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There is a paucity of data on the frequency of transfusion during pediatric surgery index cases and guidelines for pretransfusion testing, defined as type and screen and crossmatch testing, prior to operation are not standardized. This study aimed to determine the incidence of perioperative blood transfusions during index neonatal operations and identify risk factors associated with perioperative blood transfusion to determine which patients benefit from pretransfusion testing.

A retrospective review of infants who underwent index neonatal cases between 2013 and 2019 was performed. Data were collected for patients who underwent operations for Hirschsprung's disease, esophageal atresia/tracheoesophageal fistula (EA/TEF), biliary atresia, anorectal malformation, omphalocele, gastroschisis, duodenal atresia, congenital diaphragmatic hernia (non-ECMO) or pulmonary lobectomy. Infants under 6 months were included except in the case of lobectomy where infants up to 12 months were included.

Analysis was performed on 420 patients. Twenty-five (6.0%) patients received perioperative blood transfusion. Patients who received perioperative transfusion most commonly underwent EA/TEF repair. Patients who received perioperative transfusion had higher rates of structural heart disease (52.0% vs 17.7%, p<0.001), preoperative transfusion (48.0% vs 8.9%, p<0.001), and prematurity (52.0% vs 25.6%, p=0.005). Presence of all three risk factors resulted in a 48% probability of requiring perioperative transfusion.

Blood transfusion during the perioperative period of neonatal index operations is rare. Factors associated with increased risk of perioperative transfusion include prematurity, structural heart disease, and history of previous blood transfusion.

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To develop and validate a radiomic-clinical nomogram to evaluate overall survival (OS) postoperatively in patients with serous ovarian cancer.

Eighty serous ovarian cancer patients from The Cancer Imaging Archive (TCIA) database were used as the training set, and 39 eligible patients treated at Affiliated Huadu Hospital were used as the independent validation set. In total, 1,301 radiomics features were extracted from ovarian cancer lesions on venous-phase computed tomography (CT) images. Then, a radiomics signature was developed using the least absolute shrinkage and selection operator (LASSO) Cox regression algorithm in the training set. Moreover, a radiomic-clinical nomogram was constructed incorporating the radiomics signature and clinical predictors based on a multivariable Cox regression analysis. The performance of the nomogram was evaluated.

Consisting of three selected features, the radiomics signature showed good discrimination in the training and validation sets with C-indexes of 0.694 (95% confidence interval [CI] 0.613-0.775) and 0.709 (95% CI 0.517-0.901), respectively. The radiomic-clinical nomogram contained the radiomics signature and four clinical predictors, including age, tumour size, pathological staging, and tumour grade. The nomogram showed favourable discrimination in the training set (C-index [95% CI], 0.754 [0.678-0.830]), which was confirmed in the validation set (C-index [95% CI], 0.727 [0.569-0.885]). According to the model, all patients were classified into high-risk and low-risk groups. Kaplan-Meier curves showed that there was a significant distinction between the OS of the high-risk and low-risk patients.

The proposed radiomic-clinical nomogram can increase the predictive accuracy of OS in patients with serous ovarian cancer after surgery, which may aid in clinical decision-making.

The proposed radiomic-clinical nomogram can increase the predictive accuracy of OS in patients with serous ovarian cancer after surgery, which may aid in clinical decision-making.Postoperative external beam radiation therapy (EBRT) with superficial X-rays or electrons and high-dose-rate brachytherapy (HDR BT) are both viable options for managing keloid scars. However, complex keloid scars are especially challenging to manage. We aim to compare the benefit and challenges between interstitial HDR BT and electron EBRT in treating the complex keloids. Three patients with 7 complex keloids 3 jaw lines, 1 postauricular, 1 posterior neck, and 2 chest walls are included in this study. All patients are treated to 6 Gy x 3 fractions with HDR BT using the flexible interstitial catheters, and electron EBRT plans were created retrospectively for dosimetric comparison. BSO The average D90 is 21.8 ± 8.3 Gy (1 SD) (121%) and 16.9 ± 1.9 Gy (1SD) (94%) in HDR and EBRT plans, respectively. The average treatment time was 7 minutes per patient (range 6 - 8.5 minutes) for the HDR BT. Dosimetric comparison reveals that HDR plans provide superior coverage to the keloid scars than the EBRT plans. Clinical workflow is streamlined with HDR procedures. The cosmetic outcome with the interstitial HDR BT is satisfactory.

Additive production refers to the process of prototyping, which allows the production of highly complex medical devices and products. Interpretation of additive manufacturing (AM) material in Computed Tomography (CT) has not been widely investigated. The aim of this study was to determine the CT number values of commercially available fused deposition modelling (FDM) and stereolithography (SLA) AM materials.

Total of 15 AM materials, 7 FMD and 8 SLA, were selected and scanned on CT to determine the HU value and appearance on the images. All test object were designed as rectangular blocks and after their production physical description were calculated. AM materials were scanned on CT operating at 80, 100, 120 and 135kV.

