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Δευτέρα, 19 Φεβρουαρίου 2018

The accuracy and precision of Kilovoltage Intrafraction Monitoring (KIM) six degree-of-freedom prostate motion measurements during patient treatments

Publication date: Available online 19 February 2018
Source:Radiotherapy and Oncology
Author(s): Jung-Ha Kim, Doan T. Nguyen, Jeremy T. Booth, Chen-Yu Huang, Todsaporn Fuangrod, Per Poulsen, Ricky O'Brien, Vincent Caillet, Thomas Eade, Andrew Kneebone, Paul Keall
Background and purposeTo perform a quantitative analysis of the accuracy and precision of Kilovoltage Intrafraction Monitoring (KIM) six degree-of-freedom (6DoF) prostate motion measurements during treatments.Material and methodsReal-time 6DoF prostate motion was acquired using KIM for 14 prostate cancer patients (377 fractions). KIM outputs the 6DoF prostate motion, combining 3D translation and 3D rotational motion information relative to its planning position. The corresponding groundtruth target motion was obtained post-treatment based on kV/MV triangulation. The accuracy and precision of the 6DoF KIM motion estimates were calculated as the mean and standard deviation differences compared with the ground-truth.ResultsThe accuracy ± precision of real-time 6DoF KIM−measured prostate motion were 0.2 ± 1.3° for rotations and 0.1 ± 0.5 mm for translations, respectively. The magnitude of KIM-measured motion was well-correlated with the magnitude of ground-truth motion resulting in Pearson correlation coefficients of  ≥0.88 in all DoF.ConclusionsThe results demonstrate that KIM is capable of providing the real-time 6DoF prostate target motion during patient treatments with an accuracy ± precision of within 0.2 ± 1.3° and 0.1 ± 0.5 mm for rotation and translation, respectively. As KIM only requires a single X-ray imager, which is available on most modern cancer radiotherapy devices, there is potential for widespread adoption of this technology.



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The accuracy and precision of Kilovoltage Intrafraction Monitoring (KIM) six degree-of-freedom prostate motion measurements during patient treatments

To perform a quantitative analysis of the accuracy and precision of Kilovoltage Intrafraction Monitoring (KIM) six degree-of-freedom (6DoF) prostate motion measurements during treatments.

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.@JCO_ASCO latest issue features collaborative work of @OSUCCC_James @osucc_james @Harvard @broadinstitute and… https://t.co/qDpWCGzIXB

.@JCO_ASCO latest issue features collaborative work of @OSUCCC_James @osucc_james @Harvard @broadinstitute and… https://t.co/qDpWCGzIXB

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Making soft intelligence hard: a multi-site qualitative study of challenges relating to voice about safety concerns

Background

Healthcare organisations often fail to harvest and make use of the ‘soft intelligence’ about safety and quality concerns held by their own personnel. We aimed to examine the role of formal channels in encouraging or inhibiting employee voice about concerns.

Methods

Qualitative study involving personnel from three academic hospitals in two countries. Interviews were conducted with 165 participants from a wide range of occupational and professional backgrounds, including senior leaders and those from the sharp end of care. Data analysis was based on the constant comparative method.

Results

Leaders reported that they valued employee voice; they identified formal organisational channels as a key route for the expression of concerns by employees. Formal channels and processes were designed to ensure fairness, account for all available evidence and achieve appropriate resolution. When processed through these formal systems, concerns were destined to become evidenced, formal and tractable to organisational intervention. But the way these systems operated meant that some concerns were never voiced. Participants were anxious about having to process their suspicions and concerns into hard evidentiary facts, and they feared being drawn into official procedures designed to allocate consequence. Anxiety about evidence and process was particularly relevant when the intelligence was especially ‘soft’—feelings or intuitions that were difficult to resolve into a coherent, compelling reconstruction of an incident or concern. Efforts to make soft intelligence hard thus risked creating ‘forbidden knowledge’: dangerous to know or share.

