Immunohistochemical staining seems mandatory for individualizing and shortening follow-up in unilateral primary aldosteronism.

OBJECTIVE: The clinical significance of immunohistochemistry (IHC) for unilateral primary aldosteronism (PA) has been unclear. Individualized follow-up of PA patients could be in sight. Long-term outcomes of patients, classified based on IHC, need further investigation. We aimed to assess long-term clinical outcomes for unilateral PA, classifying patients based on IHC. DESIGN: A nationwide observational study, with up to 16 years follow-up, executed in 2007-2016 at Landspitali University Hospital, tertiary referral center. Patients were diagnosed and treated in line with the current guidelines. Haematoxylin and eosin (H&E) tissue slides were stained using CYP11B1 and -B2 antibodies. All cases were re-evaluated and classified according to the HISTALDO consensus. Outcomes were assessed using the PASO criteria. PATIENTS: All unilateral PA patients diagnosed in 2007-2016 in Iceland, 26 patients aged 28-73 years, who underwent adrenalectomy, were included. MEASUREMENTS: Aldosterone, renin, and cortisol values, use and dosage of antihypertensives, potassium supplementation, blood pressure and serum potassium pre-intervention and throughout follow-up, and histopathology results post-adrenalectomy. RESULTS: Following IHC, an aldosterone-producing nodule was seen in 12 adrenals, an aldosterone-producing adenoma in 10 and multiple aldosterone-producing micronodules in four. IHC altered histopathology from previous H&E diagnosis in 23% (6/26) of the patients. In total, 81% (21/26) of the patients had partial clinical success. Eight percent (2/26) of the patients needed potassium supplementation during follow-up. In the classical group, the AVS results were more determinative with significantly higher lateralization index (median 10.1 vs. 5.3, p = .04) and more contralateral suppression (median nondominant ratio 0.4 vs. 1.0, p = .03). One out of five patients with complete clinical success at 12 months post-op had severe relapse later, the other four were normotensive without antihypertensives for up to 10 years. CONCLUSIONS: We found IHC mandatory for accurate histopathologic diagnosis of PA. Our results support the importance of contralateral suppression when interpreting AVS results. Also, the study highlights the complicated assessment of clinical outcome and importance of aldosterone and renin measurements during follow-up.

Are We Only Detecting the Tip of the Iceberg? A Nationwide Study on Primary Aldosteronism with up to 8-Year Follow-up.

BACKGROUND: Long-term follow-up studies on primary aldosteronism (PA) are lacking. OBJECTIVE: We aim to review results of diagnostic procedures and histopathology for patients diagnosed during 2012-2016 in Iceland, compare unilateral (UD) and bilateral disease (BD) and assess treatment response. METHODS: Thirty-two patients aged 28-88 were diagnosed and treated according to guidelines. RESULTS: The majority had BD. Everyone needed potassium supplementation at case detection. We saw a reduction in systolic blood pressure (p < .001, both groups), antihypertensive agents (p = .002 UD and p = .04 BD) and potassium supplementation (p < .001, both groups). CONCLUSION: Similar treatment response was seen in both subgroups. Ratio of hypokalemia and number of cases indicates severe PA underdiagnosis in Iceland.

Simons Observatory: characterizing the Large Aperture Telescope Receiver with radio holography.

We present near-field radio holography measurements of the Simons Observatory Large Aperture Telescope Receiver optics. These measurements demonstrate that radio holography of complex millimeter-wave optical systems comprising cryogenic lenses, filters, and feed horns can provide detailed characterization of wave propagation before deployment. We used the measured amplitude and phase, at 4 K, of the receiver near-field beam pattern to predict two key performance parameters: 1) the amount of scattered light that will spill past the telescope to 300 K and 2) the beam pattern expected from the receiver when fielded on the telescope. These cryogenic measurements informed the removal of a filter, which led to improved optical efficiency and reduced sidelobes at the exit of the receiver. Holography measurements of this system suggest that the spilled power past the telescope mirrors will be less than 1%, and the main beam with its near sidelobes are consistent with the nominal telescope design. This is the first time such parameters have been confirmed in the lab prior to deployment of a new receiver. This approach is broadly applicable to millimeter and submillimeter instruments.

Simons Observatory HoloSim-ML: machine learning applied to the efficient analysis of radio holography measurements of complex optical systems.

