Optimal dose levels in screening chest CT for unimpaired detection and volumetry of lung nodules, with and without computer assisted detection at minimal patient radiation

OBJECTIVES The aim of this phantom study was to minimize the radiation dose by finding the best combination of low tube current and low voltage that would result in accurate volume measurements when compared to standard CT imaging without significantly decreasing the sensitivity of detecting lung nodules both with and without the assistance of CAD. METHODS An anthropomorphic chest phantom containing artificial solid and ground glass nodules (GGNs, 5-12 mm) was examined with a 64-row multi-detector CT scanner with three tube currents of 100, 50 and 25 mAs in combination with three tube voltages of 120, 100 and 80 kVp. This resulted in eight different protocols that were then compared to standard CT sensitivity (100 mAs/120 kVp). For each protocol, at least 127 different nodules were scanned in 21-25 phantoms. The nodules were analyzed in two separate sessions by three independent, blinded radiologists and computer-aided detection (CAD) software. RESULTS The mean sensitivity of the radiologists for identifying solid lung nodules on a standard CT was 89.7% ± 4.9%. The sensitivity was not significantly impaired when the tube and current voltage were lowered at the same time, except at the lowest exposure level of 25 mAs/80 kVp [80.6% ± 4.3% (p = 0.031)]. Compared to the standard CT, the sensitivity for detecting GGNs was significantly lower at all dose levels when the voltage was 80 kVp; this result was independent of the tube current. The CAD significantly increased the radiologists' sensitivity for detecting solid nodules at all dose levels (5-11%). No significant volume measurement errors (VMEs) were documented for the radiologists or the CAD software at any dose level. CONCLUSIONS Our results suggest a CT protocol with 25 mAs and 100 kVp is optimal for detecting solid and ground glass nodules in lung cancer screening. The use of CAD software is highly recommended at all dose levels.

The Effects of Smolt Stocking Strategies on Migratory Path Selection of Adult Atlantic Salmon in the Penobscot River, Maine

Understanding the homing behavior of Atlantic salmon Salmo salar is vital to the restoration program employed on the Penobscot River, Maine. To produce significant adult returns, managers currently stock hatchery-raised smolts in specific river sections, providing smolts the opportunity to imprint on chemical signals and enabling their return to productive spawning and rearing habitat as adults. In this study, we used observational evidence from passive integrated transponder telemetry to determine whether adults returning from smolt stockings behaved in a way that suggested strong homing to smolt stocking locations. Adults returning from smolt stocking locations located in or at the mouth of the Piscataquis River were more likely to be detected as entering the Piscataquis River than were adults returning from the upper Penobscot River smolt stocking locations. In general, returning adult Atlantic salmon that had been stocked near or in tributaries as smolts chose a path more quickly than those that had been stocked in more downstream or main-stem locations. These results suggest that Atlantic salmon smolts should be stocked at specific sites with superior habitat for spawning kind juvenile survival to capitalize on the strong homing tendency in adults. This technique call also be utilized to allow for natural selection and the development of localized stocks.

Search for the neutral Higgs bosons of the Minimal Supersymmetric Standard Model in pp collisions at sqrts=7 TeV with the ATLAS detector

A search for neutral Higgs bosons of the Minimal Supersymmetric Standard Model (MSSM) is reported. The analysis is based on a sample of proton-proton collisions at a centre-of-mass energy of 7 TeV recorded with the ATLAS detector at the Large Hadron Collider. The data were recorded in 2011 and correspond to an integrated luminosity of 4.7 fb(-1) to 4.8 fb(-1). Higgs boson decays into oppositely-charged in muon or tau lepton pairs are considered for final states requiring either the presence or absence of b-jets. No statistically significant excess over the expected background is observed and exclusion limits at the 95% confidence level are derived. The exclusion limits are for the production cross-section of a generic neutral Higgs boson, phi, as a function of the Higgs boson mass and for h/A/H production in the MSSM as a function of the parameters m(A) and tan beta in the m(h)(max) scenario for m(A) in the range of 90 GeV to 500 GeV.