Conclusions

The legal and bureaucratic considerations that govern formal channels for the voicing of concerns may, perversely, inhibit staff from speaking up. Leaders responsible for quality and safety should consider complementing formal mechanisms with alternative, informal opportunities for listening to concerns.



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GMC chair’s reply to Nick Ross’s second letter regarding Hadiza Bawa-Garba

The following is a letter of 12 February 2018 from the chair of the General Medical Council in reply to Nick Ross’s letter of 5 February 2018 (posted 8 February 2018).12Dear Nick,After your meeting...
recent?d=yIl2AUoC8zA recent?d=dnMXMwOfBR0 recent?i=QeqPxBUvUnc:na0jw0wQpmg:V_sGLiP recent?d=qj6IDK7rITs recent?i=QeqPxBUvUnc:na0jw0wQpmg:gIN9vFw recent?d=l6gmwiTKsz0 recent?d=7Q72WNTAKBA recent?i=QeqPxBUvUnc:na0jw0wQpmg:F7zBnMy recent?i=QeqPxBUvUnc:na0jw0wQpmg:-BTjWOF


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Ist die antizipierte Einwilligung in Behandlungen im Rahmen einer Patientenverfügung ein Weg aus der Zwangsbehandlung (im Maßregelvollzug)?

Zusammenfassung

In der Folge der Entscheidungen des Bundesverfassungsgerichts zur Behandlung gegen den Willen eines Patienten hat Hessen die Frage der Möglichkeit einer Zwangsbehandlung neu in § 7a des Hessischen Maßregelvollzugsgesetzes (HMRVG) geregelt und die Beachtung einer Patientenverfügung i. S. d. §§ 1901a und 1901b Bürgerliches Gesetzbuch (BGB) ausdrücklich aufgenommen (§ 7 Absatz 2 HMRVG).

Dreizehn an Schizophrenie erkrankte Patienten der Vitos Klinik für forensische Psychiatrie Haina haben während ihrer Unterbringung gemäß § 63 Strafgesetzbuch (StGB) per Patientenverfügung festgelegt, im Falle einer akutpsychotischen Episode mit bestimmten neuroleptischen Medikamenten nötigenfalls zwangsbehandelt zu werden. In diesem Artikel sollen anhand einer Kasuistik sowohl die Beweggründe der Patienten für eine solche Verfügung beschrieben als auch die rechtlichen Grenzen bzw. die Durchsetzbarkeit einer solchen Verfügung dargestellt werden. Zur Nutzung einer Patientenverfügung als Sicherung einer explizit gewünschten Behandlungsmethode für eine Phase der Einwilligungsunfähigkeit liegen weder eine einheitliche Literaturmeinung noch eine solche Rechtsprechung vor. Insbesondere die Frage der antizipierten Einwilligung in eine Behandlung unter Zwang wird kontrovers bewertet. Dieser Beitrag soll v. a. den Blickwinkel der unmittelbar Betroffenen aufzeigen und zur Diskussion anregen. Diese zunächst für den Maßregelvollzug angestellten Überlegungen können auch für andere Formen der Unterbringung Bedeutung haben.



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Diagnostic strategy in segmentation defect of the vertebrae: a retrospective study of 73 patients

Background

Segmentation defects of the vertebrae (SDV) are non-specific features found in various syndromes. The molecular bases of SDV are not fully elucidated due to the wide range of phenotypes and classification issues. The genes involved are in the Notch signalling pathway, which is a key system in somitogenesis. Here we report on mutations identified in a diagnosis cohort of SDV. We focused on spondylocostal dysostosis (SCD) and the phenotype of these patients in order to establish a diagnostic strategy when confronted with SDV.

Patients and methods

We used DNA samples from a cohort of 73 patients and performed targeted sequencing of the five known SCD-causing genes (DLL3, MESP2, LFNG, HES7 and TBX6) in the first 48 patients and whole-exome sequencing (WES) in 28 relevant patients.

