Automated grade classification of oral epithelial dysplasia using morphometric analysis of histology images

Oral dysplasia is a pre-malignant stage of oral epithelial carcinomas, e.g., oral squamous cell carcinoma, where significant changes in tissue layers and cells can be observed under the microscope. However, malignancy can be reverted or cured using proper medication or surgery if the grade of malignancy is assessed properly. The assessment of correct grade is therefore critical in patient management as it can change the treatment decisions and prognosis for the dysplastic lesion. This assessment is highly challenging due to considerable inter- and intraobserver variability in pathologists’ agreement, which highlights the need for an automated grading system that can predict more accurate and reliable grade. Recent advancements have made it possible for digital pathology (DP) and artificial intelligence (AI) to join forces from the digitization of tissue slides into images and using those images to train and predict more accurate grades using complex AI models. In this regard, we propose a novel morphometric approach exploiting the architectural features in dysplastic lesions i.e., irregular epithelial stratification where we measure the widths of different layers of the epithelium from the boundary layer i.e., keratin projecting inwards to the epithelium and basal layers to the rest of the tissue section from a clinically significant viewpoint

Valence-quark distributions in the pion

We calculate the pion's valence-quark momentum-fraction probability distribution using a Dyson-Schwinger equation model. Valence-quarks with an active mass of 0.30 GeV carry 71% of the pion's momentum at a resolving scale q_0=0.54 GeV = 1/(0.37 fm). The shape of the calculated distribution is characteristic of a strongly bound system and, evolved from q_0 to q=2 GeV, it yields first, second and third moments in agreement with lattice and phenomenological estimates, and valence-quarks carrying 49% of the pion's momentum. However, pointwise there is a discrepancy between our calculated distribution and that hitherto inferred from parametrisations of extant pion-nucleon Drell-Yan data.Comment: 8 pages, 3 figures, REVTEX, aps.sty, epsfig.sty, minor corrections, version to appear in PR

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Efficacy of differential dose of topical bupivacaine for post-operative pain management in paediatric ambulatory tonsillectomy: A prospective randomized study

Introduction: Tonsillectomy is one of the most commonly performed procedures in Otolaryngology. Poor postoperative pain management may result in unplanned admission. Topical application of bupivacaine has been shown to be safe with rare or no complications. This study aims to compare topical application of 0.5% bupivacaine and 0.25% Bupivacaine for post tonsillectomy pain management. Material and methods: This was a prospective randomized, double blind study of sixty patients ASA I and II patients aged between 5 to 12 years scheduled for ambulatory tonsillectomy. Anaesthesia was standardized for all patients. Patients were randomized into two groups A and B. After haemostasis was achieved, group A and B received 5mls of 0.5% and 0.25% soaked in a gauze on both sides of their tonsillar fossae tightly packed for 5 minutes. Pain intensity, Time to first analgesic dose and oral intake and cumulative dose of paracetamol before discharge was recorded. Results: There was significant reduction in pain intensity more among patients group A 1.46(±1.17) & 2.80(±0.81) compared to group B 3.16(±1.38) & 3.02(±1.62). Time to first analgesic request (TFA) was longer in group A 8.84 (3.24) hours, when compared to group B which had a mean duration of 6.72(1.56) hours, with a p-value of 0.036. The cumulative dose of paracetamol consumption (CDP) was also lower among patients who had 0.5% bupivacaine compared to 0.25% bupivacaine p-value = 0.018 Conclusion: This study demonstrated topical 0.5% Bupivacaine provided superior post-operative analgesia, early resumption to oral intake than topical application of 0.25% Bupivacaine without any side effec

Comparative effect of sedation with oral midazolam plus ketamine versus midazolam only on pre-operative behavioural changes among padiatrics day case dentistry: a prospective randomized control study

