Left-Sided Hepatectomy With a Linear Stapling Device: An Experimental Study on Pigs

Thirteen pigs underwent resection of the left liver lobe. By random selection, the animals were resected either with the aid of an RLG 90R linear stapling device or by the conventional finger-fracture technique. There was one postoperative death due to anaesthetic complications. The median operative time using the stapler was 27 min (range 19–40 min) which was significantly shorter (p = 0.0065) than that required for resection by the finger-fracture technique (42.5 min; range 37–55 min)

Image denoising in photon-counting CT using PFGM++ with hijacked regularized sampling

Deep learning (DL) has proven to be an important tool for high quality image denoising in low-dose and photon-counting CT. However, DL models are usually trained using supervised methods, requiring paired data that may be difficult to obtain in practice. Physics-inspired generative models, such as score-based diffusion models, offer unsupervised means of solving a wide range of inverse problems via posterior sampling. The latest in this family are Poisson flow generative models (PFGM)++ which, inspired by electrostatics, treat the $N$-dimensional data as positive electric charges in a $N+D$-dimensional augmented space. The electric field lines generated by these charges are used to find an invertible mapping, via an ordinary differential equation, between an easy-to-sample prior and the data distribution of interest. In this work, we propose a method for CT image denoising based on PFGM++ that does not require paired training data. To achieve this, we adapt PFGM++ for solving inverse problems via posterior sampling, by hijacking and regularizing the sampling process. Our method incorporates score-based diffusion models (EDM) as a special case as $D\rightarrow \infty$, but additionally allows trading off robustness for rigidity by varying $D$. The network is efficiently trained on randomly extracted patches from clinical normal-dose CT images. The proposed method demonstrates promising performance on clinical low-dose CT images and clinical images from a prototype photon-counting system

PPFM: Image denoising in photon-counting CT using single-step posterior sampling Poisson flow generative models

Diffusion and Poisson flow models have shown impressive performance in a wide range of generative tasks, including low-dose CT image denoising. However, one limitation in general, and for clinical applications in particular, is slow sampling. Due to their iterative nature, the number of function evaluations (NFE) required is usually on the order of $10-10^3$, both for conditional and unconditional generation. In this paper, we present posterior sampling Poisson flow generative models (PPFM), a novel image denoising technique for low-dose and photon-counting CT that produces excellent image quality whilst keeping NFE=1. Updating the training and sampling processes of Poisson flow generative models (PFGM)++, we learn a conditional generator which defines a trajectory between the prior noise distribution and the posterior distribution of interest. We additionally hijack and regularize the sampling process to achieve NFE=1. Our results shed light on the benefits of the PFGM++ framework compared to diffusion models. In addition, PPFM is shown to perform favorably compared to current state-of-the-art diffusion-style models with NFE=1, consistency models, as well as popular deep learning and non-deep learning-based image denoising techniques, on clinical low-dose CT images and clinical images from a prototype photon-counting CT system

Mitigating slipping-related mortality from purse seine fisheries for small pelagic fish: case studies from European Atlantic waters

The release of unwanted catches (UWC) from purse seines, while the catch is still in the water, is known as “slipping”. Once thought to be a benign process, compared to discarding UWC overboard from the fishing vessel, it is now recognised that “slipping” can lead to significant mortality in the released fish if done inappropriately. In this chapter, we examine purse seining and slipping operations, and discuss what drives slipping and potential mitigation measures to reduce slipping mortality. We use three examples of purse seine fisheries for small pelagic species in the North-east Atlantic; from Norway, Portugal and Spain. The ideal solution (identifying and avoiding UWC before the net is set) requires the development of tools to enable fishers to better characterise target schools in terms of key selection criteria, e.g., with respect to species, individual size and catch biomass. Such tools are being developed, based primarily on hydro-acoustic technology. However, some UWC in purse seine catches are inevitable, and operational improvements in slipping practices have been shown to significantly reduce stress and mortality in the released UWC. We conclude with a discussion on the challenges currently facing the implementation of the European Union (EU) Landing Obligation with regards to minimising slipping related mortality.info:eu-repo/semantics/publishedVersio

Randomized assessment of imatinib in patients with acute ischaemic stroke treated with intravenous thrombolysis

