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Comparison of transabdominal ultrasound and electromagnetic transponders for prostate localization.
The aim of this study is to compare two methodologies of prostate localization in a large cohort of patients. Daily prostate localization using B-mode ultrasound has been performed at the Nebraska Medical Center since 2000. More recently, a technology using electromagnetic transponders implanted within the prostate was introduced into our clinic (Calypso(R)). With each technology, patients were localized initially using skin marks. Localization error distributions were determined from offsets between the initial setup positions and those determined by ultrasound or Calypso. Ultrasound localization data was summarized from 16619 imaging sessions spanning 7 years; Calypso localization data consists of 1524 fractions in 41 prostate patients treated in the course of a clinical trial at five institutions and 640 localizations from the first 16 patients treated with our clinical system. Ultrasound and Calypso patients treated between March and September 2007 at the Nebraska Medical Center were analyzed and compared, allowing a single institutional comparison of the two technologies. In this group of patients, the isocenter determined by ultrasound-based localization is on average 5.3 mm posterior to that determined by Calypso, while the systematic and random errors and PTV margins calculated from the ultrasound localizations were 3 - 4 times smaller than those calculated from the Calypso localizations. Our study finds that there are systematic differences between Calypso and ultrasound for prostate localization
Caring for flooded lawns
"Once the flood waters have receded and the homes are recovered, it will be time to clean up the yard. Grass has been described as Mother Nature's forgiveness for our disruption of the earth. This time, people will hide the scars of Mother Nature with a blanket of grass. Common sense would tell you to pick up any debris, such as wood, glass, stones, nails and other metal objects, deposited on lawn areas. This debris is a safety hazard to operators and can damage power mowers or other equipment used on the lawn. Remove leaves or any other material that smothers grass."--Page 1.Reviewed by Manoj Chhetri (MU Extension Horticulture Field Specialist), Karen Kerkhoff (Area Horticulture Specialist), David D. Minner (State Turfgrass Specialist, Department of Horticulture)
Prognostic value of a quantitative analysis of lipoarabinomannan in urine from patients with HIV-associated tuberculosis
BACKGROUND: Detection of the mycobacterial cell wall antigen lipoarabinomannan (LAM) in urine can be used to diagnose HIV-associated tuberculosis (TB) using a qualitative (positive/negative) read-out. However, it is not known whether the quantity of LAM present in urine provides additional prognostic information. Methods/FINDINGS: Consecutively recruited adult outpatients initiating antiretroviral therapy (ART) in South Africa were investigated for TB regardless of clinical symptoms using sputum smear microscopy and liquid culture (reference standard). Urine samples were tested using the Clearview TB-ELISA for LAM and the Xpert MTB/RIF assay. The ELISA optical densities (OD) were used as a quantitative assessment of urine LAM. Among 514 patients with complete sputum and urine LAM OD results, culture-confirmed TB was diagnosed in 84 patients. Twenty-three (27.3%) were LAM-positive with a median LAM OD of 0.68 (IQR 0.16-2.43; range, 0.10-3.29) and 61 (72.6%) were LAM negative (LAM OD <0.1 above background). Higher LAM ODs were associated with a range of prognostic indices, including lower CD4 cell counts, lower haemoglobin levels, higher blood neutrophil counts and higher mycobacterial load as assessed using both sputum and urine samples. The median LAM OD among patients who died was more than 6.8-fold higher than that of patients who remained alive at 3 months (P<0.001). The small number of deaths, however, precluded adequate assessment of mortality risk stratified according to urine LAM OD. CONCLUSIONS: In patients with HIV-associated TB, concentrations of LAM in urine were strongly associated with a range of poor prognostic characteristics known to be associated with mortality risk. Urine LAM assays with a semi-quantitative (negative vs. low-positive vs. high-positive) read-out may have improved clinical utility over assays with a simple binary result
Poor uptake of reproductive health screening services by female renal transplant recipients.
Women with functioning renal transplants are a high-risk group for de novo malignancies and other gynaecological
health problems. The objective of this study was to assess patients awareness of gynaecological issues, and to assess
uptake of cervical and breast cancer screening services. A structured questionnaire on family planning, menopausal
issues and knowledge/use of cervical and breast cancer screening was administered to 64 female renal transplant
recipients. 58 (91%) responded to the questionnaire. Mean age at first transplantation was 35 years (range 11 - 69).
