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We study the impact of the geomagnetic storm of 7–9 September 2017 on the low- to mid-latitude ionosphere. The prominent feature of this solar event is the sequential occurrence of two SYM-H minima with values of -146 and -115 nT on 8 September at 01:08 and 13:56 UT, respectively. The study is based on the analysis of data from the Global Positioning System (GPS) stations and magnetic observatories located at different longitudinal sectors corresponding to the Pacific, Asia, Africa and the Americas during the period 4–14 September 2017. The GPS data are used to derive the global, regional and vertical total electron content (vTEC) in the four selected regions. It is observed that the storm-time response of the vTEC over the Asian and Pacific sectors is earlier than over the African and American sectors. Magnetic observatory data are used to illustrate the variation in the magnetic field particularly, in its horizontal component. The global thermospheric neutral density ratio; i.e., O/N2 maps obtained from the Global UltraViolet Spectrographic Imager (GUVI) on board the Thermosphere Ionosphere Mesosphere Energetics and Dynamics (TIMED) satellite are used to characterize the storm-time response of the thermosphere. These maps exhibit a significant storm-time depletion of the O/N2 density ratio in the northern middle and lower latitudes over the western Pacific and American sectors as compared to the eastern Pacific, Asian and African sectors. However, the positive storm effects in the O/N2 ratio can be observed in the low latitudes and equatorial regions. It can be deduced that the storm-time thermospheric and ionospheric responses are correlated. Overall, the positive ionospheric storm effects appear over the dayside sectors which are associated with the ionospheric electric fields and the traveling atmospheric disturbances. It is inferred that a variety of space weather phenomena such as the coronal mass ejection, the high-speed solar wind stream and the solar radio flux are the cause of multiple day enhancements of the vTEC in the low- to mid-latitude ionosphere during the period 4–14 September 2017. [ABSTRACT FROM AUTHOR]

Purpose: In patients with spinal instability, cord compression, or neurologic deficits, the standard of care is surgery followed by radiation therapy (RT). Recurrence rates after conventional RT remain high. The purpose of this study is to prospectively examine the efficacy of postoperative stereotactic body RT (SBRT) in patients who have undergone surgical intervention for spine metastases. We hypothesize that postoperative SBRT to the spine would be associated with higher local control than historical rates after conventional RT.Methods and Materials: Thirty-five adult patients with a Karnofsky Performance Status score ≥40 and spine metastases from solid tumors with no prior overlapping RT and target volumes ≤3 consecutive vertebral levels were enrolled. Thirty-three patients were treated. Two patients underwent treatment to 2 target volumes for a total of 35 target volumes. All patients received SBRT 30 Gy in 5 fractions. Patients were followed with neurological examinations and computed tomography and/or magnetic resonance imaging every 3 months. Neurologic function was assessed at the same time points using the American Spinal Injury Association (ASIA) impairment score. Pain was rated according to the 10-point visual analogue scale and MD Anderson Cancer Center brief pain index. Toxicity was recorded according to National Cancer Institute Common Toxicity Criteria for Adverse Events Version 4. The primary objective was the rate of radiographic local recurrence at 12 months after completion of SBRT.Results: Patient characteristics were as follows: 34.3% had radioresistant primaries; 71.4% were ASIA E and the remainder ASIA D; and the median baseline Karnofsky Performance Status score was 70 (range, 50-100). Radiographic and symptomatic local control at 1 year were 90% (95% confidence interval, 76%-98%). The median time to recurrence in these 3 patients was 3.5 months (range, 3.4-5.8 months), all had radiosensitive tumors, and all recurrences were epidural. No patients experienced wound dehiscence, hardware failure, or spinal cord myelopathy. The median time to return to systemic therapy was 0.5 months (range, 0-9.4 months).Conclusions: This prospective study of postoperative spine SBRT demonstrates excellent local control with low toxicity. These data suggest superior rates of local control compared with conventional RT; however, a formal comparative study is warranted. [ABSTRACT FROM AUTHOR]