6–9 days (routine‐discharge group). We used multivariable logistic regression analyses to assess the impact of early discharge on 30‐day readmission and post‐discharge complication rates. Sensitivity analyses and subgroup analyses were performed to validate the robustness of our primary analyses. Results: A total of 3 311 patients were included. Unadjusted outcomes comparison showed no difference in readmission rate (21.6% vs 23.0%) or post‐discharge complication rate (17.7% vs 19.6%) between the early‐discharge and the routine‐discharge group. Multivariable logistic regression also showed that early discharge was not associated with increased odds of readmission (odds ratio [OR] 1.00, 95% confidence interval [CI] 0.82–1.22; P = 1.000) or post‐discharge complications (OR 0.95, 95% CI 0.77–1.17; P = 0.616). Two‐step sensitivity analyses (excluding patients with LOS of 8–9 days, followed by patients with any pre‐discharge adverse event) validated the robustness of our primary analyses. Subgroup analyses also yielded similar results in all subgroups except for the subgroup of patients aged ≥85 years. Conclusions: Early discharge after RC was not associated with increased readmissions or post‐discharge complications. Future prospective studies, with defined peri‐operative care pathways, are needed to identify potential components that may enable hospitals to discharge patients early without compromising post‐discharge outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Intraoperative molecular imaging (IMI) is an emerging technology used to locate pulmonary adenocarcinomas and identify positive margins during surgery. Background noise and tissue autofluorescence have been major obstacles. The goal of this study is to optimize the image quality of folate receptor alpha (FRα) targeted IMI for pulmonary adenocarcinomas by modifying emission data.Procedures: A total of 15 lung cancer patients were enrolled in a pilot study. In the first cohort, FRα upregulation within pulmonary adenocarcinoma tumors was confirmed by analyzing specimens from five pulmonary adenocarcinoma patients with flow cytometry and immunohistochemistry. Next, in a cohort of five additional patients, autofluorescence of intrathoracic structures and tissues was quantified. Lastly, five patients with tumors at various depths from the pleural surface were enrolled and received the FRα-targeted optical contrast agent, EC17. In this final cohort, resected pulmonary adenocarcinomas were imaged at a wide range of fluorescence exposure times (0 to 200 ms), various laser powers, and with unique filter configurations. Tumor-to-noise ratio (TNR) for images was generated using region of interest software.Results: Pulmonary adenocarcinomas highly express FRα. Significant autofluorescence from native thoracic tissues was found with the highest fluorescent signals at the bronchial stump (547 ± 98, range 423-699), the pulmonary artery (267 ± 64, range 200-374), and cortical bone (266 ± 17, range 243-287). High levels of autofluorescence were appreciated after systemic administration of EC17; however, TNR was improved by altering exposure settings at the time of the imaging. Optimal fluorescent exposure time occurs at 40 ms (25 frames/s).Conclusions: Exposure properties can be manipulated to maximize TNR thus allowing for successful intraoperative detection of pulmonary adenocarcinomas during surgery. Optimization of the conditions for intraoperative molecular imaging sets the stage for future clinical trials utilizing targeted IMI techniques which can aid the surgeon at the time of cancer resection. [ABSTRACT FROM AUTHOR]

We present a comprehensive investigation into the effect of choosing the stochastic control parameters in a simplified-Parker dynamo model. Through considering the manifold of marginal stability, i.e., the region of parameter space where the mean growth rate is zero, we show that stochastic fluctuations are not prohibitive to dynamo. Furthermore, by directly comparing results obtained by periodic and Gaussian coloured noise alpha with identical characteristic time-scales and fluctuating amplitudes, we find that the transition to dynamo is significantly eased for stochastically fluctuating alpha. The effect of stochasticity in magnetic diffusion is also investigated, highlighting the importance of resonance between poloidal and toroidal magnetic fields on the growth rate. Furthermore, we show that probability density functions of the growth-rate, magnetic field, and magnetic energy can provide a wealth of useful information regarding the dynamo behaviour/intermittency. Finally, the statistical properties of the dynamo such as temporal correlation and fluctuating amplitude are found to be dependent on the distribution of the fluctuations in stocastic parameters. [ABSTRACT FROM AUTHOR]

Reports there are no signs of movement on negotiations on a new contract for non-consultant career grade doctors in emergency medicine. Poor response to a recent mail campaign to advertise the annual conference of the FASSGEM and concerns about the small numbers of overall members; Call for participation by non-consultants to increase their voice on relevant issues; Where to get details on the upcoming convention; List of regional representative contacts.

