87 research outputs found

    The Value of PIC Cystography in Detecting De Novo and Residual Vesicoureteral Reflux after Dextranomer/Hyaluronic Acid Copolymer Injection

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    The endoscopic injection of Dx/HA in the management of vesicoureteral reflux (VUR) has become an accepted alternative to open surgery. In the current study we evaluated the value of cystography to detect de novo contralateral VUR in unilateral cases of VUR at the time of Dx/HA injection and correlated the findings of immediate post-Dx/HA injection cystography during the same anesthesia to 2-month postoperative VCUG to evaluate its ability to predict successful surgical outcomes. The current study aimed to evaluate whether an intraoperatively performed cystogram could replace postoperative studies. But a negative intraoperative cystogram correlates with the postoperative study in only 80%. Considering the 75–80% success rate of Dx/HA implantation, the addition of intraoperative cystograms cannot replace postoperative studies. In patients treated with unilateral VUR, PIC cystography can detect occult VUR and prevent postoperative contralateral new onset of VUR

    Voice, autonomy and utopian desire in participatory film-making with young refugees

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    This article is a reflection on what reflexive documentary scholars call the ‘moral dimension’ (Nash 2012: 318) of a participatory filmmaking project with refugee young people, who wanted to make a film to support other new young arrivals in the process of making home in Scotland. In the first part, we highlight some of the challenges of collaborating with refugee young people, in light of the often de-humanising representations of refugees in mainstream media and the danger of the triple conflation of authenticity-voice-pain in academic narratives about refugees. In the second part, we show how honouring young people’s desire to convey the hopeful aspects of making home, emerged as a key pedagogical strategy to affirm their expert position and encourage their participation in the project. Revisiting key moments of learning and interaction, we demonstrate how young people’s process of ‘finding a voice’ in moment-by-moment filmmaking practice was not a linear, developmental process towards ‘pure’ individual empowerment and singular artistic expression. Their participation in shaping their visual (self-)representation in the final film, was embedded in the dialogical process and pragmatic requirements of a collaborative film production, in which voice, autonomy and teacher authority were negotiated on a moment-by-moment basis. We conclude that it is vital for a reflexive practice and research to not gloss over the moral dilemmas in the name of progressive ideals, for example, when representations are co-created by project filmmakers/educators, but embrace these deliberations as part of the ‘fascinating collaborative matrix’ (Chambers 2019: 29) of participatory filmmaking

    Online teacher training in a context for forced immobility: the Case of Gaza, Palestine

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    This article discusses an action research study that involved the design and delivery of an online training course for teachers of Arabic to speakers of other languages in the Gaza Strip (Palestine). Grounded in Freirean pedagogy, the course aimed to respond to the employment needs of university graduates by creating opportunities for online language teaching. The action research study explored the dynamics at play within the online educational environment, to evidence elements that challenged and/or facilitated effective collaboration between trainers and trainees. This article retraces and discusses the processes through which the course moved from didacticism to engaged critical pedagogy

    Killing Hypoxic Cell Populations in a 3D Tumor Model with EtNBS-PDT

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    An outstanding problem in cancer therapy is the battle against treatment-resistant disease. This is especially true for ovarian cancer, where the majority of patients eventually succumb to treatment-resistant metastatic carcinomatosis. Limited perfusion and diffusion, acidosis, and hypoxia play major roles in the development of resistance to the majority of front-line therapeutic regimens. To overcome these limitations and eliminate otherwise spared cancer cells, we utilized the cationic photosensitizer EtNBS to treat hypoxic regions deep inside in vitro 3D models of metastatic ovarian cancer. Unlike standard regimens that fail to penetrate beyond ∼150 µm, EtNBS was found to not only penetrate throughout the entirety of large (>200 µm) avascular nodules, but also concentrate into the nodules' acidic and hypoxic cores. Photodynamic therapy with EtNBS was observed to be highly effective against these hypoxic regions even at low therapeutic doses, and was capable of destroying both normoxic and hypoxic regions at higher treatment levels. Imaging studies utilizing multiphoton and confocal microscopies, as well as time-lapse optical coherence tomography (TL-OCT), revealed an inside-out pattern of cell death, with apoptosis being the primary mechanism of cell killing. Critically, EtNBS-based photodynamic therapy was found to be effective against the model tumor nodules even under severe hypoxia. The inherent ability of EtNBS photodynamic therapy to impart cytotoxicity across a wide range of tumoral oxygenation levels indicates its potential to eliminate treatment-resistant cell populations

