Effect of varying injection rates of a saline chaser on aortic enhancement in CT angiography: phantom study

The effect of varying injection rates of a saline chaser on aortic enhancement in computed tomography (CT) angiography was determined. Single-level, dynamic CT images of a physiological flow phantom were acquired between 0 and 50 s after initiation of contrast medium injection. Four injection protocols were applied with identical contrast medium administration (150ml injected at 5ml/s). For baseline protocol A, no saline chaser was applied. For protocols B, C, and D, 50ml of saline was injected at 2.5ml/s, 5ml/s, and 10ml/s, respectively. Injecting the saline chaser at twice the rate as the contrast medium yielded significantly higher peak aortic enhancement values than injecting the saline at half or at the same rate as the contrast medium (P  0.05). In CT angiography, saline chaser injected at twice the rate as the contrast medium leads to increased peak aortic enhancement and saline chaser injected at half the rate tends towards prolonging peak aortic enhancement platea

The Odyssey of Dental Anxiety: From Prehistory to the Present. A Narrative Review

Dental anxiety (DA) can be considered as a universal phenomenon with a high prevalence worldwide; DA and pain are also the main causes for medical emergencies in the dental office, so their prevention is an essential part of patient safety and overall quality of care. Being DA and its consequences closely related to the fight-or-flight reaction, it seems reasonable to argue that the odyssey of DA began way back in the distant past, and has since probably evolved in parallel with the development of fight-or-flight reactions, implicit memory and knowledge, and ultimately consciousness. Basic emotions are related to survival functions in an inseparable psychosomatic unity that enable an immediate response to critical situations rather than generating knowledge, which is why many anxious patients are unaware of the cause of their anxiety. Archeological findings suggest that humans have been surprisingly skillful and knowledgeable since prehistory. Neanderthals used medicinal plants; and relics of dental tools bear witness to a kind of Neolithic proto-dentistry. In the two millennia BC, Egyptian and Greek physicians used both plants (such as papaver somniferum) and incubation (a forerunner of modern hypnosis, e.g., in the sleep temples dedicated to Asclepius) in the attempt to provide some form of therapy and painless surgery, whereas modern scientific medicine strongly understated the role of subjectivity and mind-body approaches until recently. DA has a wide range of causes and its management is far from being a matter of identifying the ideal sedative drug. A patient's proper management must include assessing his/her dental anxiety, ensuring good communications, and providing information (iatrosedation), effective local anesthesia, hypnosis, and/or a wise use of sedative drugs where necessary. Any weak link in this chain can cause avoidable suffering, mistrust, and emergencies, as well as having lifelong psychological consequences. Iatrosedation and hypnosis are no less relevant than drugs and should be considered as primary tools for the management of DA. Unlike pharmacological sedation, they allow to help patients cope with the dental procedure and also overcome their anxiety: achieving the latter may enable them to face future dental care autonomously, whereas pharmacological sedation can only afford a transient respite

An overview of progress in electrolytes for secondary zinc-air batteries and other storage systems based on zinc

The revived interest and research on the development of novel energy storage systems with exceptional inherent safety, environmentally benign and low cost for integration in large scale electricity grid and electric vehicles is now driven by the global energy policies. Within various technical challenges yet to be resolved and despite extensive studies, the low cycle life of the zinc anode is still hindering the implementation of rechargeable zinc batteries at industrial scale. This review presents an extensive overview of electrolytes for rechargeable zinc batteries in relation to the anode issues which are closely affected by the electrolyte nature. Widely studied aqueous electrolytes, from alkaline to acidic pH, as well as non-aqueous systems including polymeric and room temperature ionic liquids are reported. References from early rechargeable Zn-air research to recent results on novel Zn hybrid systems have been analyzed. The ambition is to identify the challenges of the electrolyte system and to compile the proposed improvements and solutions. Ultimately, all the technologies based on zinc, including the more recently proposed novel zinc hybrid batteries combining the strong points of lithium-ion, redox-flow and metal-air systems, can benefit from this compilation in order to improve secondary zinc based batteries performance.Basque Country University (ZABALDUZ2012 program), and the Basque Country Government (Project: CIC energiGUNÉ16 of the ELKARTEK program) and the European Commission through the project ZAS: “Zinc Air Secondary innovative nanotech based batteries for efficient energy storage” (Grant Agreement 646186

