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Double-Layer Nitrogen-Rich Two-Dimensional Anionic Uranyl-Organic Framework for Cation Absorb dyes Seize and Catalytic Fixation of Fractional co2.
In x-ray computed tomography (CT), materials with different elemental compositions can have identical CT number values, depending on the mass density of each material and the energy of the detected x-ray beam. Differentiating and classifying different tissue types and contrast agents can thus be extremely challenging. In multi-energy CT, one or more additional attenuation measurements are obtained at a second, third or more energy. This allows the differentiation of at least two materials. Commercial dual-energy CT systems (only two energy measurements) are now available either using sequential acquisitions of low- and high-tube potential scans, fast tube-potential switching, beam filtration combined with spiral scanning, dual-source, or dual-layer detector approaches. The use of energy-resolving, photon-counting detectors is now being evaluated on research systems. Irrespective of the technological approach to data acquisition, all commercial CT multi-energy systems today provide dual-energy data. Material deach of the current technical approaches described. In addition, current and evolving clinical applications are introduced. Entinostat concentration Finally, the impact of multi-energy CT technology on patient radiation dose is summarized. This article is protected by copyright. All rights reserved.PURPOSE Trajectory-based treatment planning involves the combination of a gantry-couch trajectory with volumetric modulated arc therapy (VMAT) treatment plan optimization. This work presents the implementation of an optimization methodology that generates a trajectory simultaneous with treatment plan optimization (simTr-VMAT). METHODS The optimization algorithm is based on the column generation approach, in which a treatment plan is iteratively constructed through the solution of a subproblem called the "pricing problem". The property of the pricing problem to rank candidate apertures based on their associated price is leveraged to select an optimal aperture while simultaneously determining the trajectory path. A progressively increasing gantry-couch grid resolution is used to provide an initial coarse sampling of the angular solution space while maintaining fine control point spacing with the final treatment plan. The trajectory optimization was applied and compared to coplanar VMAT treatment plans for a lunthe distribution of randomly generated trajectories for the lung, glioblastoma, and prostate patients, respectively. CONCLUSION The simTr-VMAT optimization methodology resulted in treatment plans with equivalent or improved dosimetric outcomes compared to coplanar VMAT treatment plans, with the trajectories resulting from the optimization ranking among the optimal trajectories for each patient case. This article is protected by copyright. All rights reserved.We read with interest the informative review article by Ball et al. It discussed the assessment and management of patients with a suspected functional dermatological disorder, which appeared in a recent issue of Clinical and Experimental Dermatology. This article is protected by copyright. All rights reserved.The efficacy of dexmedetomidine in the prevention of postoperative delirium (POD) remains ambiguous, however, it has been used to reduce the incidence of delirium in elderly patients. Here, we conducted a meta-analysis study for assessing the effects of dexmedetomidine on POD among elderly patients following non-cardiac surgery. A systematic literature search was performed against the PubMed, EMBASE, Cochrane Library, and Web of Science databases, and all relevant literature published till November 30, 2019, were considered. Our analysis included 16 randomised controlled trials conducted with 4534 patients for exploring the effects of dexmedetomidine on POD in elderly patients following non-cardiac surgery. It was observed that the overall incidence of POD was significantly lower in the dexmedetomidine group than in the control group (risk ratio (RR)0.51, 95% confidence interval (CI) 0.43-0.61, P less then 0.01). Similar results were obtained from subgroup analysis upon comparison of the placebo (RR 0.52, 95% CI 0.41-0.66, P less then 0.01, moderate quality of evidence), propofol-treated (RR 0.55, 95% CI 0.38-0.78, P less then 0.01, low quality of evidence), and midazolam-treated (RR 0.38, 95% CI 0.20-0.71, P less then 0.01, low quality of evidence) groups. Trial sequential analysis revealed that the cumulative z-value superseded the monitoring boundary and reached the required information size. However, patients who received dexmedetomidine had a higher incidence of bradycardia and hypotension. In conclusion, the meta-analysis revealed that dexmedetomidine appears to decrease the risk of POD in elderly patients following non-cardiac surgery. However, as some of the studies were heterogeneous and of low quality, high quality trials are necessary for drawing more definitive conclusions. This article is protected by copyright. All rights reserved.An 8-year-old neutered Beagle dog was presented with polyuria and polydipsia. Routine clinicopathologic testing showed a significant lymphocytosis and proteinuria. Lymphocytes were of small to intermediate in size with a mature morphology. Infectious disease screening was negative. PCR for antigen receptor gene rearrangements showed a clonal T-cell receptor (TCR) rearrangement consistent with T-cell chronic lymphocytic leukemia (CLL). Bone marrow cytology showed less then 30% lymphocytes, while the proportion in splenic fine-needle aspirate cytology was considered increased. The dog was initially monitored but started on prednisolone and chlorambucil therapy 2 months later due to worsening clinical signs and progressive lymphocytosis. After an additional 2 weeks, the dog