Introduction: Pediatrics required conscious sedation to allay anxiety and provide optimal conditions to perform procedures. This will enhance minimal separation of the children from their parents, ease of venous access, minimizing unwarranted peri-operative behavioral and psychological stress, and minimizing movement during the procedure Methodology: This was a prospective randomized double-blind study of ASA I and II patients aged between 3-10years schedule for outpatient dental procedures. Following institutional ethics committee approval, sixty eligible patients whose parents/guardians consented were randomly divided into two groups. Group (M) received oral midazolam 0.5mg/kg alone, and group (MK) received oral midazolam 0.25mg/kg combined with oral ketamine 3mg/kg. Both study drugs were mixed in 0.2ml/kg of Lucozade Boost and administered preoperatively. Data collected included were demographic variables, ease of parental separation, and level of cooperation at intravenous cannulation, onset and duration of sedation and associated of complications. Results: Our study revealed onset of sedation was significantly faster in group M than group MK; 23.20(±2.04) vs 27.83(±2.71) minutes. P value =0.002. The duration of sedation between the two groups though different was not statistically significant (P- value = 0.608). Sedation scores were higher after 30mins in group M but no excessive sedation was observed. Separation of patients from parents and cooperation at venipuncture was significantly better among patients in group MK compared to group M (P-value =0.036). Intra-operatively more patients had tachycardia and tachypnea in the MK than M group. Conclusion: Combination of oral midazolam-ketamine is better anxiolytic for parental separation and ease to venipuncture than oral midazolam alone

Off-Axis Electron Holography for the Quantitative Study of Magnetic Properties of Nanostructures: From the Single Nanomagnet to the Complex Device

International audienc

Caracterização de géis termorreversíveis de SEBS Characterization of thermoreversible gels of SEBS

RESUMO: Géis termorreversíveis preparados a partir de um copolímero em bloco de estireno - etileno/butileno - estireno (SEBS) e polietileno de baixa densidade dissolvidos em óleos minerais parafínicos e óleos polibutênicos, bem como em suas misturas, foram preparados e caracterizados por calorimetria diferencial de varredura (DSC) e análise dinâmico mecânica (DMA). Os termogramas obtidos por DMA mostraram um comportamento bastante distinto em função do óleo utilizado como solvente. O valor de Tg e o módulo de estocagem, G' correspondente à temperatura de "onset" variaram de 25 a 47ºC e 0,25 a 9 MPa, respectivamente. Os géis compostos com óleos parafínicos apresentaram os maiores valores de Tg e de G'. As análises de DSC revelaram um pico endotérmico que foi designado como sendo de dissolução, entre 75°C e 90°C e o correspondente pico exotérmico (60°C e 40°C) verificado durante o resfriamento. Esse processo de dissolução foi atribuído aos processos de fusão e solvatação dos cristalitos de polietileno. As transições observadas por DMA estão relacionadas aos domínios de poliestireno do copolímero em bloco, em conjunto com as transições do polietileno e são muito afetadas pelo tipo de solvente. Os géis estudados apresentam dois mecanismos distintos de gelificação, via formação de cristalitos de polietileno e via formação de agregados de poliestireno dos blocos terminais do SEBS. O efeito dos óleos aromáticos e naftênicos sobre o módulo dos materiais foi relacionado com um aumento na interação entre os agregados de poliestireno e a fase etileno-butileno.<br>Thermoreversible gels of styrene-ethylene/butylene-styrene block copolymers (SEBS) and low density polyethylene dissolved in mineral paraffinic and polybutene oils, as well its mixtures, were prepared and characterized by differential scanning calorimetry (DSC) and dynamic mechanical analysis (DMA). DMA analysis showed distinct behavior depending on the solvent used. The Tg value and storage modulus (G') at onset temperature ranges were 25 to 47°C and 0.25 MPa to 9 MPa, respectively. The gels prepared with paraffinic oil showed the highest values of Tg and G'. DSC analysis showed an endothermic transition from 75°C to 90°C and its correspondent exotherm during cooling from 60°C to 40°C. This transition was designated as dissolution due to fusion and solvation process of polyethylene crystallites. The transitions observed in DMA analysis depend on the solvent and are related to polystyrene domains of the block copolymer and to the polyethylene transitions and are affected by the oil used as solvent. The studied gels showed two different mechanism of gel formation, polyethylene crystallites and polystyrene aggregates. The effect of aromatic and naphthenic oils on the modulus was related to the improvement of interaction between the polystyrene domains and the ethylene/butylene phase