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We present the first lasing results of SwissFEL, a hard X-ray free-electron laser (FEL) that recently came into operation at the Paul Scherrer Institute in Switzerland. SwissFEL is a very stable, compact and cost-effective X-ray FEL facility driven by a low-energy and ultra-low-emittance electron beam travelling through short-period undulators. It delivers stable hard X-ray FEL radiation at 1-A wavelength with pulse energies of more than 500 μJ, pulse durations of ~30 fs (root mean square) and spectral bandwidth below the per-mil level. Using special configurations, we have produced pulses shorter than 1 fs and, in a different set-up, broadband radiation with an unprecedented bandwidth of ~2%. The extremely small emittance demonstrated at SwissFEL paves the way for even more compact and affordable hard X-ray FELs, potentially boosting the number of facilities worldwide and thereby expanding the population of the scientific community that has access to X-ray FEL radiation. The first lasing results at SwissFEL, an X-ray free-electron laser, are presented, highlighting the facility’s unique capabilities. A general comparison to other major facilities is also provided.

We report a 46 XX male syndrome diagnosed after failure of gonadotropin therapy taken for hypogonadotropic hypogonadism due to a pituitary macroadenoma. A 39-year-old man with a non-functioning pituitary macroadenoma was admitted to our clinic due to vision loss and infertility. After pituitary surgery, vision loss improved while infertility still existed. Low testosterone levels without elevated gonadotropins were established suggesting hypogonadotropic hypogonadism due to pituitary adenoma. Gonadotropin treatment was initiated. There was no response to treatment after 12 months. A karyotype analysis was ordered to investigate other causes of infertility. Karyotype analysis showed a 46 XX male syndrome that can explain the failure of gonadotropin therapy. Testosterone therapy was started instead of gonadotropin therapy. 46 XX male syndrome usually presents with hypergonadotropic hypogonadism. However, in our case, it presented with hypogonadotropic hypogonadism due to pituitary mass not responding to gonadotropin therapy. It is important to keep in mind to obtain a genetic analysis of patients whose gonadotropin therapy failed, even if their gonadotropin levels are not elevated.

Recently there has been a global effort to increase the utilization of renewable energy resources. In this study, we use observed data to estimate the ocean wave power available in coastal Florida. We find that average values ranging from 2.073 to 6.939 kW/m are available annually. It is shown that these values vary spatially; regions in the Atlantic Ocean have more available wave power than those in the Gulf of Mexico. Average annual wave power also varies temporally, likely due to meteorological events, indicating that changes in the climate may have significant impacts on available wave power. Available wave power is estimated using a spectral wave power equation, which requires sparsely available spectral wave density data. Wave power is more commonly estimated using a standard wave equation, which simplifies the required parameters to wave heights and wave periods. Here, we use both equations in order to assess the impact of this simplification. We find that the estimated wave power values calculated using the two equations differ considerably; using the simplified equation underestimates available wave power by an average of 17%. The degree of underestimation varies spatially, thus we recommend using the spectral wave power equation for ocean wave power assessment whenever possible.

The Accelerator on a Chip International Program (ACHIP) is an international collaboration, funded by the Gordon and Betty Moore Foundation, with the goal of demonstrating that laser-driven accelerator can be integrated on a chip to fully build an accelerator based on dielectric structures. PSI will provide access to the high brightness electron beam of SwissFEL to test structures, approaches and methods towards achieving the final goal of the project. In this contribution, we will describe the two interaction chambers installed on SwissFEL to perform the proof-of-principle experiments. In particular, we will present the positioning system for the samples, the magnets needed to focus the beam to sub-micrometer dimensions and the diagnostics to measure beam properties at the interaction point.

