Πέμπτη 6 Απριλίου 2017
Sleep duration and quality in heart failure patients
Abstract
Purpose
Sleep-disordered breathing (SDB) is highly prevalent in patients with heart failure and reduced left ventricular ejection fraction (HF-REF). SDB is classified as predominant obstructive (OSA) or central (CSA) and may alter sleep duration, sleep quality, and quality of life. This study describes sleep quality and duration in well-characterized cohorts of these patients.
Methods
Two hundred fifty consecutive patients with HF-REF (NYHA class ≥II, ejection fraction ≤45%) underwent cardiac and pulmonary examination, plus full attended in-hospital overnight polysomnography (PSG). PSG recordings were performed according to current recommendations and underwent independent, blinded analysis at a core laboratory.
Results
Patients with HF-REF and CSA were older and had more impaired cardiac function compared to those with OSA. With respect to sleep parameters, patients with CSA spent more time in bed than those with OSA (468 ± 52 vs 454 ± 46 min, p = 0.021) while sleep efficiency was lower (67 ± 14 vs 72 ± 13% of total sleep time (TST), p = 0.008). In addition, CSA patients spent more time awake after sleep onset (101 ± 61 vs 71 ± 46 min, p = 0.001) and had more stage N1 (light) sleep (33 ± 19 vs 28 ± 16% of TST, p = 0.017). Overall, the proportion of sleep spent in N3 (slow-wave/deep) sleep in HF-REF patients with SDB was low (4.1 ± 6.3% of TST) compared with healthy adults.
Conclusions
HF-REF patients with CSA compared to OSA have worse sleep efficiency and quality. This could result in less restorative sleep, changes in sympathovagal balance, and impaired resetting of important reflexes, which might contribute to worse cardiovascular outcomes in HF-REF patients with SDB.
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Biomechanical properties of posterior transpedicular–transdiscal oblique lumbar screw fixation with novel trapezoidal lateral interbody spacer: an in vitro human cadaveric model
Abstract
Purpose
To investigate biomechanical properties of posterior transpedicular–transdiscal (TPTD) oblique lumbar screw fixation whereby the screw traverses the inferior pedicle across the posterior disc space into the super-adjacent body and lateral trapezoidal interbody spacer.
Methods
Eight fresh–frozen osteoligamentous human cadaveric spines (L1–S1) were tested in flexion–extension (FE), lateral bending (LB), and axial rotation (AR), with pure bending moment set at 7.5 Nm. Surgical constructs included (1) intact spine; (2) bilateral pedicle screw (BPS) fixation at L3–L4; (3) TPTD screw fixation at L3–L4; (4) lateral L3–L4 discectomy; (5) TPTD screw fixation with lateral interbody spacer (TPTD+S); and (6) BPS fixation with lateral interbody spacer (BPS+S). Peak range of motion (ROM) at L3–L4 was normalized to intact for statistical analysis.
Results
In FE and LB, all posterior fixation with or without interbody spacers significantly reduced motion compared with intact and discectomy. BPS and BPS+S provided increased fixation in all planes of motion; significantly reducing FE and LB motion relative to TPTD (p = 0.005, p = 0.002 and p = 0.020, p = 0.004, respectively). In AR, only BPS significantly reduced normalized ROM to intact (p = 0.034); BPS+S provided greater fixation compared with TPTD+S (p = 0.005).
Conclusions
Investigators found less stiffness with TPTD screw fixation than with BPS regardless of immediate stabilization with lateral discectomy and spacer. Clinical use should be decided by required biomechanical performance, difficulty of installation, and extent of paraspinal tissue disruption.
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Cognitive Changes after Cellular Therapy in a Case of Intellectual Disability
The post Cognitive Changes after Cellular Therapy in a Case of Intellectual Disability appeared first on Welcome to Avens.
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Integrated Guidance and Feedback Control of Underactuated Robotics System in SE(3)
Abstract
An integrated guidance and feedback control scheme for steering an underactuated vehicle through desired waypoints in three-dimensional space, is developed here. The underactuated vehicle is modeled as a rigid body with four control inputs. These control inputs actuate the three degrees of freedom of rotational motion and one degree of freedom of translational motion in a vehicle body-fixed coordinate frame. This actuation model is appropriate for a wide range of underactuated vehicles including spacecraft with internal attitude actuators, vertical take-off and landing (VTOL) aircraft, fixed-wing multirotor unmanned aerial vehicles (UAVs), maneuverable robotic vehicles, etc. The guidance problem is developed on the special Euclidean group of rigid body motions, SE(3), in the framework ofgeometric mechanics, which represents the vehicle dynamics globally on this configuration manifold. The integrated guidance and control algorithm selects the desired trajectory for the translational motion that passes through the given waypoints, and the desired trajectory for the attitude based on the desired thrust direction to achieve the translational motion trajectory. A feedback control law is then obtained to steer the underactuated vehicle towards the desired trajectories in translation and rotation. This integrated guidance and control scheme takes into account known bounds on control inputs and generates a trajectory that is continuous and at least twice differentiable, which can be implemented with continuous and bounded control inputs. The integrated guidance and feedback control scheme is applied to an underactuated quadcopter UAV to autonomously generate a trajectory through a series of given waypoints in SE(3) and track the desired trajectory in finite time. The overall stability analysis of the feedback system is addressed. Discrete time models for the dynamics and control schemes of the UAV are obtained in the form of Lie group variational integrators using the discrete Lagrange-d'Alembert principle. Almost global asymptotic stability of the feedback system over its state space is shown analytically and verified through numerical simulations.
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OnabotulinumtoxinA injections in detrusor facilitate self-catheterisation in a patient with paraplegia and bladder outlet dyssynergia
This case report describes the case of improvement of clean intermittent catheterisation procedures after each intradetrusor administration of onabotulinumtoxinA in a 45-year-old man with L1 paraplegia with neurogenic detrusor overactivity and bladder outlet dyssynergia.On three occasions, improvement on clean intermittent catheterisation procedures appeared 10 to 14 days after intradetrusor injections of onabotulinumtoxinA and lasted for 9 months. We hypothesise a possible influence of intravesical injections of onabotulinumtoxinA on the storage reflex. We also discuss the possibility of a dispersion of onabotulinumtoxinA towards contiguous structures such as the urethral sphincter.
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Perioperative Management of Older Women in Urogynecologic Surgery
Abstract
Purpose of Review
Preoperative measurements of frailty and mobility predict surgical outcomes in older patients better than measurements of medical comorbidities or American Society of Anesthesiologists (ASA) status alone. The purpose of this review is to summarize updated evidence for optimal preoperative assessment, perioperative management, and postoperative care for elective gynecologic surgery in older women.
Recent Findings
Two joint best-practice guideline statements from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) and the American Geriatrics Society (AGS) focus on preoperative (2012) and perioperative care (2016) of the geriatric patient.
Summary
Preoperative identification of frailty, cognitive impairment, and functional disability in older women may be an important way to improve outcomes. Preoperative identification has the potential to allow surgeons to better counsel patients about unique postoperative risks, tailor the aggressiveness of the surgical approach, and facilitate shared decision-making. Finally, preoperative identification can help identify patients who need extra support at hospital discharge with transitions of care. Future research is necessary to assess the impact of preoperative geriatric screening for frailty, cognitive impairment, and mobility disorders with treatment success and postoperative outcomes in older women undergoing surgical correction of pelvic floor disorders (PFDs) and other elective gynecologic procedures.
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Erratum to: First-in-human phase I study of SOR-C13, a TRPV6 calcium channel inhibitor, in patients with advanced solid tumors
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Sleep duration and quality in heart failure patients
Abstract
Purpose
Sleep-disordered breathing (SDB) is highly prevalent in patients with heart failure and reduced left ventricular ejection fraction (HF-REF). SDB is classified as predominant obstructive (OSA) or central (CSA) and may alter sleep duration, sleep quality, and quality of life. This study describes sleep quality and duration in well-characterized cohorts of these patients.
