The effects of a common stainless steel orthodontic bracket on the diagnostic quality of cranial and cervical 3T-MR images: a prospective, case-control study

Abstract OBJECTIVES: To evaluate the effect of orthodontic stainless steel brackets and two different types of archwires (stainless steel and nickel-titanium) on the diagnostic quality of 3T-MR images. METHODS: This prospective, case-control study was conducted following STROBE guidelines. The imaging protocol consisted of the axial Fluid Attenuated Inversion Recovery (FLAIR) and axial oblique double echo proton density (PD) and weighted/turbo spin echo (TSE) T2-weighted sequences for brain, paranasal sinuses and cervical region evaluation; sagittal TSE T2w, sagittal TSE T1w and axial T2* Gradient echo sequences (GRE) sequences for the cervical vertebrae; axial and coronal TSE T2w images for the head and neck structures; and sagittal, axial and coronal PD and TSE T2-weighted sequences for the temporo-mandibular joint. Two experts in neuroradiology evaluated the images. The statistical analysis was performed at the level of anatomical districts. The following statistical methods were used: descriptive statistics, Cohen's kappa coefficient (k), Kruskal-Wallis test, pairwise comparisons using the Dunn-Bonferroni approach. Significance was set at p≤0.05. RESULTS: 80 patients were included, providing 80 MRI. The presence of stainless steel brackets with or without archwires negatively influenced the MR images of the cervical region, paranasal sinuses, head and neck region and cervical vertebrae but did not influence the MR images of brain and temporomandibular joint regions. CONCLUSIONS: Patients with a stainless steel multi-bracket orthodontic appliance should remove it before cervical vertebrae, cervical region, paranasal sinuses and head and neck MRI scans. The brain and temporomandibular joint regions MRI should not require the removal of such appliances

Značajke liječenja i ishoda u starijih bolesnika s glioblastomom mozga: retrospektivna analiza niza slučajeva

Treatment modalities affecting quality of life and survival in elderly brain glioblastoma patients are not well defined. A single-institution data were analyzed during a 3-year period to disclose prognostic difference in management related to age. Karnofsky Performance Scale (KPS), overall survival (OS), and adjuvant therapy were evaluated. The case group comprised of elderly patients (>75 years), while the control group included those of younger age (<65 years). The investigated variables were correlated between the groups. Twenty elderly patients and a corresponding number of younger ones were analyzed. Preoperative KPS >70 indicated longer overall survival. Statistically significant correlation was recorded in both the control (p=0.036) and case (p=0.0053) groups. Lower postoperative KPS was significantly correlated with shorter OS in elderly patients (p=0.023). The correlation between the extent of tumor resection and OS was statistically significant in younger patients only (p=0.04). Overall survival was significantly shorter in elderly patients regardless of the extent of tumor resection (p=0.0057). Adjuvant therapy was significantly associated with longer OS in both the case (p=0.032) and control (p=0.013) groups. Elderly population is a more endangered group of surgical brain glioblastoma patients having lower quality of life and shorter overall survival. The management protocol should be personalized for each individual case in this age group of patients to reduce postoperative complications and grant a satisfactory quality of life.Modaliteti liječenja od utjecaja na kvalitetu života i preživljavanje starijih bolesnika s glioblastomom još nisu jasno određeni. Kako bi se utvrdila prognostička razlika u primijenjenim oblicima liječenja u odnosu na dob bolesnika analizirani su podaci dobiveni trogodišnjim istraživanjem uzorka. Istraživani su sljedeći pokazatelji: Karnofskyjeva ljestvica (KPS), vrijeme ukupnog preživljavanja i primjena pomoćnog liječenja. Oglednu skupinu činili su stariji bolesnici (≥75 godina), a kontrolnu skupinu oni mlađe dobi (≤65 godina). Međusobno su uspoređivani istraživani parametri iz obje skupine bolesnika. Promatrano je 20 starijih i odgovarajući broj mlađih bolesnika. Prijeoperacijski KPS >70 upućivao je na dulje sveukupno preživljavanje. Statistički značajna korelacija zabilježena je u bolesnika kontrolne (p=0,036) i ogledne (p=0,0053) skupine. Niže poslijeoperacijske vrijednosti KPS bile su značajno povezane s kraćim vremenom preživljavanja u starijih bolesnika (p=0,023). Korelacija između opsežnosti tumorske resekcije i sveukupnog preživljavanja bila je statistički značajna samo u mlađoj dobnoj skupini (p=0,04). Vrijeme sveukupnog preživljavanja bilo je značajno kraće u starijih bolesnika neovisno o stupnju kirurške resekcije (p=0,0057). Primjena pomoćne terapije bila je značajno povezana s duljim sveukupnim preživljavanjem u oglednoj (p=0,032) i kontrolnoj (p=0,013) skupini. U zaključku, starija je populacija ugroženija skupina kirurških bolesnika s glioblastomom u kojih je smanjena kvaliteta života i skraćeno vrijeme sveukupnog preživljavanja. Stoga je potrebno protokol liječenja prilagoditi svakom pojedinom bolesniku iz ove dobne skupine kako bi se smanjio udio poslijeoperacijskih komplikacija i poboljšala kvaliteta života

clinical outcome of patients over 90 years of age treated for chronic subdural hematoma

