bluuebunny/crossref_metadata_2025 huggingface dataset:
ASSESSMENT OF VILNIUS CITY DEVELOPMENT SCENARIOS BASED ON TRANSPORT SYSTEM MODELLING AND MULTICRITERIA ANALYSIS
Authors: Jakimavičius Marius , Burinskienė Marija
Published: November 2009

The paper describes the assessment of 3 Vilnius city development scenarios according to transport system parameters multi‐criteria analysis and performing transport system modelling for 2015 and 2025 years. Vilnius city development scenarios such as concentrated development, extensive development and decentralized concentrated development have been evaluated from a transport viewpoint. Vilnius city development scenarios have been evaluated by using SAW (Simple Additive Weighting) multi‐criteria method. According to this method development scenarios ranking calculations have been performed using transport system indicators. Urban transport system analysis model was developed for Vilnius conditions, which estimates the fuel consumption, average travel distance and driven time by car in morning peak hours depending on urban areas development scenario and socio‐economic data. This model should be used when calculating new projects of the transport infrastructure (by‐passes, new bridges) and when evaluating the economic efficiency of traffic organization projects. Santrauka Straipsnyje analizuojami trys susisiekimo sistemos požiūriu Vilniaus miesto plėtros scenarijai. Miesto plėtros scenarijai, kaip sutelktoji plėtra, decentralizuotai sutelktoji plėtra ir ekstensyvioji plėtra, vertinami daugiakriteriu metodu SAW ir atliekant Vilniaus miesto plėtros scenarijų modeliavimą 2015 m. ir 2025 m. Daugiakriteriu metodu nustatoma plėtros scenarijų prioritetinė eilė, vertinant Vilniaus miesto susisiekimo sistemos rodiklius. Modeliuojant plėtros scenarijų, nustatomi tokie rytinio piko metu rodikliai: kuro naudojimas, suminis nuvažiuotas atstumas, suminis kelionės laikas. Modeliavimas remiasi esamais ir numatytais bendrojo Vilniaus plano miesto gatvių tinklo duomenimis, transportinių rajonų dabartiniais ir prognozuojamais socialiniais bei ekonominiais duomenimis. Sukurtas modelis gali būti sėkmingai naudojamas vertinant transporto infrastruktūros ir eismo organizavimo projektų įtaką miesto susisiekimo sistemai.
ON SHEAR REINFORCEMENT DESIGN OF STRUCTURAL CONCRETE BEAMS ON THE BASIS OF THEORY OF PLASTICITY
Authors: Jensen Bjarne Christian , Lapko Andrzej
Published: November 2009

Modern design of reinforced concrete structural members for shear is based on the theory of plasticity. This paper is written to contribute to the understanding of the inclination of the concrete strut in the inclined strut model for design of shear reinforcement in beams, which among others are used in Eurocode 2. The problem of inclination of the compression strut in truss model is analysed depending on shear reinforcement ratio and effectiveness ratio of concrete strength for compression. Also the understanding of necessary ductility in steel reinforcing bars is discussed in the paper and especially the needs of tests on translation capacity of the shear failure are here analysed. To explain these problems the paper gives a short introduction to the theory of plasticity of reinforced concrete in shear and the background for the equations, which are used in shear design according to Eurocode 2. Santrauka Šiuolaikinis gelžbetonio elementų skersinės armatūros skaičiavimas pagrįstas plastiškumo teorijos principais. Straipsnyje pateikti sijų skersinės armatūros skaičiavimo ypatumai, taikant įstrižojo statramsčio modelį, kuris taikomas ir Eurokode 2. Išnagrinėtas gniuždomojo strypo pavertimas santvaros modelyje, atsižvelgiant į skersinės armatūros ir efektyvaus gniuždomojo betono stiprio santykį. Aptartas armatūrinio plieno strypų stamantrumas, akcentuota sijų laikomosios galios šlyčiai eksperimentinių tyrimų būtinybė. Pateiktas gelžbetoninių sijų šlyties skaičiavimas, taikant plastiškumo teorijos principus. Aptartas Eurokode 2 šlyties skaičiavimams taikomų priklausomybių teorinis pagrindas.
The U.S. Correctional System and the Older Prisoner
Authors: Smyer Tish , Burbank Patricia M.
Published: November 2009

Although older prisoners may seem an unlikely article topic, the reality is that the likelihood of health care providers encountering a prisoner who has been released is high. In addition, men age 50 and older are the fastest growing age cohort in prisons. Older prisoners consume disproportional health care resources of correctional institutions. Long histories of no medical care, alcohol and substance abuse, and poor diet contribute to a 10- to 11.5-year addition to chronological age and contribute to the risk for chronic conditions, which are prevalent, often lead to functional impairments, and require careful and deliberate management strategies. This is, however, not that different from the “free world,” where chronic illnesses account for the greatest cost burden and disability in the United States. Consequently, health care providers need an understanding of the challenges faced by this vulnerable population, as well as issues related to the graying of American prisoners.
Caring for an Aging Population: Review of Policy Initiatives
Authors: Houde Susan Crocker , Melillo Karen Devereaux
Published: November 2009

Due to the aging population in the United States, there will be a need for a larger workforce that is prepared to provide care to an older adult population. The Institute of Medicine has noted challenges related to the preparation of a geriatric workforce due to lack of faculty, inconsistent curricula, and few training opportunities, and has made recommendations to increase the geriatric workforce. In this article, several policy initiatives are discussed that address the shortage of health professionals prepared to care for older adults. Initiatives by professional nursing organizations to improve the gerontological nursing workforce are also reviewed.
Physiological Aging in Older Adults with Cancer: Implications for Treatment Decision Making and Toxicity Management
Authors: Bond Stewart M.
Published: November 2009