Methods
Two hundred fifty consecutive patients with HF-REF (NYHA class ≥II, ejection fraction ≤45%) underwent cardiac and pulmonary examination, plus full attended in-hospital overnight polysomnography (PSG). PSG recordings were performed according to current recommendations and underwent independent, blinded analysis at a core laboratory.
Results
Patients with HF-REF and CSA were older and had more impaired cardiac function compared to those with OSA. With respect to sleep parameters, patients with CSA spent more time in bed than those with OSA (468 ± 52 vs 454 ± 46 min, p = 0.021) while sleep efficiency was lower (67 ± 14 vs 72 ± 13% of total sleep time (TST), p = 0.008). In addition, CSA patients spent more time awake after sleep onset (101 ± 61 vs 71 ± 46 min, p = 0.001) and had more stage N1 (light) sleep (33 ± 19 vs 28 ± 16% of TST, p = 0.017). Overall, the proportion of sleep spent in N3 (slow-wave/deep) sleep in HF-REF patients with SDB was low (4.1 ± 6.3% of TST) compared with healthy adults.
Conclusions
HF-REF patients with CSA compared to OSA have worse sleep efficiency and quality. This could result in less restorative sleep, changes in sympathovagal balance, and impaired resetting of important reflexes, which might contribute to worse cardiovascular outcomes in HF-REF patients with SDB.
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Diagnosing and managing sleep apnea in patients with chronic cerebrovascular disease: a randomized trial of a home-based strategy
Abstract
Background
Obstructive sleep apnea is common and associated with poor outcomes after stroke or transient ischemic attack (TIA). We sought to determine whether the intervention strategy improved sleep apnea detection, obstructive sleep apnea (OSA) treatment, and hypertension control among patients with chronic cerebrovascular disease and hypertension.
Methods
In this randomized controlled strategy trial intervention, patients received unattended polysomnography at baseline, and patients with OSA (apnea-hypopnea index ≥5 events/h) received auto-titrating continuous positive airway pressure (CPAP) for up to 1 year. Control patients received usual care and unattended polysomnography at the end of the study, to identify undiagnosed OSA. Both groups received 24-h blood pressure assessments at baseline and end of the study. “Excellent” CPAP adherence was defined as cumulative use of ≥4 h/night for ≥70% of the nights.
Results
Among 225 randomized patients (115 control; 110 intervention), 61.9% (120/194) had sleep apnea. The strategy successfully diagnosed sleep apnea with 97.1% (102/105) valid studies; 90.6% (48/53, 95% CI 82.7–98.4%) of sleep apnea was undiagnosed among control patients. The intervention improved long-term excellent CPAP use: 38.6% (22/57) intervention versus 0% (0/2) control (p < 0.0001). The intervention did not improve hypertension control in this population with well-controlled baseline blood pressure: intervention, 132.7 mmHg (±standard deviation, 14.1) versus control, 133.8 mmHg (±14.0) (adjusted difference, −1.1 mmHg, 95% CI (−4.2, 2.0)), p = 0.48).
Conclusions
Patients with cerebrovascular disease and hypertension have a high prevalence of OSA. The use of portable polysomnography, and auto-titrating CPAP in the patients’ homes, improved both the diagnosis and the treatment for sleep apnea compared with usual care but did not lower blood pressure.
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Irregularly emitting air pollution sources: acute health risk assessment using AERMOD and the Monte Carlo approach to emission rate
Abstract
Intermittent irregular sources of air pollution, when used in dispersion modeling, can exaggerate the acute health risk due to improbable coincidence of release with the worst-case meteorological conditions. This problem is alleviated by randomizing the moments of emission and applying the Monte Carlo method to obtain the realistic expected yearly maxima of hourly concentrations/risks. Emissions are modeled as irregular “pulses,” possibly with additional constraints on timing. Such are major emission sources in important industries: oil refineries, gas extraction, cement production, etc. We have tested the approach in ~100 projects for industrial plants in Russia and obtained considerable reductions in estimated acute health risks: up to two orders of magnitude, depending on the level of intermittency of sources. These corrections to unrealistically high worst-case concentration values at nearby populated areas are, in many cases, a key to obtaining reasonable exclusion/protection zones for plants. To our knowledge, such a body of results on intermittent irregular sources is unique, and it can be useful especially for developing countries where the exact timeline of emissions is often unknown. Taking intermittency into account is also known to be an important step toward compliance with 1-h US National Ambient Air Quality Standard. We provide a detailed description of the Monte Carlo algorithm used. We compare Monte Carlo with the usual quantile-based approach to peak values; they agree when quantile is dependent on intermittency. The non-linearity of maximum function gives rise to some counterintuitive phenomena, which call for refinement of risk definition for intermittent irregular sources.
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Main ozone-forming VOCs in the city of Sao Paulo: observations, modelling and impacts
Abstract
High-ozone concentrations currently represent the main air pollution problem in the city of São Paulo, Brazil. To elucidate the main volatile organic compounds (VOCs), which act as ozone precursors, samples from air quality monitoring stations were evaluated. Thirty-five samples were collected in August–September of 2006 and 43 in July–August of 2008, when the consumption of ethanol was about 50 % of the total fuel used in the São Paulo Metropolitan Area. Samples were collected using electropolished stainless canisters. Chemical analyses were performed on pre-concentrated samples followed by gas chromatograph with flame ionization and mass spectrometry detection. The incremental reactivity scale was used to rank the ozone precursors using the Ozone Isopleth Package for Research (OZIPR) trajectory model coupled with chemical mechanism Statewide Air Pollution Research Center (SAPRC). Sixty-nine species of VOCs were quantified, and the ten main ozone precursors identified in 2008 were as follows: formaldehyde (42.8 %), acetaldehyde (13.9 %), ethene (12.2 %), propene (5.1 %), 1-methylcyclopentene (3.0 %), p-xylene (2.4 %), 1-butene (2.1 %), trans-2-pentene (1.9 %), 2-methyl 2-butene (1.7 %) and trans-2-butene (1.6 %). Volatile organic compound mass distribution showed that in 2008 alkanes represented 46 % of the total VOCs, alkenes 27 %, aromatics 14 %, alkadienes 1 % and aldehydes 12 %.
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Preferred nasolabial angle in Middle Eastern population
Abstract
To define the preferred nasolabial angle measurement in Middle Eastern population. An observational study was conducted from January 2012 to January 2016 at the Department of Otolaryngology, Head and Neck Surgery, King Abdulaziz University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia. A total of 1027 raters, 506 males, and 521 females were asked to choose the most ideal nasolabial angle for 5 males and 5 females lateral photographs whose nasolabial angle were modified with Photoshop into the following angles (85°, 90°, 95°, 100°, 105°, and 110°). Male raters preferred the angle of 89.5° ± 3.5° (mean ± SD) for males and 90.8° ± 5.6° for females. While female raters preferred the angle of 89.3° ± 3.8° for males and 90.5° ± 4.8° for females. ANOVA test compare means among groups: p: 0.342, and there is no statistically significant difference between groups. The results of our study showed an even more acute angles than degrees found in the literature. It shows that what young generation in our region prefers and clearly reflects that what could be explained as under rotation of the nasal tip in other cultures is just the ideal for some Middle Eastern population.
