Ultrasound-guided percutaneous laser ablation is safe and effective in the treatment of small renal tumors in patients at increased bleeding risk

Purpose: The aim of this retrospective study was to assess the safety and effectiveness of laser ablation (LA) in patients with small renal cell carcinomas (RCC) and increased risk of bleeding. Material and methods: From 2013 to 2017, nine patients (six males, three females, aged 68.5 \ub1 12.2 years) at high risk of bleeding underwent ultrasonography-guided LA for an RCC. Patients were considered at increased risk of bleeding because of impairment of coagulation parameters, concomitant antiplatelet therapy, or at-risk location of the tumor (one, five, and three patients, respectively). RCC diameter ranged from 11 to 23 mm. According to tumor size, two or three laser fibers were introduced through 21-gauge needles and 1800 J per fiber were delivered in 6 min with a fixed power of 5 W. Major and minor complications, technical success, and primary and secondary technical effectiveness and tumor recurrence were recorded. Results: Just one Grade 1 complication was observed: a small asymptomatic hematoma that spontaneously resolved. Technical success was 100%, 1 month technical efficacy was 88.9% (8/9 patients). One patient with residual tumor was successfully retreated 1 month later, and secondary efficacy rate was 100%. No local tumor recurrence occurred during a median follow-up of 26 months (range 11\u201349 months). Conclusions: LA is safe and effective in the treatment of small RCC and might represent a valid option in patients with increased risk of bleeding

Deep learning-based plane pose regression in obstetric ultrasound

PURPOSE: In obstetric ultrasound (US) scanning, the learner's ability to mentally build a three-dimensional (3D) map of the fetus from a two-dimensional (2D) US image represents a major challenge in skill acquisition. We aim to build a US plane localisation system for 3D visualisation, training, and guidance without integrating additional sensors. METHODS: We propose a regression convolutional neural network (CNN) using image features to estimate the six-dimensional pose of arbitrarily oriented US planes relative to the fetal brain centre. The network was trained on synthetic images acquired from phantom 3D US volumes and fine-tuned on real scans. Training data was generated by slicing US volumes into imaging planes in Unity at random coordinates and more densely around the standard transventricular (TV) plane. RESULTS: With phantom data, the median errors are 0.90 mm/1.17[Formula: see text] and 0.44 mm/1.21[Formula: see text] for random planes and planes close to the TV one, respectively. With real data, using a different fetus with the same gestational age (GA), these errors are 11.84 mm/25.17[Formula: see text]. The average inference time is 2.97 ms per plane. CONCLUSION: The proposed network reliably localises US planes within the fetal brain in phantom data and successfully generalises pose regression for an unseen fetal brain from a similar GA as in training. Future development will expand the prediction to volumes of the whole fetus and assess its potential for vision-based, freehand US-assisted navigation when acquiring standard fetal planes

Проблемы медицинского обслуживания моряков в Украине

Стаття присвячена деяким проблемам медичного обслуговування моряків в Україні, в тому числі питанням професійних оглядів, які визначають придатність моряка по стану здоров‘я до роботи на суднах. Розглядаються проекти пропозицій до наказу, який готується і який буде регламентувати медичні огляди моряків.The article is devoted some problems of medical service of seafarers in Ukraine, in particular to the questions of professional examinations, determining the fitness of seafarer to be fit for work on ships. The projects of appendixes are examined to the preparing order, to regulating physical examinations of seafarers

Драматичні елементи у фольклорі – традиція та актуальність

The researches of the folklore and ethnographic sources underscore, that the dramatic elements exist in the folk art (songs, fairy tales, small folklore genres, children folklore etc.), in customs and in the other forms of the life of the folk. But it's importaint what I mean by the notion "dramatic elements in the folklore". Namely, existence of the action, plot, culmination and denouement, then the place and time of the development of the action, monologue, dialogue in the action, characters, masks, dresses, text, scenography, scenario, director, audience, puppet-show, i. e. the presence of the performance. In this paper special attention is given to some dramatic acting with multitude of the dramatic elements, which are connected with large quantity of the Cristmas holidays. We also drew parallels between traditional forms and new elements of celebration and results of the actualization of some innovations in society. It is worth to refer the carnivals in Vechani and Strumitsa and also celebrations of the Eve in Skopje

Learning ultrasound plane pose regression: assessing generalized pose coordinates in the fetal brain

In obstetric ultrasound (US) scanning, the learner's ability to mentally build a three-dimensional (3D) map of the fetus from a two-dimensional (2D) US image represents a significant challenge in skill acquisition. We aim to build a US plane localization system for 3D visualization, training, and guidance without integrating additional sensors. This work builds on top of our previous work, which predicts the six-dimensional (6D) pose of arbitrarily-oriented US planes slicing the fetal brain with respect to a normalized reference frame using a convolutional neural network (CNN) regression network. Here, we analyze in detail the assumptions of the normalized fetal brain reference frame and quantify its accuracy with respect to the acquisition of transventricular (TV) standard plane (SP) for fetal biometry. We investigate the impact of registration quality in the training and testing data and its subsequent effect on trained models. Finally, we introduce data augmentations and larger training sets that improve the results of our previous work, achieving median errors of 3.53 mm and 6.42 degrees for translation and rotation, respectively.Comment: 12 pages, 9 figures, 2 tables. This work has been submitted to the IEEE for possible publication (IEEE TMRB). Copyright may be transferred without notice, after which this version may no longer be accessibl

A new generation of orthodontic retainer using 3D printing technology: report of two cases

