Histotripsy Homogenization of the Prostate: Thresholds for Cavitation Damage of Periprostatic Structures

Background and Purpose: Histotripsy is a noninvasive, pulsed ultrasound technology that produces mechanically homogenized tissue within targeted volumes. Previous work has demonstrated prostatic tissue debulking in a canine model. The aim was to establish safety thresholds by evaluating histologic changes of urinary sphincter, neurovascular bundle (NVB), and rectum after targeted histotripsy treatment of these critical structures. Materials and Methods: Rectum, urinary sphincter, and NVB in five anesthetized canines were targeted for histotripsy treatment (50 total points). Locations received 1k, 10k, or 100k acoustic pulses (4 microsecond, 1-MHz) at a repetition frequency of 500-Hz. Canine subjects were euthanized immediately (2), survived 3 days (1), or 2 weeks (3) after treatment. Prostates, periprostatic tissue, and rectum were harvested and processed for histology. Results: The sphincter was structurally intact with minimal muscle fiber disruption even after 100k pulses (n=10). Undamaged nerves, arteries, and veins of the NVB were seen despite mechanical homogenization of surrounding loose connective tissue (n=19). The rectum, however, exhibited dose-dependent damage (n=20). 1k pulses yielded mild submucosal hemorrhage. 10k pulses resulted in moderate collagen disruption and focal mucosal homogenization. 100k pulses produced damage to the mucosa and muscularis propria with extensive hemorrhage and collagen disruption. One canine treated with 100k pulses needed early euthanasia (day 3) because of complications from a urine leak. Conclusions: Histotripsy histologic tissue effect varied based on targeted structure with substantial structural preservation of NVB and sphincter. Rectal subclinical damage was apparent after 1k pulses and increased in extent and severity with escalating doses. Future work will include assessment of functional outcomes and refinement of these initial safety thresholds.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90446/1/end-2E2010-2E0648.pd

A Latter-day Disease: Mormons and Cholera in the Nineteenth Century

Nineteenth-century America saw the emergence of two seemingly parallel entities - the epidemic disease of cholera and the Church of Jesus Christ of Latter-day Saints, better known as the Mormon faith. To understand the intersection of Mormons and cholera, one must look within the interdisciplinary framework of Civil War-era history, religion, and epidemiology. Cholera epidemics in 1832 and 1849 coincided with the mass Mormon migration west, causing great suffering and death for Mormons traveling by land and sea. While their westward exodus exposed them to cholera, their religious teachings also contributed to why they contracted the disease. The Word of Wisdom, their religious doctrine received as a revelation from God, prohibited the consumption of “hot drinks,” referring to boiled water, tea, and coffee, and “strong drinks,” referring to alcoholic beverages. These drinks all have anti-cholera properties, and if consumed, could have alleviated cholera’s impact among the Mormon population and protected them from infection. In this paper, I will examine the unique relationship between cholera and the Mormon faith, and I will argue two specific tenets - that cholera helped shape Mormon history demographically and geographically, and that the Mormon religion itself affected this group’s understanding of the disease and also made them more vulnerable to contracting and succumbing to it

An evaluation of a quick perception method with meaning in grades four and five

Thesis (Ed.M.)--Boston Universit

Incidence and drug treatment of emotional distress after cancer diagnosis : a matched primary care case-control study

Notes This work is published under the standard license to publish agreement. After 12 months the work will become freely available and the license terms will switch to a Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License.Peer reviewedPublisher PD

LiCaFeF6 A zero strain cathode material for use in Li ion batteries

A new zero strain LiCaFeF6 cathode material for reversible insertion and extraction of lithium ions is presented. LiCaFeF6 is synthesized by a solid state reaction and processed to a conductive electrode composite via high energy ball milling. In the first cycle, a discharge capacity of 112 mAh g amp; 8315; is achieved in the voltage range from 2.0 V to 4.5 V. The electrochemically active redox couple is Fe3 amp; 8314; Fe2 amp; 8314; as confirmed by Mössbauer spectroscopy and X ray absorption spectroscopy. The compound has a trigonal colquiriite type crystal structure space group . By means of in situ and ex situ XRD as well as X ray absorption fine structure spectroscopy a reversible response to Li uptake release is found. For an uptake of 0.8 mol Li per formula unit only minimal changes occur in the lattice parameters causing a total change in unit cell volume of less than 0.5 . The spatial distribution of cations in the crystal structure as well as the linkage between their corresponding fluorine octahedra is responsible for this very small structural response. With its zero strain behaviour this material is expected to exhibit only negligible mechanical degradation. It may be used as a cathode material in future lithium ion batteries with strongly improved safety and cycle lif