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Reply to the letter to the editor concerning: ‘Relationship between increased carotid artery stiffness and idiopathic subjective tinnitus’
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Effect of hyaluronic acid with or without scaffold material on the regeneration of tympanic membrane perforations
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Relationship between increased carotid artery stiffness and idiopathic subjective tinnitus: methodological issues
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Idiopathic subglottic stenosis: an epidemiological single-center study
Abstract
A retrospective epidemiological study of patients treated for idiopathic subglottic stenosis (ISS) during 2003–2013 at Oslo University Hospital, Rikshospitalet, was undertaken to assess its incidence, management and treatment outcomes. Out of a total of 123 patients with subglottic stenosis (84 female, 39 men), 38 patients were diagnosed with ISS, all of whom were female. Of these, 23 lived in the South-Eastern Norway Regional Health Authority, representing an incidence of 0.2 per 100,000 (95% CI 0.13–0.3) in this region of 2.9 million inhabitants. Mean age at diagnosis was 54 years (range 20–85 years), and the mean interval between symptom onset and diagnosis was 3.1 years. The 38 patients with ISS underwent a total of 132 operations between 2003 and 2013. All patients were managed endoscopically using laser surgery, with or without corticosteroids and Mitomycin C, with dilatation by balloon or bougie. Eight patients (21.1%) required only one procedure, while 30 patients (78.9%) had multiple operations. The median follow-up for all patients from the first operation was 5.3 years. The mean interval between procedures was 1 year for patients aged 20–48 years, 1.3 years for patients aged 49–61 years and 3.0 years for patients aged 62–85 years. No clinically significant complications were observed. In conclusion, the symptoms of ISS can be treated effectively with laser surgery and dilatation but the recurrence rate remains high and the time interval between operations does not increase with time, making ISS a continuing challenge.
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Repetitive transcranial magnetic stimulation and drugs for tinnitus
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Perioperative complications and safety of type II thyroplasty (TPII) for adductor spasmodic dysphonia
Abstract
Type II thyroplasty (TPII) is one of the surgical options offered in the management of adductor spasmodic dysphonia (AdSD); however, there have been no detailed reports of its safety and associated complications during the perioperative period. Our aim was to assess the complications and safety of TPII. TPII was performed for consecutive 15 patients with AdSD from April 2012 through May 2014. We examined retrospectively the perioperative complications, the degree of surgical invasion, and recovery process from surgery. All patients underwent successful surgery under only local anesthesia. Vocal fold erythema was observed in 14 patients and vocal fold edema in 10 patients; however, all of them showed complete resolution within 1 month. No patient experienced severe complications such as acute airway distress or hemorrhage. Fourteen patients were able to have oral from the 1st postoperative morning, with the remaining patient able to have oral intake from the 2nd postoperative day. In addition, no patient experienced aspiration postoperatively. In conclusion, only minor complications were observed in association with TPII in this study. No dysphagia was observed postoperatively, which is an advantage over other treatments. The results of our study suggest that TPII is a safe surgical treatment for AdSD.
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Benchmarking of venous thromboembolism prophylaxis practice with ENT.UK guidelines
Abstract
The aim of this study was to benchmark our guidelines of prevention of venous thromboembolism (VTE) in ENT surgical population against ENT.UK guidelines, and also to encourage healthcare providers to utilize benchmarking as an effective method of improving performance. The study design is prospective descriptive analysis. The setting of this study is tertiary referral centre (Assir Central Hospital, Abha, Saudi Arabia). In this study, we are benchmarking our practice guidelines of the prevention of VTE in the ENT surgical population against that of ENT.UK guidelines to mitigate any gaps. ENT guidelines 2010 were downloaded from the ENT.UK Website. Our guidelines were compared with the possibilities that either our performance meets or fall short of ENT.UK guidelines. Immediate corrective actions will take place if there is quality chasm between the two guidelines. ENT.UK guidelines are evidence-based and updated which may serve as role-model for adoption and benchmarking. Our guidelines were accordingly amended to contain all factors required in providing a quality service to ENT surgical patients. While not given appropriate attention, benchmarking is a useful tool in improving quality of health care. It allows learning from others’ practices and experiences, and works towards closing any quality gaps. In addition, benchmarking clinical outcomes is critical for quality improvement and informing decisions concerning service provision. It is recommended to be included on the list of quality improvement methods of healthcare services.
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Primary unclassified sarcoma of the parotid gland: a case of diagnostic and therapeutic challenge
Abstract
Malignant salivary gland sarcomas represent a clinically and histologically diagnostic challenge. Primary unclassified sarcomas of the parotid gland consist a rare salivary gland tumor. We report an unusual case of such a tumor, which occurred in the right parotid gland of a 54-year-old male and presented as an asymptomatic painless mass. The pathologoanatomical examination revealed a rhabdoid large-cell unclassified sarcoma. The patient was treated with superficial parotidectomy and adjuvant radiotherapy. No recurrence was noted in a 10-year follow-up period. Due to the rare occurrence of primary unclassified sarcomas, there is no evidence-based treatment of choice. An optimal approach is best planned in a multidisciplinary setting, taking into consideration the resectability of the tumor, individual patient characteristics, presence of local or distant metastatic activity, local infiltrative behavior and tumor stage. A close follow-up of the patient is strongly recommended.
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The variants of the retro- and hypotympanum: an endoscopic anatomical study
Abstract
The retro- and hypotympanum are hidden areas of the middle ear, only poorly recognized. Nevertheless, this region is of relevant clinical significance, since it is regularly affected by disease such as cholesteatoma. The aim of this study is to explore and describe the anatomical variants of the hypo- and retrotympanum by the means of transcanal endoscopy. We hypothesize a significant variability of this hidden region of the middle ear. Moreover, we believe that the minimal invasive, endoscopic access is suitable since angled scopes may be used to explore the region. To this end a total of 125 middle ears (83 cadaveric dissections, 42 surgical cases) were explored by the means of 3 mm straight and angled scopes. The variants were documented photographically and tabularized. The bony crests ponticulus, subiculum and finiculus were most frequently represented as ridges. The ponticulus showed the highest variability with 38% ridge, 35% bridge and 27% incomplete presentation. The subiculum was bridge-shaped only in 8% of the cases, the finiculus in 17%. The sinus tympani had a normal configuration in 66%. A subcochlear canaliculus was detectable in 50%. The retro- and hypotympanum were classified, respectively, to the present bony crests and sinus in a novel classification type I–IV. In conclusion, we found abundant variability of the bony structures in the retro- and hypotympanum. The endoscopic access is suitable and offers thorough understanding and panoramic views of these hidden areas.
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Post-tonsillectomy pain after using bipolar diathermy scissors or the harmonic scalpel: a randomised blinded study
Abstract
Objective
To compare the postoperative pain following bipolar diathermy scissors tonsillectomy (higher temperature dissection) with harmonic scalpel tonsillectomy (lower temperature dissection).
Methods
Sixty patients aged 7–40 years planned for tonsillectomy with no other concurrent surgery were randomised to either bipolar diathermy scissors or harmonic scalpel as surgical technique. Blinded to the surgical technique, the patients recorded their pain scores (VAS, 0–10) at awakening and the worst pain level of the day in the postoperative period. All intake of pain medication was also recorded.
Results
No statistically significant differences were found between the two groups regarding postoperative pain levels or consumption of pain medication.
Conclusion
Usage of the harmonic scalpel does not render less postoperative pain following tonsillectomy when compared with usage of the bipolar diathermy scissors.
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Application of a computer-assisted flexible endoscope system for transoral surgery of the hypopharynx and upper esophagus
Abstract
Zenker’s diverticulum is a common pathology in the transition zone of the posterior hypopharynx and esophagus. Surgical treatment is routinely performed by ENT and general surgeons. Besides the traditional open transcervical diverticulectomy, the introduction of transoral rigid treatment led to a paradigm change and is now the preferred treatment option for patients who are fit for general anesthesia. The implementation of interventional flexible endoscopy has opened another new micro-invasive approach for patients with high morbidity. Here, we present the potential utilization of a flexible, single port, robot-assisted, and physician-controlled endoscope system to facilitate transoral surgical access to the hypopharynx and upper esophagus. Transoral surgery of the hypopharynx and upper esophagus was performed in human cadavers (n = 5) using the Flex System (Medrobotics, Raynham, USA). Anatomical landmarks were identified, and posterior cricothyroid myotomy was performed with compatible flexible instruments in all cases. The approach to the hypopharynx and upper esophagus using the Flex system is feasible in a cadaveric model. Myotomy with a flexible tool and needle knife (from the perspective of treatment of Zenker´s diverticulum) was successful in all cases. Visualization of the surgical site with the system’s HD camera is suitable and the flexible instruments meet the special needs of a micro-invasive transoral approach. Zenker´s diverticulum can be potentially treated with a transoral minimally invasive approach using a computer-assisted flexible endoscope system. This setup could be of advantage in patients with reduced mobility of the cervical spine to prevent open transcervical surgery. In our study, the Flex system enabled advanced visualization of the surgical site and extended intervention options, compared to standard flexible endoscopic treatment. However, general anesthesia is mandatory for the presented approach. Application in live patients with actual pathologies of the hypopharynx and upper esophagus will have to prove suitability for the treatment of Zenker’s diverticulum. Further development of the system could include improved instrumentation and an adoption by other disciplines with challenging anatomy such as colorectal surgery.