Results

Ten diagnoses, including four biallelic variants in TBX6, two biallelic variants in LFNG and DLL3, and one in MESP2 and HES7, were made with the gene panel, and two diagnoses, including biallelic variants in FLNB and one variant in MEOX1, were made by WES. The diagnostic yield of the gene panel was 10/73 (13.7%) in the global cohort but 8/10 (80%) in the subgroup meeting the SCD criteria; the diagnostic yield of WES was 2/28 (8%).

Conclusion

After negative array CGH, targeted sequencing of the five known SCD genes should only be performed in patients who meet the diagnostic criteria of SCD. The low proportion of candidate genes identified by WES in our cohort suggests the need to consider more complex genetic architectures in cases of SDV.



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Occupational exposure to pesticides is associated with differential DNA methylation

Objectives

Occupational pesticide exposure is associated with a wide range of diseases, including lung diseases, but it is largely unknown how pesticides influence airway disease pathogenesis. A potential mechanism might be through epigenetic mechanisms, like DNA methylation. Therefore, we assessed associations between occupational exposure to pesticides and genome-wide DNA methylation sites.

Methods

1561 subjects of LifeLines were included with either no (n=1392), low (n=108) or high (n=61) exposure to any type of pesticides (estimated based on current or last held job). Blood DNA methylation levels were measured using Illumina 450K arrays. Associations between pesticide exposure and 420 938 methylation sites (CpGs) were assessed using robust linear regression adjusted for appropriate confounders. In addition, we performed genome-wide stratified and interaction analyses by gender, smoking and airway obstruction status, and assessed associations between gene expression and methylation for genome-wide significant CpGs (n=2802).

Results

In total for all analyses, high pesticide exposure was genome-wide significantly (false discovery rate P<0.05) associated with differential DNA methylation of 31 CpGs annotated to 29 genes. Twenty of these CpGs were found in subjects with airway obstruction. Several of the identified genes, for example, RYR1, ALLC, PTPRN2, LRRC3B, PAX2 and VTRNA2-1, are genes previously linked to either pesticide exposure or lung-related diseases. Seven out of 31 CpGs were associated with gene expression levels.

Conclusions

We show for the first time that occupational exposure to pesticides is genome-wide associated with differential DNA methylation. Further research should reveal whether this differential methylation plays a role in the airway disease pathogenesis induced by pesticides.



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School nurses are able to support adolescents experiencing pain secondary to stress and unhealthy lifestyle choices

Commentary on: Høie M, Haraldstad K, Rohde G, et al. How school nurses experience and understand everyday pain among adolescents. BMC Nurs 2017;16:53.

Implications for practice and research

School nurses are well-positioned to support adolescents experiencing pain secondary to stress and unhealthy lifestyle choices, but require training relevant to addressing such antecedents of pain.

Research regarding school-based initiatives aimed at ameliorating common causes of pain, as well as helping adolescents find relief and develop resiliency, is needed.

Context

Pain in school children is a topic receiving increased attention from researchers, clinicians and parents. The impact of pain in school children stems beyond discomfort: children in pain may miss school, are unable to focus on curricular activities, forego social opportunities, and may rely on or misuse analgesic medications.1–3 Pain is a biopsychosocial experience for all, but psychosocial influences are particularly prevalent among adolescents. As a daily point of...



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Increased physical activity in older adults is associated with decreased fear of falling

Commentary on: Lee J, Choi M, Kim CO. Falls, a fear of falling and related factors in older adults with complex chronic disease. J Clin Nurs 2017;26:4964–72.

Implications for practice and research

Physical activity for older adults improves confidence in performing everyday activities without falling.

Polypharmacy should be considered in older adults with fear of falling.

Fear of falling is related to adverse health outcomes and should be investigated.

Context

Falls are a significant health problem in the elderly population around the world, and the increase in life expectancy, costs and injury consequences could be disastrous. In Korea, more than half of physical injuries in older adults are a result of falls. Risk factors for falls include age, sex, number of comorbidities, polypharmacy and type of drugs in use, history of recurrent falls, fear of falling and physical function. Some of these factors are modifiable; identifying those factors could guide nurses in assisting older...