All materials correspond to a certain human tissue and they have uniformity when printed with 100% infill. CT number ranged from a minimum of-188.0 HU to a maximum of 189.1 HU, for FDM materials, and from-15.8 HU to 167.3 HU, for SLA materials.

Knowing the CT number of an AM materials cquently used AM materials allows manufacturing anthropomorphic phantoms to investigate radiation doses in diagnostic radiology and radiotherapy.Several glycoconjugate vaccines have been licensed or are currently in clinical development to prevent bacterial infections. Here we report the development of a single analytical assay to quantify the conjugated saccharide content, as alternative to two separated total and free (unconjugated) saccharide assays used so far, for a quadrivalent conjugate vaccine containing meningococcal serogroup A polysaccharide (α-1,6-linked N-acetylmannosamine phosphate repeating unit partly O-acetylated at position C3 or C4) coupled with CRM197 protein. The results confirm a high linear correlation among the two approaches (conjugated saccharide content vs. difference of total saccharide and free saccharide). Conjugated saccharide content estimation is therefore demonstrated to be a suitable method to monitor the product quality of vaccines containing meningococcal serogroup A conjugate antigen, in the final filled presentation as demonstrated here and potentially on the bulk conjugate before formulation.γ-aminobutyric acid (GABA) is a nonstructural amino acid that serves diverse functions in unicellular and multicellular organisms. Besides its widely established role in mammals as an inhibitory neurotransmitter, the diverse biological roles and metabolism of GABA in protozoan parasites have begun to be unveiled. GABA acts as either the intracellular signal or cell-to-cell messenger to mediate a variety of cellular responses that protect the parasites from environmental and host-derived stress. Moreover, GABA metabolism was found to be tightly regulated, involving protein machinery confined to the protozoa lineage. Meanwhile, host-parasite GABAergic interaction plays a role in the pathogenesis and disease manifestation of protozoan infections. Therefore, the GABAergic system apparently is broadly involved in essential biological and pathophysiological processes and is well conserved in parasitic and free-living protozoa.

Facet cysts in the subaxial cervical spine are a relatively rare cause of neuropathy. This case series aimed to investigate the radiological and histopathological features and surgical results of these lesions, and provide possible mechanisms of cyst development.

Thirteen subaxial cervical facet cysts in 12 patients were diagnosed on the basis of magnetic resonance imaging and computed tomography with facet arthrography. Surgical outcomes were evaluated according to the Japanese Orthopaedic Association scores for cervical myelopathy, or Tanaka's scores for cervical radiculopathy. These results were presented in combination with a scoping review of the literature.

Seven cysts were found in the posteromedial region, and six in the posterolateral portion of the spinal canal. Computed tomography revealed degeneration of all involved facet joints. All patients underwent decompression, and the mean recovery rates of Japanese Orthopaedic Association scores and Tanaka's scores were 57.1% and 87.5%, respectivelyrelated to degenerative changes in the facet joint and ligamentum flavum, and rupture in degenerated ligaments can develop into a cavity, which contributes to cyst formation. The scoping review suggests that cyst resection generally results in positive outcomes without recurrence in either decompression alone or concomitant fusion.Anaphylaxis is the most severe among acute allergic diseases and potentially life threatening. Despite its increasing frequency and related burden, it remains often underdiagnosed and improperly managed. Its multisystemic involvement, protean clinical manifestations and its rapid onset are contributory factors. In recent years new acquisitions have shed light into its pathogenesis pathways (and related biomarkers), triggers, factors increasing its severity, along with peculiar clinical manifestations. These breakthrough discoveries have contributed to phenotyping and endotyping this disease, possibly paving the way to a personalized approach which is not available at present. Moreover, to disseminate awareness and standardize diagnostic criteria and management practices, several guidelines and consensus reports, albeit mainly intended for specialist care, have been issued. We here discuss the latest issues in the field of anaphylaxis from the perspective of the emergency and/or internal medicine physician, so to improve its early recognition and treatment in the acute setting and favor allergology referral to implement therapeutical and preventive strategies, such as allergen identification in unclear cases and desensitizing therapies when available (e.g., for Hymenoptera venom allergy).

Patients with intellectual and developmental disabilities (IDD) are more likely to experience poor health outcomes and family physicians receive inadequate training to provide appropriate care to this patient group. Little prior research has studied how to effectively train family physicians to care for patients with IDD.

The aim of this pilot study was to assess the value of adding an experiential component to didactic education strategies to improve family medicine resident perceived comfort, skills and knowledge related to caring for patients with IDD.

Structured education programs for residents were implemented at three primary care practices in Ontario, Canada. Two practices received didactic information only (didactic-only group); one received didactic information and an experiential training model including clinical interactions and a written reflection on that experience (didactic plus experiential group). In this separate-sample pre-post design, residents were invited to complete a brief anonymous survey prior to and following the training assessing their perceived comfort, skills and knowledge related to patients with IDD.