Background Splenectomy is indicated for selected patients with lymphoid neoplasms. We examined surgical morbidity and mortality in this high-risk patient population using a contemporary national cohort, with attention to hospitalization status before surgery. Materials and methods The American College of Surgeons National Surgical Quality Improvement Program database (2005-2013) was queried for patients with lymphoid malignancies undergoing splenectomy. Stepwise statistical analyses were performed to identify factors associated with increased risk of death and serious morbidity (DSM). A risk scoring system was developed to predict DSM. Results In 456 patients, morbidity rate was 24.1%, and mortality rate was 2.4%. Albumin <3 g/dL (odds ratio [OR] = 2.6, P = 0.005), hematocrit <30% (OR = 2.8, P < 0.0001), and a history of chronic obstructive pulmonary disease (OR = 3.4 P = 0.009) were independent predictors of DSM. Rates of DSM were stratified by these risk factors (RFs): 13.5% (0 RF), 34.4% (1 RF), and 58.5% (2-3 RF), P < 0.0001. Patients admitted before surgery (IP) were more likely to have RF compared with those undergoing surgery on the day of admission (SDS); 74.6 versus 26.4%, P < 0.001. Morbidity (39.7% versus 18.2%, P < 0.0001) and mortality (7.1% versus 0.6%, P < 0.0001) were significantly increased in the IP group. Conclusions Splenectomy for lymphoid neoplasm in hospitalized patients is associated with substantial morbidity and mortality. Risk stratification in this group may aid in perioperative management to mitigate DSM. [ABSTRACT FROM AUTHOR]

L8089 --> 961.4 --> Caffeine and creatine nitrate are two commonly used ergogenic aids purported to augment resistance and anaerobic performance; however, the safety profile of these supplements co‐ingested is unknown. The purpose was to examine the effects of caffeine and creatine nitrate alone and co‐ingested on several biochemical blood markers (creatine kinase, lactate dehydrogenase, cholesterol, alanine aminotransferase, aspartate transaminase, alkaline phosphatase, white blood cells, lymphocytes, red blood cells, hematocrit, and hemoglobin), resting heart rate and blood pressure, and self‐reported side effects. METHODS: In a double‐blind, randomized, placebo‐controlled cross over study, 12 resistance‐trained participants (22±1 y; 180.0±9.5 cm; 85.9±15.1 kg) completed 4 conditions in random order: creatine nitrate (CN: 5 g/day + 0.675 g/day of maltodextrin), caffeine (CAF: 400 mg/day + 5 g/day of maltodextrin), CN+CAF (5 g/day of creatine nitrate + 400 mg/day of caffeine), and placebo (PL: 5.4 g/day of maltodextrin). Supplements were ingested for 7 days with a 7‐day washout period between conditions. Before and after supplementation, participants provided a blood sample collected from the antecubital vein and measured resting heart rate and blood pressure. A standardized side effect questionnaire was also completed following each condition. Data were analyzed using a two‐way (within‐within) analysis of variance (p≤0.05) with a Tukey's post hoc when appropriate. For side effects, a chi‐squared non‐parametric test was used. RESULTS: There was no interaction or main effects for all blood parameters (p>0.05). Resting heart rate and blood pressure were also not different between conditions or over time (p>0.05). Lastly, there were no significant differences between conditions for any side effects on the side effect questionnaire (p>0.05). CONCLUSION: Short‐term CAF, CN, and CAF+CN co‐ingestion appears safe for healthy young resistance‐trained participants. [ABSTRACT FROM AUTHOR]

