1,493 research outputs found
Simultaneous evaluation of myocardial function, viability, and microvascular dysfunction by a new magnetic resonance technique
Electronic Medical Record Inaccuracies: Multicenter Analysis of Challenges with Modified Lung Cancer Screening Criteria.
The National Comprehensive Cancer Network expanded their lung cancer screening (LCS) criteria to comprise one additional clinical risk factor, including chronic obstructive pulmonary disease (COPD). The electronic medical record (EMR) is a source of clinical information that could identify high-risk populations for LCS, including a diagnosis of COPD; however, an unsubstantiated COPD diagnosis in the EMR may lead to inappropriate LCS referrals. We aimed to detect the prevalence of unsubstantiated COPD diagnosis in the EMR for LCS referrals, to determine the efficacy of utilizing the EMR as an accurate population-based eligibility screening trigger using modified clinical criteria. We performed a multicenter review of all individuals referred to three LCS programs from 2012 to 2015. Each individual\u27s EMR was searched for COPD diagnostic terms and the presence of a diagnostic pulmonary functionality test (PFT). An unsubstantiated COPD diagnosis was defined by an individual\u27s EMR containing a COPD term with no PFTs present, or the presence of PFTs without evidence of obstruction. A total of 2834 referred individuals were identified, of which 30% (840/2834) had a COPD term present in their EMR. Of these, 68% (571/840) were considered unsubstantiated diagnoses: 86% (489/571) due to absent PFTs and 14% (82/571) due to PFTs demonstrating no evidence of postbronchodilation obstruction. A large proportion of individuals referred for LCS may have an unsubstantiated COPD diagnosis within their EMR. Thus, utilizing the EMR as a population-based eligibility screening tool, employing expanded criteria, may lead to individuals being referred, potentially, inappropriately for LCS
Cricotracheal resection for adult subglottic stenosis : Factors predicting treatment failure
Objectives/Hypothesis Identify predictors of decannulation failure after cricotracheal resection (CTR) and thyrotracheal anastomosis (TTA) in patients with subglottic stenosis (SGS). Study Design Retrospective cohort study. Methods Charts of patients undergoing CTR and TTA for SGS at the University Health Network, Toronto, Ontario, Canada between 1988 and 2017 were reviewed. Patient, pathology, treatment, and outcome data were collected. The end points for statistical analysis were development of restenosis and permanent tracheostomy. Results One hundred fourteen patients (n = 114) were eligible for inclusion in this review. The mean age at primary resection was 46.9 years, 95 (83%) were females, and 19 (17%) were males. The rate of restenosis and permanent tracheostomy was 13% and 5%, respectively. Sixty-two patients (54%) underwent a CTR and TTA, and 52 patients (46%) underwent a CTR, laryngofissure, and TTA. Traumatic stenosis (odds ratio [OR] = 10.3, P = .017), longer T-tube duration (OR = 1.2, P = .011), combined glottic/subglottic stenosis (OR = 10.47, P = .010), start of the stenosis at the vocal cords (OR = 6.6, P = .029), postoperative minor complications (OR = 13.6, P = .028), and need for repeat surgery (OR = 44.1, P <.001) were associated with an increased risk of requiring permanent tracheostomy. Conclusions CTR and TTA are excellent surgical approaches for adult patients with subglottic stenosis. In this study, 5% of patients required permanent tracheostomy. Factors predicting treatment failure include traumatic stenosis, longer T-tube duration, combined glottic/subglottic stenosis, start of stenosis at the level of vocal cords, postoperative minor complications, and need for repeat surgery. Level of Evidence 4 Laryngoscope, 2019Peer reviewe
Quantum spin pumping mediated by magnon
We theoretically propose quantum spin pumping mediated by magnons, under a
time-dependent transverse magnetic field, at the interface between a
ferromagnetic insulator and a non-magnetic metal. The generation of a spin
current under a thermal equilibrium condition is discussed by calculating the
spin transfer torque, which breaks the spin conservation law for conduction
electrons and operates the coherent magnon state. Localized spins lose spin
angular momentum by emitting magnons and conduction electrons flip from down to
up by absorbing the momentum. The spin transfer torque has a resonance
structure as a function of the angular frequency of the applied transverse
field. This fact is useful to enhance the spin pumping effect induced by
quantum fluctuations. We also discuss the distinction between our quantum spin
pumping theory and the one proposed by Tserkovnyak et al.Comment: 27 pages, 2 figures. v2; the detail of the calculation has been added
in Appendix. The distinction from the spin pumping theory proposed by
Tserkovnyak et al. has been clarified in section 5. v3; typos correcte
A comparison of weekly versus 3-weekly cisplatin during adjuvant radiotherapy for high-risk head and neck cancer
