Determination of normal splenic volume in relation to age, gender and body habitus: a stereological study on computed tomography

Background: The aim of this study is to assess and document the dimensions of the normal spleen measured on computed tomography (CT) images with the normal splenic volume measured by Cavalieri principle on CT images and thereby serve as a baseline for comparison in cases of splenomegaly using abdominal CT. To investigate the relationship between these changes and body mass index, gender, abdominal diameters.Materials and methods: We retrospectively reviewed abdominal CT examinations of 212 adults between the ages of 20 and 88 years. There were seven groups of patients. The spleen volume (SV) measurements using abdominal CT images of each patient on the Image Information Systems were performed with Cavalieri principle.Results: The mean SV and splenic length (SL), width (SW), and thickness (ST) for the total study population of 212 patients was 198 ± 88 cm3, 9.96 ± 2.1 cm, 8.87 ±± 1.6 cm and 4.58 ± 0.8 cm, respectively. There was a strong correlation between SV and ST (r = 0.752, p < 0.001), SL (r = 0.735, p < 0.001), SW (r = 0.681,p < 0.001) mean values of total study population. Comparison between mean splenic dimension parameters for males and females showed a statistically significant difference (p = 0.032 for SV, p = 0.04 for ST) but no statistically significant difference with SL and SW. Also there was a positive correlation between SV and body height, sagittal abdominal diameter and transvers abdominal diameter in mean of total groups and female groups, there was no correlation in males.Conclusions: The normal reference ranges for SV and size given in this study canserve as a standard to judge whether splenomegaly is present in patients

Volumetric evaluation of fat in the renal sinus in normal subjects using stereological method on computed tomography images and its relationship with body composition

Background: The aim of the study was: to describe a simple, accurate and practical technique for estimating the volume of adipose tissue within the renal sinus (RS) using stereological method on computed tomography (CT) images; to establish a population database for volume of fat within the RS from 21 to 80 years of age; to investigate the effect of age, gender, body mass index (BMI) and abdominal diameters on RS fat volume in normal subjects.Materials and methods: We retrospectively reviewed abdominal CT examinations of 240 patients without renal pathology between the ages of 21 and 80 years. There were 6 groups of patients, with 40 patients for each decade.Results: RS fat volumes in the left and right kidney were 5.70 ± 2.87 cm3 and 4.15 ± 2.39 cm3, respectively, in males and 3.51 ± 2.67 cm3 and 2.49 ± 2.16 cm3, respectively, in females. RS fat volume and age were positively correlated for both kidneys (left: r = 0.46; right: r = 0.44; p < 0.001, both), though it appeared to decline after age 70.Conclusions: Quantitative data may allow clinicians to better estimate the age-related RS fat volume changes and help them in decision making

A wideband linear tunable CDTA and its application in field programmable analogue array

This document is the Accepted Manuscript version of the following article: Hu, Z., Wang, C., Sun, J. et al. ‘A wideband linear tunable CDTA and its application in field programmable analogue array’, Analog Integrated Circuits and Signal Processing, Vol. 88 (3): 465-483, September 2016. Under embargo. Embargo end date: 6 June 2017. The final publication is available at Springer via https://link.springer.com/article/10.1007%2Fs10470-016-0772-7 © Springer Science+Business Media New York 2016In this paper, a NMOS-based wideband low power and linear tunable transconductance current differencing transconductance amplifier (CDTA) is presented. Based on the NMOS CDTA, a novel simple and easily reconfigurable configurable analogue block (CAB) is designed. Moreover, using the novel CAB, a simple and versatile butterfly-shaped FPAA structure is introduced. The FPAA consists of six identical CABs, and it could realize six order current-mode low pass filter, second order current-mode universal filter, current-mode quadrature oscillator, current-mode multi-phase oscillator and current-mode multiplier for analog signal processing. The Cadence IC Design Tools 5.1.41 post-layout simulation and measurement results are included to confirm the theory.Peer reviewedFinal Accepted Versio

Capital Fixity and Mobility in Response to the 2008-09 Crisis: Variegated Neoliberalism in Mexico and Turkey

The article examines the 2008-9 crisis responses in Mexico and Turkey as examples of variegated neoliberalism. The simultaneous interests of corporations and banks relative to the national fixing of capital and their mobility in the form of global investment heavily influenced each state authority’s policy responses to the crisis at the expense of the interests of the poor, workers, and peasantry. Rather than pitching this as either evidence of persistent national differentiation or some Keynesian state resurgence, we argue from a historical materialist geographical framework that the responses of capital and state authorities in Mexico and Turkey actively constitute and reconstitute the global parameters of market regulatory design and neoliberal class rule through each state’s distinct domestic policy formation and crisis management processes. While differing in specific content the form of Mexico and Turkey’s state responses to the crisis ensured continuity in their foregoing neoliberal strategies of development and capital accumulation, most notably in the continued oppression of workers. That is, the prevailing strategy of accumulation continues to be variegated neoliberalism

Effect of Mill Type on Morphology of AA6013 Aluminium Powder

ABSTRACTIn conventional recycling method, metal chips are cast after pressing and melting in electric arc furnace. Material loss occurs during the recycling from liquid metal due to the several reasons. Direct recycling method which produces the aluminium powder from aluminium chips using mechanical mill can be an alternative to conventional recycling method. Thus material and energy losses, and labour cost will be reduced by direct recycling method without melting.In this study, the particle morphology of powder direct recycled from AA6013 aluminium alloy chips with cryogenic, disc and ball type grinders is investigated. Mechanical milling resulted flaky and irregular shaped AA6013 particles. It was ascertained that the chips did not break sufficiently in despite of the long duration milling mechanisms by ball mill. Cryogenic mill provides the energy required for milling mechanisms to act. Disc mill has the highest impact energy was determined. Consequently, efficiency of ball mill is lower than the efficiency of cryogenic and disc type mills. Shape factors of powders produced with ball and cryogenic mills were found greater than that of the powder produced by disc mill. Disc mill has the most efficient and effective impact energy which produces the smaller particles per minute, was determined.Keywords: Direct recycling method, powder production, scrap chips, aluminium alloy.