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Raman shifts in MBE‐grown SixGe1 − x − ySny alloys with large Si content

We examine the Raman shift in silicon–germanium–tin alloys with high silicon content grown on a germanium virtual substrate by molecular beam epitaxy. The Raman shifts of the three most prominent modes, Si–Si, Si–Ge, and Ge–Ge, are measured and compared with results in previous literature. We analyze and fit the dependence of the three modes on the composition and strain of the semiconductor alloys. We also demonstrate the calculation of the composition and strain of SixGe1 − x − ySny from the Raman shifts alone, based on the fitted relationships. Our analysis extends previous results to samples lattice matched on Ge and with higher Si content than in prior comprehensive Raman analyses, thus making Raman measurements as a local, fast, and nondestructive characterization technique accessible for a wider compositional range of these ternary alloys for silicon-based photonic and microelectronic devices.Deutsche Forschungsgemeinschaft http://dx.doi.org/10.13039/501100001659Peer Reviewe

The challenge of sustainability in healthcare systems: Frequency and cost of inappropriate patterns of breast cancer care (the E.Pic.A study).

Abstract Objectives In a context of decreasing economic health resources and a rise in health needs, it is urgent to face this sustainability crisis through the analysis of healthcare expenditures. Wastages, deriving from inappropriate interventions, erode resources which could be reallocated to high-value activities. To identify these areas of wastages, we developed a method for combining and analyzing data from multiple sources. Here we report the preliminary results of a retrospective cohort study evaluating the performance of breast cancer (BC) care at IRST, an Italian cancer institute. Materials and methods Four data sources gathered in a real-world setting (a clinical database, two administrative databases and a cancer registry) were linked. Essential Key Performance Indexes (KPIs) in the pattern of BC diagnosis (KPI 1 and 2) and treatment (KPI 3 and 4) based on current guidelines were developed by a board of professionals. The costs of inappropriate examinations were associated with the diagnostic KPIs. Results We found that 2798 patients treated at IRST from January 2010 to June 2016 received a total of 2516 inappropriate examinations accounting for € 573,510.80. Linkage from multiple routine healthcare data sources is feasible: it allows the measurement of important KPIs specifically designed for BC care, and the identification of areas of low-value use of the resources. Conclusion If systematically applied, this method could help provide a complete picture of inappropriateness and waste, redirect these resources to higher-value interventions for patients, and fill the gap between proper use of the resources and the best clinical results

Valorization of MSWI Bottom Ash as a Function of Particle Size Distribution, Using Steam Washing

International audienceTreatments to reduce the leaching of contaminants (chloride, sulfate, heavy metals) into the environment from bottom ash (BA) are investigated, as a function of the ash’s particle size (s). The aim is to make BA suitable for reuse as secondary raw material, in accordance with the legal requirements. Such treatments must be economically feasible and, possibly, have to use by-products of the plant (in this case, steam in excess from the turbine). For the sake of completeness and comparison, carbonation is performed on those BA particle size classes that are not positively responsive to steam washing. BA is partitioned into four different particle size classes (s ≥ 4.75, 4.75 > s ≥ 2, 2 > s ≥ 1 and s s ≥ 1 (~13 wt% of total BA) requires a combination of steam washing and carbonation to achieve a leaching below the legal limits. The finest BA fraction, s < 1 mm (~27 wt% of total BA), is treated by carbonation, which reduces heavy metals leaching by 85%, but it fails to sufficiently curb chlorides and sulfates

Seroprevalence of infection-induced SARS-CoV-2 antibodies among health care users of Northern Italy: results from two serosurveys (October-November 2019 and September-October 2021)

OBJECTIVES: The objective was to estimate the seroprevalence of SARS-CoV-2 in autumn 2019 (before case zero was identified in Italy) and 2021 among residual sera samples from health care users in the Piedmont region of northwestern Italy. METHODS: Two serosurveys were conducted. Using a semiquantitative method, samples were tested for the presence of immunoglobulin G (IgG) antibodies against the S1 domain of the spike protein. Samples with positive test results from the 2019 survey were independently retested using a multiplex panel to detect IgG antibodies against the receptor binding domain, S1 and S2 domains, and nucleocapsid. Samples with positive test results from the 2021 survey underwent repeat testing with enzyme-linked immunosorbent assay to detect anti-nucleocapsid IgG antibodies. Prevalence rates according to gender and age groups, together with their respective 95% confidence intervals (CIs), were calculated. RESULTS: Overall, the proportion of samples with positive test results was 2/353 in 2019 and 22/363 in 2021, with an estimated seroprevalence of 0.27% (95% CI 0-1.86) and 6.21% (95% CI 3.9-9.31) in 2019 and 2021 respectively. CONCLUSION: Results of this study support the hypothesis that the virus was circulating in Italy as early as autumn 2019. The role of these early cases in broader transmission dynamics remains to be determined