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There is an urgent need for evidence-based internationally agreed guidelines for the assessment of neonates at risk of developing early-onset sepsis

Commentary on: Mukhopadhyay S, Taylor JA, Von Kohorn I, et al. Variation in sepsis evaluation across a national network of nurseries. Pediatr 2017;139:e20162845.

Implications for practice and research

An optimal approach for early-onset sepsis (EOS) risk assessment in neonates would allow for standardised quality of care and would minimise disparities in management.

There is a need for the evaluation of current practices and outcomes in managing neonates at risk for EOS, as well as the development of internationally agreed evidence-based guidelines.

Context

Neonatal sepsis is a leading cause of morbidity and mortality. However, there are substantial differences in the practice of risk assessment of neonates with suspected EOS. Attempts have been made to streamline the management pathways in the USA, UK and elsewhere through publication of the national guidelines.1 2 A rational approach is needed to prioritise the treatment of sick babies, while streamlining the management pathways for well...



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Nurse education needed to address uncertainties of role and contribution in stroke rehabilitation units

Commentary on: Loft MI, Poulsen I, Esbensen BA, et al. Nurses’ and nurse assistants’ beliefs, attitudes and actions related to role and function in an inpatient stroke rehabilitation unit: a qualitative study. J Clin Nurs 2017;26:4905–14.

Implications for practice and research

Successful completion of a specialist education package should be a prerequisite for stroke unit staff induction programmes.

Similar studies in other locations and contexts are required to fully understand the contribution of the nurses’ role to stroke rehabilitation.

Context

Nurses and nurse assistants are key members of the multidisciplinary stroke rehabilitation team, being with the patient and working with them and their relatives continuously throughout their inpatient stay. However, nurses struggle to define their role and contribution in this context. Loft and colleague’s study,1 located in a small (15 beds) but well-staffed dedicated stroke rehabilitation unit (37 staff, with high levels of experience and seniority), aimed to explore the beliefs,...



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Impact of provision of time in therapeutic range value on anticoagulation management in atrial fibrillation patients on warfarin

Introduction

The importance of time in therapeutic range (TTR) in patients prescribed warfarin therapy for stroke prevention in atrial fibrillation (AF) cannot be overemphasised.

Aim

To evaluate the impact of provision of TTR results during clinic visits on anticoagulation management.

Design

Single-centred, randomised controlled study.

Setting

Fifteen arrhythmia clinics in Hong Kong.

Patients

AF patients prescribed warfarin.

Interventions

Provision of TTR or no provision of TTR.

Main outcome measures

A documented discussion between doctors and patients about switching warfarin to a non-vitamin K oral anticoagulant (NOAC).

Results

Four hundred and eighty one patients with AF prescribed warfarin were randomly assigned to (1) a TTR provision group or (2) control. Their mean age was 73.6±12.0 years and 60.7% were men. The mean CHA2DS2-VASc score was 3.2±1.6 and the mean HASBLED score was 1.7±1.2. The mean TTR was 63.9%±29.9%. At the index clinic visit, 71 of 481 patients (14.8%) had a documented discussion about switching warfarin to a NOAC. Patients with provision of TTR results were more likely to discuss switching warfarin to a NOAC than controls (19.1% vs 10.6%, P=0.03), especially those with a TTR <65% (35.2% vs 10.6%, P<0.001). A higher proportion of patients with provision of TTR results switched to a NOAC (5.9% vs 4.1%, P=0.49).

Conclusions

The provision of TTR among patients on warfarin was associated with a discussion about switching from warfarin to a NOAC in those with TTR <65%, but did not result in actual switching to a NOAC, suggesting additional barriers.