Aim In this article the fabrication and use of new type 3D printed splint of retainer after orthodontic treatments is reported. Case report Two cases, one of an adoescent female patient and the other of an adult female, are presented, describing step-by-step the clinical and laboratory procedures. The controls after 6 months are also reported. Conclusion Further randomized clinical trials are required in order to evaluate durability and efficacy and periodontal parameters in patients treated with this new type of retainer

Understanding the thermal stability of silver nanoparticles embedded in a-Si

The inclusion of silver plasmonic nanoparticles in silicon is highly relevant for photovoltaics as it may enhance optical absorption. We report an investigation of the stability of such pristine silver nanoparticles embedded in a-Si upon heat treatment. We have investigated the morphological changes via in situ and ex situ high-resolution and high-angle annular dark-field scanning transmission electron microscopy (HRTEM and HAADF STEM). The melting of Ag particles and subsequent interdiffusion of Ag and Si atoms are strongly related to the size of the Ag nanoparticles, as well as the presence of surface imperfections. Partial voids in the amorphous-Si framework are formed where sections of the Ag nanoparticles are found preferentially to diffuse away due to geometric instability. Computational simulations using ensemble molecular dynamics confirm the experimental results: the structural properties of the amorphous-Si environment are important as well as incomplete packing of the Ag nanoparticle surfaces. These factors affect the melting temperature, causing some parts of the Ag nanoparticles to dissolve preferentially and other areas to remain stable at high temperatures

Twenty-five-year trends in incidence, angiographic appearance, and management of spontaneous coronary artery dissection

BACKGROUND Spontaneous coronary artery dissection (SCAD) has been described as an infrequent cause of acute coronary syndrome (ACS). Knowledge about the disease is still limited and SCAD might still be underdiagnosed. OBJECTIVES Trends in incidence, presentation, angiographic appearance, management, and outcomes of SCAD over 25 years were analyzed. METHODS Patients with SCAD between 1997 and 2021 at the University Hospital Zurich, Switzerland, were included. Incidences were assessed as total numbers and proportions of ACS cases. Clinical data were collected from medical records and angiographic findings were reviewed. Major adverse cardiac events (MACE) were defined as the composite of all-cause death, cardiac arrest, SCAD recurrence or progression, other myocardial infarction, and stroke. RESULTS One hundred fifty-six SCAD cases were included in this study. The incidence increased significantly in total (p < 0.001) and relative to ACS cases (p < 0.001). This was based on an increase of shorter lesions (p = 0.004), SCAD type 2 (p < 0.001), and lesions in side branches (p = 0.014), whereas lesions in the left main coronary artery and proximal segments were decreasing (p-values 0.029 and < 0.001, respectively). There was an increase in conservative therapy (p < 0.001). The rate of MACE (24%) was stable, however, there was a reduced proportion of patients with a need for intensive care treatment (p = 0.017). CONCLUSIONS SCAD represents an important entity of ACS that still might be underappreciated. The increasing incidence of SCAD is likely based on better awareness and familiarity with the disease. A lower need for intensive care treatment suggests positive effects of the increasing implementation of conservative management

Long-Term Prognosis of Patients With Takotsubo Syndrome

BACKGROUND Prognosis of Takotsubo syndrome (TTS) remains controversial due to scarcity of available data. Additionally, the effect of the triggering factors remains elusive. OBJECTIVES This study compared prognosis between TTS and acute coronary syndrome (ACS) patients and investigated short- and long-term outcomes in TTS based on different triggers. METHODS Patients with TTS were enrolled from the International Takotsubo Registry. Long-term mortality of patients with TTS was compared to an age- and sex-matched cohort of patients with ACS. In addition, short- and long-term outcomes were compared between different groups according to triggering conditions. RESULTS Overall, TTS patients had a comparable long-term mortality risk with ACS patients. Of 1,613 TTS patients, an emotional trigger was detected in 485 patients (30%). Of 630 patients (39%) related to physical triggers, 98 patients (6%) had acute neurologic disorders, while in the other 532 patients (33%), physical activities, medical conditions, or procedures were the triggering conditions. The remaining 498 patients (31%) had no identifiable trigger. TTS patients related to physical stress showed higher mortality rates than ACS patients during long-term follow-up, whereas patients related to emotional stress had better outcomes compared with ACS patients. CONCLUSIONS Overall, TTS patients had long-term outcomes comparable to age- and sex-matched ACS patients. Also, we demonstrated that TTS can either be benign or a life-threating condition depending on the inciting stress factor. We propose a new classification based on triggers, which can serve as a clinical tool to predict short- and long-term outcomes of TTS. (International Takotsubo Registry [InterTAK Registry]; NCT01947621)

Optical properties of MgH2 measured in situ in a novel gas cell for ellipsometry/spectrophotometry

The dielectric properties of alpha-MgH2 are investigated in the photon energy range between 1 and 6.5 eV. For this purpose, a novel sample configuration and experimental setup are developed that allow both optical transmission and ellipsometric measurements of a transparent thin film in equilibrium with hydrogen. We show that alpha-MgH2 is a transparent, colour neutral insulator with a band gap of 5.6 +/- 0.1 eV. It has an intrinsic transparency of about 80% over the whole visible spectrum. The dielectric function found in this work confirms very recent band structure calculations using the GW approximation by Alford and Chou [J.A. Alford and M.Y. Chou (unpublished)]. As Pd is used as a cap layer we report also the optical properties of PdHx thin films.Comment: REVTeX4, 15 pages, 12 figures, 5 table