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1.
Sci Total Environ ; : 174253, 2024 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-38936713

RESUMEN

The global focus on wastewater treatment has intensified in the contemporary era due to its significant environmental and human health impacts. Pharmaceutical compounds (PCs) have become an emerging concern among various pollutants, as they resist conventional treatment methods and pose a severe environmental threat. Advanced oxidation processes (AOPs) emerge as a potent and environmentally benign approach for treating recalcitrant pharmaceuticals. To address the shortcomings of traditional treatment methods, a technology known as the electro-Fenton (EF) method has been developed more recently as an electrochemical advanced oxidation process (EAOP) that connects electrochemistry to the chemical Fenton process. It has shown effective in treating a variety of pharmaceutically active compounds and actual wastewaters. By producing H2O2 in situ through a two-electron reduction of dissolved O2 on an appropriate cathode, the EF process maximizes the benefits of electrochemistry. Herein, we have critically reviewed the application of the EF process, encompassing diverse reactor types and configurations, the underlying mechanisms involved in the degradation of pharmaceuticals and other emerging contaminants (ECs), and the impact of electrode materials on the process. The review also addresses the factors influencing the efficiency of the EF process, such as (i) pH, (ii) current density, (iii) H2O2 concentration, (iv) and others, while providing insight into the scalability potential of EF technology and its commercialization on a global scale. The review delves into future perspectives and implications concerning the ongoing challenges encountered in the operation of the electro-Fenton process for the treatment of PCs and other ECs.

2.
Glob Health Sci Pract ; 12(3)2024 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-38936961

RESUMEN

Countries that are high burden for TB must reverse the COVID-19 pandemic's devastating effects to accelerate progress toward ending TB. Vietnam's Double X (2X) strategy uses chest radiography (CXR) and GeneXpert (Xpert) rapid diagnostic testing to improve early detection of TB disease. Household contacts and vulnerable populations (e.g., individuals aged 60 years and older, smokers, diabetics, those with alcohol use disorders, and those previously treated for TB) with and without TB symptoms were screened in community campaigns using CXRs, followed by Xpert for those with a positive screen. In public non-TB district facilities, diabetics, respiratory outpatients, inpatients with lung disease, and other vulnerable populations underwent 2X evaluation. During COVID-19 restrictions in Vietnam, the 2X strategy improved access to TB services by decentralization to commune health stations, the lowest level of the health system, and enabling self-screening using a quick response mobile application. The number needed to screen (NNS) with CXRs to diagnose 1 person with TB disease was calculated for all 2X models and showed the highest yield among self-screeners (11 NNS with CXR), high yield for vulnerable populations in communities (60 NNS) and facilities (19 NNS), and moderately high yield for household contacts in community campaigns (154 NNS). Computer-aided diagnosis for CXRs was incorporated into community and facility implementation and improved physicians' CXR interpretations and Xpert referral decisions. Integration of TB infection and TB disease evaluation increased eligibility for TB preventive treatment among household contacts, a major challenge during implementation. The 2X strategy increased the rational use of Xpert, employing a health system-wide approach that reached vulnerable populations with and without TB symptoms in communities and facilities for early detection of TB disease. This strategy was effectively adapted to different levels of the health system during COVID-19 restrictions and contributed to post-pandemic TB recovery in Vietnam.


Asunto(s)
COVID-19 , Humanos , Vietnam/epidemiología , COVID-19/epidemiología , COVID-19/prevención & control , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/prevención & control , Tuberculosis Pulmonar/epidemiología , Tamizaje Masivo/organización & administración , Tamizaje Masivo/métodos , SARS-CoV-2 , Persona de Mediana Edad , Radiografía Torácica , Tuberculosis/diagnóstico , Tuberculosis/prevención & control , Tuberculosis/epidemiología , Femenino , Pandemias , Masculino , Poblaciones Vulnerables
3.
Sci Rep ; 14(1): 14798, 2024 06 26.
Artículo en Inglés | MEDLINE | ID: mdl-38926427

RESUMEN

Muscle ultrasound has been shown to be a valid and safe imaging modality to assess muscle wasting in critically ill patients in the intensive care unit (ICU). This typically involves manual delineation to measure the rectus femoris cross-sectional area (RFCSA), which is a subjective, time-consuming, and laborious task that requires significant expertise. We aimed to develop and evaluate an AI tool that performs automated recognition and measurement of RFCSA to support non-expert operators in measurement of the RFCSA using muscle ultrasound. Twenty patients were recruited between Feb 2023 and July 2023 and were randomized sequentially to operators using AI (n = 10) or non-AI (n = 10). Muscle loss during ICU stay was similar for both methods: 26 ± 15% for AI and 23 ± 11% for the non-AI, respectively (p = 0.13). In total 59 ultrasound examinations were carried out (30 without AI and 29 with AI). When assisted by our AI tool, the operators showed less variability between measurements with higher intraclass correlation coefficients (ICCs 0.999 95% CI 0.998-0.999 vs. 0.982 95% CI 0.962-0.993) and lower Bland Altman limits of agreement (± 1.9% vs. ± 6.6%) compared to not using the AI tool. The time spent on scans reduced significantly from a median of 19.6 min (IQR 16.9-21.7) to 9.4 min (IQR 7.2-11.7) compared to when using the AI tool (p < 0.001). AI-assisted muscle ultrasound removes the need for manual tracing, increases reproducibility and saves time. This system may aid monitoring muscle size in ICU patients assisting rehabilitation programmes.