Because the risk of cancer increases with age, the growth of the aging population will lead to a larger number of older adults with cancer. Standard cancer treatments can be safe and effective in older adults and result in improved survival and enhanced quality of life. Because physiological decline varies among older adults, cancer treatment requires an individualized approach. Consideration of physiological age, rather than chronological age alone, is required to guide treatment decision making and prevent and manage treatment toxicities and other complications. This article examines the impact of physiological aging on treatment decision making and toxicity management in older adults with cancer.
Understanding Physical Health of Older Adults with Schizophrenia: Building and Eroding Trust
Authors: Leutwyler Heather C. , Wallhagen Margaret I.
Published: November 2009

Adults with schizophrenia are living longer, and data suggest they face health care disparities contributing to poor physical health. This article presents findings from a study that explored the understanding of physical health among older adults with schizophrenia. One goal was to understand factors that influence experienced health care disparities. This grounded theory study used semi-structured interviews and participant observation and was conducted among 28 older adults with schizophrenia living in a variety of settings. Trust evolved as a dynamic process that was built with factors of respect, caring, advocacy, and consistency and eroded through factors of disrespect, not being heard, lack of time and provider inaction, and stigmatization. When trust is given and received between providers, the health care system, and the older adult with schizophrenia, the adult's physical health outcomes may improve and health care disparities may decline. These findings provide insights to promote optimal physical health outcomes.
Two Hypothetical Nystagmus Procedures: Augmented Tenotomy and Reattachment and Augmented Tendon Suture (
Sans
Tenotomy)
Authors: Dell'Osso Louis F. , Tomsak Robert L. , Thurtell Matthew J.
Published: November 2009

Purpose:

To review the hypothetical mechanism and therapeutic benefits of the four-muscle tenotomy and reattachment (T&R) procedure using knowledge accrued over the 10 years since its proposal; to describe an augmented tendon suture (ATS) technique to improve the procedure based on one of the originally suggested alternative methods (mechanical); and to hypothesize a new ATS procedure to achieve the same therapeutic benefits without extraocular muscle tenotomy or reattachment to the globe.

Methods:

Standard surgical methods were used.

Results:

The T&R procedure damps and improves infantile nystagmus syndrome (INS) waveforms, improves eXtended Nystagmus Acuity Function (NAFX) values, broadens the NAFX peak versus gaze angle, and damps slow eye movements but not saccades. The T&R procedure also damps acquired pendular and downbeat nystagmus, decreasing the patients' oscillopsia, and lowers the target acquisition time in INS.

Conclusion:

The T&R procedure directly affects only the enthesis of the tendon; there is idiosyncratic variation in the distribution of afferent fibers in the tendons. The ATS technique consists of placing several additional sutures in the tendon proximal to the tenotomy. Based on the hypothetical proprioceptive mechanism for the beneficial effects of the T&R procedure, the authors hypothesize that the ATS technique will maximize the therapeutic benefits and that an ATS procedure, using only tendon sutures without tenotomy, will duplicate the therapeutic effects of T&R. Eliminating the tenotomy component results in a simpler procedure more suitable for single-session, multi-muscle surgery that may be required for improving the waveforms of multiplanar nystagmus and less prone to cause complications.

[J Pediatr Ophthalmol Strabismus 2009;46:337–344.]
Refractive Errors and Strabismus in Children With Tuberous Sclerosis: A Controlled Study
Authors: Akinci Arsen , Oner Ozgur , Guven Alev , Degerliyurt Aydan , Munir Kerim
Published: November 2009

Purpose:

To evaluate the prevalence of refractive errors and strabismus in children with tuberous sclerosis and in control subjects.

Methods:

Twenty-three children with tuberous sclerosis and 151 control subjects were evaluated. All children underwent cycloplegic autorefraction or retinoscopy, slit-lamp biomicroscopy, and dilated fundus examination. Ocular alignment was assessed by the Hirschberg, Krimsky, or prism cover test.

Results:

The total prevalence of hypermetropia and amblyopia was significantly higher in patients with tuberous sclerosis (
P
= .035) than in the control subjects (
P
= .002).

Conclusion:

A high prevalence of hypermetropia seems to be an additional feature of tuberous sclerosis. Early screening for this amblyogenic factor is indicated in patients with tuberous sclerosis.

[J Pediatr Ophthalmol Strabismus 2009;46:345–348.]
Serous Retinal Detachment in Joubert Syndrome
Authors: Lau Flora H. S. , Yu Christopher B. O. , Yip Wilson W. K. , Fan Dorothy S. P.
Published: November 2009

This report describes a 3-year-old Chinese–Italian boy with Joubert syndrome. Fundus examination showed bilateral optic disc coloboma. Left serous retinal detachment was also found. This ocular finding was not reported in the previous literature. Although Joubert syndrome has many variable phenotypes and the molecular basis is still unknown, the newly reported ocular features suggest that a different genetic form may be present.
[J Pediatr Ophthalmol Strabismus 2009;46:362–364.]
Orbital Cyst of Lacrimal Derivation Presenting as a Recurrent Orbital Abscess in a Pediatric Patient
Authors: Konuk Onur , Abdulgani Ahmed , Gonul Ipek Isik , Unal Mehmet
Published: November 2009

A 2-year-old girl presented with inflammatory eyelid swelling in the left eye over a 2-week period. Ophthalmologic examination showed hyperemia and swelling, with a palpable mass at the inferior orbital rim. Orbital magnetic resonance imaging showed periorbital edema and a cystic lesion located in the inferomedial orbit. Histopathologic evaluation showed an orbital cyst of lacrimal derivation.
[J Pediatr Ophthalmol Strabismus 2009;46:365–367.]
Improvement of the Topographic Parameters of the Optic Discs After Trabeculotomy in Two Patients With Developmental Glaucoma
Authors: Yasuda Mitsuyo , Ando Akira , Otsuji Tsuyoshi , Fukui Chieko , Matsumura Miyo
Published: November 2009

