Clausengreen9315
5.2) TPS. The PSDs were contoured on the CT images, and the PSD D
values were used as the expected doses for comparison with the measured doses.
The mean difference from patient measurements was -0.22%±5.98%, with 26% being the largest deviation from the expected value (Syed case). Large deviations were observed when detectors were placed in the area where dose rates were less than 1cGy/s.
The establishment of clinical workflow for the invivo dosimetry for both the intracavitary and interstitial GYN HDR brachytherapy will potentially improve the safety of the patient treatment.
The establishment of clinical workflow for the in vivo dosimetry for both the intracavitary and interstitial GYN HDR brachytherapy will potentially improve the safety of the patient treatment.
"Nasal rustle" is a type of nasal emission associated with a small velopharyngeal (VP) gap and distracting loud noise. Currently, the mechanisms behind noise generation are unclear. In this study, we use a combination of retrospective and prospective data to test the hypotheses that bubbling of secretions could be a source of audible noise.
Retrospective Nasopharyngoscopy records of 151 patients with nasal rustle were reviewed to determine if bubbling occurred during their nasopharyngoscopy examination. Prospective Nine children with nasal rustle and bubbling of secretions were suctioned with the scope in place to assure removal of secretions. The Nasometer II was used to record the children's production of oral sentences prior to and post suctioning. All sentences were analyzed for the presence or absence of noise, nasalance scores, and Cepstral Peak Prominence (CPP). Intra-and inter-judge reliability of coding was high.
Retrospective 70% of the patients with nasal rustle had bubbling of secretions during nasopharyngoscopy. Prospective Percentages of audible noise were reduced significantly post suctioning (Friedman's Test, Chi-square=24.5, p=0.001) with the greatest decrease in syllables with fricatives and bilabial stops (p<0.05). The average CPP and nasalance scores pre-vs post-suctioning showed no significant differences (p=0.91, 0.29).
Retrospective The high percentage of patients with nasal rustle had bubbling of secretions when producing speech in nasopharyngoscopy evaluations. Prospective The incidence of audible noise was reduced as a result of suctioning. This suggests that the presence of secretions contributes to the production of nasal rustle.
Retrospective The high percentage of patients with nasal rustle had bubbling of secretions when producing speech in nasopharyngoscopy evaluations. Prospective The incidence of audible noise was reduced as a result of suctioning. This suggests that the presence of secretions contributes to the production of nasal rustle.Gastric motility disorders present both diagnostic and therapeutic challenges and likely are under-recognized in small animal practice. This review includes a comparative overview of etiopathogenesis and clinical presentation of gastric motility disorders, suggests a practical approach to the diagnosis of these conditions, and provides an update on methods to evaluate gastric motor function. Furthermore, management of gastric dysmotility is discussed, including a review of the documented effect of gastric prokinetics.
The aim of this study was to explore characteristics and outcomes of patients undergoing elective percutaneous coronary intervention (PCI) in ambulatory surgery centers (ASCs).
Little is known about patients who underwent ASC PCI before Medicare reimbursement was instituted in2020.
Using commercial insurance claims from MarketScan, adults who underwent hospital outpatient department (HOPD) or ASC PCI for stable ischemic heart disease from 2007 to 2016 were studied. Propensity score analysis was used to measure the association between treatment setting and the primary composite outcome of 30-day myocardial infarction, bleeding complications, and hospital admission.
The unmatched sample consisted of 95,492 HOPD and 849 ASC PCIs. Patients who underwent ASC PCI were more likely to be younger than 65 years, to live in the southern United States, and to have managed or consumer-driven health insurance. ASC PCI was also associated with decreased fractional flow reserve utilization (odds ratio [OR] 0.31; 95% confidence interval [CI] 0.20 to 0.48; p<0.001). In unmatched, multivariate analysis, ASC PCI was associated with increased odds of the primary outcome (OR 1.25; 95%CI 1.01 to 1.56; p=0.039) and bleeding complications (OR 1.80; 95%CI 1.11 to 2.90; p=0.016). In propensity-matched analysis, ASC PCI was not associated with the primary outcome (OR 1.23; 95%CI 0.94 to 1.60; p=0.124) but was significantly associated with increased bleeding complications (OR 2.49; 95%CI 1.25 to 4.95; p=0.009).
Commercially insured patients undergoing ASC PCI were less likely to undergo fractional flow reserve testing and had higher odds of bleeding complications than HOPD-treated patients. Further study is warranted as Medicare ASC PCI volume increases.
