Mackenziecarey9193
The US opioid epidemic has prompted dramatic changes in public attitudes and regulations governing opioid prescribing. Little is known about the experiences of patients with advanced cancer using opioids in the context of the epidemic.
Semistructured interviews of 26 patients with advanced cancer were conducted between May 2019 and April 2020; their experiences self-managing chronic pain with opioids were evaluated.
Patients consistently described the negative impact of the opioid epidemic on their ability to self-manage pain. Negative media coverage and personal experiences with the epidemic promoted stigma, fear, and guilt surrounding opioid use. As a result, many patients delayed initiating opioids and often viewed their decision to take opioids as a moral failure-as "caving in." Patients frequently managed this internal conflict through opioid-restricting behaviors (eg, skipping or taking lower doses). Stigma also impeded patient-clinician communication; patients often avoided discussing opioids or gma and the logistical complications they experienced with pharmacies and insurance coverage. Many were afraid to share their concerns about opioids with their providers. .
Patients with advanced cancer suffer from significant pain and frequently receive opioids to manage their pain. Of the 26 patients with advanced cancer interviewed, the majority of patients experienced stigma about their opioid use for cancer pain management. All patients felt that the opioid epidemic fostered this stigma. Several struggled to use opioids for pain because of this stigma and the logistical complications they experienced with pharmacies and insurance coverage. Navitoclax Many were afraid to share their concerns about opioids with their providers. .With limited information known about the zoo-housed Sichuan takin (Budorcas taxicolor tibetana), there is a need to gain more knowledge about their basic physiology to be able to better assess their well-being. Our goal was to develop noninvasive methods to evaluate stress physiology in the Sichuan takins housed under human care. The objectives were (1) validate the use of fecal glucocorticoid metabolite (FGM) analysis to monitor adrenocortical activity and (2) determine the relationship between FGM concentrations and changes in various factors including environmental conditions, reproductive hormones, and social factors. Three (one male and two females) adult Sichuan takins were included in the study from Lincoln Park Zoo. A cortisol enzyme immunoassay was used to analyze FGM from samples that were collected 2-4 times per week. FGM was biochemically validated in the laboratory and biologically validated using pregnancy and parturition. Results showed that 1 day after birth one female had a more than a six-fold increase in FGM. A positive relationship (p less then .05) was observed between FGM and temperature for two of the three takins. Finally, FGM values tended to increase during times when aggression (p = .09) and reproductive (p = .08) behaviors were observed. In conclusion, environmental, reproductive, and behavioral factors could affect adrenocortical activity in zoo-housed Sichuan takins; therefore, these methods can be used to assist in the management and conservation of this threatened species both in zoos and potentially in the wild.
To derive the mass density (ρ) from dual-energy computed tomography (DECT) data by calibrating electron density (ρ
) and effective atomic numbers (Z
) of human tissues.
We propose the DEEDZ-MD method, in which a single polynomial parameterization covers the entire human-tissue range to establish an empirical quadratic relation between the atomic number-to-mass ratio and Z
. Then, we numerically evaluate the DEEDZ-MD method in reference human tissues listed in the ICRP Publication 110 and ICRU Report 46. The tissues are considered to have unknown ρ values. The attenuation coefficients of these tissues are calculated using the XCOM Photon Cross Sections Database. The DEEDZ-MD method is also applied to experimental DECT data acquired from a tissue characterization phantom and an anthropomorphic phantom at 90kV and 150kV/Sn.
The numerical analysis of the DEEDZ-MD method reveals a single quadratic relation between the atomic number-to-mass ratio and Z
in a wide range of human tissues. The simulated ρ tissues.
This study compares the effectiveness of three fractionation schemes of equal fraction size, comprising five fractions of SBRT over 5days, 10days, or 15days, respectively.
This comparative study is based on two tumor-control-probability (TCP) models that take into account tumor cell re-sensitization and repopulation during treatment; the Zaider-Minerbo-Stavreva (ZMS) and the Ruggieri-Nahum (RN) models. The ZMS model is further modified to include also re-sensitization according to the β mechanism of the linear-quadratic (LQ) model of cell killing. The modified version of the ZMS model is verified through fitting to the experimental data set of Fisher and Moulder. The study applies an idea used in a plan ranking methodology developed for the case when the specific values of the model parameters are not known.
The TCPs of the compared regimens are calculated for various values of the model parameters and for two different values of the dose per fraction. The TCPs are presented as 2-D functions of two of t the studied cases; however this is shown to exist to a different degree by the two models. It is shown again to a different degree that reversed situations where the every week day schedule is better than the prolonged regimens are also possible. It is concluded that a 30% TCP difference observed in a clinical study in favor of the fifteen-day regimen is theoretically possible. However, the fifteen-day regimen is outperformed in terms of TCP by the every week day regimen in more cases than the regimen lasting ten days. Therefore the choice of a prolongation in time must be made with care.