Changes in the optic discs before and after trabeculotomy were evaluated with the Heidelberg retina tomograph (Heidelberg Engineering GmbH, Heidelberg, Germany) in two patients with developmental glaucoma. The topographic parameters of each optic disc improved considerably compared with adult patients in previous reports. This improvement may have been the result of the elasticity of the histologic structure of the optic disc in younger patients.
[J Pediatr Ophthalmol Strabismus 2009;46:372–375.]
Repeatability of Layered Corneal Pachymetry with the Artemis Very High-Frequency Digital Ultrasound Arc-Scanner
Authors: Reinstein Dan Z. , Archer Timothy J. , Gobbe Marine , Silverman Ronald H. , Coleman D. Jackson
Published: November 2009

Purpose:

To assess the three-dimensional repeatability of thickness measurements for epithelium, stroma, cornea, flap, and residual stromal bed using the Artemis very high-frequency (VHF) digital ultrasound arc-scanner (ArcScan Inc).

Methods:

Five consecutive measurements were obtained for 10 eyes of 10 patients 1 year after LASIK using the Artemis VHF digital ultrasound arc-scanner across the central 10-mm diameter of the cornea. Repeatability analysis was performed for thickness measurements for each corneal layer—epithelium, stroma, cornea, flap, and residual stromal bed. The standard deviation of repeated measurements (point-repeatability) was calculated for each measurement location in 0.1-mm steps for the 10×10-mm matrix. The pooled standard deviation of the point-repeatability for each measurement location within the central 1-, 2-, and 3-mm radius was calculated (region-repeatability). The corneal thickness of the baseline scan set was compared to that of subsequent scan sets within the same session and plotted over time to assess any possible hydration effects of the immersion technique.

Results:

The repeatability at the corneal vertex was 0.58
μ
m for epithelium, 1.78
μ
m for stroma, 1.68
μ
m for cornea, 1.68
μ
m for flap, and 2.27
μ
m for residual stromal bed. The region-repeatability within the central 1-mm radius was 1.01
μ
m for epithelium, 3.44
μ
m for stroma, 3.35
μ
m for cornea, 2.81
μ
m for flap, and 3.97
μ
m for residual stromal bed. The mean difference in corneal thickness from the baseline value was within 1.25
μ
m for each of the subsequent four scan sets over a 5-minute immersion period.

Conclusions:

Layered pachymetry of the epithelium, stroma, cornea, flap, and residual stromal bed showed high repeatability with the Artemis VHF digital ultrasound arc-scanner. The high repeatability validates the use of the Artemis for in vivo layered pachymetry.
Epithelial Thickness After Hyperopic LASIK: Three-Dimensional Display with Artemis Very High-Frequency Digital Ultrasound
Authors: Reinstein Dan Z. , Archer Timothy J. , Gobbe Marine , Silverman Ronald H. , Coleman D. Jackson
Published: November 2009

Purpose:

To characterize the epithelial thickness profile in a population of eyes after LASIK for hyperopia or hyperopic astigmatism.

Methods:

The epithelial thickness profile was measured in vivo by Artemis very high-frequency (VHF) digital ultrasound scanning (ArcScan Inc) across the central 10-mm diameter of the cornea on 65 eyes at least 3 months after hyperopic LASIK using a 7-mm ablation zone with the MEL 80 excimer laser (Carl Zeiss Meditec). Maps of the average, standard deviation, minimum, maximum, and range of epithelial thickness were plotted. The cross-sectional hemi-meridional epithelial thickness profile was calculated using annular averaging. Linear regression analysis was performed to evaluate correlations between epithelial thickness, spherical equivalent refraction treated, and maximum simulated keratometry.

Results:

The mean thinnest epithelial thickness was 39.7±5.6
μ
m and the mean thickest epithelial thickness was 89.3±14.6
μ
m. The average epithelial thickness profile showed an epithelial doughnut pattern characterized by localized central thinning within the 4-mm diameter zone surrounded by an annulus of thick epithelium, with the thickest epithelium at the 3.4-mm radius. The epithelium was on average 10-
μ
m thicker temporally than nasally at the 3.4-mm radius. Central epithelium was thinner and paracentral epithelium was thicker for higher hyperopic corrections and steeper maximum simulated keratometry.

Conclusions:

Three-dimensional high-resolution ultrasound mapping of epithelial thickness profile after LASIK for hyperopia demonstrated thinner epithelium centrally and thicker epithelium paracentrally. Presumably, the paracentral epithelial thickening compensated in part for the stromal tissue removed by the hyperopic ablation, whereas the central epithelial thinning compensated for the localized increase in corneal curvature.
Biomechanical and Tomographic Analysis of Unilateral Keratoconus
Authors: Fontes Bruno M. , Ambrósio Renato , Salomão Marcella , Velarde Guillermo C. , Nosé Walton
Published: November 2009

Purpose:

To evaluate and compare tomographic, clinical, and biomechanical data of patients with unilateral keratoconus and healthy controls.

Methods:

Observational, case-control study. Complete clinical eye examination was followed by topographic (ATLAS), tomographic (Pentacam), and biomechanical (Ocular Response Analyzer) evaluation. Cases were sex- and age-matched with healthy individuals for controls.