Near-field radio holography is a common method for measuring and aligning mirror surfaces for millimeter and sub-millimeter telescopes. In instruments with more than a single mirror, degeneracies arise in the holography measurement, requiring multiple measurements and new fitting methods. We present HoloSim-ML, a Python code for beam simulation and analysis of radio holography data from complex optical systems. This code uses machine learning to efficiently determine the position of hundreds of mirror adjusters on multiple mirrors with few micrometer accuracy. We apply this approach to the example of the Simons Observatory 6 m telescope.

The Simons Observatory: modeling optical systematics in the Large Aperture Telescope.

We present geometrical and physical optics simulation results for the Simons Observatory Large Aperture Telescope. This work was developed as part of the general design process for the telescope, allowing us to evaluate the impact of various design choices on performance metrics and potential systematic effects. The primary goal of the simulations was to evaluate the final design of the reflectors and the cold optics that are now being built. We describe nonsequential ray tracing used to inform the design of the cold optics, including absorbers internal to each optics tube. We discuss ray tracing simulations of the telescope structure that allow us to determine geometries that minimize detector loading and mitigate spurious near-field effects that have not been resolved by the internal baffling. We also describe physical optics simulations, performed over a range of frequencies and field locations, that produce estimates of monochromatic far-field beam patterns, which in turn are used to gauge general optical performance. Finally, we describe simulations that shed light on beam sidelobes from panel gap diffraction.

The Simons Observatory: metamaterial microwave absorber and its cryogenic applications.

Controlling stray light at millimeter wavelengths requires special optical design and selection of absorptive materials that should be compatible with cryogenic operating environments. While a wide selection of absorptive materials exists, these typically exhibit high indices of refraction and reflect/scatter a significant fraction of light before absorption. For many lower index materials such as commercial microwave absorbers, their applications in cryogenic environments are challenging. In this paper, we present a new tool to control stray light: metamaterial microwave absorber tiles. These tiles comprise an outer metamaterial layer that approximates a lossy gradient index anti-reflection coating. They are fabricated via injection molding commercially available carbon-loaded polyurethane (25% by mass). The injection molding technology enables mass production at low cost. The design of these tiles is presented, along with thermal tests to 1 K. Room temperature optical measurements verify their control of reflectance to less than 1% up to 65∘ angles of incidence, and control of wide angle scattering below 0.01%. The dielectric properties of the bulk carbon-loaded material used in the tiles is also measured at different temperatures, confirming that the material maintains similar dielectric properties down to 3 K.

Vascular plant colonisation of Surtsey Island (1965-1990) - a dataset.

BACKGROUND: The process of ecosystem development over time that takes place on a new substrate devoid of biological activity (such as, for example, lava) is called primary succession. Research on primary succession is not easy, as it is limited to rare occasions when a piece of land totally lacking in any pre-existing life occurs. The emergence of volcanic islands is such an occasion; it is a unique event that allows a natural experiment in the study of colonisation processes and primary succession. Surtsey (located in the Vestmannaeyar archipelago off the southern coast of Iceland) is an iconic example of a place where primary succession has been studied for decades and where human disturbance has been minimised due to significant geographic isolation and early protection efforts. Here, we present a georeferenced dataset of vacular plant occurrences collected during the field studies carried out on Surtsey Island during the first three decades of its existence. NEW INFORMATION: To date, no dataset containing plant distribution data documenting the process of early stages of colonisation of Surtsey has been published. What is more, to our knowledge, there is no other dataset that can be compared with our Surtsey data that is readily available for researchers working on plant colonisation dynamics and primary succession processes. Here, we present a complete, geo-referenced dataset of all plant occurrences (10,094 in total) collected on Surtsey between 1965 and 1990.

Geometrical and physical optics analysis for mm-wavelength refractor telescopes designed to map the cosmic microwave background.

We present a compact two-lens high-density polyethylene (HDPE) $ f/1.6 $f/1.6 refractor design that is capable of supporting a 28-deg diffraction-limited field of view at 1-mm wavelengths and contrast it to a similar two-lens refractor using silicon lenses. We compare the optical properties of these two systems as predicted by both geometrical and physical optics. The presented analysis suggests that by relaxing telecentricity requirements, a plastic two-lens refractor system can be made to have a surprisingly large field of view. Furthermore, this HDPE system is found to perform comparably to a similar silicon system across a wide field of view and wavelengths up to 1 mm. We show that for both telescope designs, cold stop spillover changes significantly across the field of view in a way that is somewhat inconsistent with Gaussian beam formalism and simple $ f $f-number scaling. We present results that highlight beam ellipticity dependence on both pixel location and pixel aperture size-an effect that is challenging to reproduce in standard geometrical optics. We show that a silicon refractor design suffers from larger cross-polarization compared to the HDPE design. Our results address the limitations of relying solely on geometrical optics to assess relative performance of two optical systems. We discuss implications for future refractor designs.