BackgroundImatinib, a tyrosine kinase inhibitor, has been shown to restore bloodâ brain barrier integrity and reduce infarct size, haemorrhagic transformation and cerebral oedema in stroke models treated with tissue plasminogen activator. We evaluated the safety of imatinib, based on clinical and neuroradiological data, and its potential influence on neurological and functional outcomes.MethodsA phase II randomized trial was performed in patients with acute ischaemic stroke treated with intravenous thrombolysis. A total of 60 patients were randomly assigned to four groups [3 (active): 1 (control)]; the active treatment groups received oral imatinib for 6 days at three dose levels (400, 600 and 800 mg). Primary outcome was any adverse event; secondary outcomes were haemorrhagic transformation, cerebral oedema, neurological severity on the National Institutes of Health Stroke Scale (NIHSS) at 7 days and at 3 months and functional outcomes on the modified Rankin scale (mRS).ResultsFour serious adverse events were reported, which resulted in three deaths (one in the control group and two in the 400â mg dose group; one patient in the latter group did not receive active treatment and the other received two doses). Nonserious adverse events were mostly mild, resulting in full recovery. Imatinib ameliorated neurological outcomes with an improvement of 0.6 NIHSS points per 100 mg imatinib (P = 0.02). For the 800â mg group, the mean unadjusted and adjusted NIHSS improvements were 4 (P = 0.037) and 5 points (P = 0.012), respectively, versus controls. Functional independence (mRS 0â 2) increased by 18% versus controls (61 vs. 79; P = 0.296).ConclusionThis phase II study showed that imatinib is safe and tolerable and may reduce neurological disability in patients treated with intravenous thrombolysis after ischaemic stroke. A confirmatory randomized trial is currently underway.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136298/1/joim12576_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136298/2/joim12576.pd

Changes in visual function after intraocular pressure reduction using antiglaucoma medications

Purpose To evaluate the change in visual function after starting glaucoma treatment and correlate this to a decrease in intraocular pressure (IOP) in primary open-angle glaucoma patients.Methods A prospective, randomized clinical trial was carried out involving 54 glaucoma patients (54 eyes). After inclusion, patients randomly received timolol maleate 0.5%, brimonidine tartrate 0.2%, or travoprost 0.004% in one randomly selected eye. Patients underwent Goldmann applanation tonometry, visual acuity test, standard automated perimetry (SAP), visual quality perception test (visual analogue scale), and contrast sensitivity (CS) test, in a random order before and after the 4-week glaucoma treatment.Results There were statistically significant changes in IOP (mean change [standard deviation], 7.8 [3.6] mmHg, P 0.001), SAP mean deviation index (0.84 [2.45] dB, P = 0.02), visual quality perception (0.56 [1.93], P = 0.045), and CS at frequencies of 12 cycles/degree (0.10 [0.37], P = 0.03) and 18 cycles/degree (0.18 [0.42], P = 0.02) after the 4-week treatment when compared with baseline. No statistically significant differences were found between the treatment groups in visual function changes after treatment (P > 0.40). No significant correlations between IOP reduction and changes in visual function were found (P > 0.30).Conclusions Visual quality perception, visual field mean deviation index, and CS at higher frequencies improve after starting glaucoma therapy. However, no correlation was found between IOP reduction and changes in visual function, and no differences were found in visual function when the three medications studied were compared. Eye (2009) 23, 1081-1085; doi:10.1038/eye.2008.226; published online 1 August 2008Universidade Federal de São Paulo, Glaucoma Serv, Dept Ophthalmol, BR-01404001 São Paulo, BrazilUniversidade Federal de São Paulo, Glaucoma Serv, Dept Ophthalmol, BR-01404001 São Paulo, BrazilWeb of Scienc

Safety and outcomes of routine endovascular thrombectomy in large artery occlusion recorded in the SITS Register: An observational study

Background and objective We aimed to evaluate the safety and outcomes of thrombectomy in anterior circulation acute ischaemic stroke recorded in the SITS-International Stroke Thrombectomy Register (SITS-ISTR) and compare them with pooled randomized controlled trials (RCTs) and two national registry studies. Methods We identified centres recording >= 10 consecutive patients in the SITS-ISTR with at least 70% of available modified Rankin Scale (mRS) at 3 months during 2014-2019. We defined large artery occlusion as intracranial internal carotid artery, first and second segment of middle cerebral artery and first segment of anterior cerebral artery. Outcome measures were functional independence (mRS score 0-2) and death at 3 months and symptomatic intracranial haemorrhage (SICH) per modified SITS-MOST. Results Results are presented in the following order: SITS-ISTR, RCTs, MR CLEAN Registry and German Stroke Registry (GSR). Median age was 73, 68, 71 and 75 years; baseline NIHSS score was 16, 17, 16 and 15; prior intravenous thrombolysis was 62%, 83%, 78% and 56%; onset to reperfusion time was 289, 285, 267 and 249 min; successful recanalization (mTICI score 2b or 3) was 86%, 71%, 59% and 83%; functional independence at 3 months was 45.5% (95% CI: 44-47), 46.0% (42-50), 38% (35-41) and 37% (35-41), respectively; death was 19.2% (19-21), 15.3% (12.7-18.4), 29.2% (27-32) and 28.6% (27-31); and SICH was 3.6% (3-4), 4.4% (3.0-6.4), 5.8% (4.7-7.1) and not available. Conclusion Thrombectomy in routine clinical use registered in the SITS-ISTR showed safety and outcomes comparable to RCTs, and better functional outcomes and lower mortality than previous national registry studies.Peer reviewe

