EMBOLIZATION OF RENAL ANGIOMYOLIPOMA: CASE SERIES

Renal angiomyolipomas (AML) are benign lesions usually left alone. However, lesions larger than 4 cm carry the risk of spontaneous haemorrhage and need treatment. Angiography and embolisation are the current standard of care particularly in patients with high operative risks. Angio-embolisation is a safe, minimally invasive procedure preserving maximum renal parenchyma, with the added advantage of preventing peri-procedural morbidity. Two cases of AML are presented in this case series. Key words: Angiomyolipoma, embolisation, renal

Perencanaan Struktur Gedung Maritime Education and Training Bp3ip Jakarta

Structural Design of Maritime Education and Training Improvement BP3IP Jakarta consists of six floors is located in seismic zone 3 (medium) frame structure is designed using a system of bearer Moment Medium (SRPMM) with reference to the provisions of SNI 03-1726-2002 and SNI 03-2847 - of 2001. Based on the prevailing concrete SNI (SNI 03-2847-2002) earthquake-resistant reinforced concrete structures are planned by applying the concept kapaitas design (design capacity). Implementation of this design concept for building the capacity of the receiving earthquake is the concept of "strong Columb weak beam". In the design, analysis and structure need to be taken into account Sitem to the possibility of a combination of loading (load combination) and some load cases that can work simultaneously over the life of the plan according Regulation Charging For Home and building 1989. The soil types on the basis of Maritime Education and Training Building Improvement BP3IP Jakarta based on Standard Penetration Test N values ​​in soils are included. In the structural analysis of earthquake forces using the method of dynamic analysis using Response Spectrum Analysis of Variety (Capital Spectrum Analysis) where the maximum response, and every variety of vibrating structures that occur from the spectra obtained Response Plan (Design Spectra). Analysis on the structural design of building structures is performed using the program SAP 2000 V.14, which is one program which has extensive structural analysis in civil engineering world

The effectiveness of experiential learning – stem model with formative assessment in building students' mastery on fluid dynamics

Fluid dynamics is related to science, technology, and daily lives, but students' understanding of the topic is considered not optimal yet. This study aims to investigate the effectiveness of experiential learning (EL) - STEM model with formative assessment (FA) in building the mastery of fluid dynamics and explore students' difficulties. This is a mixed-methods research with an embedded experimental design with 34 grade XI students of high school in Malang, Indonesia, as subjects, which were chosen with purposive sampling. This research used dynamics mastering test instrument in the form of 18 reasoned multiple-choice question items with a reliability of 0.65. The data were analyzed with Wilcoxon Signed Ranks test, N-gain, and the description of students' answers. The result showed that EL-STEM with FA is effective to build the mastery of fluid dynamics with the effectiveness of the subtopic of Bernoulli's law is higher than the subtopic of Continuity. Before learning, students had difficulties to understand almost all material of fluid dynamics. However, after learning, students only had difficulties to understand certain things, which are the relationship between physical quantities in Bernoulli's law, the distance between the water reservoir and the water jet, the speed of air under or above the wing of an aeroplane, and the shape of aeroplane's wing design

Texture-Based Analysis of Fetal Organs in Fetal Growth Restriction

Fetal growth restriction (FGR) is common, affecting around 10% of all pregnancies. Growth restricted fetuses fail to achieve their genetically predetermined size and often weigh <10th centile for gestation. However, even appropriately grown fetuses can be affected, with the diagnosis of FGR missed before birth. Babies with FGR have a higher rate of stillbirth, neonatal morbidity such as breathing problems, and neurodevelopmental delay. FGR is usually due to placental insufficiency leading to poor placental perfusion and fetal hypoxia. MRI is increasingly used to image the fetus and placenta. Here we explore the use of novel multi-compartment Intravoxel Incoherent Motion Model (IVIM)-based models for MRI fetal and placental analysis, to improve understanding of FGR and quantify abnormalities and biomarkers in fetal organs. In 12 normally grown and 12 FGR gestational-age matched pregnancies (Median 28+ 4 wks±3+ 3 wks) we acquired T2 relaxometry and diffusion MRI datasets. Decreased perfusion, pseudo-diffusion coefficient, and fetal blood T2 values in the placenta and fetal liver were significant features distinguishing between FGR and normal controls (p-value <0.05). This may be related to the preferential shunting of fetal blood away from the fetal liver to the fetal brain that occurs in placental insufficiency. These features were used to predict FGR diagnosis and gestational age at delivery using simple machine learning models. Texture analysis was explored to compare Haralick features between control and FGR fetuses, with the placenta and liver yielding the most significant differences between the groups. This project provides insights into the effect of FGR on fetal organs emphasizing the significant impact on the fetal liver and placenta, and the potential of an automated approach to diagnosis by leveraging simple machine learning models