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Treatment of traumatic tympanic membrane perforations
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Agrobacterium deltaense sp. nov., an endophytic bacteria isolated from nodule of Sesbania cannabina
Abstract
A Gram-negative, non-spore-forming, aerobic rods, strain YIC4121T, was isolated from root nodule of Sesbania cannabina grown in Dongying (Yellow River Delta), Shandong Province, PR China. Based on phylogenetic analysis of 16 S rRNA gene sequences, strain YIC4121T was assigned to the genus Agrobacterium with 99.7, 99.3, 99.0, 98.8 and 98.7% sequence similarities to Agrobacterium radiobacter LMG140T, A. pusense NRCPB10T, A. arsenijevicii KFB 330T, A. nepotum 39/7T and A. larrymoorei ATCC51759T. Analysis of the concatenated housekeeping genes (recA-atpD-glnII), showed lower sequence similarities (≤94.6%) between strain YIC4121T and other recognized Agrobacterium species. Strain YIC4121T shared whole-genome average nucleotide identities (ANI) 87.94, 91.27 and 77.42%, with A. pusense NRCPB10T, A. radiobacter LMG140T and A. larrymoorei ATCC51759T. The predominant cellular fatty acids were C19:0 cyclo ω8c, summed feature 2 (C12:0 aldehyde/unknown 10.9525), summed feature 8 (C18:1ω7c/C18:1ω6c), C16:0 3 OH and C16:0. The G + C content of strain YIC4121T was 59.80 mol%. Tween 80, lactulose, citric acid, α-ketoglutaric acid, glycyl-l-glutamic acid and 2, 3-butanediol could not be utilized as carbon source, distinguishing strain YIC4121T from the other related species. Based on the distinctly genetic and phenotypic dissimilarity, a novel species Agrobacterium deltaense sp. nov. is proposed with YIC4121T (=HAMBI 3654T = LMG 29283T) as the type strain.
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Electrophoretic profiles of lipopolysaccharides from Rhizobium strains nodulating Pisum sativum do not reflect phylogenetic relationships between these strains
Abstract
Rhizobia that nodulate peas comprise a heterogeneous group of bacteria. The aim of this study was to investigate the relationship between phylogeny and electrophoretic and hydroxy fatty acid lipopolysaccharide (LPS) profiles of pea microsymbionts. Based on amplified fragment length polymorphism (AFLP) fingerprinting data, the pea microsymbionts were grouped into two clusters distinguished at 58% similarity level. Based on the concatenated 16S rRNA, recA, and atpD housekeeping gene data, the microsymbionts appeared to be most closely related to Rhizobium leguminosarum biovars viciae and trifolii. Applying cluster analysis to their LPS electrophoretic profiles, the strains were assigned to two major groups with different banding patterns. All hydroxy fatty acids common to R. leguminosarum and R. etli were detected in each examined strain. Differences in the proportions of 3- to ω-1 hydroxy fatty acids allowed us to distinguish two groups of strains. This classification did not overlap with one based on LPS electrophoretic profiles. No clear correlation was apparent between the genetic traits and LPS profiles of the pea nodule isolates.
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Discursive essay on surrogacy cost
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Tricks to solve reasoning by analogy
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2500+ Short Hairstyles for Women. Find a New Haircut Today.
Short Hairstyles For Women Over 50. A woman is never too old to sport a hairstyle. The good news is that you can look absolutely pretty and feminine in short hair.
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Molecular BioSystems website - Royal Society of Chemistry
Previously, across 8 parts of this series we’ve laid the groundwork to ask perhaps the most important question of all: What should you eat to have the greatest
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Free Thesis Statement Generator - Helpful Papers
to test your ideas by distilling them into a sentence or two; to better organize and develop your argument ; to provide your reader with a guide to your argument
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10 Signs You're Exceptionally Smart Though You Don't
Nous voudrions effectuer une description ici mais le site que vous consultez ne nous en laisse pas la possibilité.
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Kant’s disputation of 1770: the dissertation and the
Crosby-Grayson, Nicola Jane (2015) Schematic and symbolic hypotyposis in Kant’s critical works. Doctoral thesis (PhD), Manchester Metropolitan University. Studies
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JFB, Vol. 8, Pages 13: Patient Education for Endoscopic Sinus Surgery: Preliminary Experience Using 3D-Printed Clinical Imaging Data
Within the Ear, Nose, and Throat (ENT) medical space, a relatively small fraction of patients follow through with elective surgeries to fix ailments such as a deviated septum or occluded sinus passage. Patient understanding of their diagnosis and treatment plan is integral to compliance, which ultimately yields improved medical outcomes and better quality of life. Here we report the usage of advanced, polyjet 3D printing methods to develop a multimaterial replica of human nasal sinus anatomy, derived from clinical X-ray computed tomography (CT) data, to be used as an educational aid during physician consultation. The final patient education model was developed over several iterations to optimize material properties, anatomical accuracy and overall display. A two-arm, single-center, randomized, prospective study was then performed in which 50 ENT surgical candidates (and an associated control group, n = 50) were given an explanation of their anatomy, disease state, and treatment options using the education model as an aid. Statistically significant improvements in patient ratings of their physician’s explanation of their treatment options (p = 0.020), self-rated anatomical understanding (p = 0.043), self-rated understanding of disease state (p = 0.016), and effectiveness of the visualization (p = 0.007) were noted from the population that viewed the 3D education model, indicating it is an effective tool which ENT surgeons may use to educate and interact with patients.
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Importance of college education articles
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BibMe: Free Bibliography & Citation Maker - MLA, APA
brings you inside access to tickets, artist news, and exclusive stories on concerts, tours, sports teams, family events, arts, theater, and festivals
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Gorilla Research - Gorilla Facts and Information
Ingenico paper rolls, Verifone paper, Hypercom paper rolls, Epson TM paper, ERC 38, Okidata Ribbon, Cash register Paper Rolls, black plastic bag, Imprinter
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Animal Testing
Intro to Cons of Animal Testing . A solution to the problem of animal extinction would be to use less of one species, and use more of a variety to even it out; for
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My Favorite Holiday Is Christmas Free Essays - StudyMode
We provide excellent essay writing service 24/7. Enjoy proficient essay writing and custom writing services provided by professional academic writers.
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Research Papers in Economics (RePEc)
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Coyote vs. Acme, Plaintiff's Opening Statement
Hamlet essay features Samuel Taylor Colleridge's famous critique based on his influential Shakespeare notes and lectures
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For becoming a successful man, one should have a certain aim in one's life. A man without aim is like a rudderless ship in a stormy sea. The aim of an individual
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College Essays: Tips and Sample Questions
Review these sample essay questions and answers before you write you college application essay so you can be prepared.
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IS PARIS BURNING? – MAURICE JARRE | Tadlow Music
TADLOW MUSIC Presents. The 50th Anniversary Recording of the Complete Score to IS PARIS BURNING? Composed by MAURICE JARRE. A Special Collectors 2CD Edition featuring
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Anti gandhi essays
Essays; Interviews; Opinions; Portraits; In Search Of Anti-Gandhi. Varma was a man whose politics was more in the style of Veer Savarkar than of Gandhi.
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Erratum to: pulp bleeding color is an indicator of clinical and histohematologic status of primary teeth
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How to Write an Evaluation - essay writing help from Essay
SMARTCOCKPIT; Our #1 goal, since 2000, is to offer the most extensive online aviation resource to worldwide professional pilots. We desire to spread the undeniable
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Beowulf Sample Essay Outlines
Paperforu Essay Samples how brave Hrothgar is for his victories in battle. Beowulf further shows his courtesy when he leaves all his Beowulf Essay.
