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Conclusion It is concluded that assessment of stress overload may help to explain the observed coronavirus disparities, and to identify populations at risk for imminent infection. The 10-item Stress Overload Scale-Short is offered as a potentially useful tool for researchers and clinicians working to map, and stem, the proliferation of coronavirus.Renal cryoablation is a treatment option for early stage renal cell carcinomas with excellent oncological outcomes and low morbidity. This review outlines the technique of renal cryoablation and provides a guide for interventional radiologists on setting up an integrated service within a renal cancer network multidisciplinary setting. Patient selection and preparation, together with the technical aspects which ensure optimal oncological outcomes and avoid collateral damage to adjacent organs are highlighted.
To develop and validate a radiomics model for preoperative identification of lymph node metastasis (LNM) in patients with early-stage cervical squamous cell carcinoma (CSCC).

Total of 190 eligible patients were randomly divided into training (
= 100) and validation (
= 90) cohorts. Handcrafted features and deep-learning features were extracted from T2W fat suppression images. The minimum redundancy maximum relevance algorithm and LASSO regression with 10-fold cross-validation were used for key features selection. A radiomics model that incorporated the handcrafted-signature, deep-signature, and squamous cell carcinoma antigen (SCC-Ag) levels was developed by logistic regression. The model performance was assessed and validated with respect to its calibration, discrimination, and clinical usefulness.

Three handcrafted features and three deep-learning features were selected and used to build handcrafted- and deep-signature. The model, which incorporated the handcrafted-signature, deep-signature, and SCC-Ag, showed satisfactory calibration and discrimination in the training cohort (AUC 0.852, 95% CI 0.761-0.943) and the validation cohort (AUC 0.815, 95% CI 0.711-0.919). Decision curve analysis indicated the clinical usefulness of the radiomics model. The radiomics model yielded greater AUCs than either the radiomics signature (AUC = 0.806 and 0.779, respectively) or the SCC-Ag (AUC = 0.735 and 0.688, respectively) alone in both the training and validation cohorts.

The presented radiomics model can be used for preoperative identification of LNM in patients with early-stage CSCC. Its performance outperforms that of SCC-Ag level analysis alone.

A radiomics model incorporated radiomics signature and SCC-Ag levels demonstrated good performance in identifying LNM in patients with early-stage CSCC.
A radiomics model incorporated radiomics signature and SCC-Ag levels demonstrated good performance in identifying LNM in patients with early-stage CSCC.
A thorough understanding of the epidemiology, patient characteristics, trauma mechanisms, and current outcomes among patients with severe traumatic brain injury (TBI) is important as it may inform potential strategies to improve prehospital emergency care. The aim of this study is to describe the prehospital epidemiology, characteristics and outcome of (suspected) severe TBI in the Netherlands.

The BRAIN-PROTECT study is a prospective observational study on prehospital management of patients with severe TBI in the Netherlands. The study population comprised all consecutive patients with clinical suspicion of TBI and a prehospital GCS score ≤ 8, who were managed by one of the 4 Helicopter Emergency Medical Services (HEMS). Patients were followed-up in 9 trauma centers until 1 year after injury. Planned sub-analyses were performed for patients with "confirmed" and "isolated" TBI.

Data from 2,589 patients, of whom 2,117 (81.8%) were transferred to a participating trauma center, were analyzed. The incidence rate of prehospitally suspected and confirmed severe TBI were 3.2 (95% CI 3.1;3.4) and 2.7 (95% CI 2.5;2.8) per 100,000 inhabitants per year, respectively. Median patient age was 46 years, 58.4% were involved in traffic crashes, of which 37.4% were bicycle related. 47.6% presented with an initial GCS of 3. The median time from HEMS dispatch to hospital arrival was 54 minutes. The overall 30-day mortality was 39.0% (95% CI 36.8;41.2).

This article summarizes the prehospital epidemiology, characteristics and outcome of severe TBI in the Netherlands, and highlights areas in which primary prevention and prehospital care can be improved.
This article summarizes the prehospital epidemiology, characteristics and outcome of severe TBI in the Netherlands, and highlights areas in which primary prevention and prehospital care can be improved.OBJECTIVE. The purpose of this study was to determine the optimal ultrasound (US) measurement technique and cutoff value for the diagnosis of ulnar neuropathy at the elbow. MATERIALS AND METHODS. A systematic literature search was conducted of the PubMed, Embase, Scopus, and Web of Science databases for studies evaluating the diagnostic accuracy of US of patients with ulnar neuropathy at the elbow before April 2019. Random-effects modeling was performed to compare the sensitivity, specificity, and diagnostic odds ratio (DOR) of different US measurements, including diameter and cross-sectional area (CSA) of the nerve at the medial epicondyle or proximal and distal levels, maximal diameter, maximal CSA, and nerve ratios. Sensitivity and metaregression analyses were performed to assess the impact of clinical and imaging-based variables on the DOR of US. RESULTS. Among 820 retrieved studies, 19 studies (1961 examinations) were included. Measuring the CSA of the ulnar nerve at the medial epicondyle with a cutoff value greater than 10-10.5 mm2 had higher sensitivity (80.4%, 95% CI, 75.4-84.7%) than other techniques. Nerve ratios had higher specificity (89.1%, 95% CI, 85.8-91.8%) than other measurements; however, the definition of ratios and cutoff values varied across studies. ROC analysis showed higher diagnostic performance for measuring CSA at the medial epicondyle (AUC, 0.931). The mean CSA value was a significant predictor of the DOR of US (β coefficient, 0.307 ± 0.074; p less then 0.001). Every 1-mm2 larger CSA was associated with a 36% increase in DOR. HIF inhibitor The diagnostic performance of US was the same in any degree of elbow flexion. CONCLUSION. Measuring CSA of the ulnar nerve at the medial epicondyle has sensitivity and diagnostic performance superior to those of other techniques for the diagnosis of ulnar neuropathy at the elbow.
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