Amustaline-glutathione pathogen-reduced red blood cell concentrates for transfusion-dependent thalassaemia

Transfusion-dependent thalassaemia (TDT) requires red blood cell concentrates (RBCC) to prevent complications of anaemia, but carries risk of infection. Pathogen reduction of RBCC offers potential to reduce infectious risk. We evaluated the efficacy and safety of pathogen-reduced (PR) Amustaline-Glutathione (A-GSH) RBCC for TDT. Patients were randomized to a blinded 2-period crossover treatment sequence for six transfusions over 8–10 months with Control and A-GSH-RBCC. The efficacy outcome utilized non-inferiority analysis with 90% power to detect a 15% difference in transfused haemoglobin (Hb), and the safety outcome was the incidence of antibodies to A-GSH-PR-RBCC. By intent to treat (80 patients), 12·5 ± 1·9 RBCC were transfused in each period. Storage durations of A-GSH and C-RBCC were similar (8·9 days). Mean A-GSH-RBCC transfused Hb (g/kg/day) was not inferior to Control (0·113 ± 0·04 vs. 0·111 ± 0·04, P = 0·373, paired t-test). The upper bound of the one-sided 95% confidence interval for the treatment difference from the mixed effects model was 0·005 g/kg/day, within a non-inferiority margin of 0·017 g/kg/day. A-GSH-RBCC mean pre-transfusion Hb levels declined by 6·0 g/l. No antibodies to A-GSH-RBCC were detected, and there were no differences in adverse events. A-GSH-RBCCs offer potential to reduce infectious risk in TDT with a tolerable safety profile

Thermodynamic properties and structural stability of thorium dioxide

Using density functional theory (DFT) calculations, we have systematically investigated the thermodynamic properties and structural stabilities of thorium dioxide (ThO$_2$). Based on the calculated phonon dispersion curves, we calculate the thermal expansion coefficient, bulk modulus, and heat capacities at different temperatures for ThO$_2$ under the quasi-harmonic approximation. All the results are in good agreement with corresponding experiments proving the validity of our methods. Our theoretical studies can help people more clearly understand the thermodynamic behaviors of ThO$_2$ at different temperatures. In addition, we have also studied possible defect formations and diffusion behaviors of helium in ThO$_2$, to discuss its structural stability. It is found that in intrinsic ThO$_2$ without any Fermi energy shifts, the interstitial Th$_i^{4+}$ defect other than oxygen or thorium vacancies, interstitial oxygen, and any kinds of Frenkel pairs, is most probable to form with an energy release of 1.74 eV. However, after upshifting the Fermi energy, the formation of the other defects also becomes possible. For helium diffusion, we find that only through the thorium vacancy can it happen with the small energy barrier of 0.52 eV. Otherwise, helium atoms can hardly incorporate or diffuse in ThO$_2$. Our results indicate that people should prevent upshifts of the Fermi energy of ThO$_2$ to avoid the formation of thorium vacancies and so as to prevent helium caused damages.Comment: 11 pages, 11 figure

Nonmyeloablative Peripheral Blood Haploidentical Stem Cell Transplantation for Refractory Severe Aplastic Anemia

New transplant approaches are urgently needed for patients with refractory severe aplastic anemia (SAA) who lack a matched sibling or unrelated donor (UD) or who have failed UD or cord blood transplant. Patients with refractory SAA are at risk of later clonal evolution to myelodysplastic syndrome and acute leukemia. We report our pilot findings with haploidentical hematopoietic stem cell transplantation (haploHSCT) using uniform reduced-intensity conditioning with postgraft high-dose cyclophosphamide in 8 patients with refractory SAA or patients who rejected a prior UD or cord blood transplant. Six of 8 patients engrafted. Graft failure was associated with donor-directed HLA antibodies, despite intensive pre-HSCT desensitization with plasma exchange and rituximab. There was only 1 case of grade II skin graft-versus-host disease. We show that haploHSCT can successfully rescue refractory SAA patients who lack donor-directed HLA antibodies but not in the presence of donor-directed HLA antibodies. This novel protocol for haploHSCT for SAA has been adopted by the European Group for Blood and Marrow Transplantation Severe Aplastic Anaemia Working Party for a future noninterventional, observational study to further evaluate its efficacy