Results:

Four patients had unilateral keratoconus, and eight healthy patients served as controls. Central corneal thickness was 508±16
μ
m in the keratoconus group, 531±12.7
μ
m in the fellow eye group, and 528.6±40.7
μ
m in the control group (
P
>.125, all comparisons). Central keratometry was 43.70±2.70 diopters (D) in the keratoconus group, 42.84±1.43 D in the fellow eye group, and 43.81±1.94 D in the control group (
P
>.45, all comparisons). Corneal astigmatism was 3.30±2.24 D in the keratoconus group, 1.38±1.49 D in the fellow eye group, and 1.34±1.13 D in the control group (
P
=.037 between the keratoconus and control groups;
P
=.25 between the keratoconus and fellow eye groups). Corneal hysteresis was 8.13±2 mmHg in the keratoconus group, 8.96±0.86 mmHg in the fellow eye group, and 9.89±1.33 mmHg in the control group (
P
>.064, all comparisons). Corneal resistance factor was 7.96±2.43 mmHg in the keratoconus group, 8.92±1.39 mmHg in the fellow eye group, and 9.90±2.24 mmHg in the control group (
P
>.33, all comparisons).

Conclusions:

Corneal hysteresis and corneal resistance factor values were not statistically different among the groups; however, a trend for lower values was found for keratoconus and fellow eyes compared to controls. Data should be interpreted with caution because of the small sample.
Physician Assessment of Changing Lesion Size of Predominantly Classic Choroidal Neovascular Membranes in Age-Related Macular Degeneration
Authors: Covert Douglas J. , Han Dennis P. , Kim Judy E. , Connor Thomas B. , Wirostko William J. , Moon Suk J. , Hamilton Richard
Published: November 2009

Background and Objective:

To quantify the interpretation of fluorescein angiograms of evolving predominantly classic choroidal neovascularization in age-related macular degeneration.

Patients and Methods:

Thirty-six fluorescein angiograms of predominantly classic choroidal neovascularization were used to define 22 fluorescein angiogram pairs. Imaging software was used to measure surface area and greatest linear dimension (GLD). Six retina physicians estimated the change in surface area and GLD for each pair before and after demarcation of the lesions' borders and GLD.

Results:

For enlarging lesions, the smallest changes consistently detected by physicians were a 5% to 15% increase in surface area and a 5% to 15% increase in GLD; for shrinking lesions, they were a 5% to 15% decrease in surface area and a 5% to 15% decrease in GLD. Linear regression demonstrated moderate correlation between physician and software estimates of surface area and GLD change (r
2
= 0.50 and 0.67, respectively;
P
< .001), which was higher with lesion demarcation (r
2
= 0.91 and 0.93, respectively;
P
< .001).

Conclusion:

Computer-assisted demarcation of lesion surface area and GLD reduced variability in physicians' estimates of choroidal neovascularization size change and improved correlation with software measurements.

[Ophthalmic Surg Lasers Imaging 2009;40:554–560.]
Comparison of Preoperative Nd:YAG Laser Anterior Capsulotomy Versus Two-Stage Curvilinear Capsulorhexis in Phacoemulsification of White Intumescent Cataracts
Authors: Coelho Roberto P. , Martin Luiz F. T. , Paula Jayter S. , Scott Ingrid U.
Published: November 2009

Background and Objective:

To compare the results of preoperative Nd:YAG laser anterior capsulotomy versus two-stage continuous curvilinear capsulorhexis (CCC) in phacoemulsification of eyes with white intumescent cataracts and liquefied cortex.

Patients and Methods:

Twenty-three eyes with white intumescent cataract were consecutively randomized for phacoemulsification with preoperative Nd:YAG laser anterior capsulotomy (group 1, n = 11) or two-stage CCC (group 2, n = 12) procedures. Intraoperative findings and postoperative outcomes were compared using the nonparametric tests.

Results:

Postoperative visual acuity, mean surgical time, mean effective phacoemulsification time, and frequency of complications were not significantly different between the two groups (
P
> .05). Two cases in each group were converted to the extracapsular technique. Excluding these four patients, surgical time was shorter in group 1 (
P
= .017).

Conclusion:

Preoperative Nd:YAG laser anterior capsulotomy is a safe technique in decompressing the capsular bag before phacoemulsification of white intumescent cataracts with liquefied cortex.

[Ophthalmic Surg Lasers Imaging 2009;40:582–585.]
The Role of Diagnostic Imaging Techniques in the Management of Retinal Detachment Due to Macular Hole in High Myopia
Authors: Carpineto Paolo , Aharrh-Gnama Agbeanda , Di Antonio Luca , Nubile Mario , Di Marzio Guido , Mastropasqua Leonardo
Published: November 2009

After preoperative assessment revealed anomalous posterior vitreous detachment, a 75-year-old woman affected with retinal detachment due to macular hole was scheduled to undergo the posterior episcleral buckling procedure. Preoperative microperimetry showed unstable eccentric fixation with a dense scotoma within the central 8°. One month postoperatively, best-corrected visual acuity increased from 1.70 to 0.88 logarithm of the minimum angle of resolution. Ultrasonography and optical coherence tomography revealed the indentation of the posterior scleral profile due to the buckle. The retina appeared fully attached and a macular hole with flattened edges was still detectable. Microperimetry showed stable central fixation with recovery of retinal sensitivity within the central 2°. Diagnostic imaging techniques guided the decision to use the posterior episcleral buckling procedure. Microperimetry was useful to explain vision improvement despite residual macular hole.
[Ophthalmic Surg Lasers Imaging 2009;40:602–606.]
Effects of the invasive macroalga Lophocladia lallemandii on the diet and trophism of Pinna nobilis (Mollusca: Bivalvia) and its guests Pontonia pinnophylax and Nepinnotheres pinnotheres (Crustacea: Decapoda)
Authors: Cabanellas-Reboredo Miguel , Blanco Andreu , Deudero Salud , Tejada Silvia
Published: November 2009

