729 research outputs found

    A comparison of the different anisometropic testing procedures as done at Pacific University

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    A comparison of the different anisometropic testing procedures as done at Pacific Universit

    Case-Control study of Firefighters with documented positive tuberculin skin test results using Quantiferon-TB testing in comparison with Firefighters with negative tuberculin skin test results

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    BACKGROUND: Phoenix Firefighters have had abnormally high rates of tuberculin skin test (TBST) results on medical surveillance. The objectives of this study were to evaluate our firefighters using QuantiFERON-TB (QFT), comparing the results to their TBST results. METHODS: Using QFT results obtained during the study, we compared previously positive TBST responders (Cases) to negative responders (Controls). We also compared both groups for QFT results for Mycobacterium avium (MA) exposure. RESULTS: QFT effectively monitored our working population. 12.9% of the 148 cases, and 3.2% of the 220 controls had a positive QFT result. Another 14.8% of cases and 4.5% of controls had conditionally positive QFT results. There was an unusually high rate of MA response on QFT testing in both groups. CONCLUSION: Phoenix Firefighters have a higher than expected TBST and QFT results, which cannot be explained by the increased MA rate. The decreased level of QFT positivity in comparison to TBST results may indicate a considerable false positive TBST rate. The QFT offers many advantages as a surveillance method over TBST in exposed worker populations

    Kyphoplasty vs Vertebroplasty: A Systematic Review of Height Restoration in Osteoporotic Vertebral Compression Fractures

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    Background: Back pain is a leading cause of morbidity in older US adults, especially those with osteoporosis. Osteoporotic vertebral compression fractures (OVCF) commonly occur in people with osteoporosis. ~1/3 of OVCF are symptomatic with acute or chronic low back pain. Annual US cases of osteoporosis with OVCF are ~700,000/year. OVCF and osteoporosis cause high levels of morbidity, decreased functional independence, and chronic pain. Conservative treatment for OVCF is often insufficient for many patients. Insufficient vertebral height caused by OVCF can lead to spinal deformities, reduced pulmonary function, depression, reduced mobility, and lower quality of life. Surgical correction is a viable option for increasing vertebral height in patients with OVCF. Kyphoplasty and vertebroplasty are vertebral augmentation therapies that can restore bone height for the alleviation of OVCF. Both procedures involve injection of a polymer cement into sites of fracture. Only kyphoplasty involves using an inflatable balloon to first make space for polymer injection. These minimally invasive procedures are recommended for patients who have OVCF but are refractory to conventional therapies. Also, patients with benign bone tumors or traumatic acute vertebral compression fractures with a local kyphotic angle greater than 15 degrees can benefit from these procedures. The aim of our systematic review was to identify the overall effectiveness of kyphoplasty and vertebroplasty. Height restoration after treatment was used as the key indicator of therapeutic success. Restoration of function and pain relief were also assessed. Purpose: To critically investigate whether vertebral body height restoration correlates with pain relief after kyphoplasty and vertebroplasty. Primary Outcome: height restoration. Secondary Outcomes: pain relief, functionality, cement leakage, Cobb’s Angle, wedge angle restoration, kyphosis angle restoration, and Gardner’s angle. We assessed only randomized controlled trials (RCTs) to generate a more robust and clinically applicable. We also provide an update on the literature comparing kyphoplasty versus vertebroplasty for height restoration, pain relief, and function restoration. We searched 6 databases to ensure that the review was comprehensive. Methods: We performed a systematic review per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol. Level II randomized controlled trials assessing kyphoplasty and/or vertebroplasty were included. Study selection inclusion criteria: patients \u3e 18 years, in English, study of OVCF, active comparator vs placebo, outcome measure of height restoration, with pain relief and functionality as secondary outcomes. Of 4147 individual articles, 238 articles were screened, and 33 were analyzed. Of the 33 analyzed studies, 6 compared kyphoplasty to vertebroplasty. Results: Vertebral Height Restoration 7 studies of vertobroplasty 2 showed height loss 1 showed height restoration 2 showed absolute height gain 20 studies of kyphoplasty None showed height loss 8 showed height restoration 8 showed absolute height gain 6 head-to-head comparisons 3 showed correlation of cement injection volume with improved height 5 favored kyphoplasty for height restoration Alleviation of Pain: Assessed by visual analogue scale (VAS)score 6 of 6 vertebroplasty studies showed reduced postop pain 6 of 18 kyphoplasty studies showed sustained reduced pain at 12 months 6 studies compared kyphoplasty & vertebroplasty and none saw a difference between the 2 for reducing postop pain Restoration of Function Assessed by Oswestry disability index (ODI) 3 studies showed improved ODI after vertebroplasty at 18 to 36 months postop 4 studies showed improved ODI at 12 months after kyphoplasty 3 studies compared kyphoplasty & vertebroplasty and all showed lower postop ODI Conclusions: Both kyphoplasty and vertebroplasty are effective treatments for OVCF and are viable options for OVCF patients. Both treatments restored some vertebral body height, reduced kyphosis angle, improved Cobbs angle, and improved wedge angle. Both treatments showed similar benefits of pain reduction and improved functionality. It was unclear whether fracture type or age of fracture influence procedure outcomes. Kyphoplasty has the possibility of cement leakage, which can lead to negative outcomes. It was not possible to conclude whether one approach was superior.https://scholarlycommons.henryford.com/sarcd2021/1006/thumbnail.jp