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Cover Letter Tips (PDF) - Michigan
Cover letters are attached to your resume when you apply for a job. The purpose of cover letters is to persuade the employer that you are well suited for the job.
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Dwight D. Eisenhower - Essay
Dwight D Eisenhower This Study Guide Dwight D Eisenhower and other 62,000+ term papers, college essay examples and free essays are available now on
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Top 10 study abroad words of wisdom
Inspirational quotes for students are the perfect solution to this dreadful problem.
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How to Write an Essay (with Sample Essays) - wikiHow
As a mode of expository writing, the narrative approach, more than any other, offers writers a chance to think and write about themselves. We all have experiences
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The Land We Love: A Photo Essay | Theodore Roosevelt
Love. Home Up Texts Search Look Up Word Discuss Site Map Transcendentalism Ralph Waldo Emerson Contact. Essays: First Series Essays: Second Series Nature: Addresses
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Latest Topics | ZDNet
MailOnline - all the latest news, sport, showbiz, science and health stories from around the world from the Daily Mail and Mail on Sunday newspapers
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The Epidemic of Gay Loneliness - The Huffington Post
The current paper presents a model of the experience of anxiety in social/evaluative situations in people with social phobia. The model describes the manner in
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Summer Camps 2017 | Admissions | Western Michigan University
Title: Writing a Cover Letter/Personal Essay for a Scholarship* Author: Wright Writing Center Last modified by: Wright Writing Center Created Date
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Goat Birthing Signs | Crazy Goat Lady
Play games at - We have many great free internet games. Come check us out!
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Western Illinois University Libraries - Libraries
All databases for NSU patrons A B C D E F G H I J K L M N O P Q R S T U V W X Y Z 566 results. 1. 18th Century Collections Online Local access for
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The Thesis Statement
This post contains background information on the topic of abortion and also includes few abortion thesis statement examples.
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Home | Hard Rock
Teen Girl Have No Choice and Fucked Hard by BBC. Pretty hot cheerleader babe sucks and fucks her coach cock in exchange of getting in to the cheer leading team.
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Phd Thesis Defense Presentation Template - Bulevar de
MP Official defense dates: (IMX) or in a laboratory of an other Institute at EPFL Some laboratories indicate Master thesis on their Web site.
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5Types of TOEFL Essays & TOEFL iBT Essay Patterns · engVid
Write a letter of request to your management with a straight forward content telling that your wife will deliver a baby within a span of time and your support is
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Charles Murray on the New American Divide - WSJ
Essay on English: free examples of essays, research and term papers. Examples of English essay topics, questions and thesis satatements
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Rocking Heart Ranch - Home
Love Horses, But Don’t Want To Ride? No worries partner, look what we have to offer! Horse-Drawn Wagon Rides Yup, we have the Big Ones! Our massive Percheron draft
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Pleasantville thesis examples
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Basics of essay writing - Thesis
A thesis statement is the single, specific claim that your essay supports. A strong thesis answers the question you want to raise; it does so by presenting a topic
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11 Facts About Shirley Jackson's The Lottery | Mental Floss
Larry Yust's short film, The Lottery (1969), produced as part of Encyclopædia Britannica's 'Short Story Showcase' series, was ranked…
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Karyn Brown *SAMPLE COVER LETTER* DO NOT COPY OR USE WORD
Free sample cover letters for your job application and resume. Cover letters are important while applying for job. Get all free resume cover letter examples which can
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An Experiment to Demonstrate How a Catalyst Affects the
Resources; Election Information; Voter Turnout; What Affects Voter Turnout Rates; What Affects Voter Turnout Rates What Affects Voter Turnout Rates? Turnout varies
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PhD Comics Archive - Piled Higher and Deeper
Home. Rumble Resources Limited (RTR) is an Australian-based mineral exploration and development company established for the purpose of acquiring a portfolio of highly
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BBC - Ethics - Capital punishment: Arguments in favour of
DEATH PENALTY ARGUMENTS: This Paper in Memoriam of Sean Burgado . My Precious Nephew - Murdered June 7, 1969 to May 21, 1997. Ì DEATH PENALTY ARGUMENTS:
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QUT cite|write - Writing an essay
Foreign Policies are designed with the aim of achieving complex domestic and international agendas. It usually involves an elaborate series of steps, in which
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Writing skills practice | LearnEnglish Teens
Describing People, Places, and Things: 40 Writing Topics Descriptive writing calls for close attention to details—details of sight and sound, sometimes even of
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Creative Writing Lesson Plan Middle School - Scary Stories
A series of lessons for creating a story. Includes a story planner and character designer. This also include the EAL resources as well for differentiated classes.
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Birmingham Zoo says tumor removed from Kumar the tiger - Alabama's News Leader
Alabama's News Leader |
Birmingham Zoo says tumor removed from Kumar the tiger
Alabama's News Leader BIRMINGHAM, AL — The Birmingham Zoo says 17-year-old Malayan tiger Kumar underwent a procedure to remove a malignant sarcoma tumor on Tuesday. The zoo is optimistic regarding Kumar's health after chest radiographs and an abdominal ultrasound showed no ... and more » |
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How to Divide Exponents: 7 Steps (with Pictures) - wikiHow
Math explained in easy language, plus puzzles, games, quizzes, worksheets and a forum. For K-12 kids, teachers and parents.
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Essay Writing Service
Try Our Friends At: The Essay Store. Free English School Essays. We have lots of essays in our essay database, so please check back here frequently to see the
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Don't Explain the Joke - TV Tropes
The visits came about through a de- sire on the part of the doctor to read to the boy from the pages of a book he was in the process of writing.
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Methods of Execution | Death Penalty Information Center
Structured Problem-solving. Structured problem-solving can be used in conjunction with several other cooperative learning structures. Have the participants brainstorm
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Health Essays - Health Care Quality
Free deceiving papers, essays, and research papers. These results are sorted by most relevant first (ranked search). You may also sort these by color rating or
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Proposal Central - Altum
How to Write a Medical Research Proposal. If you need to develop a medical research proposal, you may be trying to find applicable information about how to set up
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Referencing a thesis in the APA style - Library
Citation Machine™ helps students and professionals properly credit the information that they use. Cite your book in APA format for free.
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GCSE and A-Levels | Ealing Independent College London
Application Areas. Revware is a leading metrology software and equipment manufacturer – reshaping your world, one product at a time.
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40 Topic Suggestions for a Comparison & Contrast Essay
Compare and Contrast Structure Words. Compare and contrast structure words are transition signals which show the similarities or differences. Below are some common
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Can a thesis statement be a question
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Behind the Sun - Teach With Movies
Martin -- named Michael Lewis until he was five -- thrived with his siblings in a secure middle-class family and had a normal, happy upbringing.
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Types Most Read | Scribd
Free comparison papers, essays, and research papers. These results are sorted by most relevant first (ranked search). You may also sort these by color rating or
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Montaigne's Of Cannibals Essay Sample
To be quite truthful, reading Montaigne's Of Cannibals, was overwhelming, due to the many ideas and how modern his thinking. The main theme or focus of t
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Aliteray essay scholarships about yourself
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AP Biology - Free AP Notes, Outlines, Vocab and...
James Somers is a writer and programmer based in New York.
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What is & How to Write a Successful Cover Letter
Dozens of cover letter templates you can download and print for free. We have tips on writing cover letters as well as cover letter templates.