Pinna nobilis and its guests Pontonia pinnophylax and Nepinnotheres pinnotheres were sampled from Posidonia oceanica meadows invaded and non-invaded by the red alga Lophocladia lallemandii. Understanding the interactions among native and invasive species was the primary aim. Therefore, the effects of the invasive L. lallemandii on the percentage contribution of the food sources of P. nobilis and its guests and their trophic associations were investigated by applying mixing models to the δ13C and δ15N stable isotopes. Isotopic analyses revealed that the guests of P. nobilis occupied a higher trophic level than their host due to their capacity for food selection. The invasion of L. lallemandii altered the percentage contribution of the food sources to the consumers’ diet. Whereas the percentage contribution of the food sources to the δ13C signatures did not really change, L. lallemandii produced variations in the percentage contribution to the δ15N signatures. This red macroalga represented one of the main food sources for P. nobilis, with a real contribution of 19.4% in the invaded meadows. Moreover, L. lallemandii slightly decreased the trophic level of the consumers. This study provides the first isotopic and trophic data for the pea crab N. pinnotheres.
Adult Wilms′ tumour
Authors: Patil Tushar , Patel Kirti V , Shukla Shilin , Parikh Bharat , Anand Asha , Shah Mithun
Published: November 2009

Wilms′ tumour is most common malignant renal tumour of childhood. Rarely, it may be seen in the adults. We report a 35 year old male presenting with flank pain. Abdominal CT scan revealed a right renal mass and a clinical diagnosis of renal cell carcinoma was made. Nephrectomy was performed, and a final diagnosis of adult Wilms′ tumour was made. This case in being reported on account ot its rarity. Pertinent literature is being reviewed.
Myofibroblastoma of breast
Authors: Das Prasenjit , Sharma Alok , Arora Raman , Singh M
Published: November 2009

Myofibroblastoma of breast is an extremely rare mesenchymal lesion comprising of myofibroblasts. Less than 70 cases have been reported in the literature. Though many histological variants are known, characteristic morphological, cytologic, immunohistochemical and ultrastructural features help to differentiate it from other spindle cell lesions of breast. Here we report an epitheloid variant of myofibroblastoma breast in a 55-year-old female. Though CD34 showed only focal positivity, typical morphological and other immunohistochemical features helped in arriving at the diagnosis.
Extragonadal germ-cell tumour of vagina
Authors: Joshi Prashant , Sarda Dinesh , Laddha Ashok , Agarwal Vikram , Ahmad Ashraf , Kothari Paras
Published: November 2009

A 7-month-old female child was admitted with a short history of bleeding and mass protruding from the vagina. Alfa-feto protein levels were raised. Biopsy taken of the tumour mass was suggestive of Endodermal sinus tumour (yolk sac) of vagina. Neoadjuvant chemotherapy was given. Organ preserving resection of tumour was done successfully.
Borderline ovarian tumours : An update
Authors: Priya C , Kumar Sunesh , Kumar Lalit
Published: November 2009

Borderline ovarian tumours are clinical entities less frequently encountered by obstetricians and gynecologists. Management options keep on changing with time and fertility sparing procedures and laparoscopy keep emerging. Surgical removal of all visible tumours still remains the most effective management. So far, non surgical treatment modalities have not been found to be beneficial. Pathologists are increasingly able to identify poor prognostic features in histology. Molecular biological studies are progressively being elucidated as prognostic features which might help us more in understanding the carcinogenic process and progression of the disease. This review outlines the recent literature regarding pathology, diagnosis, treatment, prognosis and recurrence. Oncologic concerns are discussed with emphasis on mode of surgery, fertility sparing surgery and the outcomes.
Sister Mary Joseph′s nodule
Authors: Aich Ranen Kanti , Karim Md.Rejaul , Chakraborty Barunodaya , Dasgupta Subhankar , Deb Asit
Published: November 2009

Umbilical nodule, universally known as Sister Mary Joseph′s Nodule, mostly is a metastatic manifestation of an underlying advanced malignant disease and is associated with a grave prognosis. Umbilical swelling due to any benign disease is called Pseudo Sister Mary Joseph′s nodule. A 41- year-old woman presented with a gradually increasing peri-umbilical nodule. Fine needle aspiration cytology of the nodule proved to be metastatic adenocarcinoma and search for the primary revealed an advanced gastric malignancy. An apparently insignificant umbilical nodule, may be the only manifestation of an underlying advanced malignant disease and therefore clinicians should be aware of such nodule. Histological/cytological examination of such a nodule not only confirms the diagnosis but also helps the clinician to search for the possible primary site.
Post-treatment testicular activity in lymphoma patients
Authors: Ahmad Mushtaq , Lone Abdul Rashid , Kuchai Sana Ullah , Zargar Abdul Hamid , Aziz Sheikh Aejaz , Bhat Gul Mohammad , Banday Manzoor A , Jelani Samoon , Bhat Javid Rasool
Published: November 2009