Eli Nichols letter to Benjamin Lundy, March 17th, 1839

Friendly note from Eli Nichols to Benjamin Lundy covering topics in contemporary abolition, ranging from the social status of abolitionists to the oppression of the poor. Much of the letter concerns a review of contemporary social movements in equality-based education, including Shaker and Quaker communities. The letter concludes in discussion of Nichols' and Lundy's interest in forming a freed slave colony or community in then-Mexico, and describes the climate and culture of those regions in detail. Benjamin Lundy (1789-1839) was a prominent Quaker abolitionist best known for his development of abolitionist periodicals. His Genius of Universal Emancipation was first published in 1821 from his home in Mt. Pleasant, Ohio, and enjoyed a wide circulation across the antebellum United States. In the 1820s, the young William Lloyd Garrison came to work for The Genius. Benjamin Lundy traveled widely seeking subscriptions to The Genius, giving talks about the anti-slavery movement, and observing and documenting the conditions of enslaved people across the Americas. He was also involved in the establishment of freed slave colonies in Mexico

Keratinocyte Carcinoma Chemoprevention With a Combination of Imiquimod, 5-Fluorouracil, and Tretinoin

BACKGROUNDThe incidence of keratinocyte carcinomas (KCs), comprising basal and squamous cell carcinomas, is rising in the United States. Chemoprevention is one modality by which patients can reduce the incidence of KCs. METHODSWe performed a retrospective review of 327 patients who employed a combination of imiquimod 5% cream, 5-fluorouracil 2% solution, and tretinoin 0.1% cream in a field therapy regimen over the face/ears or scalp for chemoprevention. RESULTSPatients had dramatically lower odds of having KCs in the treatment location (face/ears or scalp) in the one-year period after field treatment than in the one-year period preceding field treatment (OR=0.06, 95% CI: [0.02, 0.15]). Patients were also at lower odds of having KCs in non-treated areas the year after field treatment than in the year preceding it (OR=0.25, 95% CI: [0.14, 0.42]). Additionally, fewer cryotherapy sessions were performed for actinic keratoses in the treatment areas in the year after treatment (mean=1.5, SD=1.21) than the year preceding treatment (mean=2.3, SD=0.99; t=11.68, P<0.001). CONCLUSIONSA combination of imiquimod 5% cream, 5-fluorouracil 2% solution, and tretinoin 0.1% cream were effective at reducing the incidence of new KCs for at least one year. Individualized treatment application frequency allowed for increased patient adherence. Prospective studies evaluating combination topical treatments for chemoprevention of KCs are needed to further assess the treatment effects found in this study. J Drugs Dermatol. 2023;22(5): doi:10.36849/JDD.7334

Effect of varying injection rates of a saline chaser on aortic enhancement in CT angiography: phantom study

The effect of varying injection rates of a saline chaser on aortic enhancement in computed tomography (CT) angiography was determined. Single-level, dynamic CT images of a physiological flow phantom were acquired between 0 and 50 s after initiation of contrast medium injection. Four injection protocols were applied with identical contrast medium administration (150 ml injected at 5 ml/s). For baseline protocol A, no saline chaser was applied. For protocols B, C, and D, 50 ml of saline was injected at 2.5 ml/s, 5 ml/s, and 10 ml/s, respectively. Injecting the saline chaser at twice the rate as the contrast medium yielded significantly higher peak aortic enhancement values than injecting the saline at half or at the same rate as the contrast medium (P 0.05). In CT angiography, saline chaser injected at twice the rate as the contrast medium leads to increased peak aortic enhancement and saline chaser injected at half the rate tends towards prolonging peak aortic enhancement plateau

Modifying peripheral IV catheters with side holes and side slits results in favorable changes in fluid dynamic properties during the injection of iodinated contrast material

OBJECTIVE: The purpose of this study was to compare a standard peripheral end-hole angiocatheter with those modified with side holes or side slits using experimental optical techniques to qualitatively compare the contrast material exit jets and using numeric techniques to provide flow visualization and quantitative comparisons. MATERIALS AND METHODS: A Schlieren imaging system was used to visualize the angiocatheter exit jet fluid dynamics at two different flow rates. Catheters were modified by drilling through-and-through side holes or by cutting slits into the catheters. A commercial computational fluid dynamics package was used to calculate numeric results for various vessel diameters and catheter orientations. RESULTS: Experimental images showed that modifying standard peripheral IV angiocatheters with side holes or side slits qualitatively changed the overall flow field and caused the exiting jet to become less well defined. Numeric calculations showed that the addition of side holes or slits resulted in a 9-30% reduction of the velocity of contrast material exiting the end hole of the angiocatheter. With the catheter tip directed obliquely to the wall, the maximum wall shear stress was always highest for the unmodified catheter and was always lowest for the four-side-slit catheter. CONCLUSION: Modified angiocatheters may have the potential to reduce extravasation events in patients by reducing vessel wall shear stress