In this study, novel

Objective: Pregnant women with type 1 diabetes mellitus (T1DM) have increased risk of fetal, maternal, and perinatal complications. In this report, we aimed to evaluate the effects of continuous subcutaneous insulin infusion (CSII) therapy on pregnancy outcomes, glycemic control, and acute complications in pregnant women with T1DM. Material and Methods: We retrospectively analyzed the data of 15 women with T1DM who were on CSII therapy during their pregnancy, and who were followed up at our clinic between 2008 and 2014. Acute complications, fetal/maternal, and perinatal complications, and glycemic control were analyzed. Results: The mean age of the patients was 28.2 +/- 3.6 years, and the mean duration of diabetes was 8 +/- 5.4 years. We did not observe severe hypoglycemic episodes and diabetic ketoacidosis during their pregnancy. The mean HbA1c levels at 4-8 weeks of pregnancy decreased from 7.4 +/- 1.3% to 6.3 +/- 0.7% at 34-38 weeks of pregnancy. The mean duration of pregnancy and neonatal birth weight were 37.1 +/- 1.2 weeks and 3.537 +/- 794 g, respectively. There were no stillbirths, perinatal infant deaths, or congenital malformations noted. There were two preterm births due to preeclampsia, one of whom had a low birth weight (1.800 g). We recorded one macrosomic baby (4.730 g). Conclusion: We observed that glycemic control improved with CSII therapy during pregnancy. We did not detect severe hypoglycemia or diabetic ketoacidosis in our research. In pregnant women with T1DM who had inadequate glycemic control with multiple daily insulin injection therapy, CSII might be a safe and appropriate treatment regimen.

The Pencil Beam Scanning (PBS) technique in proton therapy uses fast magnets to scan the tumor volume rapidly. Changing the proton energy allows changing to layers in the third dimension, hence scanning the same volume several times. The PBS approach permits adapting the speed and/or current to modulate the delivered dose. We built a simple prototype that measures the dose distribution in a single step. The active detection material consists of a single layer of scintillating fibers (i.e., 1D) with an active length of 100 mm, a width of 18.25 mm, and an insignificant space (20 &mu, m) between them. A commercial CMOS-based camera detects the scintillation light. Short exposure times allow running the camera at high frame rates, thus, monitoring the beam motion. A simple image processing method extracts the dose information from each fiber of the array. The prototype would allow scaling the concept to multiple layers read out by the same camera, such that the costs do not scale with the dimensions of the fiber array. Presented here are the characteristics of the prototype, studied under two modalities: spatial resolution, linearity, and energy dependence, characterized at the Center for Proton Therapy (Paul Scherrer Institute), the dose rate response, measured at an electron accelerator (Swiss Federal Institute of Metrology).

Aim To assess the sagittal soft tissue morphology of patients with acromegaly in comparison with a healthy control group. Methods Twenty-seven patients with acromegaly (11 male, 16 female; mean age 47.3 ± 11.5 years) and 30 healthy subjects (15 male, 15 female; mean age 42.2 ± 17.4 years) were included in the study. Linear and angular measurements were made on lateral cephalograms to evaluate soft tissue and skeletal characteristics. The intergroup comparisons were analysed with the Student’s t-test. Results Facial convexity (p < 0.01) and the nasolabial angle (p < 0.001) were reduced in patients with acromegaly, whereas nose prominence (p < 0.01), upper lip sulcus depth (p < 0.01), upper lip thickness (p < 0.01), basic upper lip thickness (p < 0.01), lower lip protrusion (p < 0.05), mentolabial sulcus depth (p < 0.05) and soft tissue chin thickness (p < 0.001) were increased. Anterior cranial base length (p < 0.05), the supraorbital ridge (p < 0.01), the length of the maxilla and mandible (p < 0.001, p < 0.01, respectively) were significantly increased, and mandibular prognathism was an acromegalic feature (p < 0.05). Conclusion Acromegalic coarsening and thickening of the craniofacial soft tissues was identified from lateral cephalograms, which may therefore contribute to early diagnosis when evaluated together with other changes caused by the disease.