L8033 --> 961.5 --> BACKGROUND: Ingestion of creatine nitrate and caffeine individually improve anaerobic and muscular endurance performance; however, co‐ingestion of creatine nitrate and caffeine remains unclear. METHODS: In a double‐blind, randomized, placebo‐controlled cross over study, 12 resistance‐trained participants (22±1 y; 180.0±9.5 cm; 85.9±15.1 kg) completed 4 conditions in random order: creatine nitrate (CN: 5 g/day + 0.675 g/day of maltodextrin), caffeine (CAF: 400 mg/day + 5 g/day of maltodextrin), CN+CAF (5 g/day of creatine nitrate + 400 mg/day of caffeine), and placebo (PL: 5.4 g/day of maltodextrin). Supplements were ingested for 7 days with a 7‐day washout period between conditions. Before and after supplementation, muscular endurance (bench press and leg press; 3 sets at 70% 1RM) and a Wingate anaerobic test were performed. Peak power (PP), mean power (MP), and fatigue index (FI) were calculated. Data were analyzed using a two‐way (within‐within) analysis of variance (p≤0.05) with a Tukey's post hoc when appropriate. Absolute change (post minus pre‐testing) was calculated and analyzed with a repeated‐measures ANOVA. RESULTS: There was a significant main effect of time for both leg press (p=0.009) and bench press (p<0.001) with post‐testing greater than pre‐testing; however, there were no differences between conditions. For peak power, there was no significant interaction (p=0.436), the main effect of time (p=0.967), or differences between conditions for absolute change (p=0.436). For mean power, there was a significant interaction (p=0.037); however, post hoc analysis revealed no significant pairwise effects; however, absolute change for mean power between conditions was significant (p=0.037), with post hoc analysis revealing a trend (p<0.10) for both CN conditions (CN alone and CN+CAF) to be superior compared to CAF. There were no significant differences between conditions or overtime for fatigue index. CONCLUSION: Short‐term CN and CAF ingested either individually, or co‐ingested could not augment upper or lower body muscular endurance or anaerobic performance compared to PL in resistance‐trained participants. [ABSTRACT FROM AUTHOR]

Upscaling Carbon Capture and Storage requires identification of suitable storage sites, with robust reservoir seals. The Utsira Formation in the northern North Sea has been flagged as a target for further storage. However, there are no regional studies of seal variability addressing heterogeneities that could facilitate seal bypass. This study aims to: (a) identify, assess and map the elements that promote or restrict fluid migration, (b) develop a matrix to regionally map containment confidence (CC) and (c) rank the different areas for CO2 containment across the Utsira Formation. The seal and overburden were mapped using a high‐resolution, pre‐stack depth‐migrated 3D broadband seismic reflection dataset and 141 exploration wells. Seal geometry, sandstone presence and sandstone connectivity in the seal and overburden were assigned relative CC scores, which were summed to map overall CC of the Utsira Fm. Indicators for shallow gas and migration were mapped and correlated with the other elements. Areas with the lowest CC are in the west of the Utsira Fm. Here, sandstones within the Seal Interval are connected through the overburden via sandy submarine fans. In the southeast, dipping stratigraphy downlaps onto the Utsira Fm., increasing the potential for connection with glacially‐derived channel‐lobe systems in the overburden. The areas with the highest CC are the central and northeast parts of the Utsira Fm., where the Seal Interval is mudstone‐dominated and parallel to the reservoir, and channel‐lobe systems identified in the Overburden Interval are disconnected from the reservoir. This area coincides with a thick depocentre of the northern Utsira Fm. These results can be used to inform CO2 storage site selection and constrain future CO2 plume simulation analyses for the Utsira Fm. The CC matrix outlined here can also be adapted and applied to regionally assess the containment of other potential CO2 storage reservoirs in any setting. [ABSTRACT FROM AUTHOR]

An extensive 3D seismic dataset was used to investigate the contemporary hydrocarbon distribution and historical fluid migration in Melville Bay offshore northwest Greenland, providing the first inventory of shallow gas and gas hydrate along this part of the Greenland margin. The shallow gas anomalies vary in seismic character and have been subdivided into four categories that represent (I) isolated shallow gas, (II) free gas trapped at the base of the gas hydrate stability zone (GHSZ), (III) gas charged glacial clinoforms and (IV) a giant mass transport deposit gas reservoir. Gas hydrate deposits have been identified across an area of 537 km2 via the identification of a discontinuous bottom simulating reflector (BSR) that marks the base of the GHSZ. The BSR has been used to estimate a geothermal gradient of 49 °C/km across the GHSZ and a heat flow of 70–90 mW/m2, providing the first publically available heat flow estimates offshore western Greenland. The contemporary hydrocarbon distribution and historical fluid migration is influenced by the underlying paleo-rift topography and multiple shelf edge glaciations since ~2.7 Ma. Continued uplift of the Melville Bay Ridge, as well as glacial-sediment redistribution and basinward margin tilting from isostatic compensation, have led to a concentration of gas within the Cenozoic stratigraphy above the ridge. Furthermore, repeated variations in subsurface conditions during glacial-interglacial cycles likely promoted fluid remigration, and possibly contributed to reservoir leakage and increased fluid migration through faults. The top of the gas hydrate occurrence at 650 m water depth is well below the hydrate-free gas phase boundary (~350 m) for the present bottom-water temperature of 1.5 °C, suggesting this hydrate province mainly adjusted to glacial-interglacial changes by expansion and dissociation at its base and is relatively inert to current levels of global warming. Glacial-related dissociation may have significantly contributed to the numerous free gas accumulations observed below the GHSZ at present day. • The first shallow gas and hydrate deposits have been mapped offshore NW Greenland • Shallow geothermal gradient and heat flow have been estimated across the gas hydrate stability zone • Fluid migration has been influenced by paleo-rift topography and multiple cycles of shelf-edge glaciation • Large water depths make gas hydrate deposits less sensitive to future climate warming [ABSTRACT FROM AUTHOR]

