Abstract Background Degenerative Cervical Myelopathy (DCM) is the most common cause of non‐traumatic, chronic spinal cord dysfunction worldwide, causing debilitating disability with a diminishing quality of life. The natural history of DCM is poorly understood. This is a preliminary report of the first 60 patients recruited to the MYelopathy NAtural History (MYNAH) Registry. Methods MYNAH Registry is an investigator‐initiated, multicenter, prospective, non‐interventional, longitudinal, national observational study (Registry ID ACSQHC‐ARCR‐258). Given the observational nature of the Registry, participants' clinical management plan is neither changed nor affected. Participants are recruited via an opt‐in approach. A patient with DCM diagnosed by a spine/neurosurgeon after 1st January 2018 onwards is eligible to participate regardless of their surgical status. The Patient‐Reported Outcome Measures (PROMs) are NDI, EQ5D5L and EQ‐VAS; and the Practitioner‐Reported Outcome Measures (PrROMs) are mJOA Score and Nurick Grade. Results Sixty participants ( n = 60) have now been recruited of which male participants 34 (56.7%) and females are 26 (43.3%), with a mean age of 62.3 years (SD 14.1) and biospecimens for Proteomics have been collected from 33 (66%) participants. The median mJOA Score was 16.5 (8–18), with myelopathy severity recorded as mild in 42 (70%), moderate in 13 (21.7%) and severe in 5 (8.3%) participants. Median Nurick Grade 0 (0–5), NDI 14 (0–45), EQ5D5L Score 0.850 (−0.288–1) and EQ‐VAS 70 (10–96). Conclusions The MYNAH National DCM Registry in Australia is a novel spinal surgical initiative, that will inform the decision(s) to proceed with the scientific, evidence‐based and personalised management of DCM globally in the future.
E023 Imaging Deep Geology Using Full Tensor Gravity Gradiometry Inversion: K-2 Deepwater Gulf of Mexico 1 Mark A. Davies 2 John O’Brien 2 Arnold Rodriguez 1 Phillip Houghton 1 Gary Barnes & 1 John Lumley 1 ARKeX Limited Newton House Cowley Road Cambridge CB4 0WZ UK 2 Anadarko Petroleum Corporation The Woodlands Houston USA A common misunderstanding in the oil industry is that Full Tensor Gravity Gradient (FTG) data is only of use when resolving shallow sections of the earth model. This paper will highlight the ability of FTG to resolve deep as well as shallow geological targets by showing
Two types of dedicated Tristructural isotropic (TRISO) nuclear fuel particles, PyC-1 (Kernel/Buffer/PyC) and PyC-2 (Kernel/Buffer/SiC/PyC) from PYCASSO (Pyrocarbon irradiation for creep and swelling/shrinkage of objects) neutron irradiation experiments, were studied. For unirradiated particles, crushing experiments using a unique hot cell, combined with in situ X-ray computed micro-tomography (XCT) imaging, were conducted at room temperature (RT) and at 1000 °C. Although the SiC layer on the particles is presumed to provide 'mechanical stability' to the TRISO particles, results showed a remarkable reduction (~45%) in the crushing strength of the PyC-2 particles at 1000 °C compared to RT. The fracture patterns of the two types of particles, both at the contact zone and on subsequent propagation, differ significantly at RT and 1000 °C. Further, irradiated particles (irradiation temperature: 1000 ± 20 °C; irradiation doses: 1.08–1.23 dpa and 1.49–1.51 dpa) were imaged by XCT; 250 PyC-1 particles and 223 PyC-2 particles were studied in total and the change in radius/layer thickness in each type was examined. It was found that the buffer densification was lower in PyC-1 particles compared to PyC-2 particles, and the PyC layer shrank in the PyC-I particles, whereas it expanded in PyC-2. Results are discussed in terms of how the residual stresses can impact the high-temperature and post-irradiation behavior of these particles.
A common misunderstanding in the oil industry is that Full Tensor Gravity Gradient (FTG) data is only of use when resolving shallow sections of the earth model. This paper will highlight the ability of FTG to resolve deep as well as shallow geological targets by showing examples from an imaging study of the presalt K‐2 Field, Deep Water Gulf of Mexico. Combined Pre Stacked Depth Migration (PreSDM) and gravity gradient inversion was used to resolve the base of salt at a depth in excess of 24 000 ft. This was subsequently confirmed by wave equation prestack depth imaging.