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Leakiness of Pinned Neighboring Surface Nanobubbles Induced by Strong Gas–Surface Interaction

TOC Graphic

ACS Nano
DOI: 10.1021/acsnano.7b08614
ancac3?d=yIl2AUoC8zA


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Effect of health education on severe thalassemia prevention and control in communities in Cambodia

Severe thalassemia diseases are a major health problem in Southeast Asia. In Cambodia, there has never been a significant program for prevention or control of severe thalassemia. We, therefore, studied the eff...

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Positive clinical trial results involving repurposed drugs often go unnoticed - see what the ReDO project is doing… https://t.co/GiQSFxIHI7

Positive clinical trial results involving repurposed drugs often go unnoticed - see what the ReDO project is doing… https://t.co/GiQSFxIHI7

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://twitter.com/ecancer/status/965610671277789184
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.@US_FDA approves durvalumab ( $AZN Imfinzi ) for unresectable stage III non-small cell #lungcancer https://t.co/xXiwK0akIl

.@US_FDA approves durvalumab ( $AZN Imfinzi ) for unresectable stage III non-small cell #lungcancer https://t.co/xXiwK0akIl

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Watch our interview with Dr Jeffery Graham on cytoreductive nephrectomy in #metastatic papillary renal cell carcino… https://t.co/LjEhffrwV5

Watch our interview with Dr Jeffery Graham on cytoreductive nephrectomy in #metastatic papillary renal cell carcino… https://t.co/LjEhffrwV5

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Time to Release Medicare Advantage Claims Data

This Viewpoint argues for Medicare Advantage claims data to be made publicly available for research and analysis purposes.

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Service Sharing as a Path to Viability for Small Physician Practices

This Viewpoint discusses the use of shared service arrangements as a means for small physician practices to pool and manage resources, stay competitive for value-based contracts, and remain viable in the face of market forces favoring consolidation.

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GENETICS IN ENDOCRINOLOGY: The expanding genetic horizon of primary aldosteronism

Aldosterone is the main mineralocorticoid hormone in humans and plays a key role in maintaining water and electrolyte homeostasis. Primary aldosteronism (PA), characterized by autonomous aldosterone overproduction by the adrenal glands, affects 6% of the general hypertensive population and can be either sporadic or familial. Aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia (BAH) are the two most frequent subtypes of sporadic PA and 4 forms of familial hyperaldosteronism (FH-I to FH-IV) have been identified. Over the last six years, the introduction of next-generation sequencing has significantly improved our understanding of the molecular mechanisms responsible for autonomous aldosterone overproduction in both sporadic and familial PA. Somatic mutations in four genes (KCNJ5, ATP1A1, ATP2B3 and CACNA1D), differently implicated in intracellular ion homeostasis, have been identified in nearly 60% of the sporadic APAs. Germline mutations in KCNJ5 and CACNA1H cause FH-III and FH-IV, respectively, while germline mutations in CACNA1D cause the rare PASNA syndrome, featuring primary aldosteronism seizures and neurological abnormalities. Further studies are warranted to identify the molecular mechanisms underlying BAH and FH-II, the most common forms of sporadic and familial PA whose molecular basis is yet to be uncovered.



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miRNA-124-3p/neuropilin-1(NRP-1) axis plays an important role in mediating glioblastoma growth and angiogenesis

Abstract

Glioblastoma Multiforme (GBM) is the most lethal brain malignancy which involves multi-gene abnormality. Unfortunately, effective therapy against GBM is still lacking. Previously, we found that NRP-1 and its downstream NRP-1/GIPC1 pathway played an important role in GBM. In this study, we further investigated the upstream signaling of NRP-1 to understand how it is regulated. Firstly, we identified that hsa-miR-124-3p was miRNA differentially expressed in GBM and in normal brain tissues by high-throughput sequencing. Then, by dual luciferase reporter gene, we found miR-124-3p can specially bind to the 3'UTR region of the NRP-1 thus suppresses its expression. Moreover, miR-124–3p overexpression significantly inhibited GBM cell proliferation, migration and tumor angiogenesis which resulted in GBM apoptosis and cell cycle arrest, putatively via NRP-1 mediated PI3K/Akt/NFκB pathways activation in GBM cells. Meanwhile, miR-124-3p overexpression also suppressed tumor growth and reduced tumor angiogenesis when targeted by NRP-1 in a PDX model. Furthermore, NRP-1 mAb exerted synergistic inhibitory effects with miR-124–3p overexpression in GBM. Thus, we discovered that miR-124-3p acts as the upstream suppressor of NRP-1 which promotes GBM cell development and growth by PI3K/Akt/NFκB pathway. The miR-124-3p/NRP-1/GIPC1 pathway as a new pathway has a vital role in GBM, and it could be considered as the potential target for malignant gliomas in future. This article is protected by copyright. All rights reserved.