Storylines of family medicine V:ways of thinking-honing the therapeutic self

Storylines of Family Medicine is a 12-part series of thematically linked essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'V: ways of thinking-honing the therapeutic self', authors present the following sections: 'Reflective practice in action', 'The doctor as drug-Balint groups', 'Cultivating compassion', 'Towards a humanistic approach to doctoring', 'Intimacy in family medicine', 'The many faces of suffering', 'Transcending suffering' and 'The power of listening to stories.' May readers feel a deeper sense of their own therapeutic agency by reflecting on these essays.</p

Pilot study to define criteria for Pituitary Tumors Centers of Excellence (PTCOE):results of an audit of leading international centers

Purpose: The Pituitary Society established the concept and mostly qualitative parameters for defining uniform criteria for Pituitary Tumor Centers of Excellence (PTCOEs) based on expert consensus. Aim of the study was to validate those previously proposed criteria through collection and evaluation of self-reported activity of several internationally-recognized tertiary pituitary centers, thereby transforming the qualitative 2017 definition into a validated quantitative one, which could serve as the basis for future objective PTCOE accreditation. Methods: An ad hoc prepared database was distributed to nine Pituitary Centers chosen by the Project Scientific Committee and comprising Centers of worldwide repute, which agreed to provide activity information derived from registries related to the years 2018–2020 and completing the database within 60 days. The database, provided by each center and composed of Excel® spreadsheets with requested specific information on leading and supporting teams, was reviewed by two blinded referees and all 9 candidate centers satisfied the overall PTCOE definition, according to referees’ evaluations. To obtain objective numerical criteria, median values for each activity/parameter were considered as the preferred PTCOE definition target, whereas the low limit of the range was selected as the acceptable target for each respective parameter. Results: Three dedicated pituitary neurosurgeons are preferred, whereas one dedicated surgeon is acceptable. Moreover, 100 surgical procedures per center per year are preferred, while the results indicated that 50 surgeries per year are acceptable. Acute post-surgery complications, including mortality and readmission rates, should preferably be negligible or nonexistent, but acceptable criterion is a rate lower than 10% of patients with complications requiring readmission within 30 days after surgery. Four endocrinologists devoted to pituitary diseases are requested in a PTCOE and the total population of patients followed in a PTCOE should not be less than 850. It appears acceptable that at least one dedicated/expert in pituitary diseases is present in neuroradiology, pathology, and ophthalmology groups, whereas at least two expert radiation oncologists are needed. Conclusion: This is, to our knowledge, the first study to survey and evaluate the activity of a relevant number of high-volume centers in the pituitary field. This effort, internally validated by ad hoc reviewers, allowed for transformation of previously formulated theoretical criteria for the definition of a PTCOE to precise numerical definitions based on real-life evidence. The application of a derived synopsis of criteria could be used by independent bodies for accreditation of pituitary centers as PTCOEs.</p

Standards of care for medical management of acromegaly in pituitary tumor centers of excellence (PTCOE)

Purpose: A series of consensus guidelines on medical treatment of acromegaly have been produced in the last two decades. However, little information is available on their application in clinical practice. Furthermore, international standards of acromegaly care have not been published. The aim of our study was to report current standards of care for medical therapy of acromegaly, using results collected through an audit performed to validate criteria for definition of Pituitary Tumor Centers of Excellence (PTCOE). Methods: Details of medical treatment approaches to acromegaly were voluntarily provided by nine renowned international centers that participated in this audit. For the period 2018–2020, we assessed overall number of acromegaly patients under medical treatment, distribution of patients on different treatment modalities, overall biochemical control rate with medical therapy, and specific control rates for different medical treatment options. Results: Median number of total patients and median number of new patients with acromegaly managed annually in the endocrinology units of the centers were 206 and 16.3, respectively. Median percentage of acromegaly patients on medical treatment was 48.9%. Among the patients on medical treatment, first-generation somatostatin receptor ligand (SRL) monotherapy was used with a median rate of 48.7%, followed by combination therapies with a median rate of 29.3%. Cabergoline monotherapy was used in 6.9% of patients. Pegvisomant monotherapy was used in 7 centers and pasireotide monotherapy in 5 centers, with median rates of 7.9% and 6.3%, respectively. Conclusions: Current standards of care in PTCOEs include use of first-generation SRLs as the first medical option in about 50% of patients, as recommended by consensus guidelines. However, some patients are kept on this treatment despite inadequate control suggesting that cost-effectiveness, availability, patient preference, side effects, and therapeutic inertia may play a possible role also in PTCOE. Moreover, at odds with consensus guidelines, other monotherapies for acromegaly appear to have a marginal role as compared to combination therapies as extrapolated from PTCOE practice data. Presence of uncontrolled patients in each treatment category suggest that further optimization of medical therapy, as well as use of other therapeutic tools such as radiosurgery may be needed

Communication Research

Contains reports on seven research projects.Rockefeller FoundationCarnegie Foundatio

Communication Research

Contains reports on nine research projects.Bell Telephone Laboratories, Incorporate