    Clinical Research on Transcatheter Aortic Valve Replacement for Bicuspid Aortic Valve Disease: Principles, Challenges, and an Agenda for the Future

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    Bicuspid aortic valve disease (BAVD) is present in up to half of all patients referred for surgical aortic valve replacement (SAVR) yet was an exclusion criterion for all randomized controlled trials (RCTs) comparing transcatheter aortic valve replacement (TAVR) to SAVR. Nonetheless, approximately 10% of patients currently treated with TAVR have BAVD and available observational data for performing TAVR in these patients are limited by selection bias. Many in the cardiovascular community have advocated for RCTs in this population, but none have been performed. The Heart Valve Collaboratory (HVC) is a multidisciplinary community of stakeholders with the aim of creating significant advances in valvular heart disease by stimulating clinical research, engaging in educational activities, and advancing regulatory science. In December 2020, the HVC hosted a Global Multidisciplinary workshop involving over 100 international experts in the field. Following this 2-day symposium, working groups with varied expertise were convened to discuss BAVD, including the need for and design of RCTs. This review, conducted under the auspices of the HVC, summarizes available data and knowledge gaps regarding procedural therapy for BAVD, outlining specific challenges for trials in this population. We also propose several potential studies that could be performed and discuss respective strengths and weaknesses of each approach. Finally, we present a roadmap for future directions in clinical research in TAVR for BAVD with an emphasis both on RCTs and also prospective registries focused on disease phenotyping to develop parameters and risk scores that could ultimately be applied to patients to inform clinical decision-making

    Wildfire Risk as a Socioecological Pathology

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    Wildfire risk in temperate forests has become a nearly intractable problem that can be characterized as a socioecological “pathology”: that is, a set of complex and problematic interactions among social and ecological systems across multiple spatial and temporal scales. Assessments of wildfire risk could benefit from recognizing and accounting for these interactions in terms of socioecological systems, also known as coupled natural and human systems (CNHS). We characterize the primary social and ecological dimensions of the wildfire risk pathology, paying particular attention to the governance system around wildfire risk, and suggest strategies to mitigate the pathology through innovative planning approaches, analytical tools, and policies. We caution that even with a clear understanding of the problem and possible solutions, the system by which human actors govern fire-prone forests may evolve incrementally in imperfect ways and can be expected to resist change even as we learn better ways to manage CNHS