developed multifocal spinal pain and single-node lymphadenomegaly. Cytology of the lymph node showed a monomorphic population of large lymphoblasts consistent with lymphoma. Cytology of a cerebrospinal fluid sample also showed large lymphoblasts. PCR for antigen receptor gene rearrangement at both sites showed a clonal TCR rearrangement of the same molecular size as in the initial leukemic cells. The dog was diagnosed with a transformation of the CLL to Richter syndrome (RS) with involvement of the central nervous system (CNS). Therapy was started with L-asparaginase and an increased dose of prednisolone; however, the dog was euthanized due to progressive clinical signs. To our knowledge, this is the first report of canine RS with direct involvement of the CNS. © 2020 American Society for Veterinary Clinical Pathology.On 20th January 2020, the first COVID-19 case was reported in Shanghai, China. As of 12th March 2020, 344 cases with laboratory-confirmed COVID-19 infection have been detected in Shanghai, of which three died, 321 patients are discharged, 20 patients still receive ongoing treatments (Shanghai Municipal Health Commission, 2020). This article is protected by copyright. All rights reserved.PURPOSE The SRS MapCHECK® , a recently developed patient-specific quality assurance (PSQA) tool for end-to-end testing of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT), was evaluated in a multi-institution study and compared with radiochromic film. METHODS The SRS MapCHECK was used to collect data on 84 SBRT or SRS PSQA plans/fields at 9 institutions on treatment delivery devices (TDD) manufactured by Varian and Elekta. PSQA plans from 5 different treatment planning software (TPS) were selected and executed on TDDs operating at beam energies of 6 MV and 10 MV with and without a flattening filter. The patient plans were all VMAT except for ten conformal arc therapy fields. The plans were selected to encompass a range of size and tumor sites including brain, lung, spine, abdomen, ear, pancreas, and liver. Corresponding radiochromic film data was acquired in 50 plans/fields. Results were evaluated using Gamma analysis with absolute dose criterion of 3% global dose-difference (DD) and 1 mm distance-to-agreement (DTA). RESULTS The mean 3% DD / 1 mm DTA Gamma pass rate of SRS MapCHECK in comparison to film was 95.9%, whereas comparison of SRS MapCHECK to the treatment planning software was 94.7%. 80% of SRS MapCHECK comparisons against film exceed 95% pass rate, and about 30% of SRS MapCHECK comparisons against film exceed 99% pass rate. To maintain good agreement between SRS MapCHECK and film or TPS, authors recommend avoiding plans with a Modified Modulation Complexity Score (MMCS) 3 mu/cGy. CONCLUSIONS SRS MapCHECK has been validated for PSQA for a variety of clinical SRS/SBRT plans in a wide range of treatment delivery conditions. The SRS MapCHECK comparison with film demonstrates near-equivalence for analysis of patient-specific QA deliveries comprised of small field measurements. This article is protected by copyright. All rights reserved.The pathogenesis of inflammatory bowel disease (IBD) remains unclear, and it is currently believed that an imbalance in regulatory T (Treg) cells/T helper 17 cells (Th17 cells) is related to the occurrence and development of IBD. Recently, the JAK2 inhibitor AG490 has been used in animal models such as rheumatoid arthritis and bronchial asthma models and shown to exert immunoregulatory functions that improve disorder in the Treg/Th17 cell balance. This study aimed to evaluate the effect of AG490 on the intestinal inflammatory process in an IBD rat model. A dextran sulfate sodium (DSS)-induced IBD rat model was established, and disease activity index (DAI) scores were calculated. The histopathological damage score was determined by haematoxylin-eosin (H&E) staining. Treg/Th17 cells in the spleen were detected by flow cytometry. The levels of IL-10, IL-6 and IL-17A were detected by enzyme-linked immunosorbent assay (ELISA). AG490 attenuated DSS-induced IBD injury by regulating the Treg/Th17 balance and related cytokine secretion to reduce the DAI and colonic tissue damage. Thus, AG490 may be a new method for effective treatment of IBD. This article is protected by copyright. All rights reserved.The preferential blood supply from the hepatic artery to liver tumors allows for the regional delivery of chemotherapy, commonly referred to as hepatic artery infusion chemotherapy via a subcutaneous pump. Hepatic artery infusion chemotherapy has been demonstrated to improve overall survival in select patients with colorectal liver metastasis and is a promising treatment for unresectable intrahepatic cholangiocarcinoma. This review focuses on the technical aspects of hepatic artery infusion pump placement. © 2020 Wiley Periodicals, Inc.Training for minimally invasive pancreas surgery is critical as an evolving body of literature supports its use with acceptable outcomes during training and improved short term outcomes following completion. Although case volume needed to achieve mastery remains unclear, improved outcomes for both laparoscopic and robotic pancreatectomy are demonstrated following a learning curve and inflection point. Therefore, dedicated training curricula for both laparoscopic and robotic pancreatectomy have been developed to mitigate this learning curve and improve outcomes. © 2020 Wiley Periodicals, Inc.Intraoperative liver ultrasound (US) is an imperative adjunctive procedure during any liver surgical procedure. Intraoperative US can be used to confirm preoperative findings, to identify new findings, and to guide the conduct of the procedure. A major barrier to incorporation of US into the surgeon's toolbox is training and education. A standardized training program for surgical fellows has been developed based on the mastery learning framework. © 2020 Wiley Periodicals, Inc.
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