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Master of Arts in Criminology & Criminal Justice
WRITING A THESIS PROPOSAL: INDEPENDENT LEARNING RESOURCES © 2001 Learning Centre, University of Sydney 4 HONOURS MASTERS MINOR THESIS MASTERS MAJOR THESIS
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The Big Five Project - Personality Test - Out of Service
A free and anonymous version of the Big Five personality test used by academic psychologists for personality research. The test takes about 10 minutes and provides
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Hypopharyngeal Cancer - Pipeline Review, H1 2017 - PharmiWeb.com (press release)
Hypopharyngeal Cancer - Pipeline Review, H1 2017
PharmiWeb.com (press release) Hypopharyngeal cancer is a term used for tumors of a subsite of the upper aerodigestive tract, and like most other subsite designations, the distinction is anatomic rather than pathophysiologic within the group of head and neck malignancies. The ... and more » |
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Rent vs. Buy: Why Buying a House Generally Wins -- The
JOHANNESBURG – Is buying a house an investment if you plan to live there yourself? Should you rather be renting and investing in shares? There has been some heated
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What are the advantages and disadvantages of machine
Facebook, arguably the most famous social networking site, comes with its own pros and cons. Here in this article, I will try to show some of the advantages and
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Statistics of Animal Use in Research and Teaching in Australia
MEDICAL STATISTICS MADE EASY Michael Harris General Practitioner and Lecturer in General Practice, Bath, UK and Gordon Taylor Senior Research Fellow in Medical
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The Biology Project
AP Central Meta Description --> Course materials, exam information, and professional development opportunities for AP teachers and coordinators.
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Pathological findings of uterine tumors preoperatively diagnosed as red degeneration of leiomyoma by MRI
Abstract
Purpose
Venous infarction of a leiomyoma is known as red degeneration of leiomyoma (RDL) and can be a cause of acute abdomen. Although magnetic resonance imaging (MRI) is the only modality that can depict the inner condition of a leiomyoma, the typical MR findings of RDL are sometimes identified incidentally even in asymptomatic patients. The purpose of this study is to clarify common pathological findings of uterine tumors preoperatively diagnosed as RDL by MRI.
Methods
We diagnosed 28 cases of RDL by MRI from March 2007 to April 2015. The ten lesions subjected to pathological analysis after resection were included in the study and reviewed by a gynecological pathologist. The average time from MRI to operation was 4.7 months.
Results
The typical beefy-red color was not observed on the cut surface of the tumor except in one tumor resected during the acute phase. All lesions diagnosed as RDL by MRI had common pathological findings consistent with red degeneration of leiomyoma, including coagulative necrosis. Other common pathological features of RDL besides extensive coagulative necrosis appear to be a lack of inflammatory cell infiltrate or hemorrhage in the entire lesion.
Conclusions
Although RDL is known to cause acute abdomen, its typical MR findings can be observed even in asymptomatic patients in a condition that manifests long after red degeneration. The characteristic pathological findings in both the acute phase and the chronic phase that we found in this study, along with radiology reports, will be helpful references for gynecologists and pathologists in suspecting a history of red degeneration and confirming the diagnosis.
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Validation study of a new semi-automated software program for CT body composition analysis
Abstract
Background
Computed tomography (CT) has been increasingly used to quantify abdominal muscle and fat in clinical research studies, and multiple studies have shown importance of body composition in predicting clinical outcome. The purpose of study is to compare newly developed semi-automated software (BodyCompSlicer) to commercially available validated software (Slice-O-Matic) for CT body composition analysis.
Methods
CT scans of abdomen at L3 level in 30 patients were analyzed by two reviewers and using two softwares (BodyCompSlicer and Slice-O-Matic). Body composition analysis using BodyCompSlicer was semi-automated. The program automatically segmented subcutaneous fat (SF), skeletal muscle (SM), and visceral fat (VF) areas. Reviewers manually corrected the segmentation using computer–mouse interface as necessary. Body composition analysis using Slice-O-Matic was performed by manually segmenting each area using computer-mouse interface (brush tool). After segmentation, SM, SF, and VF areas were calculated using CT attenuation thresholds. Inter-observer and inter-software variability of measurements were analyzed using intraclass correlation coefficients (ICC) and coefficient of variation (COV).
Results
Inter-observer ICC and COV using BodyCompSlicer were 0.997 and 1.5% for SM, 1.000 and 0.8% for SF, and 1.000 and 1.0% for VF, whereas those using Slice-O-Matic were 0.993 and 2.5% for SM, 0.995 and 3.1% for SF, and 0.999 and 2.3% for VF. Inter-software ICCs and COV were 0.995–0.995 and 2.0–2.1% for SM, 0.991–0.994 and 3.4–3.9% for SF, and 0.998–0.998 and 2.8–3.3% for VF. Time to analyze 30 cases was 70–100 min and 150–180 min using BodyCompSlicer and Slice-O-Matic, respectively.
Conclusion
BodyCompSlicer is comparable to Slice-O-Matic for CT body composition analysis.
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Create Infographics, Charts and Maps
Cooking Shows, Gardening, Arts & Crafts, Travel, and Home Improvement. How-to shows all on Create TV.
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Attributes of God
What are they, what are they good for, and how do I create my own attributes?
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Making an Outline - Organizing Your Social Sciences
An outline is a “blueprint” or “plan” for your paper. It helps you to organize your thoughts and arguments. A good outline can make conducting research and
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International Taekwon-Do Essay
Why did the South Asian Tsunami happen? Suggestions by many scientists, secularists, etc. Sponsored link. In summary: The devastating Tsunami (. ocean surge, or
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Photography websites designs
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Research paper about canteen restaurant
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Night by Elie Wiesel: Chapter Summaries & Analysis
When in trouble, head for Auschwitz, preferably in the company of Elie Wiesel. It’s as foolproof a character reference as is available today, at least within the
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The white man's burden: Bill Leak and telling 'the truth
The web site had 33 newly created or updated essays during 2017-FEB, including the above book review. New essays are marked N; updated essays are marked U:
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Fifty Orwell Essays - Project Gutenberg Australia
Free black panther party papers, essays, and research papers.
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Connect with EarthLink, the award-winning Internet service
Save on EarthLink's award-winning Internet services for your home: dial-up, DSL, high-speed cable & more. Plus, web hosting & software. Connect with us!
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Understanding Assignments - The Writing Center at UNC
4 PwC | International Assignment Perspectives corporate culture, rather than as a critical component of an individual’s overall career plan.
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Essay Writing Service
LITERARY ELEMENTS: the basic items that make up a work of literature: LITERARY DEVICES: literary techniques and methods employed to help the author get his or her
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How to Write a Critical Evaluation Essay
Good titles offer potential readers the reason for reading the essay in the first place. The best place to find the reason for an essay is in the thesis statement.
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Vital Links Between Obesity and Psychopathology: The Impact of Stigma
The increasing prevalence of obesity across the world is well documented as is the rise in psychopathological conditions. The association between obesity and psychopathology holds important implications for practitioners, academics, and policy-makers. Of interest is the influence of weight stigma on the development of psychopathological conditions. Thus, this article explores the link between psychopathology and obesity, in particular, the role of weight stigma in the development of psychopathology. This review also highlights the implications for assessment, treatment, and research.
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Thesis statement for research project
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APlace to Stand Essay - 647 Words - StudyMode
A PLACE TO STAND is a memoir of Jimmy's childhood of abandonment, his career selling drugs, and his time in prison.
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Siding Contractors | Residential Roofing | Replacement
Himalayan Chef is the world largest pink salt products manufacturer. Himalayan salt products Includes pink salt plates, seasoning salt.
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The vikings essay writing
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Online Home Business Ideas | Legitimate Internet Income
How to make money in Entropia Universe is a question regularly asked. This up-to-date guide discusses possibilities, compares different methods, exemplifies one
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Music Schools, colleges, universities and Institutes in India
Chronicling America is a Website providing access to information about historic newspapers and select digitized newspaper pages, and is produced by the National
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Content-Area Literacy | Hot Topics in Adolescent Literacy
How to Write an Argumentive Essay. Read More. More Articles. How to Write a Proposal for a Doctorate. Read More. How to Write Proposals on Recent Topics in Economics.