Abstract Benign bone tumors are rare but are more common than primary malignant bone tumors. The early accurate diagnosis and reliable differentiation of these rare benign tumors and tumor mimickers from the even rarer malignant tumors with subsequent appropriate treatment or watchful waiting is crucial for the clinical outcome. Bone tumors are often a source of diagnostic and therapeutic uncertainty. Thus this European Society of Musculoskeletal Radiology consensus document is intended to help radiologists in their decision making and support discussion among clinicians who deal with patients with suspected or proven bone tumors. Evaluating these tumors starts with a patient history and physical examination. Radiography is the principal imaging modality and often can reliably diagnose a benign bone tumor by providing information about localization, matrix, aggressiveness, size, and (potential) multiplicity. In a significant number of cases, additional imaging is not necessary. Potentially malignant entities recognized by radiography should be referred for magnetic resonance imaging, which also serves as a preoperative local staging modality, with specific technical requirements. Indeterminate tumors, or tumors in which therapy depends on histology results, should be biopsied. For biopsy, we strongly recommend referral to a specialist regional sarcoma treatment center (RSTC), where a multidisciplinary tumor team, including a specialist pathologist, radiologist, and sarcoma surgeon, are involved. Additional staging modalities are entity specific and should be performed according to the recommendations of the RSTC.
Carotid endarterectomy (CEA) for asymptomatic carotid artery stenosis is among the most common procedures performed in the United States. However, consensus is lacking regarding optimal preoperative imaging, carotid duplex ultrasound criteria, and ultimately, the threshold for surgery. We sought to characterize national variation in preoperative imaging, carotid duplex ultrasound criteria, and threshold for surgery for asymptomatic CEA.The Society for Vascular Surgery Vascular Quality Initiative (VQI) database was used to identify all CEA procedures performed for asymptomatic carotid artery stenosis between 2003 and 2014. VQI currently captures 100% of CEA procedures performed at >300 centers by >2000 physicians nationwide. Three analyses were performed to quantify the variation in (1) preoperative imaging, (2) carotid duplex ultrasound criteria, and (3) threshold for surgery.Of 35,695 CEA procedures in 33,488 patients, the study cohort was limited to 19,610 CEA procedures (55%) performed for asymptomatic disease. The preoperative imaging modality used before CEA varied widely, with 57% of patients receiving a single preoperative imaging study (duplex ultrasound imaging, 46%; computed tomography angiography, 7.5%; magnetic resonance angiography, 2.0%; cerebral angiography, 1.3%) and 43% of patients receiving multiple preoperative imaging studies. Of the 16,452 asymptomatic patients (89%) who underwent preoperative duplex ultrasound imaging, there was significant variability between centers in the degree of stenosis (50%-69%, 70%-79%, 80%-99%) designated for a given peak systolic velocity, end diastolic velocity, and internal carotid artery-to-common carotid artery ratio. Although 68% of CEA procedures in asymptomatic patients were performed for an 80% to 99% stenosis, 26% were performed for a 70% to 79% stenosis, and 4.1% were performed for a 50% to 69% stenosis. At the surgeon level, the range in the percentage of CEA procedures performed for a <80% asymptomatic carotid artery stenosis is from 0% to 100%. Similarly, at the center level, institutions range in the percentage of CEA procedures performed for a <80% asymptomatic carotid artery stenosis from 0% to 100%.Despite CEA being an extremely common procedure, there is widespread variation in the three primary determinants-preoperative imaging, carotid duplex ultrasound criteria, and threshold for surgery-of whether CEA is performed for asymptomatic carotid stenosis. Standardizing the approach to care for asymptomatic carotid artery stenosis will mitigate the significant downstream effects of this variation on health care costs.
Phil Houghton, Duncan Bate, Mark Davies, and John Lumley of ARKeX discuss the rationale behind the company’s development of an airborne gravity gradiometry method illustrated by a case study over difficult terrain in Canada. Exploring in difficult terrain and complex geology is challenging for any technology and traditionally in frontier areas, such as the Utah Hinge Line and the interior basins of North East British Columbia, regional reconnaissance is the first step. Explorationists gather information from surface geology maps, available seismic and well data in order to assess a region’s prospectivity. In addition, potential field techniques are often utilized, as surveys can be performed relatively easily, especially from the air.
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