Cold steel versus impedance-dependent tissue sealer tonsillectomy - a study protocol for a randomised controlled trial

INTRODUCTION: Approximately 7,000 tonsillectomies are performed annually in Denmark on a benign basis. The cold steel surgical technique is the gold standard. The risk of post tonsillectomy bleeding (PTH) in a centre in Jutland is 7.9%. A new impedance-dependent tissue sealer (IDTS) device has been developed, with preliminary results showing a reduction in operation time, perioperative bleeding and post-operative risk of bleeding of 4.5%.METHODS: A randomised, controlled, double-blinded multicentre trial of cold steel tonsillectomy versus IDTS will be performed on 1,250 patients. The main endpoint is PTH, perioperative bleeding, operation time and post-operative pain. The secondary outcomes are days until return to work, food intake, activity and quality of life. Included in the study are patients with indication for surgery weighing ≥ 16 kg, and excluded are patients with malignancy, bleeding disorders and unwillingness to participate in the study.CONCLUSIONS: To our knowledge, the present study is the largest randomised controlled trial in ENT surgery in the Nordic countries. The study will potentially provide evidence on PTH regarding two tonsillectomy methods.FUNDING: The authors have no potential conflicts of interest to declare. The study is supplied with instruments from Medtronic needed for the surgical procedures. Furthermore, a minor part of the funding of the entire project is provided by the aforementioned company. The funding providers have no role in design or conduct of the study.CLINICALTRIALS: gov with the identification number NCT05270109.</p

Project Half Double: results of phase 1 and phase 2 - June 2019

The purpose of this report in a series of reports from Project Half Double is to present the final overall results from phase 1 and phase 2 of Project Half Double as well as to describe the nine pilot projects from phase 2 in detail

Selection criteria for early breast cancer patients in the DBCG proton trial – The randomised phase III trial strategy

Background and purpose Adjuvant radiotherapy of internal mammary nodes (IMN) improves survival in high-risk early breast cancer patients but inevitably leads to more dose to heart and lung. Target coverage is often compromised to meet heart/lung dose constraints. We estimate heart and lung dose when target coverage is not compromised in consecutive patients. These estimates are used to guide the choice of selection criteria for the randomised Danish Breast Cancer Group (DBCG) Proton Trial.Materials and methods 179 breast cancer patients already treated with loco-regional IMN radiotherapy from 18 European departments were included. If the clinically delivered treatment plan did not comply with defined target coverage requirements, the plan was modified retrospectively until sufficient coverage was reached. The choice of selection criteria was based on the estimated number of eligible patients for different heart and lung dose thresholds in combination with proton therapy capacity limitations and dose-response relationships for heart and lung.Results Median mean heart dose was 3.0 Gy (range, 1.1-8.2 Gy) for left-sided and 1.4 Gy (0.4-11.5 Gy) for right-sided treatment plans. Median V17Gy/V20Gy (hypofractionated/normofractionated plans) for ipsilateral lung was 31% (9-57%). The DBCG Radiotherapy Committee chose mean heart dose ≥ 4 Gy and/or lung V17Gy/V20Gy ≥ 37% as thresholds for inclusion in the randomised trial. Using these thresholds, we estimate that 22% of patients requiring loco-regional IMN radiotherapy will be eligible for the trial.Conclusion The patient selection criteria for the DBCG Proton Trial are mean heart dose ≥ 4 Gy and/or lung V17Gy/V20Gy ≥ 37%

Uniform Atmospheric Retrieval Analysis of Ultracool Dwarfs I : Characterizing Benchmarks, Gl570D and HD3651B

Michael Line, et al, 'UNIFORM ATMOSPHERIC RETRIEVAL ANALYSIS OF ULTRACOOL DWARFS. I. CHARACTERIZING BENCHMARKS, Gl 570D AND HD 3651B', The Astrophysical Journal, Vol. 802 (2), July 2015, doi: https://doi.org/10.1088/0004-637X/807/2/183, published by IOP.Interpreting the spectra of brown dwarfs is key to determining the fundamental physical and chemical processes occurring in their atmospheres. Powerful Bayesian atmospheric retrieval tools have recently been applied to both exoplanet and brown dwarf spectra to tease out the thermal structures and molecular abundances to understand those processes. In this manuscript we develop a significantly upgraded retrieval method and apply it to the SpeX spectral library data of two benchmark late T-dwarfs, Gl570D and HD3651B, to establish the validity of our upgraded forward model parameterization and Bayesian estimator. Our retrieved metallicities, gravities, and effective temperature are consistent with the metallicity and presumed ages of the systems. We add the carbon-to-oxygen ratio as a new dimension to benchmark systems and find good agreement between carbon-to-oxygens ratio derived in the brown dwarfs and the host stars. Furthermore, we have for the first time unambiguously determined the presence of ammonia in the low-resolution spectra of these two late T-dwarfs. We also show that the retrieved results are not significantly impacted by the possible presence of clouds, though some quantities are significantly impacted by uncertainties in photometry. This investigation represents a watershed study in establishing the utility of atmospheric retrieval approaches on brown dwarf spectra.Peer reviewedFinal Published versio