84% were aware as to why they should have regular cervical smears. 15 (26%) had, however, never had a smear and only 9
(16%) were having yearly smears. 12 of 28 postmenopausal women entered the menopause under the age of 41 years, but
only 5 of these had received Hormone Replacement Therapy. Breast self examination is practiced by 71%, but only 26%
have had mammograms. These figures suggest that female renal transplant patients are not adequately screened for
cervical and breast cancer. The results also indicate a need for further education regarding family planning issues
and menopausal health concerns. We conclude that formal gynaecological review should be routinely available for women with renal transplants
Blood neutrophil counts in HIV-infected patients with pulmonary tuberculosis: association with sputum mycobacterial load.
BACKGROUND: Increasing evidence suggests that neutrophils play a role in the host response to Mycobacterium tuberculosis. We determined whether neutrophil counts in peripheral blood are associated with tuberculosis (TB) and with mycobacterial load in sputum in HIV-infected patients. METHODOLOGY/PRINCIPAL FINDINGS: Adults enrolling in an antiretroviral treatment (ART) clinic in a Cape Town township were screened for TB regardless of symptoms. Paired sputum samples were examined using liquid culture, fluorescence microscopy, and the Xpert MTB/RIF assay. Absolute neutrophil counts (ANC) were measured in blood samples. Of 602 HIV-infected patients screened, 523 produced one or more sputum samples and had complete results available for analysis. Among these 523 patients, the median CD4 count was 169×10(9)/L (IQR, 96-232) and median ANC was 2.6×10(9)/L (IQR, 1.9-3.6). Culture-positive pulmonary tuberculosis was diagnosed in 89 patients. Patients with TB had a median ANC of 3.4×10(9)/L (IQR, 2.4-5.1) compared to 2.5×10(9)/L (IQR, 1.8-3.4) among those who were culture negative (p7.5×10(9)/L; p = 0.0005). Patients were then classified into four mutually exclusive groups with increasing sputum mycobacterial load as defined by the results of culture, Xpert MTB/RIF and sputum smear microscopy. Multivariable analyses demonstrated that increasing sputum mycobacterial load was positively associated with blood ANC ≥2.6×10(9)/L and with neutrophilia. CONCLUSIONS/SIGNIFICANCE: Increased blood neutrophil counts were independently associated with pulmonary TB and sputum mycobacterial burden in this HIV-infected patient group. This observation supports the growing body of literature regarding the potential role for neutrophils in the host response to TB
Spectroscopy of a Cooper-Pair box in the Autler-Townes configuration
A theoretical spectroscopic analysis of a microwave driven superconducting
charge qubit (Cooper-pair box coupled) to an RLC oscillator model is performed.
By treating the oscillator as a probe through the backreaction effect of the
qubit on the oscillator circuit, we extract frequency splitting features
analogous to the Autler-Townes effect from quantum optics, thereby extending
the analogies between superconducting and quantum optical phenomenology. These
features are found in a frequency band that avoids the need for high frequency
measurement systems and therefore may be of use in qubit characterization and
coupling schemes. In addition we find this frequency band can be adjusted to
suit an experimental frequency regime by changing the oscillator frequency.Comment: 13 pages, 7 figures. v2: Revised version after referee comments.
Accepted for publication by Physical Review
Modeling Heatshield Erosion Due to Dust Particle Impacts for a Martian Entry Vehicle
Because planetary missions to Mars take years from initial design to arrival at Mars, and because of the unpredictability of major global dust storms, the de-sign of the thermal protection system (TPS) of a Mars entry vehicle requires an estimation for the potential damage caused by dust particle impacts on the heat-shield. This paper will review previous analytical and experimental approaches to modeling dust particle ero-sion and will compare the legacy models against more modern computational techniques and new dust ero-sion models that will be based on upcoming experi-ments in the German Aerospace Center (DLR) GBK facility. The various models will be compared by incorporating them into the Icarus material response code applied to a representative vehicle entering the Martian atmosphere
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