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CAMTA1 could serve as diagnostic marker; especially on limited cytology material. Additional studies will be helpful in supporting our results.
This study evaluates the clinical use of the RUBY modular QA phantom for linac QA to validate the integrity of IGRT workflows including the congruence of machine isocenter, imaging isocenter, and room lasers. The results have been benchmarked against those obtained with widely used systems. Additionally, the RUBY phantom has been implemented to perform system QA (End-to-End testing) from imaging to radiation for IGRT-based VMAT and stereotactic radiations at an Elekta Synergy linac.
The daily check of IGRT workflow was performed using the RUBY phantom, the Penta-Guide, and the STEEV phantom. Furthermore, Winston-Lutz tests was carried out with the RUBY phantom and a ball-bearing phantom to determine the offsets and the diameters of the isospheres of gantry, collimator, and couch rotations, with respect to the room lasers and kV-imaging isocenter. System QA was performed with the RUBY phantom and STEEV phantom for eight VMAT treatment plans. Additionally, the visibility of the embedded objects within theseeck the IGRT-based VMAT and stereotactic radiations workflow at an Elekta Synergy linac.
Diagnostic sweat testing is required for infants with positive newborn-screening (NBS) tests for cystic fibrosis (CF). Infants have "quantity not sufficient" (QNS) sweat volumes more often than older children. A comprehensive study of QNS sweat volumes in infants has not previously been reported.
We surveyed US CF Centers to obtain QNS rates in all infants who had sweat testing at under 14 days and under 3 months of age. We then calculated QNS rates reported to the Cystic Fibrosis Foundation Patient Registry (CFFPR) 2010-2018 in 10-day increments from 1 to 60 days of life. We compared QNS sweat test rates in preterm (<37-weeks gestational age) vs term infants. We assessed age at sweat test and proportion of infants who did not have a sweat test reported by 60 days of age.
Thirty-nine of 144 (27%) of CF Centers reported a mean QNS rate of 10.5% (range, 0-100) in infants 14-days-old or younger. CFFPR data showed the highest QNS rates in the youngest infants and in those born before 37 weeks of gestation. The median age at sweat testing decreased over time, but more than 22% of infants did not have a sweat test reported by 60 days.
Higher QNS rates are seen in the youngest infants with CF, but more than 80% of infants younger than 2 weeks of age have adequate sweat volumes. Sweat testing should not be delayed in infants with a positive CF NBS test.
Higher QNS rates are seen in the youngest infants with CF, but more than 80% of infants younger than 2 weeks of age have adequate sweat volumes. Sweat testing should not be delayed in infants with a positive CF NBS test.Genetically encoded RNA devices have emerged for various cellular applications in imaging and biosensing, but their functions as precise regulators in living systems are still limited. #link# Inspired by protein photosensitizers, we propose here a genetically encoded RNA aptamer based photosensitizer (GRAP). Upon illumination, the RNA photosensitizer can controllably generate reactive oxygen species for targeted cell regulation. The GRAP system can be selectively activated by endogenous stimuli and light of different wavelengths. Compared with their protein analogues, GRAP is highly programmable and exhibits reduced off-target effects. These results indicate that GRAP enables efficient noninvasive target cell ablation with high temporal and spatial precision. This new RNA regulator system will be widely used for optogenetics, targeted cell ablation, subcellular manipulation, and imaging.
Fabry disease (FD) is a rare X-linked lysosomal storage disorder due to the absent or deficient activity of lysosomal hydrolase a-galactosidase A (α-Gal A), which leads to the accumulation of its substrates in various organs and tissues. Classic clinical manifestations include angiokeratomas, proteinuria, renal failure, neuropathic pain, and left ventricular hypertrophy. Fever is one of the rare symptoms that may occur during FD.
Three Chinese Han patients with FD referred to Peking Union Medical College Hospital were reported. The complete medical records were established, and detailed data were collected. Whole-exome sequencing by next-generation sequencing and α-Gal A enzyme activity assay were performed to confirm the diagnosis.
These three patients all presented with recurrent fever of unknown origin initially, accompanied with arthralgia/arthritis and other symptoms. We identified two known variants in the GLA gene, c.1176_1179delGAAG and c.782G>A (p.G261D), and a novel variant c.440G>A (p.G147E) which is likely pathogenic in our patient.
FD should be considered as a rare cause of recurrent fever of unknown origin. The coexistence of gene variants related to systemic autoinflammatory diseases may make the clinical phenotypes of FD more complex and prone to recurrent fever.
FD should be considered as a rare cause of recurrent fever of unknown origin. The coexistence of gene variants related to systemic autoinflammatory diseases may make the clinical phenotypes of FD more complex and prone to recurrent fever.Magnetic resonance imaging (MRI) can indirectly reflect microscopic changes in lesions on the spinal cord; however, the application of deep learning to MRI to classify and detect lesions for cervical spinal cord diseases has not been sufficiently explored. In this study, we implemented a deep neural network for MRI to detect lesions caused by cervical diseases. We retrospectively reviewed the MRI of 1,500 patients irrespective of whether they had cervical diseases. The patients were treated in our hospital from January 2013 to December 2018. We randomly divided the MRI data into three groups of datasets disc group (800 datasets), injured group (200 datasets), and normal group (500 datasets). We designed the relevant parameters and used a faster-region convolutional neural network (Faster R-CNN) combined with a backbone convolutional feature extractor using the ResNet-50 and VGG-16 networks, to detect lesions during MRI. Experimental results showed that the prediction accuracy and speed of Faster R-CNN with ResNet-50 and VGG-16 in detecting and recognizing lesions from a cervical spinal cord MRI were satisfactory. The mean average precisions (mAPs) for Faster R-CNN with ResNet-50 and VGG-16 were 88.6 and 72.3%, respectively, and the testing times was 0.22 and 0.24 s/image, respectively. Faster R-CNN can identify and detect lesions from cervical MRIs. To some extent, it may aid radiologists and spine surgeons in their diagnoses. link2 The results of our study can provide motivation for future research to combine medical imaging and deep learning.
