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Idiopathic intracranial hypertension (IIH) is a syndrome characterized by elevated intracranial pressure without an identifiable underlying cause. Pregnancy has unique and important diagnostic and therapeutic implications for patients with IIH. Despite these implications, there are no guidelines to assist clinicians in managing IIH during pregnancy. Our review aims to summarize the key considerations related to the diagnosis and management of IIH during pregnancy, to optimize the care of these patients and mitigate the risk of disease-related complications. The optimal management of IIH in pregnancy should include a multidisciplinary team, including an obstetrician (or maternal-fetal medicine specialist), a neurologist, and an ophthalmologist (or neuro-ophthalmologist).

Study question Does Preconception TSH levels affect the clinical outcomes of Infertile Women Undergoing Fresh Embryo Transfer Cycle? Summary answer Among euthyroid patients, preconceptional TSH values in the high-normal range (between 2.5 and 4.0 mIU/L) are associated with adverse clinical outcomes. What is known already Serum thyroid-stimulating hormone (TSH) levels are routinely screened in women with infertility given the negative impact of thyroid disease on ovarian function and pregnancy is associated with poor outcomes.In fact, an underlying thyroid abnormality was found in 46% for women experiencing IVF failure and TSH levels were inversely proportional to the fertilization rate at IVF. While it is clear that pregnancies complicated by subclinical hypothyroidism in the fertile population have poor outcomes, the relevance of preconception subclinical hypothyroidism in infertile patients undergoing ART has not been thoroughly examined. Study design, size, duration Outcomes of all fresh IVF patients with an embryo transfer from from January 2019 to August 2021 within 1 yr of TSH screening at a our center were studied. IVF cycles using donor oocyte, TESE sperm, PGT, or those lacking follow-up were excluded. For patients with more than one Preconception TSH measurement prior IVF, the most recent measurement before the IVF cycle was used. Participants/materials, setting, methods Cycles were categorized into two groups based on preconceptional TSH values: Euthyroid (0.4–2.5 μIU/mL), subclinical hypothyroidism (>2.5-4.0 μIU/mL). All women underwent standard IVF protocols following usual individualized practice in our IVF clinic. Chi-square test was used to evaluate the differences between the patient cohorts. Main results and the role of chance A total of 2,669 fresh-ET cycles were reviewed retrospectively by dividing them into a euthyroid group (0.4-2.5 uIU/mL, n = 2397) and subclinical hypothyroidism group (2.5-4.0 uIU/mL, n=272). The overall biochemical pregnancy rate and clinical pregnancy rate was significantly lower in women with subclinical hypothyroidism (50.0% vs 43.4%, 40.0% vs 30.9%, p Limitations, reasons for caution This is a retrospective study and results must be confirmed on a well-designed randomized controlled study. Correlations must be considered with caution since the role of TSH is under study, especially when considering LBR outcome. Wider implications of the findings Among euthyroid patients, preconceptional TSH values in the high-normal range (between 2.5 and 4.0 mIU/L) are associated with adverse clinical outcomes. Our findings suggest that subclinical hypothyroidism may affect clinical outcomes. Trial registration number not applicable

The change in the physical and chemical properties of a LaC2-2C disk (Ф: 50 mm, thickness: 1.3 mm), was investigated after a high temperature integrity tests (HTITs). The tests were conducted as precedent research to UCx, which is as an isotope separation on-line (ISOL) target material. The HTITs were performed under 10−6 Torr at three different temperatures (1600 °C, 1800 °C and 2000 °C) and two exposure times (24 h and 48 h). The microstructure and composition of the disks were analyzed by scanning electron microscopy (SEM) and X-ray diffraction (XRD). The density of the disks were also measured to calculate the porosity. The test results indicate that the LaC2-2C target disk satisfies the requirements for use as an ISOL target.

