Boysenhendricks7609

MR task performance was not different between euthymic bipolar and schizophrenia patients. CONCLUSION Our study results indicate that manipulation of internal representation, especially in the egocentric MR, is impaired in bipolar disorder even in the emotionally-stable state. We speculate that impaired imagery manipulation might be related to alterations in empathic ability, susceptibility of mental imagery, and emotion regulation strategies observed in bipolar disorder. Altered resting-state functional connectivity (rsFC) of the amygdala has been demonstrated to be implicated in schizophrenia neuronal pathophysiology. However, whether rsFC of amygdala subregions is differentially affected in schizophrenia remains unclear. This study compared the functional networks of each amygdala subdivision between healthy controls (HC) and patients with first-episode schizophrenia (FES). In total, 47 HC and 78 patients with FES underwent resting-state functional magnetic resonance imaging. The amygdala was divided into the following three subregions using the Juelich histological atlas basolateral amygdala (BLA), centromedial amygdala (CMA), and superficial amygdala (SFA). The rsFC of the three amygdala subdivisions was computed and compared between the two groups. Significantly increased rsFC of the right CMA with the right postcentral gyrus and decreased rsFC of the right BLA with the left precentral gyrus were observed in the FES group compared with the HC group. Notably, the right BLA-left precentral gyrus connectivity was negatively correlated with positive symptoms and conceptual disorganization in patients with FES. In conclusion, this study found that patients with FES had abnormal functional connectivity in the amygdala subregions, and the altered rsFC was associated with positive symptoms. The present findings demonstrate the disruptive rsFC patterns of amygdala subregional-sensorimotor networks in FES and may provide new insights into the neuronal pathophysiology of FES. PURPOSE To present a reference Monte Carlo (MC) beam model developed in GATE/Geant4 for the MedAustron fixed beam line. The proposed model includes an absolute dose calibration in Dose-Area-Product (DAP) and it has been validated within clinical tolerances for non-isocentric treatments as routinely performed at MedAustron. MATERIAL AND METHODS The proton beam model was parametrized at the nozzle entrance considering optic and energy properties of the pencil beam. The calibration in terms of absorbed dose to water was performed exploiting the relationship between number of particles and DAP by mean of a recent formalism. Typical longitudinal dose distribution parameters (range, distal penumbra and modulation) and transverse dose distribution parameters (spot sizes, field sizes and lateral penumbra) were evaluated. The model was validated in water, considering regular-shaped dose distribution as well as clinical plans delivered in non-isocentric conditions. RESULTS Simulated parameters agree with measurements within the clinical requirements at different air gaps. The agreement of distal and longitudinal dose distribution parameters is mostly better than 1 mm. The dose difference in reference conditions and for 3D dose delivery in water is within 0.5% and 1.2%, respectively. Clinical plans were reproduced within 3%. CONCLUSION A full nozzle beam model for active scanning proton pencil beam is described using GATE/Geant4. Absolute dose calibration based on DAP formalism was implemented. The beam model is fully validated in water over a wide range of clinical scenarios and will be inserted as a reference tool for research and for independent dose calculation in the clinical routine. Treatment of metastatic renal cell carcinoma (mRCC) has been revolutionized by an expanding armamentarium of systemic therapies, which have resulted in improved patient outcomes. Multimodal approaches that include cytoreductive nephrectomy (CN), immunotherapy, and targeted therapy are necessary to optimize clinical care. Active surveillance (AS) and CN are two cornerstones of treatment in mRCC, which require reexamination in the context of new systemic therapies. Herein, we review the data and provide a practical approach for the incorporation of AS and CN in the management of mRCC. OBJECTIVE The clinical data on olfactory neuroblastomas (ONBs) are scarce owing to their rarity. This study aimed to assess the potential prognostic factors, outcomes, and optimal treatment strategies in patients with ONB. METHODS AND MATERIALS The data of 217 patients with ONB between 1991 and 2019 were retrospectively reviewed. Long-term survival, potential prognostic factors, and outcomes with combined treatment strategies were analyzed. RESULTS All patients received radiotherapy (RT); 185 patients underwent surgery, and 139 patients received chemotherapy. The 5-year overall survival (OS), progression-free survival (PFS), locoregional failure-free survival (LRFS), and distant metastasis-free survival (DMFS) of the entire cohort were 80.0%, 79.0%, 79.3%, and 80%, respectively. On univariate analyses, R0/R1 resection, early Kadish stage, negative lymph nodes, absence of orbital invasion, and administration of surgery with RT were found to be favorable factors. Conversely, combined sequential treatment with surgery, RT, and chemotherapy was not associated with survival. Multivariate analysis demonstrated lymph node status, orbital invasion, and the combination of surgery and RT to be independent prognostic factors. CONCLUSIONS Patients with ONB, who had lymph node metastases, orbital invasion diseases, advanced Kadish stages, R2 resection margins, and received RT alone, had poor outcomes. Combined administration of surgery and RT may be a potentially useful strategy in patients with advanced Kadish stages; the role of chemotherapy in these stages requires further evaluation. OBJECTIVES We performed this study to assess the feasibility and efficacy of intraoperative neural monitoring (IONM) in remote access robotic and endoscopic thyroidectomy. Wnt-C59 cost MATERIALS AND METHODS We studied 104 consecutive patients (122 nerves at risk, NARs) who underwent robotic or endoscopic thyroidectomy via a postauricular facelift approach or transoral approach while performing intermittent IONM. RESULTS IONM was successful in 86/104 patients (82.7%). The success rate was significantly lower in the first 15 cases using a transoral approach than in the subsequent cases (7/15 vs. 41/43, p  less then  0.001). The standard IONM procedure (obtaining V1/R1/R2/V2 signals) was performed on 32/42 NARs (76.2%) undergoing thyroidectomy via a facelift approach and 10/58 NARs (17.2%) undergoing thyroidectomy via a transoral approach (p  less then  0.001). Loss of signal occurred in 6/100 NARs in 86 patients receiving successful IONM. Of these 6 LOS, 5 were false positives, and 1 was a true positive. A false negative occurred in 1/100 NARs.