We aimed to investigate whether early tracheal intubation (TI) is associated with a reduced risk of mortality and increased ventilator-free days (VFD).
We performed a retrospective cohort study of children 0 to 18 years old in a pediatric intensive care unit (PICU), between 2008 and 2017. Patient demographics, vital signs, and laboratory findings were extracted. Using a time-dependent propensity score-matched algorithm, each patient was matched with another equally likely to be intubated within the same hour but was actually intubated with ≤2 hours, 2 to 4 hours, and 4 to 6 hoursdelays. Outcomes were mortality and VFD.
Among 333 patients, the median age was 1.72 years (interquartile range [IQR] 0.17-7.75). Thirty children died (9.0%) and the median PICU length of stay was 6.7 days (IQR 3.9-13.2). Early TI did not decrease mortality significantly when compared to a ≤2 hour delay (odds ratios [OR] 0.86; 95% CI, 0.40-1.85), a 2 to 4 hour delay (OR, 0.81; 95% CI, 0.39-1.69), or a 4 to 6 hour delay (OR, 0.87; 95% CI, 0.43-1.79). Similarly, early TI did not significantly increase VFD. AR-42 order with early TI had 0.09 more VFD (95% CI -1.83 to 2.01) when compared to a delay within 2 hours, 0.23 more VFD (95% CI -1.66 to 2.13) when compared to a 2 to 4-hour delay and 0.56 more VFD (95% CI -1.49-2.61) when compared to a 4 to 6-hour delay.
We did not find a significant association between the timing of TI and mortality or VFD in critically ill children.
We did not find a significant association between the timing of TI and mortality or VFD in critically ill children.
Introduction of allergenic solid foods, especially peanut and hen's egg reduces the risk of food allergy development in early childhood. Ideally, parents will offer their infants home-prepared foods; however, many rely on the availability of convenient ready to purchase infant foods. This audit aimed to assess the major food allergen content of commercial infant foods.
Infant foods available for sale in 2019 in Australia were the focus of this audit. The major food allergens investigated were peanut, tree nuts, hen's egg, cows milk, wheat, fish, shellfish, soy, sesame and lupin. Websites of infant food manufacturers and major supermarkets were used to identify ingredient lists of infant foods available for purchase. Where ingredients listings were unavailable this information was sourced directly from the product labels in the supermarket.
Fourteen companies were identified, manufacturing over 251 foods specifically for the infants aged less than 1 year of age. link3 Although there were many choices availableancy.
To perform a prospective longitudinal analysis of lung ultrasound findings in critically ill patients with coronavirus disease 2019 (COVID-19).
Eighty-nine intensive care unit (ICU) patients with confirmed COVID-19 were prospectively enrolled and tracked. Point-of-care ultrasound (POCUS) examinations were performed with phased array, convex, and linear transducers using portable machines. The thorax was scanned in 12 lung areas anterior, lateral, and posterior (superior/inferior) bilaterally. Lower limbs were scanned for deep venous thrombosis and chest computed tomographic angiography was performed to exclude suspected pulmonary embolism (PE). Follow-up POCUS was performed weekly and before hospital discharge.
Patients were predominantly male (84.2%), with a median age of 43 years. The median duration of mechanical ventilation was 17 (interquartile range, 10-22) days; the ICU length of stay was 22 (interquartile range, 20.2-25.2) days; and the 28-day mortality rate was 28.1%. On ICU admission, POCUS deasound depicted B-lines, pleural line irregularities, and variable consolidations. Lung ultrasound findings were significantly decreased by ICU discharge, suggesting persistent but slow resolution of at least some COVID-19 lung lesions. Although POCUS identified deep venous thrombosis in less than 20% of patients at the bedside, nearly one-fourth of all patients were found to have computed tomography-proven PE.
Salmonella is an important foodborne pathogen that causes acute diarrhea in humans worldwide. This study analyzed the relationships of serotypes and antibiotic resistance with virulence genes of Salmonella isolated from children with salmonellosis.
Serological typing was performed using the slide-agglutination method. The Kirby-Bauer disk diffusion method was used to test antibiotic susceptibility. Twenty virulence genes were detected by PCR.
Salmonella Typhimurium (21 isolates, 34.43%) and SEnteritidis (12 isolates, 19.67%) were the predominant species among the 61 isolates. Ampicillin resistance was most common (63.93%), and among the cephalosporins, resistance was most often found to cefotaxime, a third-generation cephalosporin (19.67%). Among the 20 virulence genes, prgH, ssrB, and pagC were detected in all Salmonella isolates. In STyphimurium, the detection rates of hilA, sipB, marT, mgtC, sopB, pagN, nlpI, bapA, oafA, and tolC were high. In SEnteritidis, the detection rates of icmF, spvB, spvR, and pefA were high.
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