The effect of Si addition on the initial deformation mechanism of Fe–30Mn–9Al–0.9C–0.5Mo cast lightweight steel has been investigated. Atomic-scale analysis by three-dimensional atom-probe tomography confirmed that Si addition accelerates the formation kinetics of the κ-carbide, and increases remarkably the partitioning coefficient of carbon by more than 2 times. Promotion of C partitioning into κ-carbides by Si addition leads to deformation localization in an aged state. This is attributed not only to the increase of the κ-carbide size associated with higher coherency strain, but also to higher frequency of Al-C bonding formation. First-principles calculations indicated that the energy required for a/2 shearing of κ-carbide in the aged 1%-Si steel is higher (561 mJ/m2) than that in the aged Si-free steel (494 mJ/m2). Therefore, Si addition leads to a significant energy difference for shearing and results in different shear bands formation. The operative deformation mechanism can be calculated for this alloy system as a function of precipitates volume fraction and size. It was determined that deformation proceeds primarily by κ-carbide shearing as long as the radius of κ-carbides is smaller than 13.4 nm.

This work develops an artificially intelligent (AI) tokamak operation design algorithm that provides an adequate operation trajectory to control multiple plasma parameters simultaneously into different targets. An AI is trained with the reinforcement learning technique in the data-driven tokamak simulator, searching for the best action policy to get a higher reward. By setting the reward function to increase as the achieved β p, q 95, and l i are close to the given target values, the AI tries to properly determine the plasma current and boundary shape to reach the given targets. After training the AI with various targets and conditions in the simulation environment, we demonstrated that we could successfully achieve the target plasma states with the AI-designed operation trajectory in a real KSTAR experiment. The developed algorithm would replace the human task of searching for an operation setting for given objectives, provide clues for developing advanced operation scenarios, and serve as a basis for the autonomous operation of a fusion reactor.

We report on the experimental results for laser ionization spectroscopy of atomic tin using a four-color three-step laser ionization scheme in conjunction with an atomic beam apparatus. Typically, the laser ionization efficiency is remarkably limited for certain elements whose thermal population is distributed over its higher lying components of the fine structure at high temperature (e.g. about 2000 K). We demonstrate that the laser ionization efficiency can be increased by simultaneous excitation from the 3 P 0 and 3 P 1 fine-structure components of the 5s25p2 ground-state of atomic tin. This was achieved using two lasers, operating at 283 nm and 301 nm. Furthermore, four-level N-type mutiphoton Raman resonances in this four-color ionization scheme can be utilized to enhance the ionization efficiency allowing an additional ionization process from the third ground state 5 s 2 5 p 2 3 P 2 .

We report on the experimental results of the ionization efficiency of Rb and Cs using a surface ionization source prototype at Rare Isotope Science Project (RISP) of Institute for Basic Science (IBS). A hot-cavity surface ionization source has been studied in an off-line test bench equipped with a mass separator and a beam diagnostic system which allow accurate ionization efficiency measurements. Ionization efficiencies of 76% and 77% have been measured for Rb and Cs, respectively, from the Ta prototype of the RISP surface ionization source.

The primary objective of this long-term research activity is to build a climatology of vertical aerosol profiles in and above the Arctic Boundary Layer. To this aim since 2011, an international research team has performed yearly field campaigns at the Ny-Ålesund super-site thanks the support of the Italian CNR Arctic Station Dirigibile Italia and the German-French AWIPEV station. We employed various aerosol payloads and tethered balloons systems (TBS) and recorded, up to date, about 500 aerosol profiles in the first 2 km, providing detailed information on black carbon (BC) concentration, aerosol size distribution, aerosol scattering coefficients, and chemical composition. These pieces of information are necessary for the understanding of the aerosol formation, long-range transport, and fate in the Arctic troposphere. Case studies will be highlighted describing the influence of ship emissions, Arctic haze and new particle formation events on the vertical aerosol structure. In situ TBS activities have been often accompanied by simultaneous lidar profiling and a closure study of aerosol microphysical property retrieval is in progress based on this data and also on a full chemical aerosol characterization both at a bulk level on filter samples and on single particles by scanning electron microscopy. Complementary information has also been obtained from extensive computational studies of air mass transport utilizing Eulerian and Gaussian models. Since 2016 the study of the horizontal distribution of BC and nanoparticles has been initiated and performed along transects of the main glaciers around Ny-Ålesund exploiting portable instrumentation with the primary goal of studying the processes at the atmosphere/snow boundary. More recently in summer 2018 a TBS campaign has been performed in Longyearbyen for investigating pollution due to ship emission, and during the winter 2018/2019, for the first time, vertical aerosol profiles have been measured during the polar night. These scientific activities have been accompanied by constant development of the instrumentation and payload performances as well as by regular intercomparison campaigns with ground-based measurements performed at the Gruvebadet laboratory and the CCT. The next generation of aerosol payloads, currently under development and test, will include the possibility of characterizing the Arctic thin clouds, with dedicated measurements of cloud droplet size distribution, cloud chemistry, and cloud microbiology, within the framework of collaborations with the Korean polar research Institute (KOPRI) institute and other national research teams.

