Placental transmogrification of the lung associated with unilateral pleural effusion: A case report with a comprehensive review of the literature

© 2018 The Authors Placental transmogrification of the lung (PTL) is a rare benign pulmonary lesion resembling chorionic villi. With fewer than 40 cases reported in literature, associations have thus far been made with bullous emphysema, pulmonary fibrochondromatous hamartomas and adenocarcinoma of the lung. Typically presenting as unilateral solitary cystic or bullous lesion, we report the first case of PTL presenting with unilateral pleural effusion. A 70-year-old male presented with recurrent unilateral pleural effusion that failed to resolve with multiple thoracenteses. He underwent thoracoscopic excision and biopsy of a cystic mass identified on computed tomography (CT) scan which revealed characteristic villous and papillary changes. We describe the case and review the literature on this benign but rare pulmonary disease entity

An Upgraded Transverse Electromagnetic Parallel Plates for Dielectric Measurement

A new version of transverse electromagnetic parallel plates with irregular plates’ width and plate separation has been developed for dielectric measurement. The separations between the plates are supported by four rectangular Teflon block and 1 mm of groove is proposed at the center of the upper plate to maintain the measurement repeatability. The groove enables the samples which are slightly higher than 2 cm to be fitted well between the plates without introducing extra force to the plates. Theperformance of both parallel plates has been compared in the frequency range from 100 MHz to 1.1 GHz. It is found that the upgraded parallel plate offers better return loss and insertion loss above 500 MHz compared to the previous parallel plate. It is reported from this work that the return loss of the parallel plate must be lower than -15 dB in order to achieve accurate dielectric constant. However, the insertion loss of the parallel plates does not influence the real permeability significantly. The upgraded TEM parallel plateproduces a consistent reading with a standard deviation of less than 0.05 above frequency 200 MHz. The dielectric measurement of Polypropylene (PP) has proven the capability of this upgraded TEM parallelplate

Factors associated with severity of hepatic fibrosis in people with chronic hepatitis C infection

The document attached has been archived with permission from the editor of the Medical Journal of Australia. An external link to the publisher’s copy is included.OBJECTIVE: To determine factors associated with hepatic fibrosis development in people with chronic hepatitis C virus (HCV) infection. METHODS: As a requirement for access to interferon therapy through the S100 scheme in Australia, individual pretreatment demographic and clinical information was collected on 2986 patients from 61 hospital-based liver clinics from 1 October 1994 through 31 December 1996. Patients with both a hepatic fibrosis score and an estimated duration of HCV infection (910) were divided into 540 with no or minimal hepatic fibrosis (stage 0–1) and 370 with moderate to severe hepatic fibrosis (stage 2–3). Seven factors were examined: age at HCV infection, sex, ethnicity, source of infection, duration of infection, alcohol intake, and mean ALT level. A further analysis was performed for all 1135 patients with a hepatic fibrosis score disregarding age at and duration of HCV infection. RESULTS: In multivariate analysis, four factors were significantly associated with moderate to severe hepatic fibrosis: age at infection (OR, 2.33 for age 31–40 years, 5.27 for age > 40 years, and 0.20 for age 30 years, compared with 3 times, compared with 1.5–2 times the upper limit of normal). In the analysis disregarding age at HCV infection and duration of HCV infection, older age was strongly associated with moderate to severe hepatic fibrosis (OR, 2.32 for age 36–40 years, 2.46 for age 41–50 years, 7.87 for age 51–60 years, and 7.15 for age > 60 years, compared with 16–30 years). There was no association in either analysis with sex or source of HCV infection. CONCLUSION: These factors may assist in targeting patients for both liver biopsy-based investigation and therapeutic intervention.Mark Danta, Gregory J Dore, Lisa Hennessy, Yueming Li, Chris R Vickers, Hugh Harley, Meng Ngu, William Reed, Paul V Desmond, William Sievert, Geoff C Farrell, John M Kaldor and Robert G Bate

Timing of Contact X-ray Brachytherapy in organ-preserving treatment of rectal cancer