A geohazard assessment workflow is presented that maximizes the use of 3D seismic reflection data to improve the safety and success of offshore scientific drilling. This workflow has been implemented for International Ocean Discovery Program (IODP) Proposal 909 that aims to core seven sites with targets between 300 and 1000 m below seabed across the north-western Greenland continental shelf. This glaciated margin is a frontier petroleum province containing potential drilling hazards that must be avoided during drilling. Modern seismic interpretation techniques are used to identify, map and spatially analyse seismic features that may represent subsurface drilling hazards, such as seabed structures, faults, fluids and challenging lithologies. These hazards are compared against the spatial distribution of stratigraphic targets to guide site selection and minimize risk. The 3D seismic geohazard assessment specifically advanced the proposal by providing a more detailed and spatially extensive understanding of hazard distribution that was used to confidently select eight new site locations, abandon four others and fine-tune sites originally selected using 2D seismic data. Had several of the more challenging areas targeted by this proposal only been covered by 2D seismic data, it is likely that they would have been abandoned, restricting access to stratigraphic targets. The results informed the targeted location of an ultra-high-resolution 2D seismic survey by minimizing acquisition in unnecessary areas, saving valuable resources. With future IODP missions targeting similarly challenging frontier environments where 3D seismic data are available, this workflow provides a template for geohazard assessments that will enhance the success of future scientific drilling. [ABSTRACT FROM AUTHOR]

Purpose: Intraoperative molecular imaging (IMI) utilizes optical dyes that accumulate within tumors to assist with detection during a cancer operation. IMI can detect disease not visualized preoperatively, as well as positive margins. However, these dyes are limited by autofluorescence, signal reflection, and photon-scatter. We hypothesize that a novel dye with a wide separation between excitation and emission spectra, SS180, would help overcome these obstacles.Procedures: Two targeted molecular contrast agents, OTL38 and SS180, were selected for this study. Both dyes had the same targeting ligand to folate receptor alpha (FRα). OTL38, a well-annotated IMI agent in human trials, has a Stokes shift of 22 nm, whereas SS180, the new dye, has a Stokes shift of 129 nm. Cell lines were tested for FRα expression and incubated with dyes to demonstrate receptor-dependent binding. Cells were incubated in various concentrations of the dyes to compare dose- and time-dependent binding. Finally, cells tagged with the dyes were injected subcutaneously in a murine model to estimate tumor burden necessary to generate fluorescent signal.Results: Cellular studies demonstrated that SS180 binds cells in a dose-, receptor-, and time-dependent manner and exhibits higher mean fluorescence intensities by flow cytometry when compared with OTL38 for each time point and concentration. In an in vivo flank tumor model, SS180 had a higher tumor-to-background ratio (TBR) than OTL38, though not statistically significant (p = 0.08). Ex vivo, OTL38 had a higher TBR than SS180 (p = 0.02). The subcutaneous model revealed that SS180 had a higher TBR at 5 × 106 cells than OTL38 (p = 0.05). No toxicity was observed in the animals.Conclusions: SS180 exhibits greater TBRs in vivo, but not ex vivo. These findings suggest that SS180 may have weaker fluorescence, but superior contrast. Studies in large animal models and clinical trials may better elucidate the clinical value of a long Stokes shift. [ABSTRACT FROM AUTHOR]

