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The emission characteristics of X-ray pulsars are governed by magnetospheric accretion within the Alfvén radius, leading to a direct coupling of accretion column properties and interactions at the magnetosphere. The complexity of the physical processes governing the formation of radiation within the accreted, strongly magnetized plasma has led to several sophisticated theoretical modelling efforts over the last decade, dedicated to either the formation of the broad band continuum, the formation of cyclotron resonance scattering features (CRSFs) or the formation of pulse profiles. While these individual approaches are powerful in themselves, they quickly reach their limits when aiming at a quantitative comparison to observational data. Too many fundamental parameters, describing the formation of the accretion columns and the systems’ overall geometry are unconstrained and different models are often based on different fundamental assumptions, while everything is intertwined in the observed, highly phase-dependent spectra and energy-dependent pulse profiles. To name just one example: the (phase variable) line width of the CRSFs is highly dependent on the plasma temperature, the existence of B-field gradients (geometry) and observation angle, parameters which, in turn, drive the continuum radiation and are driven by the overall two-pole geometry for the light bending model respectively. This renders a parallel assessment of all available spectral and timing information by a compatible across-models-approach indispensable. In a collaboration of theoreticians and observers, we have been working on a model unification project over the last years, bringing together theoretical calculations of the Comptonized continuum, Monte Carlo simulations and Radiation Transfer calculations of CRSFs as well as a General Relativity (GR) light bending model for ray tracing of the incident emission pattern from both magnetic poles. The ultimate goal is to implement a unified fitting model for phase-resolved spectral and timing data analysis. We present the current status of this project.

Objective: The aim of this study was to report on the use of laparoscopic implantation of leads on the branches of the sacral plexus for neuromodulation in the treatment of chronic pelvic pain (CPP) in a multidisciplinary setting with the help of electrophysiological neuromonitoring., Materials and Methods: Between 2012 and 2019, six female patients complaining of chronic pain and bladder and bowel dysfunctions underwent laparoscopic exposure and nerve identification with the help of electrophysiological neuromonitoring. A lead was placed laparoscopically in direct contact with the affected nerve. Pain intensity (numerous ranking scale [NRS]), generic health status (EQ-5D-5L), Becks Depressions Inventory (BDI-V), Pain Catastrophizing Scale (PCS), and Client Satisfaction Questionnaire (CSQ-8) were assessed pre-/postoperatively as well as three and six months after surgery. Statistical analysis was performed using Mann-Whitney U and Wilcoxon rank-sum test., Results: The median age was 36.5 years. NRS improved from a median of 9.5 preoperatively to 3.0 (p < 0.001) at six-month follow-up. Median EQ-5D-5L index value before treatment was 0.18, indicating a notably lowered quality of life and increased up to 0.83 after six months (p < 0.001). Preoperative median BDI-V scores indicated a major depressive mood and improved from a median of 46.0 to 12.0 after six months (p = 0.007). Preoperative PCS was elevated with a median score of 41.0 and decreased to 4.0 after six months (p < 0.001). CSQ showed that patients were satisfied with the treatment., Conclusions: This unique method is an alternative and effective treatment option for CPP even years after primary endometriosis surgery., (© 2020 International Neuromodulation Society.)

Sphingosine‑1‑phosphate (S1P) plays a key role in cell survival, growth, migration, and in angiogenesis. In glioma, it triggers the activity of the S1P‑receptor 1 and of the sphingosine kinase 1; thus influencing the survival rate of patients. The aim of the present study was to investigate the anti‑proliferative effect of the S1P analogue FTY720 (fingolimod) in glioblastoma (GBM) cells. A172, G28, and U87 cells were incubated with micromolar concentrations of FTY720 or temozolomide (TMZ) for 24 to 72 h. Proliferation and half maximal inhibitory concentration (IC50) were determined by using the xCELLigence system. FACS analysis was performed to check the cell cycle distribution of the cells after a 72‑h incubation with FTY720. This was then compared to TMZ‑incubated and to untreated cells. Gene expression was detected by RT‑qPCR in A172, G28, U87 and three primary GBM‑derived cell lines. FTY720 was able to reduce the number of viable cells. The IC50 value was 4.6 µM in A172 cells, 17.3 µM in G28 cells, and 25.2 µM in U87 cells. FTY720 caused a significant arrest of the cell cycle in all cells and stabilized or over‑expressed the level of AKT1, MAPK1, PKCE, RAC1, and ROCK1 transcripts. The TP53 transcript level remained stable or was downregulated after treatment with FTY720. FTY720 may be a promising target drug for the treatment of GBM, as it has a strong anti‑proliferative effect on GBM cells.

Background:  Insertion of a frontal external ventricular drain (EVD) is a common emergency procedure in neurosurgery. Malpositioning of the EVD and/or triggering a new intracerebral or intraventricular hemorrhage (nICVH) are typical complications. The standard procedure (SP) uses a tape measure to identify the Kocher's point for placement of a frontal burr hole. A faster alternative to determine the correct position is the freehand technique (FHT). This study compared both techniques with regard to the correct positioning of the EVD tip and the induction catheter-induced nICVH., Methods:  We performed a retrospective analysis of patients who required an EVD for acute or chronic hydrocephalus between January 2013 and March 2014. The study consisted of two groups. In the first group, EVDs were placed with the FHT. In the second group the SP was used. Postoperative computed tomography scans were analyzed regarding correct positioning of the ventricular catheter, malpositioning of the tip of the EVD using a 4-point-scale, and evidence for catheter-induced nICVH., Results:  A total of 95 patients could be included. The FHT was performed in 43 cases and the SP in 52 cases. No significant differences between the two groups were found regarding the correct position of the EVD tip ( p  = 0.38) and nICVH ( p  = 0.12). There was no significant difference in malpositioning of the EVD tip between the groups ( p  = 0.34)., Conclusion:  Our results show no significant differences between the two methods with regard to correct position, malpositioning, and nICVH. Thus we conclude that the FHT is a fast, safe, and effective alternative to the SP., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (Georg Thieme Verlag KG Stuttgart · New York.)