    Prodrug Strategy for PSMA-targeted Delivery of TGX-221 to Prostate Cancer Cells

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    TGX-221 is a potent, selective, and cell membrane permeable inhibitor of the PI3K p110β catalytic subunit. Recent studies showed that TGX-221 has anti-proliferative activity against PTEN-deficient tumor cell lines including prostate cancers. The objective of this study was to develop an encapsulation system for parenterally delivering TGX-221 to the target tissue through a prostate-specific membrane aptamer (PSMAa10) with little or no side effects. In this study, PEG-PCL micelles were formulated to encapsulate the drug, and a prodrug strategy was pursued to improve the stability of the carrier system. Fluorescence imaging studies demonstrated that the cellular uptake of both drug and nanoparticles were significantly improved by targeted micelles in a PSMA positive cell line. The area under the plasma concentration time curve of the micelle formulation in nude mice was 2.27-fold greater than the naked drug, and the drug clearance rate was 17.5-fold slower. These findings suggest a novel formulation approach for improving site-specific drug delivery of a molecular-targeted prostate cancer treatment

    Search for the Higgs boson in events with missing transverse energy and b quark jets produced in proton-antiproton collisions at s**(1/2)=1.96 TeV

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    We search for the standard model Higgs boson produced in association with an electroweak vector boson in events with no identified charged leptons, large imbalance in transverse momentum, and two jets where at least one contains a secondary vertex consistent with the decay of b hadrons. We use ~1 fb-1 integrated luminosity of proton-antiproton collisions at s**(1/2)=1.96 TeV recorded by the CDF II experiment at the Tevatron. We find 268 (16) single (double) b-tagged candidate events, where 248 +/- 43 (14.4 +/- 2.7) are expected from standard model background processes. We place 95% confidence level upper limits on the Higgs boson production cross section for several Higgs boson masses ranging from 110 GeV/c2 to 140 GeV/c2. For a mass of 115 GeV/c2 the observed (expected) limit is 20.4 (14.2) times the standard model prediction.Comment: 8 pages, 2 figures, submitted to Phys. Rev. Let

    A search for resonant production of ttˉt\bar{t} pairs in $4.8\ \rm{fb}^{-1}ofintegratedluminosityof of integrated luminosity of p\bar{p}collisionsat collisions at \sqrt{s}=1.96\ \rm{TeV}$

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    We search for resonant production of tt pairs in 4.8 fb^{-1} integrated luminosity of ppbar collision data at sqrt{s}=1.96 TeV in the lepton+jets decay channel, where one top quark decays leptonically and the other hadronically. A matrix element reconstruction technique is used; for each event a probability density function (pdf) of the ttbar candidate invariant mass is sampled. These pdfs are used to construct a likelihood function, whereby the cross section for resonant ttbar production is estimated, given a hypothetical resonance mass and width. The data indicate no evidence of resonant production of ttbar pairs. A benchmark model of leptophobic Z \rightarrow ttbar is excluded with m_{Z'} < 900 GeV at 95% confidence level.Comment: accepted for publication in Physical Review D Sep 21, 201

    Observation and Mass Measurement of the Baryon Ξb\Xi^-_b

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    We report the observation and measurement of the mass of the bottom, strange baryon Ξb\Xi^-_b through the decay chain ΞbJ/ψΞ\Xi^-_b \to J/\psi \Xi^-, where J/ψμ+μJ/\psi \to \mu^+ \mu^-, ΞΛπ\Xi^- \to \Lambda \pi^-, and Λpπ\Lambda \to p \pi^-. Evidence for observation is based on a signal whose probability of arising from the estimated background is 6.6 x 10^{-15}, or 7.7 Gaussian standard deviations. The Ξb\Xi^-_b mass is measured to be 5792.9±2.55792.9\pm 2.5 (stat.) ±1.7\pm 1.7 (syst.) MeV/c2c^2.Comment: Minor text changes for the second version. Accepted by Phys. Rev. Let
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