The equivocal appendix at CT: prevalence in a control population

The purpose of the study was to determine the prevalence of appendices with an equivocal appearance at computed tomography (CT) in a control population. We retrospectively identified a control population of 150 patients who underwent CT of the abdomen and pelvis for evaluation of hematuria (without abdominal pain, fever, or colonic disease). One reader measured the diameter of the appendix and noted if the appendix was either isodense in appearance or airless and fluid filled. Sixty-seven of 150 cases (44.6%) demonstrated appendiceal diameter greater than 6 mm. The appendix was collapsed or isodense in 34/150 cases (22.7%). Only ten of 150 or 6.6% of cases were isodense in combination with diameter greater than 6 mm, and none had diameter greater than 10 mm. Only one of 150 cases (0.67%) demonstrated airless fluid within the lumen, and the appendix measured less than 6 mm. While the diameter of the normal appendix is frequently greater than 6 mm, none measured greater than 10 mm in combination with ambiguous morphology. Furthermore, in the normal appendix, airless fluid filling the lumen is a rare appearance with a prevalence of less than 1%. While appendicitis could undoubtedly occur in an isodense appendix between 6 and 10 mm in diameter, such an appearance can occur in up to 6.6% of the normal populatio

Group-based pelvic floor muscle training is a more cost-effective approach to treat urinary incontinence in older women: economic analysis of a randomised trial

Question(s): How cost-effective is group-based pelvic floor muscle training (PFMT) for treating urinary incontinence in older women? Design: Economic evaluation conducted alongside an assessor-blinded, multicentre randomised non-inferiority trial with 1-year follow-up. Participants: A total of 362 women aged 60 years with stress or mixed urinary incontinence. Intervention: Twelve weekly 1-hour PFMT sessions delivered individually (one physiotherapist per woman) or in groups (one physiotherapist per eight women). Outcome measures: Urinary incontinence-related costs per woman were estimated from a participant and provider perspective over 1 year in Canadian dollars, 2019. Effectiveness was based on reduction in leakage episodes and quality-adjusted life years. Incremental cost-effectiveness ratios and net monetary benefit were calculated for each of the effectiveness outcomes and perspectives. Results: Both group-based and individual PFMT were effective in reducing leakage and promoting gains in quality-adjusted life years. Furthermore, group-based PFMT was 60% less costly than individual treatment, regardless of the perspective studied: –$914 (95$509 (95% CI –523 to –496) from the provider’s perspective. Differences in effects between study arms were minor and negligible. Adherence to treatment was high, with low loss to follow-up and no between-group differences. Conclusion: Compared with standard individual PFMT, group-based PFMT was less costly and as clinically effective and widely accepted. These results indicate that patients and healthcare decisionmakers should consider group-based PFMT to be a cost-effective first-line treatment option for urinary incontinence. Trial registration: ClinicalTrials.gov NCT0203983

Direct observation of the injection dynamics of a laser wakefield accelerator using few-femtosecond shadowgraphy

International audienceWe present few-femtosecond shadowgraphic snapshots taken during the non-linear evolution of the plasma wave in a laser wakefield accelerator with transverse synchronized few-cycle probe pulses. These snapshots can be directly associated with the electron density distribution within the plasma wave and give quantitative information about its size and shape. Our results show that self-injection of electrons into the first plasma wave period is induced by a lengthening of the first plasma period. Three dimensional particle in cell simulations support our observations

High-resolution μCT of a mouse embryo using a compact laser-driven X-ray betatron source

High-resolution microcomputed tomography with benchtop X-ray sources requires long scan times because of the heat load limitation on the anode. We present an alternative, high-brightness plasma-based X-ray source that does not suffer from this restriction. A demonstration of tomography of a centimeter-scale complex organism achieves equivalent quality to a commercial scanner. We will soon be able to record such scans in minutes, rather than the hours required by conventional X-ray tubes

Recruitment, use, and satisfaction with a web platform supporting families of children with suspected or diagnosed developmental coordination disorder: A randomized feasibility trial

Objectives. To determine the feasibility of recruiting families of children with suspected or diagnosed developmental coordination disorder (sdDCD) and explore their satisfaction with a web-based intervention Design. A feasibility randomized trial was conducted. Participants were the parents of 5-12-year-old children with sdDCD. The intervention group had access to online resources, group and private forums, and videoconferencing with a therapist. Main outcomes were recruitement and retention rates. Satisfaction was documented through a post-intervention survey and interview. Results. The recruitment rate was seven participants per month (n = 28 participants) and retention rate was 68%. Satisfaction was moderate. No differences in use and satisfaction were observed between groups. Participants formulated recommendations for improving the intervention, including targeting families earlier in the diagnosis process, and pre-scheduling meetings with therapists. Conclusions. This study demonstrated the feasibility of future trials, and highlighted avenues for improvement. Parent involvement during the development of the intervention is discussed at length. Abbreviations: DCD: Developmental Coordination Disorder; sdDCD: suspected or diagnosed Developmental Coordination Disorder; RCT: randomized-controled trial

Angularly resolved characterization of ion beams from laser-ultrathin foil interactions

Methods and techniques used to capture and analyze beam profiles produced from the interaction of intense, ultrashort laser pulses and ultrathin foil targets using stacks of Radiochromic Film (RCF) and Columbia Resin #39 (CR-39) are presented. The identification of structure in the beam is particularly important in this regime, as it may be indicative of the dominance of specific acceleration mechanisms. Additionally, RCF can be used to deconvolve proton spectra with coarse energy resolution while mantaining angular information across the whole beam