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Tobacco-attributable burden of cancer according to socioeconomic position in France

Abstract

Smoking is a major preventable cause of cancers and is increasingly concentrated among the most deprived individuals leading to increasing socioeconomic inequalities in the incidence of cancers linked to smoking. We aimed to estimate the tobacco-attributable cancer burden according to socioeconomic position in France. The analysis was restricted to cancer sites for which tobacco smoking was recognized as a risk factor. Cancer cases by sex, age group and European Deprivation Index (EDI) among people aged 30–74 between 2006 and 2009 were obtained from cancer registries covering approximately 20% of the French population. The tobacco-attributable burden of cancer according to EDI was estimated applying the population attributable fraction (PAF) computed with the Peto-Lopez method. The PAF increased from 56% in the least deprived EDI quintile to 70% in the most deprived EDI quintile among men and from 26% to 38% among women. In total, 28% of the excess cancer cases in the four most deprived EDI quintiles in men and 43% in women could be prevented if smoking in these 4 EDI quintiles was similar to that of the least deprived EDI quintile. A substantial smoking-attributable burden of cancer by socioeconomic position was observed in France. The results highlight the need for policies reducing tobacco consumption. More comprehensive interventions integrating the various dimensions of health determinants and proportionate according to socioeconomic position may essentially contribute to the reduction of socioeconomic inequalities in cancer. This article is protected by copyright. All rights reserved.



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Low T3 syndrome as a predictor of poor prognosis in chronic lymphocytic leukemia

Abstract

Low triiodothyronine (T3) state is associated with poor prognosis in critical acute and prolonged illness. However, the information on thyroid dysfunction and cancer is limited. The aim of our study was to evaluate the prognostic value of low T3 syndrome in chronic lymphocytic leukemia (CLL). Two hundred and fifty-eight patients with detailed thyroid hormone profile at CLL diagnosis were enrolled. Low T3 syndrome was defined by low free T3 (FT3) level accompanied by normal-to-low free tetraiodothyronine (FT4) and thyroid-stimulating hormone (TSH) levels. A propensity score-matched method was performed to balance the baseline characteristics. Multivariate Cox regression analyses screened the independent prognostic factors related to time-to-first-treatment (TTFT) and cancer-specific survival (CSS). Area under the curve (AUC) assessed the predictive accuracy of CLL-International Prognostic Index (IPI) together with low T3 syndrome. The results showed that 37 (14.34%) patients had low T3 syndrome, which was significantly associated with unfavorable TTFT and CSS in the propensity-matched cohort, and it was an independent prognostic indicator for both TTFT and CSS. Serum FT3 level was positively related to protein metabolism and anemia, and inversely related to inflammatory state. Patients with only low FT3 demonstrated better survival than those with synchronously low FT3 and FT4, while those with synchronously low FT3, FT4 and TSH had the worst clinical outcome. Low T3 syndrome together with CLL-IPI had larger AUCs compared with CLL-IPI alone in TTFT and CSS prediction. In conclusion, low T3 syndrome may be a good candidate for predicting prognosis in future clinical practice of CLL. This article is protected by copyright. All rights reserved.



