Accuracy of chest computed tomography in distinguishing cystic pleuropulmonary blastoma from benign congenital lung malformations in children

Importance: The ability of computed tomography (CT) to distinguish between benign congenital lung malformations and malignant cystic pleuropulmonary blastomas (PPBs) is unclear. Objective: To assess whether chest CT can detect malignant tumors among postnatally detected lung lesions in children. Design, Setting, and Participants: This retrospective multicenter case-control study used a consortium database of 521 pathologically confirmed primary lung lesions from January 1, 2009, through December 31, 2015, to assess diagnostic accuracy. Preoperative CT scans of children with cystic PPB (cases) were selected and age-matched with CT scans from patients with postnatally detected congenital lung malformations (controls). Statistical analysis was performed from January 18 to September 6, 2020. Preoperative CT scans were interpreted independently by 9 experienced pediatric radiologists in a blinded fashion and analyzed from January 24, 2019, to September 6, 2020. Main Outcomes and Measures: Accuracy, sensitivity, and specificity of CT in correctly identifying children with malignant tumors. Results: Among 477 CT scans identified (282 boys [59%]; median age at CT, 3.6 months [IQR, 1.2-7.2 months]; median age at resection, 6.9 months [IQR, 4.2-12.8 months]), 40 cases were extensively reviewed; 9 cases (23%) had pathologically confirmed cystic PPB. The median age at CT was 7.3 months (IQR, 2.9-22.4 months), and median age at resection was 8.7 months (IQR, 5.0-24.4 months). The sensitivity of CT for detecting PPB was 58%, and the specificity was 83%. High suspicion for malignancy correlated with PPB pathology (odds ratio, 13.5; 95% CI, 2.7-67.3; P = .002). There was poor interrater reliability (κ = 0.36 [range, 0.06-0.64]; P \u3c .001) and no significant difference in specific imaging characteristics between PPB and benign cystic lesions. The overall accuracy rate for distinguishing benign vs malignant lesions was 81%. Conclusions and Relevance: This study suggests that chest CT, the current criterion standard imaging modality to assess the lung parenchyma, may not accurately and reliably distinguish PPB from benign congenital lung malformations in children. In any cystic lung lesion without a prenatal diagnosis, operative management to confirm pathologic diagnosis is warranted

A high-DC-voltage GaAs photoemission gun: Transverse emittance and momentum spread measurements

We have built a high-DC-voltage photoemission gun and a diagnostic beamline permitting us to measure rms transverse emittance ({epsilon}{sub x}) and rms momentum spread ({delta}) of short-duration electron pulses produced by illuminating the cathode with light from a mode-locked, frequency-doubled Nd:YLF laser. The electron gun is a GaAs photocathode source designed to operate at 500kV. We have measured {epsilon}{sub x} and {delta} for conditions ranging from emittance-dominated to space-charge-dominated. We report these measurements as functions of microbunch charge for different beam radii, pulse lengths, and voltages/field gradients at the cathode, and compare them with PARMELA calculations

Understanding the rift, the (still) uneasy bedfellows of History and Organization Studies

Although the use of History has become increasingly discussed and more widely applied within Organization Studies (OS), its relevance for OS still remains far from centrally accepted. This article historicizes the relationship between Sociology and History as a means of better understanding the tensions, perceived and real, that exist between History and Organization Studies. In particular we analyse three differences of epistemological standpoint (method, objectivity and usefulness) that are commonly seen as the foundation stones to incompatibility. Perhaps surprisingly for an analysis of apparent disciplinary differences, we find that these distinctions in terms of approach, once closely examined, are rarely clear-cut and historians and OS scholars are frequently closer in intention and method than they are distant. However, despite their large intersection of interests, we argue that important distinctions between the two fields should be acknowledged. Our contribution to the debates over the need for more historical approaches within OS therefore centrally rests on abandoning aspirations for fully integrative models of working together, in favour of cooperative modes that concede the fields’ differences. This subtle shift of emphasis will, we believe, greatly benefit OS scholars who hope to include historical perspectives in their work

The Earth: Plasma Sources, Losses, and Transport Processes

This paper reviews the state of knowledge concerning the source of magnetospheric plasma at Earth. Source of plasma, its acceleration and transport throughout the system, its consequences on system dynamics, and its loss are all discussed. Both observational and modeling advances since the last time this subject was covered in detail (Hultqvist et al., Magnetospheric Plasma Sources and Losses, 1999) are addressed

Very high-energy electron therapy as light-particle alternative to transmission proton FLASH therapy - An evaluation of dosimetric performances.

Clinical translation of FLASH-radiotherapy (RT) to deep-seated tumours is still a technological challenge. One proposed solution consists of using ultra-high dose rate transmission proton (TP) beams of about 200-250 MeV to irradiate the tumour with the flat entrance of the proton depth-dose profile. This work evaluates the dosimetric performance of very high-energy electron (VHEE)-based RT (50-250 MeV) as a potential alternative to TP-based RT for the clinical transfer of the FLASH effect. Basic physics characteristics of VHEE and TP beams were compared utilizing Monte Carlo simulations in water. A VHEE-enabled research treatment planning system was used to evaluate the plan quality achievable with VHEE beams of different energies, compared to 250 MeV TP beams for a glioblastoma, an oesophagus, and a prostate cancer case. Like TP, VHEE above 100 MeV can treat targets with roughly flat (within ± 20 %) depth-dose distributions. The achievable dosimetric target conformity and adjacent organs-at-risk (OAR) sparing is consequently driven for both modalities by their lateral beam penumbrae. Electron beams of 400[500] MeV match the penumbra of 200[250] MeV TP beams and penumbra is increased for lower electron energies. For the investigated patient cases, VHEE plans with energies of 150 MeV and above achieved a dosimetric plan quality comparable to that of 250 MeV TP plans. For the glioblastoma and the oesophagus case, although having a decreased conformity, even 100 MeV VHEE plans provided a similar target coverage and OAR sparing compared to TP. VHEE-based FLASH-RT using sufficiently high beam energies may provide a lighter-particle alternative to TP-based FLASH-RT with comparable dosimetric plan quality