    Comparative review of human and canine osteosarcoma: morphology, epidemiology, prognosis, treatment and genetics

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    Osteosarcoma (OSA) is a rare cancer in people. However OSA incidence rates in dogs are 27 times higher than in people. Prognosis in both species is poor, with five year osteosarcoma survival rates in people not having improved in decades. For dogs, one year survival rates are only around ~45%. Improved and novel treatment regimens are urgently required to improve survival in both humans and dogs with OSA. Utilising information from genetic studies could assist in this in both species, with the higher incidence rates in dogs contributing to the dog population being a good model of human disease. This review compares the clinical characteristics, gross morphology and histopathology, aetiology, epidemiology, and genetics of canine and human osteosarcoma. Finally, the current position of canine osteosarcoma genetic research is discussed and areas for additional work within the canine population are identified

    Vision 20/20: Molecular-guided surgical oncology based upon tumor metabolism or immunologic phenotype: Technological pathways for point of care imaging and intervention

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    Surgical guidance with fluorescence has been demonstrated in individual clinical trials for decades, but the scientific and commercial conditions exist today for a dramatic increase in clinical value. In the past decade, increased use of indocyanine green based visualization of vascular flow, biliary function, and tissue perfusion has spawned a robust growth in commercial systems that have near-infrared emission imaging and video display capabilities. This recent history combined with major preclinical innovations in fluorescent-labeled molecular probes, has the potential for a shift in surgical practice toward resection guidance based upon molecular information in addition to conventional visual and palpable cues. Most surgical subspecialties already have treatment management decisions partially based upon the immunohistochemical phenotype of the cancer, as assessed from molecular pathology of the biopsy tissue. This phenotyping can inform the surgical resection process by spatial mapping of these features. Further integration of the diagnostic and therapeutic value of tumor metabolism sensing molecules or immune binding agents directly into the surgical process can help this field mature. Maximal value to the patient would come from identifying the spatial patterns of molecular expression in vivo that are well known to exist. However, as each molecular agent is advanced into trials, the performance of the imaging system can have a critical impact on the success. For example, use of pre-existing commercial imaging systems are not well suited to image receptor targeted fluorophores because of the lower concentrations expected, requiring orders of magnitude more sensitivity. Additionally the imaging system needs the appropriate dynamic range and image processing features to view molecular probes or therapeutics that may have nonspecific uptake or pharmacokinetic issues which lead to limitations in contrast. Imaging systems need to be chosen based upon objective performance criteria, and issues around calibration, validation, and interpretation need to be established before a clinical trial starts. Finally, as early phase trials become more established, the costs associated with failures can be crippling to the field, and so judicious use of phase 0 trials with microdose levels of agents is one viable paradigm to help the field advance, but this places high sensitivity requirements on the imaging systems used. Molecular-guided surgery has truly transformative potential, and several key challenges are outlined here with the goal of seeing efficient advancement with ideal choices. The focus of this vision 20/20 paper is on the technological aspects that are needed to be paired with these agents

    Doxorubicin and carboplatin trials in Tasmanian devils (Sarcophilus harrisii) with Tasmanian devil facial tumor disease

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    Abstract not availableDavid N. Phalen, Angela E. Frimberger, Sarah Peck, Stephen Pyecroft, Colette Harmsen, Suzanneth Lola, Antony S. Moor
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