High frequency multiphase 4DCT for the detection of parathyroid adenomas, a pictorial essay

4DCT for the detection of (an) enlarged parathyroid(s) is a commonly performed examination in the management of primary hyperparathyroidism. In our center we introduced a high frequency multiphase 4DCT protocol obtaining 16 phases, including 11 different arterial phases. Exposure to this multiphase 4DCT technique is comparable to that for classic helical 4DCT. In this pictorial essay we reconstructed our multiphase 4DCT series in the manner of a classic helical 4DCT and compare both techniques. We illustrate how multiphase 4DCT may aid in the detection of parathyroid adenomas. We find 17 out of 19 lesions demonstrating a type A pattern of enhancement, therefore suggesting this pattern could be more prevalent than previously thought. Some parathyroid adenomas may be mistaken for enlarged lymph nodes using classic 4DCT whereas high frequency multiphase 4DCT can detect a temporary rise in enhancement, thus suggesting the lesions in question to be of parathyroid origin. Smaller lesions may prove more obvious as the difference in enhancement between parathyroid and thyroid can become more prominent.

Merging One's Way to the Top: AB Inbev versus Heineken

Leuven's Den Hoorn brewery, now AB Inbev SA, has become the world's largest brewing group by far, but critics say the company overpaid for its acquisitions. In this article, we study typical stock market reactions to the many takeover announcements by AB Inbev and the industry's runner-up, Heineken. Unlike Heineken's, the market leader's takeover announcements were met by, on average, a –2% price reaction in the stock market in the announcement month, but most of that is already undone in the next month. For Heineken, the same pattern shows up, only faster: the V-shaped reaction takes a few weeks rather than a few months. Such V-reactions may actually reflect a temporary rise in uncertainty rather than overpaying. The finding that reactions are reversed and heterogeneous across firms, raises issues of interpretation and optimal test design of event studies. (JEL Classifications: G12, G14, G17)

The UK Economy

GDP is forecast to grow at a rate of 1.7 per cent this year and 1.9 per cent in 2018.Consumer price inflation is projected to peak at 3.4 per cent at the end of 2017.We expect the MPC to keep interest rates unchanged until mid-2019, despite the temporary rise in inflation.The current fiscal rule suggests further fiscal tightening is now needed in the next Parliament.

The UK Economy: Forecast Summary

GDP is expected to grow by 1.7 per cent in 2016, slowing to just 1 per cent in 2017. GDP is likely to decline by 0.2 per cent in the third quarter of this year and there is a risk of a further deterioration.Inflation is forecast to increase significantly, peaking at just over 3 per cent at the end of 2017. The Bank of England is expected to ‘look through’ this temporary rise and ease monetary policy substantially in the coming months.Government announcements have effectively ‘over-ridden’ the Fiscal Charter and borrowing is expected to increase by an additional £47 billion over the period 2016–17 to 2020–21.

Comparison of Inflammatory Response to Transgastric and Transcolonic NOTES

Aims.The aim of our study was to determine the physiologic impact of NOTES and to compare the transgastric and transcolonic approaches.Methods.Thirty pigs were randomized to transgastric, transcolonic, or laparoscopic peritoneoscopy. Blood was drawn and analyzed for C-reactive protein (CRP), tumor necrosis factor-α(TNF-α), interleukin- (IL-) 1β, IL-6, WBCs, and platelets.Results.Endoscopic closure with an OTSC was successful in all 20 animals. The postoperative course was uneventful in all animals. CRP values rose on day 1 in all animals and slowly declined to baseline levels on day 14 with no differences between the groups (P>0.05, NS). The levels of TNF-αwere significantly increased in the transcolonic group (P<0.01); however this difference was already present prior to the procedure and remained unchanged. No differences were observed in IL1-βand IL-6 values. There was a temporary rise of WBC on day 1 and of platelets on day 7 in all groups (P>0.05, NS).Conclusions.Transgastric, transcolonic, and laparoscopic peritoneoscopy resulted in similar changes in systemic inflammatory markers. Our findings do not support the assumption that NOTES is less invasive than laparoscopy.