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SparkNotes: A Raisin in the Sun: Context
A Raisin in the Sun, written by Lorraine Hansberry and produced on stage in 1959, marks a watershed moment in American theater. On the face of it, A Raisin in the Sun
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Gcse pendulum coursework examples of figurative language
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The Importance of Agricultural Education and the FFA
Policy paper. The importance of music: a national plan for music education
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Literary works of thomas paine
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Essay on rainy seasons drawing
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Friedrich schiller essays for esl
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Best dissertation reviews
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What to write in christmas cards
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Punishment vs rehabilitation essay format
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Cornell university mfa creative writing
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Percentage problem solving test
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Cornell university creative writing mfa
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Budget 2017: the winners & losers - Money
Champions League winners and losers. The beauty of Monaco, Leicester's next chapter, Guardiola's failure. It's all here, folks...
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Math 30-1: Polynomial Functions
The derivative of a cubic function is a quadratic function, a parabola.
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Department of History | University of Toronto
History Day has been the vehicle that creates an understanding and appreciation of history while developing the necessary 21st-century tools, skills and aptitudes for
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Essay on Retention and Turnover - 1677 Words | Majortests
Several students tend to relax and wait for the last minute to start working, but as the deadline for the essay writing approaches, they start getting nervous and
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What Does Product Quality Really Mean?
What does it mean to be pro-choice? pro-choice is a nice euphanism that allows the user to support abortion sans the label, pro-abortion.
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Student Interactives - ReadWriteThink
Your introductory guide to citing, referencing and academic writing at QUT. QUT cite|write
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Purdue Online Writing Lab (OWL) - Welcome to the Purdue
The New Jerusalem Bible (NJB) is a Catholic translation of the Bible published in 1985. The New Jerusalem Bible (NJB) has become the most widely used Roman Catholic
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The New Press
Walnut Valley Unified School District is located in Walnut, CA and serves K-12 students.
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Critical review example essay about myself
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Help with spanish coursework one word
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Scholarships for college students with low gpa
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Disadvantages of internet essay in hindi
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Protection from discrimination at work – Employee
Employment discrimination: The next frontier for LGBT community. Crystal Moore, a police chief in Latta, South Carolina, knew the new mayor in town would
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ACADEMIC WRITING A GUIDE TO WRITING AN ESSAY
This Study Guide addresses the topic of essay writing. The essay is used as a form of assessment in many academic disciplines, and is used in both coursework and
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Eurasc - New Members
AIA Los Angeles announces the upcoming schedule of ARE seminars for 2011 to help candidates prepare for the licensing exam given by the California Architects Board.
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Free feminism Essays and Papers - 123helpme
In this interactive lesson you will explore how Ralph Waldo Emerson defines individualism in Self-Reliance.
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Slavoj Zizek-Bibliography/The Thing from Inner Space/Lacan
The Federalist Papers is a treatise on free government in peace and security. It is the outstanding American contribution to the literature on constitutional
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Solving Multi-Step Equations - AlgebraLAB
When solving equations of this form, we must carefully simplify the equation using a special two-step order. The term that is either adding to or subtracting from the
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Marco's troulis thesis example
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Lovitts dissertation coach from liberty
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Algebra - Solving Equations and Inequalities
Fun math practice! Improve your skills with free problems in 'Solve systems of linear inequalities by graphing' and thousands of other practice lessons.
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Public Sex, Street Sex & Outdoor Sex - Only Cute Girls in
Abused by Madame Willow Amateur at home Femdom. Action Girls Action girls showcases breathtaking women who kick ass! Alice in Bondage Land Join us on our bondage
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/~ jik/src/Attic/kerberos_ password
- . .,mn 0 01 05_1 1 10 100 10th 11 11_d0003 12 13 14 141a 143b 15 16 17 17igp 18 19 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915
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Harriet Tubman - Activist, Civil Rights
There are many Speech Therapy Apps on the market, this list of free apps are must haves for members of our profession.
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ATop Private Christian University in California
The University of Southern California is one of the world's leading private research universities, located in the heart of Los Angeles.
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Sigma Phi Epsilon - SigEp at Louisiana State University
LA Beta, Sigma Phi Epsilon , Louisiana State University, chapterspot fraternity websites, chapterspot sorority websites,
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50 Narrative Essay Topics and Prompts
Narrative writing involves the production of stories or personal essays. It encourages writers to use their creativity and powers of observation to
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Research Guides: APA Citation Style, 6th edition: Edition
A guide to help users create citations using APA (American Psychological Association) style, 6th edition.
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Which Engineering Has Best Scope In Pakistan | In Future
The nation’s leading school furniture dealer, Hertz Furniture embraces technology, flexibility and durability to enhance 21st century learning.
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META-INF//audet/samuel/shorttyping
We provide excellent essay writing service 24/7. Enjoy proficient essay writing and custom writing services provided by professional academic writers.
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Free English School Essays - The Essay Organization
In December 1951, LIFE published one of the most extraordinary photo essays ever to appear in the magazine. Across a dozen pages, and featuring more than 20 of the
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Clinical efficacy of anti-VEGF medications for central serous chorioretinopathy: a meta-analysis
Abstract
Background Central serous chorioretinopathy (CSC) is a widespread retinal disorder, and 30–50% of patients eventually result in retinal pigment epithelium atrophy and irreversible vision loss. Aim of the review To evaluate the effectiveness of medications based on anti-vascular endothelial growth factor (anti-VEGF) on central serous chorioretinopathy (CSC). Method A systematic search on anti-VEGF medication treatments for CSC was performed in Pubmed, Embase, and the Cochrane Library prior to May 2016. The main outcome variables were best-corrected visual acuity (BCVA) and central macular thickness (CMT). All effects were analyzed via Review Manager 5.3. Results Fourteen studies were incorporated with a total of 266 eyes, divided into a comparative group and a non-comparative group. The comparative group included acute and chronic CSC studies, while the non-comparative group included chronic CSC only. Meta-analysis revealed that for acute CSC, anti-VEGF treatment was not superior to observation at a 6-month follow-up in BCVA and CMT. For chronic CSC in the comparative group, no significant difference was observed between anti-VEGF treatment and observation in BCVA; however, the observed difference in CMT (WMD = −67.78, 95% CI 20.17–115.38) was statistically significant. In the non-comparative group, significant differences were observed after anti-VEGF treatment in BCVA and CMT at 1, 6, and 12 months follow-ups. Conclusion Our meta-analysis partially indicated that anti-VEGF medications might be a viable choice for the treatment of chronic CSC; however, due to the self-limiting nature of CSC, care should be applied in the clinical application of anti-VEGF medications.
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400 Topics for Essays and Speeches
Interesting Definition Essay Examples. Usually, students in order to write a definition essay successfully, first of all need nice definition essay topics.
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Creative Writing Master of Fine Arts (MFA) program
Graduate Creative Writing Programs. Distinguished writing programs in the . and Canada Leading directory for the study of writing and literature. MFA MA PhD
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Campbell University | Leading With Purpose
Our Scholarship Essay Competition $2500 Essay Scholarship for College Students. Do you need money for college? How about for books? We understand these expenses can
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Philip Massinger. . Eliot. 1921. The Sacred Wood
Call of the Wild study guide contains a biography of Jack London, a complete e-text, quiz questions, major themes, characters, and a full summary and analysis.
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The ACT Writing Sample Essays - Test Preparation | ACT
Language Arts Student Resources. Textbook Companion Sites; Interactive Textbooks; Milestones in Lit – Check out historical literary events that took place this month.
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Common Lebanese Terms and Phrases - Lebanese Language
Ever wondered what the most common grammar mistakes are that bloggers make? Run-on sentences, punctuation, or maybe use of wrong tenses? This infographic highlights
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Modeling Reading and Analysis Processes with the Works of
Shmoop guide to Edgar Allan Poe timeline. Key events and dates in a Edgar Allan Poe timeline, compiled by PhDs and Masters from Stanford, Harvard, Berkeley
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The Herald | Zimbabwe's largest daily newspaper
Get all the information you need about available property for sale in Zimbabwe from Pam Golding Properties and invest in Africa today.
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Custom Essays, Term Papers, Research Paper, Thesis
Preliminary versions of economic research. Using detailed bank balance sheet data obtained under the United States’ stress testing programs we examine how a
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The Uk Constitution - UK Essays
Essay On The . Constitution. The Onion Ap Language Essay, essay on so much to tell you.