Commercially insured patients undergoing ASC PCI were less likely to undergo fractional flow reserve testing and had higher odds of bleeding complications than HOPD-treated patients. Further study is warranted as Medicare ASC PCI volume increases.Pharmaceutical companies fund most clinical trials on drugs. However, there are clinical issues that might not be a priority from a commercial point of view, but that should certainly be addressed, given their importance for patients and society in general. Independent clinical research represents a fundamental pillar here and its basic element is investigator-initiated studies/trials. In these studies, it is the researcher who conceives the idea, develops the project and also acts as the sponsor. Most researchers are familiar with participating as collaborators in studies sponsored by pharmaceutical companies. In these studies, the company is in charge of all the scientific, legal and financial aspects, leaving the responsibility of the researcher mainly limited to the inclusion of patients and compliance with the protocol. On the contrary, the start-up and development of an independent research study requires considerable resources - of knowledge, money and time - and careful planning on the part of the researcher. In this manuscript, we will review the main characteristics of the studies initiated by the researcher and their fundamental differences with those sponsored by the pharmaceutical industry. We will also outline what its strengths and limitations are. Finally, we will propose some solutions to the main challenges they pose. Our ultimate goal is to stimulate potential researchers to undertake the challenge of conducting an independent clinical research project.It has been 35 years since Professor Thoenes and his colleagues discovered chromophobe renal cell carcinoma (RCC). Since then, our knowledge about this tumour entity has changed and novel tumour entities have been discovered. The aim of this review is to discuss recent molecular findings and open questions in diagnosing chromophobe-like/oncocytic neoplasms. The broader differential diagnosis of chromophobe-like and oncocytoma-like neoplasms includes SDH-deficient renal cell carcinoma, fumarate hydratase (FH) deficient RCC, epitheloid angiomyolipoma ('oncocytoma like'), MiT family translocation RCC and the emerging entity of eosinophilic solid and cystic renal cell carcinoma. After separation of these tumours from chromophobe RCC, it becomes evident that chromophobe RCC are low malignant tumours with a 5-6% risk of metastasis. Recent next generation sequencing (NGS) and DNA methylation profiling studies have confirmed Thoenes' theory of a distal tubule derived origin of chromophobe RCC and renal oncocytomas. Comprehensive genomic analyses of chromophobe RCC have demonstrated a low somatic mutation rate and identified TP53 and PTEN as the most frequently mutated genes, whereas 'unclassified' RCC with oncocytic or chromophobe-like features can show somatic inactivating mutations of TSC2 or activating mutations of MTOR as the primary molecular alterations. For the future, it would be desirable to create a category of 'oncocytic/chromophobe RCC, NOS' with the potential of further molecular studies for identification of TSC1/2 mutations in these rare tumours.Generation of alum sludge (AS) at drinking water treatment plants represents an environmental liability and adds to the cost of water purification. Consequently, this study explored the feasibility of using low and high carbon containing alum sludge from two water treatment plants to synthesize zeolite LTA. The hypothesis was that zeolite LTA synthesis was dependant upon alum sludge source and that a range of strategies may be required to optimize zeolite crystallinity. Zeolite characteristics such as morphology, phase composition, crystallinity, and particle size distribution were recorded. Fumarate hydratase-IN-1 in vitro "One pot" hydrothermal synthesis of precursor gel with molar composition 4.2Na2OAl2O31.2SiO2168H2O at 80°C for 3 hr resulted in 25 and 46 wt.% zeolite LTA from high and low carbonaceous sludge, respectively. Prior to hydrothermal reaction stage it was discovered that ageing of the gel, addition of zeolite LTA seeds, ultrasonic treatment and calcination all promoted zeolite LTA formation. Calcination of the alum sludge at 700°C for 2 hr before hydrothermal synthesis resulted in particle size reduction and the highest amount of crystalline zeolite LTA 79 wt.% from low carbon sludge and 65 wt.% from high carbon sludge. Notably, the zeolite crystallinity reported in this study was the higher than previous studies on this topic. The outlined approach may allow value adding of alum waste and produce a commodity which could be used locally by the water treatment plant as a water softener.Alginate is an abundant natural polysaccharide widely utilized in various biomedical applications. Alginate also possesses numerous hydroxyl and carboxylate functional groups that allow chemical modifications to introduce different functionalities. However, it is difficult to apply various chemical reactions to alginate due to limited solubility in organic solvents. Herein, functional moieties for radical polymerization and cell adhesion were separately conjugated to hydroxyl and carboxylate groups of alginate, respectively, in order to independently control the crosslinking density and cell adhesive properties of hydrogels. Sodium counterions of alginate are first substituted with tetrabutylammonium ions to facilitate the dissolution in an organic solvent, followed by in situ conjugations of (1) cell adhesion molecules (CAM) via carbodiimide-mediated amide formation and (2) methacrylate via ring-opening nucleophilic reaction. The resulting CAM-linked methacrylic alginate was able to not only crosslink different monomers to form hydrogels with varying mechanical properties, but also induce stable cell adhesion to the hydrogels.The myocardial I/R damage is very complicated. Apoptosis is considered to its a critical mechanism. During the cardiac muscle I/R process, oxygen-free radicals play a pivotal role. Arrhythmias, as well as enlargement of the area of myocardial infarction after cardiac muscle I/R process, are caused by adequate blast generated O2- ion free radicals. During the ischemia-reperfusion process, a large amount of O2- ion free radicals destroyed the cell structure, and it undergoes lipid peroxidation with unsaturated fatty acids that contain a large number of phospholipids in the cell membrane, causing membrane proteins such as ion channels and enzymes on the cell membrane. The activity of cell is reduced, which affects the function of cell membrane and organelle membrane, destroys its integrity and reduces fluidity.We observed the effects of cerium dioxide nanoparticles on glutathione peroxidase as well as superoxide dismutase, also propionate in myocardial tissue of I/R injury in the mouse. Its effects of malondialdehyde and apoptosis were explored to see its protective effect and to provide more preventive measures for ischemia-reperfusion injury.