Fabrication and characterization of Si1- x Ge x nanocrystals in as-grown and annealed structures: a comparative study.

Multilayer structures comprising of SiO2/SiGe/SiO2 and containing SiGe nanoparticles were obtained by depositing SiO2 layers using reactive direct current magnetron sputtering (dcMS), whereas, Si and Ge were co-sputtered using dcMS and high-power impulse magnetron sputtering (HiPIMS). The as-grown structures subsequently underwent rapid thermal annealing (550-900 °C for 1 min) in N2 ambient atmosphere. The structures were investigated using X-ray diffraction, high-resolution transmission electron microscopy together with spectral photocurrent measurements, to explore structural changes and corresponding properties. It is observed that the employment of HiPIMS facilitates the formation of SiGe nanoparticles (2.1 ± 0.8 nm) in the as-grown structure, and that presence of such nanoparticles acts as a seed for heterogeneous nucleation, which upon annealing results in the periodically arranged columnar self-assembly of SiGe core-shell nanocrystals. An increase in photocurrent intensity by more than an order of magnitude was achieved by annealing. Furthermore, a detailed discussion is provided on strain development within the structures, the consequential interface characteristics and its effect on the photocurrent spectra.

Oblique angle deposition of nickel thin films by high-power impulse magnetron sputtering.

Background: Oblique angle deposition is known for yielding the growth of columnar grains that are tilted in the direction of the deposition flux. Using this technique combined with high-power impulse magnetron sputtering (HiPIMS) can induce unique properties in ferromagnetic thin films. Earlier we have explored the properties of polycrystalline and epitaxially deposited permalloy thin films deposited under 35° tilt using HiPIMS and compared it with films deposited by dc magnetron sputtering (dcMS). The films prepared by HiPIMS present lower anisotropy and coercivity fields than films deposited with dcMS. For the epitaxial films dcMS deposition gives biaxial anisotropy while HiPIMS deposition gives a well-defined uniaxial anisotropy. Results: We report on the deposition of 50 nm polycrystalline nickel thin films by dcMS and HiPIMS while the tilt angle with respect to the substrate normal is varied from 0° to 70°. The HiPIMS-deposited films are always denser, with a smoother surface and are magnetically softer than the dcMS-deposited films under the same deposition conditions. The obliquely deposited HiPIMS films are significantly more uniform in terms of thickness. Cross-sectional SEM images reveal that the dcMS-deposited film under 70° tilt angle consists of well-defined inclined nanocolumnar grains while grains of HiPIMS-deposited films are smaller and less tilted. Both deposition methods result in in-plane isotropic magnetic behavior at small tilt angles while larger tilt angles result in uniaxial magnetic anisotropy. The transition tilt angle varies with deposition method and is measured around 35° for dcMS and 60° for HiPIMS. Conclusion: Due to the high discharge current and high ionized flux fraction, the HiPIMS process can suppress the inclined columnar growth induced by oblique angle deposition. Thus, the ferromagnetic thin films obliquely deposited by HiPIMS deposition exhibit different magnetic properties than dcMS-deposited films. The results demonstrate the potential of the HiPIMS process to tailor the material properties for some important technological applications in addition to the ability to fill high aspect ratio trenches and coating on cutting tools with complex geometries.

Primary aldosteronism: from case detection to histopathology with up to 6 years of follow-up.

The authors aimed to investigate the clinical characteristics, accuracy of diagnostic tests, and long-term outcomes after interventions in patients diagnosed with primary aldosteronism (PA) in Iceland throughout 5 years. A retrospective chart review was performed for all patients diagnosed with PA during the years 2007-2011 at Landspitali Hospital in Iceland, a referral center for the whole country. Workup after detection included salt loading test, positional test, computed tomography, and adrenal vein sampling. Patients with unilateral disease were offered treatment with adrenalectomy. A total of 33 patients were diagnosed with PA during the study period: 17 patients with bilateral disease and 16 with unilateral disease. Results from salt loading test were positive in 90% of patients. In patients with adenoma, 36% were responsive on their positional test and computed tomography scan showed a nodule in 73%. All patients with unilateral disease had a lateralization index ≥3. After surgery, patients had lower systolic blood pressure (P<.001) and number of hypertensive medications (P<.01).