Background: Prolactinomas are the most common functional pituitary adenomas. Treatment with dopamine agonists is considered as first-line therapy. Cystic prolactinoma is a variant prolactinoma. . It was assumed that since cystic area does not contain dopamine receptors, cystic prolactinomas would not respond to medical treatment. However, in recent years, it has been shown that cystic prolactinomas can also be treated with dopamine agonists, and medical treatment has become more preferred than surgical treatment. In this report, we aimed to evaluate the treatment effectiveness of patients with cystic prolactinomas who treated medically in our clinic. Materials and methods: Twenty-nine prolactinoma patients who were followed up in our hospital between 2019-2020 were evaluated retrospectively. Four patients (13%) were being followed up for cystic prolactinoma. Radiological images, laboratory findings, patients records were reviewed. Results: Four patients were being followed up for cystic prolactinoma and all were women. The average age of the patients followed up for cystic prolactinoma was 36 years. 3 patients (75%) had menstrual irregularity, 2 (50%) patients had galactorrhea, and 1 patient (25%) had headache at the time of admission. Tumor size regressed with medical treatment in two patients and the tumor disappeared completely in one patient. Although the symptomatic improvement and normalization of prolactin was achieved in one of our patients, the lesion did not shrink. We continued with medical treatment in this patient since there was no indication for surgery. Discussion: There was conflicting results in the literature regarding the management of cystic prolactinomas. Recently, dopamin agonist therapy is suggested as first- line treatment option in cystic prolactinomas. A study reported male predominance for cyst formation but we observed female predominance in our report. Faje et al. also reported female predominance in their study. Presentation of our patients were not different from solid prolactinomas. And although we evaluated very limited number of patients in our report, all of our patients respond to medical treatment which was consistent with recent literature.

In recent decades, utilization of renewable energy resources, including ocean waves, has been promoted as part of a global effort to transition away from the use of fossil fuels. This is largely due to the accompanying greenhouse gas emissions and its catastrophic impacts on the environment, which are expected to worsen with the changing climate. Energy from ocean waves can be harnessed and converted into electricity with devices referred to as wave energy converters (WECs). Many researchers have studied the impacts of the WECs on coastal hydrodynamics, however, the impact on morphodynamics is not as well understood. In this paper, we review studies that assess the impacts of wave farms on coastal erosion. The results of a number of studies that focus on various locations around the world show that WECs often generate clean and renewable energy without negatively impacting local coastlines, and in fact often mitigate coastal erosion.

Dipeptidyl peptidase-4 (DPP-4) plays a role in metabolic and inflammatory diseases. Increased adenosine deaminase (ADA) has been suggested to induce insulin resistance and inflammation. We measured serum DPP-4 and ADA activities. Serum ADA activity was significantly higher in PCOS group (p=.006), whereas there was no difference in serum DPP-4 activity between the groups (p>.05). When the study subjects were divided into four groups in terms of obesity; an increasing trend in serum ADA activity between the groups was observed and ADA activity was significantly higher in overweight and obese patients with PCOS than nonobese controls (p=.016), there were no significant differences between the other groups (p>.05). A positive correlation was found between ADA and BMI in the whole group (p=.022). Multivariate regression analyses revealed that significant determinants were diastolic blood pressure, ADA, and the presence of PCOS for DPP-4 (R-2=0.344, F=9.079, p

EgeUn###, Gerbera (Gerbera jamesonii H. Bolus ex. J.D. Hook) is one of the major cut flowers in Turkey, with approximately 114.00 ha and a production of 128 million per year. Gerbera decline was observed in several greenhouses in Izmir province of Turkey. Affected plants exhibited yellowing and wilting of leaves, growth deficiency and decline in flower quality. Infected roots and crowns rotted. A fungus-like organism was consistently isolated from necroses that appeared on roots and crowns of gerbera in Izmir in 2016. Diseased gerberas were collected from five districts where more than 90% amount of gerberas cultivating areas in Izmir. The pathogen was identified as Phytophthora cryptogea based on morphological characteristics and DNA sequence of internal transcribed spacer (ITS) region. Pathogenicity of the isolates were tested under growth chamber conditions (22-24 degrees C, 16/8h day/night) on 2-month-old gerbera 'Sky Line' seedlings. Isolates of P. cryptogea were pathogenic on gerberas that were infected soils via inoculated rice grains. After 3 weeks, root and crown rot, yellowing and wilting of leaves developed in plants that inoculated with P. cryptogea. This study demonstrated that P. cryptogea causing root and crown rot of gerbera in Izmir province in Turkey.