A High-Average-Power Free Electron Laser for Microfabrication and Surface Applications

CEBAF has developed a comprehensive conceptual design of an industrial user facility based on a kilowatt ultraviolet (UV) (160-1000 mm) and infrared (IR) (2-25 micron) free electron laser (FEL) driven by a recirculating, energy recovering 200 MeV superconducting radio frequency (SRF) accelerator. FEL users, CEBAF's partners in the Lase Processing Consortium, including AT&T, DuPont, IBM, Northrop Grumman, 3M, and Xerox, are developing applications such as metal, ceramic, and electronic material micro-fabrication and polymer and metal surface processing, with the overall effort leading to later scale-up to industrial systems at 50-100 kW. Representative applications are described. The proposed high-average-power FEL overcomes limitations of conventional laser sources in available power, cost-effectiveness, tunability, and pulse structure

Drift or shift? Continuity, change, and international variation in knowledge production in OR/MS

With the aim of contributing to the debate around OR/MS as a discipline, this study provides a historical comparative investigation of publicly available knowledge production in the field. The empirical investigation is based on a content analysis of 300 randomly selected articles from six major journals in the field. We have found: (1) since the late 1950s to the present day there has been no significant change in the types of published research in OR/MS in North America; (2) from the late 1950s to the present day, there have been significant differences in types of published research in OR/MS internationally. The imputed imbalance between theory and applications in published work had already occurred in the early stages of the development of OR/MS in North America and has since remained very much the same. Furthermore, research in the United Kingdom has been distinctly different from that dominant in North America and elsewhere. There are also indications that outside North America and the United Kingdom there is an emerging turn towards applications-oriented research. Over the last two or three decades there has been a significant increase overall in the share of articles published by academic authors

Prenatal Metal Exposure Alters the Placental Proteome in a Sex-Dependent Manner in Extremely Low Gestational Age Newborns: Links to Gestational Age

Prenatal exposure to toxic metals is associated with altered placental function and adverse infant and child health outcomes. Adverse outcomes include those that are observed at the time of birth, such as low birthweight, as well as those that arise later in life, such as neurological impairment. It is often the case that these adverse outcomes show sex-specific responses in relation to toxicant exposures. While the precise molecular mechanisms linking in utero toxic metal exposures with later-in-life health are unknown, placental inflammation is posited to play a critical role. Here, we sought to understand whether in utero metal exposure is associated with alterations in the expression of the placental proteome by identifying metal associated proteins (MAPs). Within the Extremely Low Gestational Age Newborns (ELGAN) cohort (n = 230), placental and umbilical cord tissue samples were collected at birth. Arsenic (As), cadmium (Cd), lead (Pb), selenium (Se), and manganese (Mn) concentrations were measured in umbilical cord tissue samples via ICP-MS/MS. Protein expression was examined in placental samples using an LC-MS/MS-based, global, untargeted proteomics analysis measuring more than 3400 proteins. MAPs were then evaluated for associations with pregnancy and neonatal outcomes, including placental weight and gestational age. We hypothesized that metal levels would be positively associated with the altered expression of inflammation/immune-associated pathways and that sex-specific patterns of metal-associated placental protein expression would be observed. Sex-specific analyses identified 89 unique MAPs expressed in female placentas and 41 unique MAPs expressed in male placentas. Notably, many of the female-associated MAPs are known to be involved in immune-related processes, while the male-associated MAPs are associated with intracellular transport and cell localization. Further, several MAPs were significantly associated with gestational age in males and females and placental weight in males. These data highlight the linkage between prenatal metal exposure and an altered placental proteome, with implications for altering the trajectory of fetal development

Modeling of oropharyngeal articulatory adaptation to compensate for the acoustic effects of nasalization

Hypernasality is one of the most detrimental speech disturbances that lead to declines of speech intelligibility. Velopharyngeal inadequacy, which is associated with anatomic defects such as cleft palate or neuromuscular disorders that affect velopharygneal function, is the primary cause of hypernasality. A simulation study by Rong and Kuehn [J. Speech Lang. Hear. Res. 55(5), 1438–1448 (2012)] demonstrated that properly adjusted oropharyngeal articulation can reduce nasality for vowels synthesized with an articulatory model [Mermelstein, J. Acoust. Soc. Am. 53(4), 1070–1082 (1973)]. In this study, a speaker-adaptive articulatory model was developed to simulate speaker-customized oropharyngeal articulatory adaptation to compensate for the acoustic effects of nasalization on /a/, /i/, and /u/. The results demonstrated that (1) the oropharyngeal articulatory adaptation effectively counteracted the effects of nasalization on the second lowest formant frequency (F2) and partially compensated for the effects of nasalization on vowel space (e.g., shifting and constriction of vowel space) and (2) the articulatory adaptation strategies generated by the speaker-adaptive model might be more efficacious for counteracting the acoustic effects of nasalization compared to the adaptation strategies generated by the standard articulatory model in Rong and Kuehn. The findings of this study indicated the potential of using oropharyngeal articulatory adaptation as a means to correct maladaptive articulatory behaviors and to reduce nasalit