Asunto(s)
Enfermedad Crítica , Unidades de Cuidados Intensivos , Atrofia Muscular , Ultrasonografía , Humanos , Masculino , Ultrasonografía/métodos , Femenino , Persona de Mediana Edad , Anciano , Atrofia Muscular/diagnóstico por imagen , Músculo Esquelético/diagnóstico por imagen , Músculo Cuádriceps/diagnóstico por imagen , Inteligencia Artificial , Adulto
4.
Eur J Neurol ; : e16380, 2024 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-38924331

RESUMEN

BACKGROUND AND PURPOSE: This study aimed to investigate the effect of collateral circulation on the outcomes of thrombectomy versus medical management alone in basilar artery occlusion (BAO) patients with varying stroke severities. METHODS: Data from the ATTENTION cohort were used to perform a post-hoc analysis comparing the outcomes of thrombectomy with medical management in BAO patients with varying degrees of collateral circulation and stroke severity. Basilar Artery on Computed Tomography Angiography (BATMAN) scores were used to quantify the collateral circulation, and the effect was estimated through a primary outcome of 90-day functional independence (modified Rankin Scale score, mRS ≤2). Favorable versus unfavorable BATMAN scores were analyzed as both continuous and categorical variables, and an adjusted multivariate regression model was applied. RESULTS: Among 221 BAO patients, thrombectomy significantly improved functional independence compared to medical management in patients with favorable BATMAN scores (aOR 7.75, 95% CI 2.78-26.1), but not in those with unfavorable BATMAN scores (aOR 1.33, 95% CI 0.28-6.92; pinteraction = 0.028). When treated as a continuous variable, increased BATMAN score was found to be associated with a higher likelihood of functional independence in the thrombectomy group (aOR 1.97, 95% CI 1.44-2.81; pinteraction = 0.053). In severe stroke patients with higher BATMAN scores (National Institutes of Health Stroke Scale (NIHSS) ≥21), we identified a significant interaction for treatment effect with thrombectomy compared to medical management (pinteraction = 0.042). CONCLUSION: An increased BATMAN score was significantly associated with a higher probability of functional independence after thrombectomy than after medical management, particularly in patients with severe BAO.

5.
PLoS One ; 19(6): e0305869, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38913676

RESUMEN

BACKGROUND: This study aimed to measure the preferences for mental health support among health professionals, their willingness to support the mental health of colleagues and associated factors. METHOD: A descriptive cross-sectional study was performed from August to October 2022 within five hospitals located in Hanoi, Vietnam. A total of 244 health professionals participated in the study. Data on socio-economic status, health and COVID-19-related characteristics, Depression Anxiety Stress Scale (DASS-21); and preferences for mental health support services were collected by using a structured self-reported questionnaire. Multivariate logistic regression models were utilized to identify associated factors with the demand for mental support services. RESULTS: 13.9%, 17.1% and 8.6% reported having at least mild depression, anxiety and stress, respectively. There 13.9% did not seek any mental health support during the COVID-19 pandemic. The most common support included talking with friends (52.9%), family (50.8%), colleagues (47.6%) and using social networks/Internet (43.5%). There 31.1% had been aware of mental health services, but only 18.0% used this service at least once. Regarding preferences, 47.3% had a demand for mental support services, and the most preferred service was providing coping skills (25.9%), followed by skills to support others against mental problems (22.2%). Major sources of support included psychiatrists (34.4%), colleagues (29.1%) and family (27.9%). The main preferred channels for support included telephone/mobile phone (35.7%) and Internet (20.9%). Only 12.3% were willing to provide mental support for colleagues during the pandemic. Age, education, perceived mental health status, ever seeking any mental service, and DASS-21 depression score were associated with demand for mental support services. CONCLUSION: This study found a lack of awareness of mental health services for health professionals, as well as moderate levels of demand for this service in this population. Raising awareness and developing tailored mental health support services are important to enhancing the mental well-being of health professionals in Vietnam to prepare for the next pandemic.