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Analysis Essay Writing - Easy Essay Help
Sample essay. The remainder of this essay writing tutorial is based on a short sample 'divorce essay' (about 1,000 words). To complete all of the associated tasks, it
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Catharism, Levitov, and the Voynich Manuscript
Creation-Evolution Baloney Detector: How to Avoid Propaganda and Logical Fallacies.
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Mixed Methods research: a discussion paper - NCRM
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Off Campus Students (Learning Support) - Monash University
What is the difference between formative and summative assessment? Formative assessment. The goal of formative assessment is to monitor student learning to provide
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Books - NYU Press | NYU Press
Latest breaking news, including politics, crime and celebrity. Find stories, updates and expert opinion.
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PicoTrace .de
Boxing news site that gives fans the opportunity to voice their opinion on the sweet science
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WORK - crossword answers, clues, definition, synonyms
PCDD/PCDF Analytical Method Solutions; Individual PCDDs & PCDFs: Native and Mass-Labelled; Specialty Solution/Mixtures of PCDDs and PCDFs; PCB Analytical Method Solutions
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Business Plan Template | Bplans
Your business needs a strong plan that sets out what you want to achieve, how you'll do it, and what you'll get out of it. Our business plan template can help.
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Application Instructions & Components | Yale College
School Region SAT Essay Required ACT Essay Required; Abilene Christian University: South: Recommended: Recommended: Adelphi University: Mid-Atlantic: Optional
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For The Record | The Huffington Post
NEW CUSTOMER DISCOUNT! Buy an essay now with 20% OFF using the code new20! 100% Original papers, ready in 3 hours. Don’t miss the chance to buy essays online cheaper!
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Write good introduction psychology schachter
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Free online courses for credit
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Private schools vs public school funding
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Under 18's Saturday - Notts Youth Football League
El Hotel Boutique Casa Diamante es una empresa 100% mexicana que se conforma a partir de valorar la importancia de la actividad turística en el estado de Guanajuato
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PwC: United States: Entertainment & Media: Publications
Mercer is arguably the top global consulting leader in talent, health, retirement, and investments. Read on for our pro interview tips and insider info.
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Combination of serum histidine and plasma tryptophan as a potential biomarker to detect clear cell renal cell carcinoma
In previous work, we showed that serum-free amino acid (SFAA) profiles were different between kidney cancer patients and age and sex matched controls. The goals of the current study are to: (1) confirm our ini...
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Sample Reference List - APA Style - Subject Guides at
Do you have any sample papers that I can view? It would be helpful to compare some different types of papers written in APA Style format.
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Purdue OWL: MLA Formatting and Style Guide
BOOK I. I MEAN to inquire if, in the civil order, there can be any sure and legitimate rule of administration, men being taken as they are and laws as they
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Research Proposal Example Topics
An example of a research paper based on the experiment of Stanley Milgram. How to construct a research paper.
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Essay help | Essay Writing
Professional Writing Help: we do not miss deadlines and our writers do not plagiarize! Writing help by qualified writers!
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International Business Ethics Institute | Ethics Training
The Pioneering Organization in Applied Global Business Ethics Welcome to the International Business Ethics Institute, the first organization dedica
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-Best Essay Writing Service. Urgent & Cheap
Since the day her son participated in the most devastating high school shooting America has ever seen, I have wanted to sit down with Susan Klebold to ask her the
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Self Reflective Essay #2 | brysanp
What are tips on writing a self-reflective essay? Through my work on my final research paper, How do you write a personal reflection essay?
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Disconnection: the PR and the Truth
I am dissapointed with this site, it's my frank answer., propylene glycol mono, >:OO, whoopi goldbergmonologues, thwgw, accessory bathroom brass, 89540, wholesale
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EasyBib: Free Bibliography Generator - MLA, APA, Chicago
Collects, disseminates, archives, and preserves theses and dissertations published by graduate students at The University of Western Ontario
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Chart compares power of nuclear bombs - Business Insider
Quotations about human mistreatment of planet Earth, from The Quote Garden.
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Browse through Ancient History
Browse through History in an interactive website designed for students. Includes FREE colorful and engaging standards-based lessons, interactive quizzes, and videos.
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Most ridiculous thesis example
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Business proposal letter Samples
Dozens of cover letter templates you can download and print for free. We have tips on writing cover letters as well as cover letter templates.
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Welcome to Math Homework Help
This is a comprehensive listing of online resources offering homework help to students of all ages. Vetted by our experts for safety and quality, and totally free.
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ALL THE WAY DOWN THE SLIPPERY SLOPE: GUN PROHIBITION IN
The Exodus Route The population of the Exodus Jews The Number of the Exodus How many Hebrews were in the Exodus. - million. Exodus Route home page
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Why Critical Thinking is Important
Tutorial C01: What is Critical Thinking and Why is it Important? By: Jonathan Chan Introduction Critical thinking is the ability to think clearly and rationally.
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Resume Samples | Resume Writing Center
Executive resume writing services by award-winning executive resume writer Laura Smith-Proulx, ranked among the best executive resume writers in the world.
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MBA Watch, a Service of Beat The GMAT. Get into the
Use your Section Score, not the raw score of number correct per section or the percentile. Enter your GPA for the admissions calculator on the right to determine your
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Adobe mobile, iPhone, iPad, Android apps | Adobe Creative
Beautiful views for every display. Magic Window brings beautiful timelapse views from around the world to any Apple device or connected display. Using Magic Window is
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Bob Dylan Wins Nobel Prize in Literature - The Atlantic
Two economists, Oliver Hart at Harvard and Bengt Holmström at MIT, have won a Nobel Prize in economic sciences for their contributions in contract theory.
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How to Write a Descriptive Essay (with Pictures) - wikiHow
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New product thesis sample
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Music technology essay format
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10 Things you MUST Do to Have a Successful Online Craft
Students of all ages can create multimedia presentations using Microsoft PowerPoint. Teach them how using this fun-filled, online tutorial.
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Relationship Quotes Page 4 - BrainyQuote
We bring you world's best Relationship Quotes hand-picked by our editors that you can share on your Facebook, Twitter and Blogs and We keep updating these with
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Powerpoint on essay writing for middle school
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Green books | WWF
What animal is black and white and loved all over the world? If you guessed the giant panda, you're right! The giant panda is also known as the panda bear, bamboo
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Arvine Pipe and Supply Co.
Notice: We are a community based organization dedicated to the implementation of fair and consistent guidelines in all California counties as a safe harbor from
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Wonderland Days Sim Date - Pacthesis Games
Idol Days Sim Date - Play online for free now on Pacthesis Games - official home to romantic dating games.
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The 100 Greatest Mathematicians
To link to this poem, put the URL below into your page: <a href=http:///poems/>Song of Myself by Walt Whitman</a> Plain for Printing
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Supply & Demand - Shmoop
Aplia significantly improves outcomes and elevates thinking by increasing student effort and engagement. Developed by teachers, Aplia assignments connect concepts to
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SparkNotes: To Kill a Mockingbird: Plot Overview
Tags:To Kill a Mockingbird Full Movie, Watch Free To Kill a Mockingbird Movie Streaming, To Kill a Mockingbird Movie Full Streaming,
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Christian Doctrines | Reasonable Faith
What is Hamartiology? What is the doctrine of sin? What does the Bible teach us about sin and its consequences?
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Horticulturae | An Open Access Journal from MDPI
The Instructional Services Section is responsible for assisting schools with the frameworks/systems/supports that are needed to provide effective instruction.
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The Tragedy of the Commons, by Garrett Hardin (1968)
Dana Cup Hjørring er Danmarks største sports event og verdens mest internationale ungdomsfodboldturnering. hold deltager fra over 45 forskellige lande hvert år.
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Pay for Essay and Get the Best Paper You Need
Essay Topics for Kids That Help Sharpen Their Writing Skills. Writing essays is often a part of school projects, however, choosing from a variety of topics can be
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