The SwissFEL soft X-ray free-electron laser (FEL) beamline Athos will be ready for user operation in 2021. Its design includes a novel layout of alternating magnetic chicanes and short undulator segments. Together with the APPLE X architecture of undulators, the Athos branch can be operated in different modes producing FEL beams with unique characteristics ranging from attosecond pulse length to high-power modes. Further space has been reserved for upgrades including modulators and an external seeding laser for better timing control. All of these schemes rely on state-of-the-art technologies described in this overview. The optical transport line distributing the FEL beam to the experimental stations was designed with the whole range of beam parameters in mind. Currently two experimental stations, one for condensed matter and quantum materials research and a second one for atomic, molecular and optical physics, chemical sciences and ultrafast single-particle imaging, are being laid out such that they can profit from the unique soft X-ray pulses produced in the Athos branch in an optimal way., Journal of Synchrotron Radiation, 26 (4), ISSN:0909-0495, ISSN:1600-5775

Purpose: Thyroglobulin (Tg) assessment in the needle washout after fine-needle aspiration biopsy (FNAB) of a suspicious neck lymph node (LN) is known to improve the diagnostic accuracy in patients with papillary thyroid cancer (PTC). However, there is still controversy on the best diagnostic cut-off levels for FNAB-Tg and whether thyroglobulin antibody (TgAb) positivity affects FNAB-Tg. The objectives of this study were to determine (i) the diagnostic power of different cut-offs for FNAB-Tg and (ii) if serum TgAb(+) negatively affects the FNAB-Tg evaluation. Methods: This was a retrospective cohort study analyzing PTC patients with suspicious neck LNs, in a university hospital setting, from October 2009 to October 2013. In total, 103 patients with PTC (226 LNs) undergoing ultrasound-guided FNAB for LNs were included. Cytology and FNAB-Tg levels were compared in reference to LN histopathology and the effect of TgAb(+) on FNAB-Tg levels was evaluated. Results: The diagnostic accuracies of FNAB-Tg cut-off of 1 and 10 ng/mL were 94.1% and 88.2%, respectively. Raising the cut-off from 1 to 10 ng/mL led to decreased sensitivity rates (91.9% vs. 83.9%). The receiver operating characteristic curve analysis demonstrated that the best FNAB-Tg cut-off was 1.2 ng/mL. There were no LNs with an FNAB-Tg >= 10 ng/mL that turned out to be cytologically or histopathologically benign. FNAB-Tg levels of the histopathologically malignant LNs were similar between TgAb (+) and TgAb (-) patients (p = 0.546). Serum Tg predicted FNAB-Tg levels above 1 ng/mL (p = 0.002) and FNAB-Tg predicted malignant histopathology (p = 0.004), both independently of the TgAb status of the patient. Conclusions: FNAB-Tg >= 1 ng/mL has a superior diagnostic power, irrespective of TgAb (+), in PTC patients with suspected LN involvement.

The generation of low-emittance electron beams has received significant interest in recent years. Driven by the requirements of X-ray-free electron lasers, the emittance of photocathode injectors has been reduced significantly, with corresponding increase in beam brightness. This has put increasingly stringent requirements on the instrumentation to measure the beam size. These requirements are even more stringent for novel accelerator developments, such as laser-driven accelerators based on dielectric structures or on a plasma. We present here the generation and measurement of a sub-micrometer electron beam, at a particle energy of 330 MeV, and a bunch charge below 1 pC. An electron-beam optics with a vertical β-function of a few millimeters has been setup. The beam is characterized through a wire scanner that employs a 1 μm wide metallic structure fabricated using the electron-beam lithography. The smallest (rms) transverse beam size presented here is

