243 research outputs found
Rectal use of levetiracetam: best practice report for a stepwise approach for sustainable off-label decision making and treatment
City policies to promote entrepreneurship: A cross-country comparison of Poland and Germany
Purpose: The policy to promote entrepreneurship plays a central role in the strategic management of cities. Therefore, the research question asks how urban policies in Poland support knowledge spillovers and entrepreneurship in comparison to German cities’ policies. Also investigated is how do Polish and German cities support entrepreneurship in different forms (including social entrepreneurship, youth entrepreneurship, and creative industries). Methodology: To answer this question, we have adopted a multiple-case study methodology relying on multiple sources of evidence, primarily strategic documents of the biggest Polish cities in the context of cross-country comparison with selected large cities in Germany, and semi-structured interviews with decision-makers representing municipalities from the analyzed cities in Poland. Building on the concept of the knowledge spillover theory of entrepreneurship, we refer to the approach in which spillovers of knowledge are a strategic lever through which firms distribute innovation and have profound implications for the region’s entrepreneurial activities development. Findings/research and practical implications: The research enriches our understanding of urban policies in Poland that support knowledge spillovers and entrepreneurship, and discovers the possible relationship between factors determining entrepreneurship in Polish and German cities. In all Polish and German cities, entrepreneurship was an important component of economic development strategy. However, Polish cities depend on EU funding to a much greater extent than German cities in implementing their economic development strategies. Cluster strategies in the framework of key cities’ industries were embedded in most urban policies, but a majority of Polish respondents believed that their cities should place greater emphasis on this policy. The main challenge for policy-makers is that current entrepreneurial polices should be more effective and oriented towards reinforcing the social perception of entrepreneurship, especially among young inhabitants. Originality/value: The research allowed enough data to be gathered to answer the research questions. However, future research validating the results in quantitative study is suggested. Also, some limitations in the research process were highlighted, such as a lack of personal contact with the respondents or different levels of economic development among Polish and German cities. Our research demonstrates the opportunities for knowledge spillover and sharing of good practices between the two countrie
Reproducibility of lymphovascular space invasion (LVSI) assessment in endometrial cancer
Aims Lymphovascular space invasion (LVSI) in endometrial cancer (EC) is an important prognostic variable impacting on a patient's individual recurrence risk and adjuvant treatment recommendations. Recent work has shown that grading the extent of LVSI further improves its prognostic strength in patients with stage I endometrioid EC. Despite this, there is little information on the reproducibility of LVSI assessment in EC. Therefore, we designed a study to evaluate interobserver agreement in discriminating true LVSI from LVSI mimics (Phase I) and reproducibility of grading extent of LVSI (Phase II). Methods and results Scanned haematoxylin and eosin (H&E) slides of endometrioid EC (EEC) with a predefined possible LVSI focus were hosted on a website and assessed by a panel of six European gynaecological pathologists. In Phase I, 48 H&E slides were included for LVSI assessment and in Phase II, 42 H&E slides for LVSI grading. Each observer was instructed to apply the criteria for LVSI used in daily practice. The degree of agreement was measured using the two-way absolute agreement average-measures intraclass correlation coefficient (ICC). Reproducibility of LVSI assessment (ICC = 0.64, P < 0.001) and LVSI grading (ICC = 0.62, P < 0.001) in EEC was substantial among the observers. Conclusions Given the good reproducibility of LVSI, this study further supports the important role of LVSI in decision algorithms for adjuvant treatment
Видатний український історик-музикознавець (М. О. Грінченко)
У статті розкриваються основні віхи життєвого й творчого шляху М. О. Грінченка. Характеризуються провідні тенденції еволюції українського музикознавства другої половини ХIХ – першої третини ХХ ст. Виявляється роль музично-історичної спадщини вченого в тогочасному музикознавчому процесі, а також її зв’язки з музично-історичними дослідженнями наступних радянських десятиліть, сучасного періоду.В статье раскрываются основне вехи жизненного и творческого пути Н. А. Гринченко. Характеризуються ведущие тенденции эволюции украинского музыковедения второй половины ХIХ – первой трети ХХ в. Выявляется роль музыкально-исторического наследия ученого в контексте музыковедческого процесса того времени, а также его связи с музыкально-историческими исследованиями последующих советских десятилетий, современного периода.In the article main events of the outstanding Ukrainian musicologist M. Grinchenko`s life are considered. There are characterized tendencies of the Ukrainian musicology development (the latter half of the 19th – the 1st triens of the 20th). There is brought out the role of scientific works by M. Grinchenko in the context of that time
The impact of bone marrow sparing on organs at risk dose for cervical cancer:a Pareto front analysis