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Computed tomography analysis of frontal cell prevalence according to the International Frontal Sinus Anatomy Classification

Background

The International Frontal Sinus Anatomy Classification (IFAC) is an international consensus document published in 2016 to standardize the nomenclature of cells in the region of the frontal recess and frontal sinus. The IFAC was designed to be surgically relevant and anatomically precise. The current study was undertaken to assess the prevalence of the frontal cell variants as defined by the IFAC, as well as to determine the interrater reliability of the IFAC.

Methods

Three independent reviewers examined triplanar nondiseased maxillofacial computed tomography (CT) scans to assess the anatomy of the frontal recess according to the IFAC system. The prevalence of each cell type was assessed and interrater reliability was measured using an intraclass correlation coefficient (ICC).

Results

One hundred CT scans (200 sides) were examined. Of the 200 sides, 96.5% contained an agger nasi cell (ICC, 0.82; 95% confidence interval [CI], 0.77-0.86), 30.0% contained a supra agger cell (ICC, 0.89; 95% CI, 0.86-0.92), 20.0% contained a supra agger frontal cell (ICC 0.80; 95% CI 0.74-0.84), 72.0% contained a supra bulla cell (ICC, 0.81; 95% CI, 0.76-0.85), 5.5% contained a supra bulla frontal cell (ICC, 0.71; 95% CI, 0.63-0.77), 28.5% contained a supraorbital ethmoid cell (ICC, 0.78; 95% CI, 0.72-0.83), and 30.0% contained a frontal septal cell (ICC, 0.80; 95% CI, 0.74-0.84). The ICC was good to excellent for identification of all frontal cell types.

Conclusions

This study describes the normative distribution of frontal recess cells in a nondiseased population according to IFAC and demonstrates favorable interrater reliability of the classification system.



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The impact of video nasal endoscopy on patient satisfaction

Background

Video nasal endoscopy has significant associated expense for practices, but its use has been justified by the benefit it provides to the examiner. No study has examined the perceived benefit to the patient. In this study, the impact of video endoscopy on patient satisfaction is evaluated.

Methods

A prospective, randomized, single-blinded study was performed on new patients receiving care in the rhinology clinics of a tertiary-care center. Patients were randomized into the standard endoscopic examination (SEE) or video endoscopic examination (VEE) groups. SEE patients had their examination performed with the physician viewing the exam through the eyepiece, without a video camera, and subsequently had their examination explained. VEE patients had their examination performed with a video camera attached to the scope, recorded, and then used for the explanation. All patients were asked to complete the 22-item Sino-Nasal Outcome Test (SNOT-22) and the 18-item Patient Satisfaction Questionnaire Short-Form (PSQ-18). Statistical analysis was performed to identify differences between cohorts.

Results

There was no significant demographic difference between groups. SNOT-22 total and domain scores were similar between both groups (p > 0.05). VEE patients had significantly higher general satisfaction (p = 0.048) and communication (p = 0.028) domains within the PSQ-18. There was no difference between other domains (p > 0.05).

Conclusion

VEE is a valuable tool for otolaryngologists and patients. Further studies evaluating variance in patient compliance and symptomatology may provide further justification for its use.



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From Music to Mathematics: Exploring the Connections (Review)

A review of Gareth Roberts's book From Music to Mathematics: Exploring the Connections

-- Read more on ScientificAmerican.com
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Programming Hierarchical Self-Assembly of Patchy Particles into Colloidal Crystals via Colloidal Molecules

TOC Graphic

ACS Nano
DOI: 10.1021/acsnano.7b07633
ancac3?d=yIl2AUoC8zA


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Attitudes Toward e-Mental Health Services in a Community Sample of Adults: Online Survey



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Surgeons urge NHS England to ban minimum waits

The Royal College of Surgeons has urged NHS England to stop clinical commissioning groups imposing minimum waiting times that result in some patients waiting at least three months to see a...
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Arsenite and methylarsonite inhibit mitochondrial metabolism and glucose-stimulated insulin secretion in INS-1 832/13 β cells