Choosing the Path of Austerity: How Policy Coalitions Shape Welfare-policy Choices in Periods of Fiscal Consolidation

In general, fiscal adjustments are associated with significant reductions in social spending. Hence, the welfare state is not spared from austerity. Because the welfare state is still central to party competition, this is electorally risky. The paper addresses the following questions: Do left parties differ from their centrist and rightist competitors in the design of austerity measures? And does government type has an impact on the extent to which austerity policies rely on social spending cuts? By comparing 17 OECD countries between 1982 and 2009 we show that if governments embark on a path to austerity, their ideology does not have a significant effect on the magnitude of welfare state retrenchment. However, if major opposition parties and interest groups rally against social spending cuts, a broad pro-reform coalition is a crucial precondition for large fiscal consolidation programs to rely on substantial cuts to social security.

Natural Tracers in recent groundwaters from different Alpine aquifers

Groundwater with underground residence times between days and a few years have been investigated over more than 20 years from 487 remote sites located in different aquifer types in the Alpine belt. Analysis of the data reveals that groundwaters evolved in crystalline, evaporite, carbonate, molasse, and flysch aquifers can be clearly distinguished based on their major and trace element composition and degree of mineralisation. A further subdivision can be made even within one aquifer type based on the trace element compositions, which are characteristic for the lithologic environment. Major and trace element concentrations can be quantitatively described by interaction of the groundwater with the aquifer- specific mineralogy along the flow path. Because all investigated sites show minimal anthropogenic influences, the observed concentration ranges represent the natural background concentrations and can thus serve as a “geo-reference” for recent groundwaters from these five aquifer types. This “geo-reference” is particularly useful for the identification of groundwater contamination. It further shows that drinking water standards can be grossly exceeded for critical elements by purely natural processes

Next-to-Minimal SOFTSUSY

We describe an extension to the SOFTSUSY program that provides for the calculation of the sparticle spectrum in the Next-to-Minimal Supersymmetric Standard Model (NMSSM), where a chiral superfield that is a singlet of the Standard Model gauge group is added to the Minimal Supersymmetric Standard Model (MSSM) fields. Often, a Z3 symmetry is imposed upon the model. SOFTSUSY can calculate the spectrum in this case as well as the case where general Z3 violating (denoted as ) terms are added to the soft supersymmetry breaking terms and the superpotential. The user provides a theoretical boundary condition for the couplings and mass terms of the singlet. Radiative electroweak symmetry breaking data along with electroweak and CKM matrix data are used as weak-scale boundary conditions. The renormalisation group equations are solved numerically between the weak scale and a high energy scale using a nested iterative algorithm. This paper serves as a manual to the NMSSM mode of the program, detailing the approximations and conventions used.

RADIX: a minimal-resources rapid-access drilling system

Determining the expected age at a potential ice-core drilling site on a polar ice sheet generally depends on a combination of information from remote-sensing methods, estimates of current accumulation and modelling. This poses irreducible uncertainties in retrieving an undisturbed ice core of the desired age. Although recently perfected radar techniques will improve the picture of the ice sheet below future drilling sites, rapid prospective drillings could further increase the success of deep drilling projects. Here we design and explore a drilling system for a minimum-size rapid-access hole. The advantages of a small hole are the low demand for drilling fluid, low overall weight of the equipment, fast installing and de-installing and low costs. We show that, in theory, drilling of a 20mm hole to a depth of 3000m is possible in ~4 days. First concepts have been realized and verified in the field. Both the drill cuttings and the hole itself can be used to characterize the properties of the ice sheet and its potential to provide a trustworthy palaeo-record. A candidate drilling site could be explored in ~2 weeks, which would enable the characterization of several sites in one summer season.

Minimal intervention dentistry: part 5. Ultra-conservative approach to the treatment of erosive and abrasive lesions.