Young age to predict for transient elevation in PSA after definitive stereotactic body radiation therapy for prostate cancer.

118 Background: Stereotactic Body Radiation Therapy (SBRT) is a standard therapeutic option for men with prostate adenocarcinoma. There is a small body of literature characterizing a PSA bump after treatment with SBRT. Despite this, there is a paucity of data addressing rates of transient PSA increase immediately after SBRT treatment and what factors portend for this rare occurrence. This study reports outcomes on initial PSA after SBRT therapy for men who have received definitive SBRT for prostate cancer. Methods: Between May 2006 and February 2014, 921 patients with prostate cancer were treated with SBRT delivered via Cyberknife therapy. The mean age was 67 years old. 68.5% of patients were Caucasian, 17.4% African American, and 14.1% were another ethnicity. Patients were divided into prognostic risk groups with 44.7%, 43.5%, and 11.1% of patients falling in the low, intermediate, and high risk stratifications. Gleason scores were < 6 in 44.4%, 7 in 41.3%, and 8-10 in 14.2%. 37 patients also received supplemental external beam radiation (median dose 4500cGy) and 8.9% of patients received Androgen Deprivation Therapy (ADT) as part of their treatment regimen. Pre-treatment PSA was 0.8 – 205 ng/ml (median 6.1). Results: At 3 months’ follow-up, 2.8% of patients had a PSA elevated above their baseline value. 27.8% of patients age ≤50 (p<.0001) and 8.4% of patients age ≤60 (p=.001) experienced an increased in baseline PSA. African Americans were more likely to experience a transient increase in PSA over Caucasians (7.8% vs. 3.0%, p=.06). Patients treated with fewer beams were also more likely have a temporary rise in PSA (p=.056). Gleason Score, Risk grouping, prostate volume, ADT, and EBRT did not predict for rise on Pearson Chi-Square analysis. On multivariate analysis, only age ≤50 (p<.0001) portended for increased PSA at 3 months’ time. Conclusions: This represents the largest series evaluating elevation of PSA after definitive SBRT for prostate cancer. Temporary rise in baseline PSA after SBRT is rare. Despite that, a significant cohort of younger patients can experience transient elevation. Patient age ≤50 was found to be the only predictor of this otherwise rare occurrence.

Research of the Salinity Effect on Nail-Holding Power of Dimension Lumber

This article mainly studied the effect of salinity on the nail-holding power in wood construction. The results showed that: in saline solution, the holding power of nails was smaller than that in purified water condition. With the increase of salt concentration, the surface and side nail-holding power of the wood specimens would both decline, but the differences between salinity treatments would be not significant. However, compared to the surface and side nail-holding power, the power on the edge was generally smaller and the difference was not obvious in the treatment of different salt concentrations. In the same concentration of salt environment, with the extension of the processing cycle, the performance of holding power of nails showed a downward trend, expect the temporary rise in the middle.

Modelling the Sovereign Debt Crisis in Europe

This note examines the impact of rising bond yields in certain Euro Area countries on debt sustainability. It concludes that without the financial assistance of the bailout packages, government debt in Greece would clearly have been unsustainable, while Ireland and Portugal would have been extremely vulnerable. We also examine the case of vulnerable countries which have not received bailouts — Italy, Spain and Belgium. We conclude that while they can absorb some temporary rise, as has been seen in recent weeks, a significant further sustained rise — more than 100–200 basis points — would call their solvency into question in the absence of financial assistance.

FY2012-FY2014 Medium-Term Budget

With the global financial landscape still unsettled, temporary spending looks set to remain at current levels over the next few years. Lending commitments and crisis-management activities have surged since the onset of the crisis: by the end of December 2010, there were 60 program and financial arrangements in place, compared with 40 at the time of the Fund’s restructuring in early 2008. The higher lending has generated a sharp but temporary rise in income, but has also required an increase in temporary spending. This expenditure will unwind over time, but only marginally over the FY 12–14 MTB period