Objectives: For young patients receiving cancer chemotherapy, the major concern is gonadal dysfunction with impaired reproductive capacity. The impact of such therapy in patients with lymphoma was focus of this study. Methods : Semen analysis and serum FSH and LH levels were determined pretreatment, immediately after completion of therapy and at follow-up in 60 patients of lymphoma receiving chemotherapy. Results : Pretreatment infertility was present in 13.2% of patients. After completion of treatment, 76.9% developed azoospermia. However, after a mean follow up of 56.66 months, percentage of normospermic patients declined to 43.3%, recovery being better in patients of age less than 30 years. Conclusion : The effects of chemotherapy on testicular activity were significant with combination containing cyclophosphamide and procarbazine. Recovery in spermatogenesis and FSH levels to normal was seen in patients receiving cyclophosphamide, vincristine and prednisolone but was least when procarbazine was added to this. 90% patients continued to have azoospermia at 5 years in the group which received cyclophosphamide in combination with procarbazine.
Hematopoietic stem cell transplantation for hemoglobinopathies: Progress and prospects
Authors: Krishnamurti Lakshmanan , Gupta D
Published: November 2009

Allogeneic bone marrow transplantation from an HLA-identical donor is currently the only means of curing thalassemia . Transplant outcome depends upon the presence of risk factors (hepatomegaly, portal fibrosis and poor quality of chelation). patients are defined to have class I - if no risk factor, class II with one or two and class III - if all three risk factors are present. For patients under 16 years of age, for class I, class II and III the probabilities of survival are approximately 95%, >80% and 60-70%, respectively. The risk of transplant related morbidity& mortality is low when transplant is done at an early age. Currently, busulfan, cyclophospahmide and antithymocyte globulin based combination is used for conditioning. More than 200 patients with sickle cell disease (SCD) have undergone allogeneic SCT with long term survival in >80% of patients. Results are better if donor is an HLA-identical sibling and if transplant is done early in the course of disease. Presently, experience with reduced intensity SCT and matched unrelated donor transplant is limited to recommend their routine use.
Non hodgkin′s lymphoma of tongue - A case report
Authors: Vaswani Bharat , Shah Mithun , Shah P , Parikh B , Anand A , Sharma Gopal
Published: November 2009

Primary non-Hodgkin′s lymphoma (NHL) of the oral region is rare. Oral manifestations are present in 3-5% of cases of NHL and oral lesions are rarely the initial manifestation. We describe a 40 year old male who presented with a mass lesion primarily involving the tongue and was diagnosed as diffuse large B cell lymphoma. The patient was treated with CHOP chemotherapy with complete disappearance of lesion after first cycle. Pertinent literature is being reviewed.
Evaluation of Virtual Grid processed clinical pelvic radiographs
Authors: Gossye Tim , Buytaert Dimitri , Smeets Peter V. , Morbée Lieve , Vereecke Elke , Kellens Pieter‐Jan , Achten Eric , Bacher Klaus
Published: May 2024

Background

A physical scatter grid is not often used in pelvic bedside examinations. However, multiple studies regarding scatter correction software (SC SW) are available for mobile chest radiography but the results are unclear for pelvic radiography.

Purpose

We evaluated SC SW of Fujifilm (Virtual Grid) on gridless pelvic radiographs obtained from a human Thiel‐embalmed body to investigate the potential of Virtual Grid in pelvic bedside examinations.

Methods

Gridless, Virtual Grid, and physical grid pelvic radiographs of a female Thiel‐embalmed body were collected with a broad range of tube loads. Different software (SW) grid ratios—6:1, 10:1, 13:1, 17:1, and 20:1—were applied on the gridless radiographs to investigate the image quality (IQ) improvement of 13 IQ criteria in a visual grading analysis (VGA) setup.

Results

Gridless radiograph scores are significantly lower (p < 0.001) than Virtual Grid and physical grid scores obtained with the same tube load. Virtual Grid radiographs score better than gridless radiographs obtained with a higher tube load which makes a dose reduction possible. The averaged ratings of the IQ criteria processed with different SW ratios increase with increasing SW grid ratios. However, no statistically significant differences were found between the SW grid ratios. The scores of the physical grid radiographs are higher than those of the Virtual Grid radiographs when they are obtained with the same tube load.

Conclusion

We conclude that Virtual Grid with an SW ratio of 6:1 improves the IQ of gridless pelvic radiographs in such a manner that a dose reduction is possible. However, physical grid radiograph ratings are higher compared to those of Virtual Grid radiographs.
Efficient EPID‐based quality assurance of beam time delay for respiratory‐gated radiotherapy with validation on Catalyst™ and AlignRT™ systems
Authors: Yao Kaining , Wang Meijiao , Du Yi , Liu Jiacheng , Wang Qingying , Wang Ruoxi , Wu Hao , Yue Haizhen
Published: May 2024

Purpose

To propose a straightforward and time‐efficient quality assurance (QA) approach of beam time delay for respiratory‐gated radiotherapy and validate the proposed method on typical respiratory gating systems, Catalyst™ and AlignRT™.

Methods

The QA apparatus was composed of a motion platform and a Winston‐Lutz cube phantom (WL3) embedded with metal balls. The apparatus was first scanned in CT‐Sim and two types of QA plans specific for beam on and beam off time delay, respectively, were designed. Static reference images and motion testing images of the WL3 cube were acquired with EPID. By comparing the position differences of the embedded metal balls in the motion and reference images, beam time delays were determined. The proposed approach was validated on three linacs with either Catalyst™ or AlignRT™ respiratory gating systems. To investigate the impact of energy and dose rate on beam time delay, a range of QA plans with Eclipse (V15.7) were devised with varying energy and dose rates.

Results

For all energies, the beam on time delays in AlignRT™ V6.3.226, AlignRT™ V7.1.1, and Catalyst™ were 92.13 5.79 ms, 123.11 6.44 ms, and 303.44 4.28 ms, respectively. The beam off time delays in AlignRT™ V6.3.226, AlignRT™ V7.1.1, and Catalyst™ were 121.87 1.34 ms, 119.33 0.75 ms, and 97.69 2.02 ms, respectively. Furthermore, the beam on delays decreased slightly as dose rates increased for all gating systems, whereas the beam off delays remained unaffected.