Background The use of imatinib combined with chemotherapy has demonstrated improved outcome in adults with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-positive ALL). However, a substantial proportion of patients continue to die as a result of disease progression. Patients and methods We assessed the minimal residual disease (MRD)-based effect and long-term outcome of first-line incorporation of dasatinib (100 mg once daily) into chemotherapy alternatively for adults with Ph-positive ALL. The primary end point was the major molecular response (MMR) rate by the end of the second dasatinib cycle. Patients with a donor proceeded to allogeneic stem cell transplantation (SCT) as early as possible. MRD monitoring was centrally evaluated by real-time quantitative polymerase chain reaction (4.5-log sensitivity) using bone marrow samples. Results Fifty-one patients (median age, 46 years) were enrolled and treated with this strategy. After the first dasatinib cycle, 50 patients (98.0%) achieved complete remission (CR). By the end of the second dasatinib cycle, 46 (93.9%) of 49 assessable patients had persistent CR, and 38 (77.6%) had MMR (32.7%) or undetectable MRD (44.9%). On the basis of the MRD kinetics by this time point, the numbers of early-stable, late, and poor molecular responders were 23 (46.9%), 15 (30.7%), and 11 (22.4%), respectively. Thirty-nine patients (76.5%) underwent allogeneic SCT in CR1. After a median follow-up of 54 months, the 4-year cumulative incidence of relapse and disease-free survival (DFS) rate for all patients were 30.0% and 52.0%, respectively, and the corresponding outcomes among those receiving allogeneic SCT in CR1 were 20.5% and 64.1%, respectively. Poor molecular responders had a higher risk of relapse and DFS than those of early-stable molecular responders. Conclusion This dasatinib-based protocol was effective for achieving a good quality molecular response and durable DFS in adults with Ph-positive ALL. Trial registration clinicaltrials.gov, NCT01004497.

To compare the performance of axial images of the ankle joint on three-dimensional (3D) volume isotropic turbo spin echo acquisition (VISTA) with that of two-dimensional (2D) fast spin echo (FSE) T2-weighted images for the diagnosis of anterior talofibular ligament (ATFL) injury.This retrospective study included 101 patients who underwent both 2D FSE T2-weighted and 3D VISTA magnetic resonance imaging (MRI) of the ankle. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of both sequences were measured. The anatomical identification score and diagnostic performances of both sequences were evaluated by two radiologists. The diagnostic performances of 3D VISTA and 2D FSE images were analysed in terms of sensitivity, specificity, and accuracy for diagnosing ATFL injury. Surgically or clinically confirmed diagnoses were used as reference standards.The margin sharpness scores on 3D VISTA were significantly inferior to those of 2D FSE (p0.001). Other scores (entire length, entire width) were not significantly different between the two imaging methods. The SNRs and CNRs of 3D VISTA were significantly higher than those of 2D FSE (p0.001). When diagnoses were classified as normal and abnormal, the specificity of the 3D VISTA images for the diagnosis of ATFL injury was 95.7%, significantly superior to 2D FSE (84.3-85.7%). There were no significant differences between 3D VISTA and 2D FSE images in sensitivity or accuracy for diagnosis (p=0.227-1.000), with the exception of accuracy by reader 1 (p=0.039).3D VISTA imaging has a diagnostic performance comparable to that of 2D FSE for the diagnosis of ATFL injury, although 3D VISTA is inferior to 2D FSE for the evaluation of margin sharpness. Replacing axial and coronal images with 3D VISTA can save imaging time without negatively impacting the diagnostic ability for ATFL injury.