The therapeutic management of tooth wear lesions does not require the removal of diseased tissue. Nevertheless, diverse etiological factors may be associated with the condition and they could be difficult to eliminate; this has to be considered when planning therapy. Interceptive procedures should be reserved for such situations while regular monitoring is recommended for other cases, in accordance with advice provided for using the Basic Erosive Wear Examination (BEWE). Direct and indirect adhesive procedures with composite resins allow treatment of most clinical situations, including even extensive restorations. The possibility of managing subsequent interventions should be considered when planning the initial therapeutic approach.

Uniqueness of black holes with bubbles in minimal supergravity

We generalize uniqueness theorems for non-extremal black holes with three mutually independent Killing vector fields in five-dimensional minimal supergravity in order to account for the existence of non-trivial two-cycles in the domain of outer communication. The black hole space-times we consider may contain multiple disconnected horizons and be asymptotically flat or asymptotically Kaluza–Klein. We show that in order to uniquely specify the black hole space-time, besides providing its domain structure and a set of asymptotic and local charges, it is necessary to measure the magnetic fluxes that support the two-cycles as well as fluxes in the two semi-infinite rotation planes of the domain diagram.

On the right path? Land concessions in Laos

Land investment is booming in Laos, driven especially by demand for resources among its rapidly developing neighbours. Still, Laos remains one of the poorest countries in Southeast Asia. The government hopes that projects linked to land investments will improve local productivity, infrastructure, and poverty rates. But there are many risks to local livelihoods and the environment. Ensuring that land investment truly benefits the broader population demands effective regulation and strong political will. This policy brief provides key insights and recommendations drawn from the national inventory of land concessions and leases, the most comprehensive accounting of such land deals to date for a single country.

Off-pump compared to minimal extracorporeal circulation surgery in coronary artery bypass grafting.

OBJECTIVE Coronary artery bypass grafting (CABG) using extracorporeal circulation (ECC) is still the gold standard. However, alternative techniques have been developed to avoid ECC and its potential adverse effects. These encompass minimal extracorporeal circulation (MECC) or off-pump coronary artery bypass grafting (OPCAB). However, the prevailing potential benefits when comparing MECC and OPCABG are not yet clearly established. METHODS In this retrospective study we investigated the potential benefits of MECC and OPCABG in 697 patients undergoing CABG. Of these, 555 patients had been operated with MECC and 142 off-pump. The primary endpoint was Troponin T level as an indicator for myocardial damage. RESULTS Study groups were not significantly different in general. However, patients undergoing OPCABG were significantly older (65.01 years ± 9.5 vs. 69.39 years ± 9.5; p value <0.001) with a higher Logistic EuroSCORE I (4.92% ± 6.5 vs. 5.88% ± 6.8; p value = 0.017). Operating off pump significantly reduced the need for intra-operative blood products (0.7% vs. 8.6%; p-value <0.001) and the length of stay in the intensive care unit (ICU) (2.04 days ± 2.63 vs. 2.76 days ± 2.79; p value <0.001). Regarding other blood values a significant difference could not be found in the adjusted calculations. The combined secondary endpoint, major cardiac or cerebrovascular events (MACCE), was equal in both groups as well. CONCLUSIONS Coronary artery bypass grafting using MECC or OPCABG are two comparable techniques with advantages for OPCABG regarding the reduced need for intra-operative blood products and shorter length of stay in the ICU. However serological values and combined endpoint MACCE did not differ significantly in both groups.

How minimal grade goals and self-control capacity interact in predicting test grades

The present research examined the prediction of school students' grades in an upcoming math test via their minimal grade goals (i.e., the minimum grade in an upcoming test one would be satisfied with). Due to its significance for initiating and maintaining goal-directed behavior, self-control capacity was expected to moderate the relation between students' minimal grade goals and their actual grades. Self-control capacity was defined as the dispositional capacity to override or alter one's dominant response tendencies. Prior to a scheduled math test, 172 vocational track students indicated their minimal grade goal for the test and completed a measure of self-control capacity. The test grade was assessed at a second time of measurement. As expected, minimal grade goals more strongly predicted the actual test grades the higher the students' self-control capacity. Implications can be seen in terms of optimizing the prediction and advancement of academic performance.