Timing of Contact X-ray Brachytherapy in organ-preserving treatment of small rectal cancer Objective For patients with early rectal cancer, who are either at high risk for or refuse surgery, a planned organ preservation treatment involving a combination of external beam radiotherapy (EBRT) and Contact X-ray Brachytherapy (CXB) can be offered as an alternative option to surgery. (1-3) However, the ideal sequence of treatment for small rectal tumours (≤3cm), whether to administer CXB first or after EBRT, has not yet been well established, leading to variable sequences of this organ-preserving treatment being used.(3-5) This study has compared the oncological outcomes between the two treatment approaches using propensity score matching and inverse probability treatment weighting (IPTW) analysis to evaluate whether starting with CXB confers any benefits to patients. Method We analysed patients who had undergone both EBRT and CXB with curative intent, regardless of the treatment sequence, from the prospectively collected database at Clatterbridge Cancer Centre (2008-2019). Only patients who had well to moderately differentiated rectal adenocarcinoma (cT1-3, cN0-1, cM0) and small tumour size (≤ 3cm) were included. The variables of age, sex, fitness for surgery, performance status, tumour stage, nodal stage, EBRT regimen and CXB total dose, were considered possible confounders of the association between treatment regimen and outcomes. The balance of covariates before and after propensity matching and IPTW was assessed by examining the standardised mean difference (SMD) between the groups (Figure 1). The oncological outcomes based on the treatment sequence were first assessed in an unadjusted analysis followed by an adjusted model analysis considering all variables as confounders. Then, we performed propensity score matching (nearest-neighbour method, calliper= 0.25) and calculated IPTW to weigh the full cohort in each regression model. Statistical analysis was performed in R 4.3.1. The primary outcome measures were overall survival (OS) and disease-free survival (DFS). Secondary outcome measures consisted of the local regrowth rate, organ preservation rate, and presence of post-treatment rectal bleeding. Results A total of 251 eligible patients, who received either EBRT (n=103) or CXB (n=148) as their initial treatment with curative intent were included in the study. Patients received a CXB dose of 90-110Gy in 3-4 fractions over 4-6 weeks (each fraction two weeks apart) either before or after EBRT. EBRT was administered either as long-course chemoradiotherapy (45-50Gy/25 #/35 days), long-course radiotherapy alone (45Gy/20#/28days), or short-course radiotherapy (25Gy/5#/5 days). Following treatment, a watch-and-wait policy was adopted for patients who achieved a clinical complete/near response. The median follow-up was 37 [IQR:18-56] months for the EBRT-first group and 32 [IQR:16-54] months for the CXB-first group. In the unadjusted analysis, a higher risk of grade-1(26%) and grade-2(6%) rectal bleeding (p=0.008) was observed in patients who started with CXB, but no significant differences in any of the survival parameters were found. Analysis using the adjusted, propensity matching, and IPTW models, demonstrated a significant improvement of OS (p=0.04, HR (95%CI): 0.69 (0.48-0.98) and a higher risk of grade 1-2 rectal bleeding (p=0.01, OR (95%CI): 2.35(1.16-4.76) in those patients who had been received CXB as their initial treatment (Figure 2). However, DFS (p=0.87), local regrowth rate (p=0.70), and organ preservation rate (p=0.80) were not significantly different between the two groups. Conclusion Small rectal cancer (≤3cm), commencing treatment with CXB, as opposed to EBRT, was associated with improved overall survival, despite an increased risk of grade 1 and 2 rectal bleeding. However, there was no statistically significant improvement in terms of disease-free survival, local regrowth rate, or organ preservation rate with this treatment strategy

Неравенство доходов в различных секторах экономики Вьетнама: анализ структурных связей

Несмотря на выдающиеся достижения в области сокращения бедности, неравенство доходов во Вьетнаме по-прежнему имеет тенденцию к увеличению, оказывая негативное влияние на устойчивое развитие страны. Цель исследования — выявление и измерение влияния секторов экономики на доходы различных групп населения; полученные данные могут быть использованы для снижения уровня бедности во Вьетнаме. Связь между секторами экономики и распределением доходов населения Вьетнама была выявлена при помощи методологии анализа структурных связей, основанной на матрице социальных счетов за 2016 г., которая до сих пор не получила широкого применения среди вьетнамских ученых. По сравнению с предыдущими работами, данное исследование проведено на уровне страны, а не региона. Также были подробно описаны факторы, влияющие на распределение доходов, такие как секторы экономики, трудовые ресурсы и группы населения. Анализ выявил, что распределение большей части доходов 25 секторов экономики происходит по 513 потокам. При расширении секторов экономики вследствие политических изменений повышение доходов населения в основном зависит от таких показателей, как квалификация работников, капитал и масштаб межотраслевых связей. Примечательно, что на доходы городских домохозяйств существенное влияние оказывает показатель «высококвалифицированный труд», в то время как капитал является наиболее важным фактором, влияющим на доходы сельских домохозяйств. Согласно проведенному анализу, 32 потока наиболее значимо влияют на доходы населения. Важную роль в борьбе с бедностью играют следующие секторы экономики: лесное хозяйство, древесина и изделия из древесины, рыболовство, добыча угля, сырой нефти и природного газа, производство обуви, поставки электроэнергии, газа, воды и коммунальных услуг, а также розничная и оптовая торговля. Полученные данные послужили основой для рекомендаций в области сокращения неравенства доходов

Неравенство доходов в различных секторах экономики Вьетнама: анализ структурных связей