Safety and outcomes of routine endovascular thrombectomy in large artery occlusion recorded in the SITS Register: An observational study

[Background and objective] We aimed to evaluate the safety and outcomes of thrombectomy in anterior circulation acute ischaemic stroke recorded in the SITS–International Stroke Thrombectomy Register (SITS-ISTR) and compare them with pooled randomized controlled trials (RCTs) and two national registry studies.[Methods] We identified centres recording ≥10 consecutive patients in the SITS-ISTR with at least 70% of available modified Rankin Scale (mRS) at 3 months during 2014–2019. We defined large artery occlusion as intracranial internal carotid artery, first and second segment of middle cerebral artery and first segment of anterior cerebral artery. Outcome measures were functional independence (mRS score 0-2) and death at 3 months and symptomatic intracranial haemorrhage (SICH) per modified SITS-MOST.[Results] Results are presented in the following order: SITS-ISTR, RCTs, MR CLEAN Registry and German Stroke Registry (GSR). Median age was 73, 68, 71 and 75 years; baseline NIHSS score was 16, 17, 16 and 15; prior intravenous thrombolysis was 62%, 83%, 78% and 56%; onset to reperfusion time was 289, 285, 267 and 249 min; successful recanalization (mTICI score 2b or 3) was 86%, 71%, 59% and 83%; functional independence at 3 months was 45.5% (95% CI: 44–47), 46.0% (42–50), 38% (35–41) and 37% (35–41), respectively; death was 19.2% (19–21), 15.3% (12.7–18.4), 29.2% (27–32) and 28.6% (27–31); and SICH was 3.6% (3–4), 4.4% (3.0–6.4), 5.8% (4.7–7.1) and not available.[Conclusion] Thrombectomy in routine clinical use registered in the SITS-ISTR showed safety and outcomes comparable to RCTs, and better functional outcomes and lower mortality than previous national registry studies.SITS (Safe Implementation of Treatment in Stroke) is financed directly and indirectly by grants from Karolinska Institutet, Stockholm County Council, the Swedish Heart-Lung Foundation, the Swedish Order of St. John, Friends of Karolinska Institutet and private donors, as well as from an unrestricted sponsorship from Boehringer Ingelheim. SITS has previously received grants from the European Union Framework 7, the European Union Public Health Authority, Ferrer International and EVER Pharma. SITS is currently conducting studies supported by Boehringer Ingelheim and Biogen, as well as in collaboration with Karolinska Institutet, supported by Stryker, Covidien and Phenox. N Ahmed is supported by grants provided by the Stockholm County Council and the Swedish Heart-Lung Foundation. S Holmin is supported by grants provided by the Söderberg Foundations, the Stockholm County Council, the Erling Persson Foundation, VINNOVA and HMT. Irene Escudero-Martínez has received a grant from ‘Fundación Progreso y Salud, Junta de Andalucía’ (grant EF-0437-2018). RM has been supported by the project no. LQ1605 from the National Program of Sustainability II (MEYS CR). RH has been supported by the grants no. DRO–UHHK 00179906 from the Ministry of Health of the Czech Republic and no. PROGRES Q40 from Charles University, Czech Republic.Peer reviewe

The Role of TiO2 Doping on RuO2-Coated Electrodes for the Water Oxidation Reaction

Electrochemical water splitting into H2 and O2 presents a significant and challenging energy loss due to the high overpotential required at the anode. Today, in industrially relevant applications, dimensionally stable anodes (DSA) based on the electrocatalytic active RuO2 are conventionally utilized. To enhance the resistance against corrosion, incorporation of TiO2 in the RuO2-coated electrodes is widely employed. In the present work we have used scanning electrochemical microscopy (SECM) to demonstrate that TiO2-doped RuO2-coated electrodes, in addition to being more durable, also show an electrocatalytic activity that is, on average, 13% higher as compared to the pure RuO2-coated electrodes. We also demonstrate that cracks in the pure RuO2 coating are the most active zones, probably because Ti from the Ti support has diffused into the first applied layer of the RuO2 coating. To reveal the nature of this enhanced activity for water oxidation displayed on TiO2-doped RuO2 electrodes, we have employed X-ray photoelectron spectroscopy (XPS) for material characterization. The results show that the electrocatalytic activity enhancement displayed on the mixed (Ru1–x:Tix)O2 coating is promoted through a charge transfer from the RuO2 to the TiO2, which provides new and more reactive sites designated as activated RuO2δ+.This study has partly been carried out in the framework of the European Commission FP7 Initial Training Network “ELCAT”, Grant Agreement No. 214936-2. Portions of this research were performed at SPring-8 with the approval of Japan Synchrotron Radiation Research Institute as Nanotechnology Support Project of the Ministry of Education, Culture, Sports, Science and Technology (Proposal No. 2007A2005 and 2008A1671/BL-47XU)