Abstract

Growing evidence suggests that exposure to environmental contaminants contributes to the current diabetes epidemic. Inorganic arsenic (iAs), a drinking water and food contaminant, is one of the most widespread environmental diabetogens according to epidemiological studies. Several schemes have been proposed to explain the diabetogenic effects of iAs exposure; however, the exact mechanism remains unknown. We have shown that in vitro exposure to low concentrations of arsenite (iAsIII) or its trivalent methylated metabolites, methylarsonite (MAsIII) and dimethylarsinite (DMAsIII), inhibits glucose-stimulated insulin secretion (GSIS) from isolated pancreatic islets, with little effect on insulin transcription or total insulin content. The goal of this study was to determine if exposure to trivalent arsenicals impairs mitochondrial metabolism, which plays a key role in the regulation of GSIS in β cells. We used a Seahorse extracellular flux analyzer to measure oxygen consumption rate (OCR), a proxy for mitochondrial metabolism, in cultured INS-1 832/13 β cells exposed to iAsIII, MAsIII, or DMAsIII and stimulated with either glucose or pyruvate, a final product of glycolysis and a substrate for the Krebs cycle. We found that 24-h exposure to 2 μM iAsIII or 0.375–0.5 μM MAsIII inhibited OCR in both glucose- and pyruvate-stimulated β cells in a manner that closely paralleled GSIS inhibition. In contrast, 24-h exposure to DMAsIII (up to 2 µM) had no effects on either OCR or GSIS. These results suggest that iAsIII and MAsIII may impair GSIS in β cells by inhibiting mitochondrial metabolism, and that at least one target of these arsenicals is pyruvate decarboxylation or downstream reactions.



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Electric eel-inspired batteries could power life-long pacemakers

A new battery made of fleshy hydrogel layers generates and stores power like electric eels do. It could power pacemakers without ever needing to be replaced

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Flu is evolving in new and unpredictable ways in China’s poultry

A woman in China has been infected by a new type of flu. With thousands of people travelling after Chinese new year, the risk of new strains spreading is high

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Real-life Lord of the Flies experiment led us up the warpath

Muzafer Sherif’s notorious experiment with children is held up as proof that conflict is in our blood – but a look behind the scenes tells a different story

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Should we revisit ethically dubious experiments from the past?

From deadly Nazi medical experiments to sociological studies on children, past science has taken paths we wouldn't tread today, but the results still have value

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Copper(I) and silver(I) complexes of 9,9-dimethyl-4,5-bis(di-tert-butylphosphino)xanthene: photophysical properties and structural rigidity under pressure

GA?id=C7PP00432J

Photochem. Photobiol. Sci., 2018, Advance Article
DOI: 10.1039/C7PP00432J, Paper
Sarah Keller, Alessandro Prescimone, Edwin C. Constable, Catherine E. Housecroft
Structural, photophysical and electrochemical properties of heteroleptic copper(I) and silver(I) complexes [M(tBu-xantphos)(bpy)][PF6] are described where tBu-xantphos is 4,5-bis(di-tert-butylphosphino)-9,9-dimethylxanthene.
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry


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Electric eel-inspired batteries could power life-long pacemakers

A new battery made of fleshy hydrogel layers generates and stores power like electric eels do. It could power pacemakers without ever needing to be replaced

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Flu is evolving in new and unpredictable ways in China’s poultry

A woman in China has been infected by a new type of flu. With thousands of people travelling after Chinese new year, the risk of new strains spreading is high

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Real-life Lord of the Flies experiment led us up the warpath

Muzafer Sherif’s notorious experiment with children is held up as proof that conflict is in our blood – but a look behind the scenes tells a different story

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New Scottish GP contract increases risk for remote and rural communities

General practitioners in Scotland have voted to accept the 2018 contract,1 which says that “generalism, by definition, is a form of care that is person not disease centred.”2 But the fundamental...
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How to Fight Bias with Predictive Policing

The data-driven technique can perpetuate inequality, but if done right, it also presents an unprecedented opportunity to advance social justice

-- Read more on ScientificAmerican.com
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