On the NW Greenland shelf, a gas charged sandy mass transport deposit (MTD) reservoir has been identified that covers an area of 420 km2 above the Melville Bay Ridge rift. The MTD displays landslide characteristics with distinct jigsaw-like mega-blocks that geometrically fit back together. These blocks show clear direct hydrocarbon indicators (DHIs) such as bright 'soft' amplitudes at the top reservoir and velocity push down, suggesting a reservoir composed of gas charged porous sands. Much of this reservoir, however, now exists as distributed reservoir blocks up to 1000 m wide and 80 m thick. The reconstruction of 499 MTD blocks has been completed using a combination of seismic geomorphology and GIS techniques. This process highlighted depositional features such as areas of non-deposition and thicker units containing clinoforms as well as deformation kinematics in the form of block transport paths. The result suggests that primary deposition likely occurred within a shallow marine spit complex that developed along the submarine extension of an emergent ridge axis during the Eocene. Reservoir remobilisation was triggered shortly after original deposition by rejuvenation and a southward tilt of the Melville Bay Ridge, leading to bi-directional sliding and emplacement of reservoir blocks. Sliding occurred slowly, along a low angled (<0.5°) decollement surface with block coherency maintained by intra-formational shales and possibly by early-stage diagenesis. In areas of higher dip such as on the ridge flanks, the sand rich blocks disaggregated and sand was shed down slope into deeper waters and now exist as either canyon fill or basin floor fans in the deeper graben. This MTD provides a high-quality analogue for post-depositional sliding of reservoir facies along decollement surfaces whilst the use of landslide reconstruction provides evidence for the timing and style of basin development, including post-rift tectonic adjustments leading to multi-directional slide emplacement. [ABSTRACT FROM AUTHOR]

Background: With increasing focus on health care quality and cost containment, volume-based referral strategies have been proposed to improve value in high-cost procedures, such as esophagectomy. While the effect of hospital volume on outcomes has been demonstrated, our goal was to evaluate the economic consequences of volume-based referral practices for esophagectomy.Methods: The nationwide inpatient sample (NIS) was queried for the years 2004-2013 for all patients undergoing esophagectomy. Patients were stratified by hospital volume quartile and substratified by preoperative risk and age. Clustered multivariable hierarchical logistic regression analysis was used to assess adjusted costs and mortality.Results: In total, 9270 patients were clustered based on annual hospital volume quartiles of < 7, 7 to 22, 23 to 87, and > 87 esophagectomies. After stratification by patient variables, high-volume centers performed esophagectomies in high-risk patients at the same cost as low-volume centers without significant difference in resource utilization. Overall, mortality decreased across volume quartiles (lowest 8.9 versus highest 3.6%, p < 0.0001). The greatest volume-mortality differences were observed among patients aged between 70 and 80 years (lowest 12.2 versus highest 6.2%, p = 0.009). Patients with high preoperative risk also derived mortality benefits with increasing hospital volume (lowest 17.5 versus highest 11.8%, p < 0.0001).Conclusions: This study demonstrates that the mortality improvements for high-risk patients undergoing esophagectomy at high-volume centers do not come at increased costs. These results suggest that health systems should consider selectively referring high-risk patients to high-volume centers within their region. [ABSTRACT FROM AUTHOR]

Objective: To propose a novel method to perform indocyanine green (ICG) based near-infrared (NIR) fluorescence imaging during pelvic lymph node dissection (PLND) for prostate cancer patients with lymph node metastasis (LNM).Materials and Methods: A prostate cancer cell line PC3 was used to establish xenograft model in NOD/SCID mice. After tumor growth, the mice were injected with ICG through the tail vein. Xenografts and surrounding tissues were imaged with NIR camera 24 hours after intravenous ICG, and tumor-to-background ratios were calculated. We then performed a pilot human study to evaluate the role of NIR imaging in robotic PLND after systemic ICG in 4 patients with prostate cancer and preoperative lymphadenopathy.Results: ICG localized to PC3 xenografts in the mice and all xenografts were highly fluorescent compared with surrounding tissues, with a median tumor-to-background ratio of 2.85 (interquartile range = 2.64-3.90). In the human study, intraoperative in vivo NIR imaging identified 3 of the 4 preoperative lymphadenopathies as fluorescence-positive, and back table ex vivo NIR imaging identified all 4 lymphadenopathies as fluorescence-positive. All the lymphadenopathies were found to be LNMs by pathologic examination. Two of the four cases had additional LNMs, all of which were fluorescence-positive with intraoperative in vivo NIR imaging.Conclusion: Intravenously administered ICG accumulates in prostate cancers in both a murine model and human patients. NIR fluorescence based on intravenous ICG may serve as a useful tool to facilitate the identification of positive nodes during PLND in patients with higher risk of LNMs. [ABSTRACT FROM AUTHOR]