Conclusions

The validation results demonstrate the proposed QA approach of beam time delay for respiratory‐gated radiotherapy was both reproducible and time‐efficient to practice for institutions to customize accordingly.
Prognostic Value of the 2019 EULAR/American College of Rheumatology Systemic Lupus Erythematosus Classification Criteria to Renal Response One Year After Treatment in a Cohort With Childhood‐Onset Lupus Nephritis
Authors: Patrizi Sara T. , Tandel Megha D. , Boothroyd Derek , Simard Julia F. , Hsu Joyce J.
Published: May 2024

Objective

In 2019, the EULAR/American College of Rheumatology developed classification criteria for systemic lupus erythematosus (SLE). A positive correlation between summary score at diagnosis and SLE disease activity at five years has been noted in adult patients with lupus, but little is known among the pediatric population. We evaluated the prognostic value of higher summary scores and number of extrarenal domains at diagnosis (low/moderate number [1–5] vs high number [6–9]) to renal outcomes after one year of treatment in pediatric patients with lupus nephritis (LN).

Methods

This retrospective, single‐center cohort study included 74 pediatric patients with LN. Published pediatric renal response definitions were used for our outcome measure (no, partial, and complete response). Descriptive statistics were reported, and an ordinal logistic regression estimated adjusted odds ratios (ORs) for renal response including 95% confidence intervals (CIs).

Results

Patients with high extrarenal domains had OR 1.47 (95% CI 0.55–2.91) of having a complete renal response compared to patients with low/moderate domains. Patients with a summary score <30 had OR 1.31 (95% CI 0.50–3.44) of having a complete renal response relative to a summary score ≥30, though a larger proportion of patients with a summary score of ≥30 had no renal response after one year of treatment.

Conclusion

More extrarenal domains at diagnosis did not have a statistically significant impact on renal response at one year, nor did a higher summary score. However, a larger portion of patients with a summary score <30 achieved complete renal response compared to patients with a score ≥30.
Enhancement of Bone Tissue Regeneration with Multi‐Functional Nanoparticles by Coordination of Immune, Osteogenic, and Angiogenic Responses
Authors: Jeong Hyewoo , Byun Hayeon , Lee Jinkyu , Han Yujin , Huh Seung Jae , Shin Heungsoo
Published: May 2024

Inorganic nanoparticles are promising materials for bone tissue engineering due to their chemical resemblance to the native bone structure. However, most studies are unable to capture the entirety of the defective environment, providing limited bone regenerative abilities. Hence, this study aims to develop a multifunctional nanoparticle to collectively control the defective bone niche, including immune, angiogenic, and osteogenic systems. The nanoparticles, self‐assembled by biomimetic mineralization and tannic acid (TA)‐mediated metal‐polyphenol network (MPN), are released sustainably after the incorporation within a gelatin cryogel. The released nanoparticles display a reduction in M1 macrophages by means of reactive oxygen species (ROS) elimination. Consequently, osteoclast maturation is also reduced, which is observed by the minimal formation of multinucleated cells (0.4%). Furthermore, the proportion of M2 macrophages, osteogenic differentiation, and angiogenic potential are consistently increased by the effects of magnesium from the nanoparticles. This orchestrated control of multiple systems influences the in vivo vascularized bone regeneration in which 80% of the critical‐sized bone defect is regenerated with new bones with mature lamellar structure and arteriole‐scale micro‐vessels. Altogether, this study emphasizes the importance of the coordinated modulation of immune, osteogenic, and angiogenic systems at the bone defect site for robust bone regeneration.
Advanced Anode Materials for Aqueous Potassium‐Ion Batteries
Authors: Zheng Junhao , Wu Yuanji , Li Hongyan
Published: May 2024

Aqueous electrolytes are praised for their inherent safety, cost‐effectiveness, and minimal environmental impact, making aqueous potassium‐ion batteries (APIBs) a viable alternative for sustainable and eco‐friendly energy solutions. Researchers have endeavored to anode materials that align with the unique requirements of aqueous electrolytes, and some proud achievements are made. The research about APIBs anode has focused on organic materials and polyanionic compounds, both exhibiting desirable hydrated potassium storage performance, and in recent years, on the development of metal compounds and alloy‐based materials with high theoretical capacities. However, the anode of APIBs faces a narrow electrochemical stability window (ESW) caused by aqueous electrolytes and volume expansion problems due to the large radius of potassium ions, which prevents them from exhibiting appreciable capacity with satisfactory cycling stability. This review meticulously delineates the latest advancements and representative materials for the anode of APIBs and introduces several common aqueous electrolytes and effective improvement strategies for them. The focus is on the advantages and bottlenecks faced by different types of anode materials, culminating in a proposed methodology to enhance APIBs anode efficacy. This review endeavors to furnish novel perspectives on the development and pragmatic deployment of APIBs anodes.
Tuning the Solvation Structure in Water‐Based Solution Enables Surface Reconstruction of Layered Oxide Cathodes toward Long Lifespan Sodium‐Ion Batteries
Authors: Hao Youchen , Xia Yufan , Liu Wen , Sun Guojie , Feng Lihua , Zhou Xiaochong , Iqbal Sikandar , Tian Ziqi , Zhang Zhongcai , Li Yong , Zhang Xuan , Jiang Yinzhu
Published: May 2024