Accurately delineating clinical target volumes (CTV) is essential for completing radiotherapy plans but is time-consuming, labor-intensive, and prone to inter-observer variation. Automating CTV delineation has the benefits of both speeding up contouring process and improving the quality of contours. Recently, auto-segmentation approaches based on deep learning have achieved some improvements. However, unlike organ segmentation, the CTV contains potential tumor spread tissues or subclinical disease tissues, resulting in poorly defined margin interface and irregular shape. It is not reasonable to directly apply the deep learning segmentation algorithms to CTV tasks without considering the unique characteristics of shape and margin. In this work, we propose a novel automatic CTV delineation algorithm based on deep learning addressing the unique shape and margin challenges.
Our deep learning method, called RA-CTVNet, segments the CTV from cervical cancer CT images. RA-CTVNet denotes our automatic CTV delineatNet can improve the quality of CTV contours, which has great potential for reducing the burden of experts and increasing the accuracy of delineation. In the future, if with more training data, further improvements are possible, bringing this approach closer to real clinical practice.Mixing a small amount of magnetic beads and regents with large volume samples evenly in microcavities of a microfluidic chip is always the key step for the application of microfluidic technology in the field of magnetophoresis analysis. This article proposes a microfluidic chip for DNA extraction by magnetophoresis, which relies on bubble rising to generate turbulence and microvortices of various sizes to mix magnetic beads with samples uniformly. The construction and working principle of the microfluidic chip are introduced. CFD simulations are conducted when magnetic beads and samples are irritated by the generation of gas bubbles with the variation of supply pressures. The whole mixing process in the microfluidic chip is observed through a high-speed camera and a microfluidic system when the gas bubbles are generated continuously. The influence of supply pressure on the mixing characteristics of the microfluidic chip is investigated and discussed with both simulation and experiments. Compared with magnetic mixing, bubble mixing can avoid the magnetic beads gather phenomenon caused by magnetic forces and provide a rapid and high efficient solution to realize mixing small amount of regents in large volume samples in a certain order without complex moving structures and operations in a chip. Two applications of mixing with the proposed microfluidic chip are also carried out and discussed.In the present study, we carried out comprehensive transcript profiling of diverse genes under salinity (200 mM NaCl) at different time points, accompanied by certain biochemical alterations of the indica (IR-64 and Pokkali) and japonica (Nipponbare and M-202) rice. The higher susceptibility of Nipponbare and IR-64 was reflected by lower relative water content, chlorophyll loss, higher malondialdehyde content, and accumulation of H2 O2 , and reduced nitrate reductase activity, compared to M-202 and Pokkali, where such changes were less pronounced. Enhanced levels of anthocyanins and reduced glutathione, together with elevated phenylalanine ammonia lyase activity, mainly conferred protection to Nipponbare and IR-64, while metabolites like phenolics, flavonoids, proline, and polyamines were more induced in M-202 and Pokkali. Varietal differences in the expression pattern of diverse groups of genes during different durations (6, 24, and 48 h) of stress were striking. A gene showing early induction for a particular variety exhibited a delayed induction in another variety or a gradually decreased expression with treatment time. Pokkali was clearly identified as the salt-tolerant genotype among the examined varieties based on increased antioxidant potential and enhanced expression of genes encoding for PAL, CHS, and membrane transporters like SOS3, NHX-1, and HKT-1. The results presented in this work provide insight into the complex varying regulation patterns for different genes across the investigated rice varieties in providing salt tolerance and highlights distinct differences in expression patterns between susceptible and tolerant indica and japonica rice.
Malabsorption of fat and protein contributes to poor nutritional status in people with cystic fibrosis. Impaired pancreatic function may also result in increased gastric acidity, leading in turn to heartburn, peptic ulcers and the impairment of oral pancreatic enzyme replacement therapy. The administration of gastric acid-reducing agents has been used as an adjunct to pancreatic enzyme therapy to improve absorption of fat and gastro-intestinal symptoms in people with cystic fibrosis. It is important to establish the evidence regarding potential benefits of drugs that reduce gastric acidity in people with cystic fibrosis. This is an update of a previously published review.
To assess the effect of drug therapies for reducing gastric acidity for nutritional status; symptoms associated with increased gastric acidity; fat absorption; lung function; quality of life and survival; and to determine if any adverse effects are associated with their use.
We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic and non-electronic database searches, handsearches of relevant journals, abstract books and conference proceedings.