The relationship between reproductive breast risk factors and breast cancer survival in patients with different breast cancer subtypes is not well known.We examined a large-sized, retrospective study of 23,882 subjects from the Korean Breast Cancer Registry. The breast cancer subtype was determined by immunohistochemical staining for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2). Information regarding reproductive factors, including breastfeeding, age at first birth (AFB), and parity, was gathered. Multivariate Cox regression analysis was used to estimate the association among breast cancer subtypes, such as luminal A, luminal B, Her-2/neu overexpressing, and triple negative breast cancer (TNBC), and breast cancer survival as dependent variables and adjusting for age and stage.High parity (≥ 5) increased the recurrence risk of luminal A and B breast cancer (hazard ratio [HR], 1.95; 95% confidence interval [CI], 0.96-3.97; P = .0055 and HR, 1.12; 95% CI, 0.42-3.02, respectively; P = .0073) in breast cancer-specific survival (BCSS), but 1 to 3 child births decreased the recurrence risk of luminal A breast cancer (HR, 0.56; 95% CI, 0.34-0.91; P = .0055) and luminal B breast cancer (HR, 0.32; 95% CI, 0.17-0.61; P = .0073) in BCSS. Early AFB (20 years) increased the recurrence risk of luminal A breast cancers (HR, 1.61; 95% CI, 0.62-4.26; P = .039) in BCSS and of TNBC (HR, 1.31; 95% CI, 0.78-2.21; P = .0006) in overall survival. Her-2/neu overexpressing breast cancer had no correlation with parity and AFB in breast cancer survival.High parity (≥ 5) and early AFB (20 years) were correlated with worse clinical outcomes in patients with luminal breast cancer, but not with other subtyped breast cancers.

It aimed to investigate whether increased stroke volume (SV) after ventricular premature complex (VPC) is related to VPC-related symptoms. We selected patients having an isolated VPC during echocardiography from a prospective registry that included patients with a structurally normal heart and 24

Introduction/Background When an intervertebral disc degenerates, structural deterioration occurs in a wide range of anatomical components within and adjacent to the disc, being clearly represented in cross-sectional imaging. To suggest reliable and valid MRI-based morphologic parameters to quantify lumbar disc degeneration, the reliabilities of 6 parameters were analyzed to choose those with high reliability. The selected parameters were further tested to determine validity by correlating with disc height, which is regarded as a hallmark of structural integrity of the intervertebral disc. Material and method Eighty-five patients over 60 years old who underwent MRI of the lumbar spine for mild low back pain were included. Two reviewers independently assessed the degree of degeneration and assigned one of the 4 ordinal scores from 0 to 3 in the following 6 parameters at 6 spinal segments: T2-signal intensity (T2-SI), disc extension beyond interspace (DEBIT), annular fissure, Modic changes, endplate integrity, and osteophytes. Inter-observer and intra-observer agreements were assessed using Cohen's kappa statistic. For those parameters with high reliability, relationships with disc height were examined by calculating Pearson's correlation coefficients. Results While intra-observer agreements were excellent for all parameters (weighted kappa range 0.801–0.875), the inter-observer agreements were substantial to excellent for T2-SI, DEBIT, Modic changes, and endplate integrity (weighted kappa range 0.629–0.874), moderate for osteophytes (weighted kappa 0.573), and only fair for annular fissure (weighted kappa 0.29). Modic changes (r = −0.497, P Conclusion To quantify lumbar disc degeneration using MRI, Modic changes, endplate integrity, osteophytes, T2-SI, and DEBIT could be used as reliable parameters. However, different weights might be applied to each parameter because validities to represent degeneration varied.

For the success of PAL-XFEL, two critical systems, namely a low emittance injector and a variable gap out-vacuum undulator, are under development. In order to realize the target emittance of the PAL-XFEL injector we carried out an optimization study of various parameters, such as the laser beam transverse profile, the laser pulse length, the laser phase, and the gun energy. The transverse emittance measured at the Injector Test Facility (ITF) is ${\it\varepsilon}_{x}=0.48\pm 0.01~\text{mm}~\text{mrad}$ . An undulator prototype based on the EU-XFEL design and modified for PAL-XFEL was built and tested. A local- $K$ pole tuning procedure was developed and tested. A significant reduction (90%) of the local- $K$ fluctuation was observed. The requirement of undulator field reproducibility better than $2\times 10^{-4}$ and the undulator gap setting accuracy below $1~{\rm\mu}\text{m}$ were achieved for the prototype. The optical phase jitter after the pole height tuning at the tuning gap was calculated to be $2.6^{\circ }$ rms, which satisfies the requirement of $5.0^{\circ }$ .