The cardiovascular effects of short-term overt hypothyroidism are not well known. We investigated proprotein convertase subtilisin/kexin type 9 (PCSK9), soluble lectin-like oxidized LDL receptor 1 (sLOX-1) and the ankle brachial index (ABI) in thyroid cancer patients with short-term overt hypothyroidism due to thyroid hormone withdrawal (THW). Twenty-one patients requiring radioactive iodine (RAT) ablation or scanning and 36 healthy control subjects were enrolled. Patients were evaluated in the subclinical thyrotoxic phase when they were on suppressive levothyroxine therapy and in the overt hypothyroid phase due to THW for four weeks. PCSK9, sLOX-1, lipids and ABI were measured in the patient and control groups. Total cholesterol, LDL cholesterol, triglycerides and Apo B levels were increased in short overt hypothyroidism compared with the control group (p

To present the rare case of a patient who developed destructive thyroiditis accompanied by transient thyrotoxicosis resulting from infliximab therapy for the treatment of psoriasis.The clinical presentation and management of a case with infliximab-associated thyroiditis is described with a brief review of the literature.A 57-year-old male who suffered from psoriasis was treated with infliximab therapy for 4 years. Thyroid function tests were normal before infliximab therapy. When the patient presented in our clinic, he had thyrotoxicosis and was using propylthiouracil. A 99m Technetiumpertechnetate thyroid scintigraphy scan showed no visualization of either thyroid lobe or decreased thyroid iodine uptake. Thyroid-stimulating hormone (TSH) receptor antibody, thyroid peroxidase antibody (anti-TPO Ab) and thyroglobulin antibody (anti-Tg Ab) were negative. Thyroid ultrasonography revealed a heterogeneous thyroid gland without nodules. After stopping propylthiouracil therapy, we advised monitoring of his thyroid function tests in the following weeks, and infliximab therapy for psoriasis was continued. Four weeks later, his thyroid function tests showed an elevated TSH level with normal levels of free triiodothyronine and thyroxine (FT3 and FT4, respectively), and levothyroxine treatment was administered to the patient. Thyroid function tests normalized after levothyroxine treatment. One year later, infliximab therapy was stopped because of clinical remission. Simultaneously, levothyroxine treatment was also stopped. His thyroid function tests were normal 6 weeks after the cessation of levothyroxine treatment.To our knowledge, the present report is the third infliximab-associated thyroid disorder case. Periodic follow-up of thyroid function tests is necessary during infliximab therapy.

Our aim was to investigate body composition changes, epicardial adipose tissue thickness (EATT), serum omentin-1 levels, and the relationship among them along with some atherosclerosis markers in overt hypothyroidism. Twenty-eight newly diagnosed overt hypothyroid patients were evaluated before and after 6 months of thyroid hormone replacement therapy (THRT) and compared to the healthy subjects in this prospective longitudinal study. Body compositions were measured with dual-energy X-ray absorptiometry, and EATT was measured by echocardiography. Carotid intima-media thickness (c-IMT), flow-mediated dilatation (FMD), thyroid hormone levels, lipid parameters, high sensitive c-reactive protein, homocysteine, and omentin-1 levels were measured in all subjects. Body weight and lean body mass were higher in patients with hypothyroidism compared to euthyroid state after THRT (p = 0.012, 0.034, respectively). EATT was higher in patients with hypothyroidism than the control group (p < 0.001) and decreased with THRT (p = 0.012) but still remained higher than the control group (p < 0.001). Free T4 levels were found to be an independent factor to predict EATT (p < 0.001). In hypothyroid state, omentin-1 levels were lower than controls (p = 0.037) but increased in 6 months with THRT (p = 0.001). The c-IMT was higher, and FMD was lower in hypothyroidism compared to euthyroid state and control group (p < 0.05). Increasing lean body mass, but not adipose tissue mass, was found to be responsible for weight gain in hypothyroidism. The increased amount of EATT and decreased omentin-1 levels can contribute to the development of atherosclerosis in addition to other factors in hypothyroidism.

The SwissFEL X-ray Free Electron Laser (XFEL) facility started construction at the Paul Scherrer Institute (Villigen, Switzerland) in 2013 and will be ready to accept its first users in 2018 on the Aramis hard X-ray branch. In the following sections we will summarize the various aspects of the project, including the design of the soft and hard X-ray branches of the accelerator, the results of SwissFEL performance simulations, details of the photon beamlines and experimental stations, and our first commissioning results.