Несмотря на выдающиеся достижения в области сокращения бедности, неравенство доходов во Вьетнаме по-прежнему имеет тенденцию к увеличению, оказывая негативное влияние на устойчивое развитие страны. Цель исследования — выявление и измерение влияния секторов экономики на доходы различных групп населения; полученные данные могут быть использованы для снижения уровня бедности во Вьетнаме. Связь между секторами экономики и распределением доходов населения Вьетнама была выявлена при помощи методологии анализа структурных связей, основанной на матрице социальных счетов за 2016 г., которая до сих пор не получила широкого применения среди вьетнамских ученых. По сравнению с предыдущими работами, данное исследование проведено на уровне страны, а не региона. Также были подробно описаны факторы, влияющие на распределение доходов, такие как секторы экономики, трудовые ресурсы и группы населения. Анализ выявил, что распределение большей части доходов 25 секторов экономики происходит по 513 потокам. При расширении секторов экономики вследствие политических изменений повышение доходов населения в основном зависит от таких показателей, как квалификация работников, капитал и масштаб межотраслевых связей. Примечательно, что на доходы городских домохозяйств существенное влияние оказывает показатель «высококвалифицированный труд», в то время как капитал является наиболее важным фактором, влияющим на доходы сельских домохозяйств. Согласно проведенному анализу, 32 потока наиболее значимо влияют на доходы населения. Важную роль в борьбе с бедностью играют следующие секторы экономики: лесное хозяйство, древесина и изделия из древесины, рыболовство, добыча угля, сырой нефти и природного газа, производство обуви, поставки электроэнергии, газа, воды и коммунальных услуг, а также розничная и оптовая торговля. Полученные данные послужили основой для рекомендаций в области сокращения неравенства доходов

A clamped bar model for the sompoton vibrator

The sompoton is one of famous traditional musical instruments in Sabah. This instrument consists of several parts with the vibrator being the most important one. In this paper, the vibrator is modeled as a clamped bar with a uniformly distributed mass. By means of this model, the fundamental frequency is analyzed with the use of an equivalent single degree of freedom system (SDOF) and exact analysis. The vibrator is made of aluminum in different sizes and is excited using a constant air jet to obtain its fundamental resonance frequency. The fundamental frequency obtained from the experimental measure- ment is compared with the theoretical values calculated based on the equivalent SDOF and exact analysis theories. It is found that the exact analysis gives a closer value to the experimental results as compared to the SDOF system. Although both the experimental and theoretical results exhibit the same trend, they are different in magnitude. To overcome the differences in both theories, a correction factor is added to account for the production errors

Contact X-ray brachytherapy (CXB) as a salvage treatment for rectal cancer patients who developed local tumor re-growth after watch-and-wait approach.

PurposeA watch-and-wait approach is an alternative to surgery for rectal cancer patients who have achieved a clinical complete response (cCR) following neoadjuvant (chemo)radiotherapy. However, approximately 25-38% of patients experience subsequent local tumor re-growth that requires salvage surgery. We evaluated the effectiveness of contact X-ray brachytherapy (CXB) as an alternative method of salvage therapy for those patients who were either unfit for or refused surgery. Oncological outcomes, tolerability, and feasibility of subsequent surgery for local treatment failure following CXB were reported.Material and methodsFrom 2009-2021, all patients treated with CXB as salvage therapy for local rectal cancer re-growth after watch-and-wait approach at our center were analyzed.ResultsContact X-ray brachytherapy as a salvage treatment (range, 90-110 Gy) was offered to 56 patients who experienced tumor re-growth following (chemo)radiation and watch-and-wait protocol. Median age was 76 (IQR = 66-83) years. Most patients (82%) had early-stage re-growth (ycT1/ycT2, ycN0), and 18% had more advanced stages (ycT3/ycT4, ycN0). After a median of 37-month follow-up (IQR = 19-53), 48% of patients who had early-stage re-growth achieved a sustained complete remission after CXB compared with 20% of those who had more advanced tumor stages. Disease-free and overall survivals for the whole cohort were 69% and 100% at 1-year, 51% and 82% at 3-year, and 51% and 65% at 5-years. CXB effectively controlled local re-growth-related symptoms. Mild post-CXB side effects occurred in 18% of cases. All (100%) eight patients who developed further local relapse, and 29% of those who had residual disease post-CXB salvage were successfully managed with subsequent surgery.ConclusionsContact X-ray brachytherapy offers a new treatment option for patients in this situation whose other therapy options are not suitable for or refused initial surgery. Early local tumor re-growth responded best with minimal treatment-related toxicity and excellent symptom control. Disease-free and overall survival rates were acceptable, and delaying surgical salvage for local re-growth did not compromise patients' eventual long-term outcomes