Introduction: Fluorescence-guided surgery has emerged as a powerful tool to detect, localize and resect tumors in the operative setting. Our laboratory has pioneered a novel way to administer an FDA-approved near-infrared (NIR) contrast agent to help surgeons with this task. This technique, coined Second Window ICG, exploits the natural permeability of tumor vasculature and its poor clearance to deliver high doses of indocyanine green (ICG) to tumors. This technique differs substantially from established ICG video angiography techniques that visualize ICG within minutes of injection. We hypothesized that Second Window ICG can provide NIR optical contrast with good signal characteristics in intracranial brain tumors over a longer period of time than previously appreciated with ICG video angiography alone. We tested this hypothesis in an intracranial mouse glioblastoma model, and corroborated this in a human clinical trial. Methods: Intracranial tumors were established in 20 mice using the U251-Luc-GFP cell line. Successful grafts were confirmed with bioluminescence. Intravenous tail vein injections of 5.0 mg/kg (high dose) or 2.5 mg/kg (low dose) ICG were performed. The Perkin Elmer IVIS Spectrum (closed field) was used to visualize NIR fluorescence signal at seven delayed time points following ICG injection. NIR signals were quantified using LivingImage software. Based on the success of our results, human subjects were recruited to a clinical trial and intravenously injected with high dose 5.0 mg/kg. Imaging was performed with the VisionSense Iridium (open field) during surgery one day after ICG injection. Results: In the murine model, the NIR signal-to-background ratio (SBR) in gliomas peaks at one hour after infusion, then plateaus and remains strong and stable for at least 48 hours. Higher dose 5.0 mg/kg improves NIR signal as compared to lower dose at 2.5 mg/kg (SBR = 3.5 vs. 2.8; P = 0.0624). Although early (≤ 6 hrs) visualization of the Second Window ICG accumulation in gliomas is stronger than late (≥24 hrs) visualization (SBR = 3.94 vs. 2.32; p<0.05) there appears to be a long plateau period of stable ICG NIR signal accumulation within tumors in the murine model. We call this long plateau period the “Second Window” of ICG. In glioblastoma patients, the delayed visualization of intratumoral NIR signal was strong (SBR 7.50 ± 0.74), without any significant difference within the 19 to 30 hour visualization window (R2 = 0.019). Conclusion: The Second Window ICG technique allows neurosurgeons to deliver NIR optical contrast agent to human glioblastoma patients, thus providing real-time tumor identification in the operating room. This nonspecific tumor accumulation of ICG within the tumor provides strong signal to background contrast, and is not significantly time dependent between 6 hours to 48 hours, providing a broad plateau for stable visualization. This finding suggests that optimal imaging of the “Second Window of ICG” may be within this plateau period, thus providing signal uniformity across subjects. [ABSTRACT FROM AUTHOR]

Burglary prevalence within neighbourhoods is well understood but the risk from bordering areas is under-theorised and under-researched. If it were possible to fix a neighbourhood’s location but substitute its surrounding areas, one might expect to see some influence on its crime rate. However, by treating surrounding areas as independent observations, ecological studies assume that identical neighbourhoods with markedly different surroundings are equivalent. If not, knowing the impact of different peripheries would have significance for crime prevention, land use planning and other policy domains. This paper tests whether knowledge of the demographic make-up of surrounding areas can improve on the prediction of a neighbourhood’s burglary rate based solely on its internal socio-demographics. Results identify significant between-area effects with certain types of periphery exerting stronger influences than others. The advantages and drawbacks of the spatial error and predictor lag model used in the analysis are discussed and areas for further research defined. [ABSTRACT FROM PUBLISHER]

R4759 --> Purpose: To determine the effects of different doses of acute normobaric hypoxia on sprint interval training (SIT) and cognitive performance (CP) in male and female athletes. Methods: In this double‐blind, randomized, counterbalanced, crossover study, participants (13 men, 13 women) performed 6 x 15‐sec maximum effort SIT training with two minutes active recovery between sprints on a cycle ergometer in normoxia (NOR, 0 m), moderate hypoxia (MH, 2,500 m), and high hypoxia (HH, 3,500 m) while wearing face masks and without using the face mask as a control condition (CON). The peak and mean power, CP, blood lactate (BL), heart rate (HR), and the rating of perceived exertion (RPE) were measured pre‐ and post‐SIT and at various time points during the experimental protocol. Results: We did not observe any change in the peak and mean power, CP, HR, and RPE between trials and genders (p>0.05). However, in the HH, the post‐test BL was significantly higher for both genders than the CON condition (p=0.034, p=0.025) and NOR (p=0.11, p=0.034). Conclusions: This study showed that different hypoxia doses did not affect SIT and cognitive performance and did not differ between genders. [ABSTRACT FROM AUTHOR]