The planarity of the stickface motion in the field hockey hit

The field hockey hit is an important but poorly understood stroke. This study investigated the planarity of the stickface motion during the downswing, in order to better characterise the kinematics and to assess the suitability of planar pendulum models for simulating the hit. Thirteen experienced female field hockey players were filmed executing hits with a single approach step, and the kinematics of the centre of the stickface were measured. A method was developed for identifying how far back from impact the stickface motion was planar. Orthogonal least-squares regression was used to determine best-fit planes for sections of the stickface path of varying length, each of which ended at impact, and these sections were considered planar if the mean residual between the stickface path and the fitted plane was less than 0.25% of the distance traveled by the stickface during that period. On average the stickface motion was planar for the last 83±12% of its downswing path, with the length of the planar section ranging from 1.85 m to 2.70 m. The suitability of a planar model for the stickface motion was supported, but further investigation of the stick and arm kinematics is warranted

An overview of urinary incontinence

Urinary incontinence is a common problem that is often under-reported due to the embarrassing nature and social stigma attached. Urinary incontinence can have a considerable effect on an individual’s quality of life, but can be significantly improved with correct assessment, treatment and management. Conservative treatment options including: pelvic floor exercises, bladder retraining and fluid modification are recommended before referral to secondary services. This article provides an overview of the main types of urinary incontinence, and summarises recent guidelines for the assessment, diagnosis and effective conservative treatment options for them and when a referral for specialist care is required

Investigating antimalarial drug interactions of emetine dihydrochloride hydrate using CalcuSyn-based interactivity calculations

The widespread introduction of artemisinin-based combination therapy has contributed to recent reductions in malaria mortality. Combination therapies have a range of advantages, including synergism, toxicity reduction, and delaying the onset of resistance acquisition. Unfortunately, antimalarial combination therapy is limited by the depleting repertoire of effective drugs with distinct target pathways. To fast-track antimalarial drug discovery, we have previously employed drug-repositioning to identify the anti-amoebic drug, emetine dihydrochloride hydrate, as a potential candidate for repositioned use against malaria. Despite its 1000-fold increase in in vitro antimalarial potency (ED50 47 nM) compared with its anti-amoebic potency (ED50 26±32 uM), practical use of the compound has been limited by dose-dependent toxicity (emesis and cardiotoxicity). Identification of a synergistic partner drug would present an opportunity for dose-reduction, thus increasing the therapeutic window. The lack of reliable and standardised methodology to enable the in vitro definition of synergistic potential for antimalarials is a major drawback. Here we use isobologram and combination-index data generated by CalcuSyn software analyses (Biosoft v2.1) to define drug interactivity in an objective, automated manner. The method, based on the median effect principle proposed by Chou and Talalay, was initially validated for antimalarial application using the known synergistic combination (atovaquone-proguanil). The combination was used to further understand the relationship between SYBR Green viability and cytocidal versus cytostatic effects of drugs at higher levels of inhibition. We report here the use of the optimised Chou Talalay method to define synergistic antimalarial drug interactivity between emetine dihydrochloride hydrate and atovaquone. The novel findings present a potential route to harness the nanomolar antimalarial efficacy of this affordable natural product

Development Officers and Discrimination

This paper deals with what a government funded development agency should do when a developing country imposes restrictions on the development process which discriminate on the basis of gender against some members of the development agency’s staff. The conclusion is that there are circumstances in which development agencies should continue their work in the face of gender discrimination but they should not instigate development projects if doing so would involve them in gender discrimination. A set of procedures for a development agency to follow in these difficult circumstances is outlined. It is argued that an agency is entitled to violate a moral principle when so doing will reduce violations of that same principle