Layered oxides of sodium‐ion batteries suffer from severe side reactions on the electrode/electrolyte interface, leading to fast capacity degradation. Although surface reconstruction strategies are widely used to solve the above issues, the utilization of the low‐cost wet chemical method is extremely challenging for moisture‐sensitive Na‐based oxide materials. Here, the solvation tuning strategy is proposed to overcome the deterioration of NaNi1/3Mn1/3Fe1/3O2 in water‐based solution and conduct the surface reconstruction. When capturing the water molecules by the solvation structure of cations, here is Li+, the structural collapse and degradation of layered oxides in water‐based solvents are greatly mitigated. Furthermore, Li(H2O)3EA+ promotes the profitable Li+/Na+ exchange to build a robust surface, which hampers the decomposition of electrolytes and the structural evolution upon cycling. Accordingly, the lifespan of Li‐reinforced materials is prolonged to three times that of the pristine one. This work represents a step forward in understanding the surface reconstruction operated in a water‐based solution for high‐performance sodium layered oxide cathodes.
Pressure‐Dependent “Insulator–Metal–Insulator” Behavior in Sr‐Doped La3Ni2O7
Authors: Xu Mingyu , Huyan Shuyuan , Wang Haozhe , Bud'ko Sergey L. , Chen Xinglong , Ke Xianglin , Mitchell John F. , Canfield Paul C. , Li Jie , Xie Weiwei
Published: May 2024

Recently, superconductivity at high temperatures is observed in bulk La3Ni2O7−δ under high pressure. However, the attainment of high‐purity La3Ni2O7−δ single crystals remains a formidable challenge. Here, the crystal structure and physical properties of single crystals of Sr‐doped La3Ni2O7 synthesized at high pressure (20 GPa) and high temperature (1400 °C) are reported. Through single crystal X‐ray diffraction, it is shown that high‐pressure‐synthesized paramagnetic Sr‐doped La3Ni2O7 crystallizes in an orthorhombic structure with Ni─O─Ni bond angles of 173.4(2)° out‐of‐plane and 175.0(2)°and 176.7(2)°in plane. The substitution of Sr alters in band filling and the ratio of Ni2+/Ni3+ in Sr‐doped La3Ni2O7, aligning them with those of “La3Ni2O7.05”, thereby leading to significant modifications in properties under high pressure relative to the unsubstituted parent phase. At ambient pressure, Sr‐doped La3Ni2O7 exhibits insulating properties, and the conductivity increases as pressure goes up to 10 GPa. However, upon further increasing pressure beyond 10.7 GPa, Sr‐doped La3Ni2O7 transits back from a metal‐like behavior to an insulator. The insulator–metal–insulator trend under high pressure dramatically differs from the behavior of the parent compound La3Ni2O7−δ, despite their similar behavior in the low‐pressure regime. These experimental results underscore the considerable challenge in achieving superconductivity in nickelates.
The ever‐changing microenvironment of Staphylococcus aureus in cutaneous infections
Authors: Zhou Zhenru , Tian Jing , Li Shi , Fei Liyue , Dai Min , Long Nana
Published: May 2024

Background

Staphylococcus aureus is responsible for the majority of skin and soft tissue infections, which are often diagnosed at a late stage, thereby impacting treatment efficacy. Our study was designed to reveal the physiological changes at different stages of infection by S. aureus through the combined analysis of variations in the skin microenvironment, providing insights for the diagnosis and treatment of S. aureus infections.

Methods

We established a murine model of skin and soft tissue infection with S. aureus as the infectious agent to investigate the differences in the microenvironment at different stages of infection. By combining analysis of the host immune status and histological observations, we elucidate the progression of S. aureus infection in mice.

Results

The results indicate that the infection process in mice can be divided into at least two stages: early infection (1–3 days post‐infection) and late infection (5–7 days post‐infection). During the early stage of infection, notable symptoms such as erythema and abundant exudate at the infection site were observed. Histological examination revealed infiltration of numerous neutrophils and bacterial clusters, accompanied by elevated levels of cytokines (IL‐6, IL‐10). There was a decrease in microbial alpha diversity within the microenvironment (Shannon, Faith's PD, Chao1, Observed species, Simpson, Pielou's E). In contrast, during the late stage of infection, a reduction or even absence of exudate was observed at the infected site, accompanied by the formation of scabs. Additionally, there was evidence of fibroblast proliferation and neovascularization. The levels of cytokines and microbial composition gradually returned to a healthy state.

Conclusion

This study reveals synchrony between microbial composition and histological/immunological changes during S. aureus‐induced SSTIs.
Kinase Inhibition via Small Molecule‐Induced Intramolecular Protein Cross‐Linking
Authors: Wang Xuan , Sun Jie , Huang Huisi , Tang Guanghui , Chen Peng , Xiang Menghua , Li Lin , Zhang Zhi‐Min , Gao Liqian , Yao Shao Q.
Published: May 2024

Remarkable progress has been made in the development of cysteine‐targeted covalent inhibitors. In kinase drug discovery, covalent inhibitors capable of targeting other nucleophilic residues (i.e. lysine, or K) have emerged in recent years. Besides a highly conserved catalytic lysine, almost all human protein kinases possess an equally conserved glutamate/aspartate (e.g. E/D) that forms a K–E/D salt bridge within the enzyme's active site. Electrophilic ynamides were previously used as effective peptide coupling reagents and to develop E/D‐targeting covalent protein inhibitors/probes. In the present study, we report the first ynamide‐based small‐molecule inhibitors capable of inducing intramolecular cross‐linking of various protein kinases, leading to subsequent irreversible inhibition of kinase activity. Our strategy took advantage of the close distance between the highly conserved catalytic K and E/D residues in a targeted kinase, thus providing a conceptually general approach to achieve irreversible kinase inhibition with high specificity and desirable cellular potency. Finally, this ynamide‐facilitated, ligand‐induced mechanism leading to intramolecular kinase cross‐linking and inhibition was unequivocally established by using recombinant ABL kinase as a representative.