A cryogenic rotation stage with a large clear aperture for the half-wave plates in the Spider instrument.

We describe the cryogenic half-wave plate rotation mechanisms built for and used in Spider, a polarization-sensitive balloon-borne telescope array that observed the cosmic microwave background at 95 GHz and 150 GHz during a stratospheric balloon flight from Antarctica in January 2015. The mechanisms operate at liquid helium temperature in flight. A three-point contact design keeps the mechanical bearings relatively small but allows for a large (305 mm) diameter clear aperture. A worm gear driven by a cryogenic stepper motor allows for precise positioning and prevents undesired rotation when the motors are depowered. A custom-built optical encoder system monitors the bearing angle to an absolute accuracy of ±0.1(∘). The system performed well in Spider during its successful 16 day flight.

Variable temperature effects of Open Top Chambers at polar and alpine sites explained by irradiance and snow depth.

Environmental manipulation studies are integral to determining biological consequences of climate warming. Open Top Chambers (OTCs) have been widely used to assess summer warming effects on terrestrial biota, with their effects during other seasons normally being given less attention even though chambers are often deployed year-round. In addition, their effects on temperature extremes and freeze-thaw events are poorly documented. To provide robust documentation of the microclimatic influences of OTCs throughout the year, we analysed temperature data from 20 studies distributed across polar and alpine regions. The effects of OTCs on mean temperature showed a large range (-0.9 to 2.1 °C) throughout the year, but did not differ significantly between studies. Increases in mean monthly and diurnal temperature were strongly related (R(2)  = 0.70) with irradiance, indicating that PAR can be used to predict the mean warming effect of OTCs. Deeper snow trapped in OTCs also induced higher temperatures at soil/vegetation level. OTC-induced changes in the frequency of freeze-thaw events included an increase in autumn and decreases in spring and summer. Frequency of high-temperature events in OTCs increased in spring, summer and autumn compared with non-manipulated control plots. Frequency of low-temperature events was reduced by deeper snow accumulation and higher mean temperatures. The strong interactions identified between aspects of ambient environmental conditions and effects of OTCs suggest that a detailed knowledge of snow depth, temperature and irradiance levels enables us to predict how OTCs will modify the microclimate at a particular site and season. Such predictive power allows a better mechanistic understanding of observed biotic response to experimental warming studies and for more informed design of future experiments. However, a need remains to quantify OTC effects on water availability and wind speed (affecting, for example, drying rates and water stress) in combination with microclimate measurements at organism level.

Arteriovenous fistula in an autotransplanted kidney segment: successful angiographic management.

Autotransplantation is a management option in complex renal or ureteral diseases. This report describes a case of bilateral renal cell carcinoma treated with partial nephrectomy using bench surgery followed by a contralateral total nephrectomy. This procedure was complicated by an arteriovenous fistula in the transplanted segment that was successively embolized angiographically.

Global negative vegetation feedback to climate warming responses of leaf litter decomposition rates in cold biomes.

Whether climate change will turn cold biomes from large long-term carbon sinks into sources is hotly debated because of the great potential for ecosystem-mediated feedbacks to global climate. Critical are the direction, magnitude and generality of climate responses of plant litter decomposition. Here, we present the first quantitative analysis of the major climate-change-related drivers of litter decomposition rates in cold northern biomes worldwide. Leaf litters collected from the predominant species in 33 global change manipulation experiments in circum-arctic-alpine ecosystems were incubated simultaneously in two contrasting arctic life zones. We demonstrate that longer-term, large-scale changes to leaf litter decomposition will be driven primarily by both direct warming effects and concomitant shifts in plant growth form composition, with a much smaller role for changes in litter quality within species. Specifically, the ongoing warming-induced expansion of shrubs with recalcitrant leaf litter across cold biomes would constitute a negative feedback to global warming. Depending on the strength of other (previously reported) positive feedbacks of shrub expansion on soil carbon turnover, this may partly counteract direct warming enhancement of litter decomposition.