Background and purpose: To quantify the increase in bladder and rectum dose of a bone marrow sparing (BMS) VMAT strategy for primary treatment of locally advanced cervical cancer (LACC). Materials and methods: Twenty patients with stage IB-IVA cervical cancer were selected for this study. The whole Pelvic Bones (PB) was taken as substitute for bone marrow. For every patient, Pareto-optimal plans were generated to explore the trade-off between rectum, bladder, and PB mean dose. The PB mean dose was decreased in steps of 1 Gy. For each step, the increase in rectum and bladder mean dose was quantified. The increase in mean dose of other OAR compared to no BMS was constrained to 1 Gy. Results: In total, 931 plans of 19 evaluable patients were analyzed. The average [range] mean dose of PB without BMS was 22.8 [20.7-26.2] Gy. When maximum BMS was applied, the average reduction in mean PB dose was 5.4 [3.0-6.8] Gy resulting in an average mean PB dose of 17.5 [15.8-19.8] Gy. For <1 Gy increase in both the bladder and the rectum mean dose, the PB mean dose could be decreased by >2 Gy, >3 Gy, >4 Gy, and >5 Gy for 19/19, 13/19, 5/19, and 1/19 patients, respectively. Conclusion: Based on the comprehensive three-dimensional Pareto front analysis, we conclude that 2-5 Gy BMS can be implemented without a clinically relevant increase in mean dose to other OAR. If BMS is too dominant, it results in a large increase in mean dose to other OAR. Therefore, we recommend implementing moderate BMS for the treatment of LACC patients with VMAT.</p
Cerebral attenuation on single-phase CT angiography source images: Automated ischemia detection and morphologic outcome prediction after thrombectomy in patients with ischemic stroke
Objectives: Stroke triage using CT perfusion (CTP) or MRI gained importance after successful application in recent trials on late-window thrombectomy but is often unavailable and time-consuming. We tested the clinical value of software-based analysis of cerebral attenuation on Single-phase CT angiography source images (CTASI) as CTP surrogate in stroke patients. Methods: Software-based automated segmentation and Hounsfield unit (HU) measurements for all regions of the Alberta Stroke Program Early CT Score (ASPECTS) on CTASI were performed in patients with large vessel occlusion stroke who underwent thrombectomy. To normalize values, we calculated relative HU (rHU) as ratio of affected to unaffected hemisphere. Ischemic regions, regional ischemic core and final infarction were determined on simultaneously acquired CTP and follow-up imaging as ground truth. Receiver operating characteristics analysis was performed to calculate the area-under-the-curve (AUC). Resulting cut-off values were used for comparison with visual analysis and to calculate an 11-point automated CTASI ASPECTS. Results: Seventy-nine patients were included. rHU values enabled significant classification of ischemic involvement on CTP in all ten regions of the ASPECTS (each p<0.001, except M4-cortex p = 0.002). Classification of ischemic core and prediction of final infarction had best results in subcortical regions but produced lower AUC values with significant classification for all regions except M1, M3 and M5. Relative total hemispheric attenuation provided strong linear correlation with CTP total ischemic volume. Automated classification of regional ischemia on CTASI was significantly more accurate in most regions and provided better agreement with CTP cerebral blood flow ASPECTS than visual assessment. Conclusions: Automated attenuation measurements on CTASI provide excellent performance in detecting acute ischemia as identified on CTP with improved accuracy compared to visual analysis. However, value for the approximation of ischemic core and morphologic outcome in large vessel occlusion stroke after thrombectomy was regionally dependent and limited. This technique has the potential to facilitate stroke imaging as sensitive surrogate for CTP-based ischemia
An anthropomorphic deformable phantom of the vaginal wall and cavity
Brachytherapy is a common treatment in cervical, uterine and vaginal cancer management. The technique is characterised by rapid developments in the fields of medical imaging, dosimetry planning and personalised medical device design. To reduce unnecessary burden on patients, assessments and training of these technologies should preferable be done using high-fidelity physical phantoms. In this study, anthropomorphic deformable phantoms of the vaginal wall and cavity were developed for image-guided adaptive brachytherapy, in which vaginal wall biomechanics were mimicked. Phantoms were produced from both silicone and polyvinyl alcohol materials. Material characterisations were performed with uniaxial tensile tests, via which Young’s moduli and toughness were quantified. In addition, the contrast between adjacent phantom layers was quantified in magnetic resonance images. The results showed that stress-strain curves of the silicone phantoms were within the range of those found in healthy human vaginal wall tissues. Sample preconditioning had a large effect on Young’s moduli, which ranged between 2.13 and 6.94 MPa in silicone. Toughness was a more robust and accurate metric for biomechanical matching, and ranged between 0.23 and 0.28 ·106 J·m-3 as a result of preconditioning. The polyvinyl alcohol phantoms were not stiff or tough enough, with a Young’s modulus of 0.16 MPa and toughness of 0.02 ·106 J·m-3. All materials used could be clearly delineated in magnetic resonance images, although the MRI sequence did affect layer contrast. In conclusion, we developed anthropomorphic deformable phantoms that mimic vaginal wall tissue and are well visible in magnetic resonance images. These phantoms will be used to evaluate the properties and to optimise the development and use of personalised brachytherapy applicators.</p
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