SummaryObjectivesTo compare cumulative cisplatin dose and toxicity between patients who received 3-weekly versus weekly cisplatin during adjuvant radiotherapy for high-risk head and neck squamous cell carcinoma (HNSCC).Materials and methodsConsecutive HNSCC patients with involved resection margins and/or extra-capsular extension in two tertiary cancer centers with different institutional practices were identified. Cumulative cisplatin dose was calculated and information on toxicity reviewed and compared between patients who received 3-weekly versus weekly cisplatin.ResultsOf 270 high risk patients, 60 received 3-weekly 100mg/m2 and 48 received weekly 50mg/m2 cisplatin during adjuvant radiotherapy (60–66Gy in 30–33 fractions). Fourteen patients received other chemotherapy schedules and 148 received no chemotherapy. Mean cumulative cisplatin dose was 199.4mg/m2 (standard error (SE) 5.4) in 3-weekly versus 239.8mg/m2 (SE 11.0, P=0.001) in weekly treated patients. Cumulative cisplatin ⩾200mg/m2 was given to 67.7% of patients in the 3-weekly cohort and 85.2% (P=0.039) in the weekly cohort. The rate of feeding tube dependency 6months after treatment, osteoradionecrosis, neutropenic fever, and persistent renal function decline were not statistically different.ConclusionsAbout one half of high-risk HNSCC patients are not eligible for cisplatin during postoperative radiotherapy. Patients treated with weekly 50mg/m2 cisplatin received a higher cumulative dose with comparable toxicity as patients who received 3-weekly 100mg/m2 cisplatin. Efficacy and applicability to the frequently used weekly 40mg/m2 schedule remains to be evaluated
Programmed cell death 4 loss increases tumor cell invasion and is regulated by miR-21 in oral squamous cell carcinoma
<p>Abstract</p> <p>Background</p> <p>The tumor suppressor Programmed Cell Death 4 (<it>PDCD4</it>) has been found to be under-expressed in several cancers and associated with disease progression and metastasis. There are no current studies characterizing PDCD4 expression and its clinical relevance in Oral Squamous Cell Carcinoma (OSCC). Since nodal metastasis is a major prognostic factor in OSCC, we focused on determining whether PDCD4 under-expression was associated with patient nodal status and had functional relevance in OSCC invasion. We also examined <it>PDCD4 </it>regulation by microRNA 21 (miR-21) in OSCC.</p> <p>Results</p> <p><it>PDCD4 </it>mRNA expression levels were assessed in 50 OSCCs and 25 normal oral tissues. <it>PDCD4 </it>was under-expressed in 43/50 (86%) OSCCs, with significantly reduced mRNA levels in patients with nodal metastasis (<it>p = 0.0027</it>), and marginally associated with T3-T4 tumor stage (<it>p = 0.054</it>). PDCD4 protein expression was assessed, by immunohistochemistry (IHC), in 28/50 OSCCs and adjacent normal tissues; PDCD4 protein was absent/under-expressed in 25/28 (89%) OSCCs, and marginally associated with nodal metastasis (<it>p = 0.059</it>). A matrigel invasion assay showed that PDCD4 expression suppressed invasion, and siRNA-mediated PDCD4 loss was associated with increased invasive potential of oral carcinoma cells. Furthermore, we showed that miR-21 levels were increased in PDCD4-negative tumors, and that <it>PDCD4 </it>expression may be down-regulated in OSCC by direct binding of miR-21 to the 3'UTR <it>PDCD4 </it>mRNA.</p> <p>Conclusions</p> <p>Our data show an association between the loss of PDCD4 expression, tumorigenesis and invasion in OSCC, and also identify a mechanism of PDCD4 down-regulation by microRNA-21 in oral carcinoma. PDCD4 association with nodal metastasis and invasion suggests that PDCD4 may be a clinically relevant biomarker with prognostic value in OSCC.</p
Pairing in nuclear systems: from neutron stars to finite nuclei
We discuss several pairing-related phenomena in nuclear systems, ranging from
superfluidity in neutron stars to the gradual breaking of pairs in finite
nuclei. We focus on the links between many-body pairing as it evolves from the
underlying nucleon-nucleon interaction and the eventual experimental and
theoretical manifestations of superfluidity in infinite nuclear matter and of
pairing in finite nuclei. We analyse the nature of pair correlations in nuclei
and their potential impact on nuclear structure experiments. We also describe
recent experimental evidence that points to a relation between pairing and
phase transitions (or transformations) in finite nuclear systems. Finally, we
discuss recent investigations of ground-state properties of random two-body
interactions where pairing plays little role although the interactions yield
interesting nuclear properties such as 0+ ground states in even-even nuclei.Comment: 74 pages, 33 figs, uses revtex4. Submitted to Reviews of Modern
Physic
Experimental quantum-enhanced estimation of a lossy phase shift
When standard light sources are employed, the precision of the phase
determination is limited by the shot noise. Quantum entanglement provides means
to exceed this limit with the celebrated example of N00N states that saturate
the ultimate Heisenberg limit on precision, but at the same time are extremely
fragile to losses. In contrast, we provide experimental evidence that
appropriately engineered quantum states outperform both standard and N00N
states in the precision of phase estimation when losses are present.Comment: 5 page
Development and validation of a Surgical Prioritization and Ranking Tool and Navigation Aid for Head and Neck Cancer (SPARTAN‐HN) in a scarce resource setting: Response to the COVID‐19 pandemic
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163412/2/cncr33114_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163412/1/cncr33114.pd
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