Asunto(s)
COVID-19 , Depresión , Personal de Salud , Servicios de Salud Mental , Salud Mental , Humanos , COVID-19/epidemiología , COVID-19/psicología , Vietnam/epidemiología , Masculino , Femenino , Adulto , Estudios Transversales , Personal de Salud/psicología , Persona de Mediana Edad , Depresión/epidemiología , Ansiedad/epidemiología , Pandemias , Encuestas y Cuestionarios , SARS-CoV-2 , Estrés Psicológico/epidemiología , Apoyo Social
6.
Artículo en Inglés | MEDLINE | ID: mdl-38928938

RESUMEN

This research aimed to explore factors associated with the fear of falling (FOF) among community-dwelling older adults in Vietnam. A cross-sectional study was conducted in five communes in Soc Son, Hanoi, Vietnam, from March to June 2017. We recruited a total of 487 participants, which provided sufficient data for analysis. The outcome variable was fear of falling. Several covariates, including demographics, medical history, general health status, geriatric syndromes, eye diseases, assessment of fall risk environment, timed up-and-go test, and number of standing up in 30 s, were collected. A multivariable logistic regression model was performed to determine predictors associated with FOF. The results showed that 54.6% of the participants had FOF. Furthermore, the logistic multivariable regression model revealed several factors associated with FOF among participants in the research sites, including polypharmacy status (OR: 1.79; 95%CI 1.07-2.99), higher scores in quality of life according to the EQ-5D-5L index (OR:6.27; 95%CI: 2.77-14.17), and having fallen during the past 12 months (OR:4.4; 95%CI: 2.39-8.11). These findings contribute to a comprehensive understanding of the intricate relationship between FOF and several associated factors, notably polypharmacy status, quality of life, and having a fall during the past 12 months.


Asunto(s)
Accidentes por Caídas , Miedo , Población Rural , Humanos , Accidentes por Caídas/estadística & datos numéricos , Anciano , Vietnam , Masculino , Femenino , Miedo/psicología , Estudios Transversales , Población Rural/estadística & datos numéricos , Anciano de 80 o más Años , Vida Independiente/psicología , Calidad de Vida , Factores de Riesgo , Persona de Mediana Edad
7.
Artículo en Inglés | MEDLINE | ID: mdl-38920310

RESUMEN

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease in which multiple organs are damaged by the immune system. Although standard treatment options such as hydroxychloroquine (HCQ), glucocorticoids (GCs), and other immunosuppressive or immune-modulating agents can help to manage symptoms, they do not offer a cure. Hence, there is an urgent need for the development of novel drugs and therapies. In recent decades, cell therapies have been used for the treatment of SLE with encouraging results. Hematopoietic stem cell transplantation, mesenchymal stem cells, regulatory T (Treg) cell, natural killer cells, and chimeric antigen receptor T (CAR T) cells are advanced cell therapies which have been developed and evaluated in clinical trials in humans. In clinical application, each of these approaches has shown advantages and disadvantages. In addition, further studies are necessary to conclusively establish the safety and efficacy of these therapies. This review provides a summary of recent clinical trials investigating cell therapies for SLE treatment, along with a discussion on the potential of other cell-based therapies. The factors influencing the selection of common cell therapies for individual patients are also highlighted.

8.
Phys Chem Chem Phys ; 2024 Jun 26.
Artículo en Inglés | MEDLINE | ID: mdl-38921698

RESUMEN

In this work, structural modification at Ga sites of the gallium sulfide (GaS) monolayer is explored to create new two-dimensional (2D) materials towards spintronic applications. GaS monolayer is a non-magnetic indirect-gap semiconductor material with an energy gap of 2.38 (3.27) eV as calculated using the PBE(HSE06) functional. Half-metallicity is induced in this 2D material by creating a single Ga vacancy, where S atoms around the defect site produce mainly the magnetic properties with a total magnetic moment of 1.00µB. In contrast, the non-magnetic nature is preserved under the effects of a pair of Ga vacancies, which metallize the monolayer. V, Mn, and Fe doping leads to the emergence of the diluted magnetic semiconductor nature, while doping with Cr creates a new 2D half-metallic material from the GaS monolayer. In these cases, total magnetic moments between 2.00 and 5.00µB are obtained and the 3d orbital of transition metal (TM) impurities mainly induces the system magnetism. In addition, the effects of doping with a pair of TM (pTM) atoms are also investigated, in which the antiferromagnetism is found to be stable rather than the ferromagnetism to follow the Pauli exclusion principle. Significant magnetization of the GaS monolayer is also achieved with zero total magnetic moment because of the structural mirror-symmetry. pV-, pMn-, and pFe-doped systems are antiferromagnetic semiconductor materials with energy gaps of 1.06, 1.90, and 1.84 eV, respectively. Meanwhile, the monolayer is metallized by doping with a pCr pair. The results presented herein indicate that the defective and doped GaS monolayers are prospective 2D candidates for spintronic applications - which are hindered for the pristine GaS monolayer because of the absence of intrinsic magnetism.

9.
IJID Reg ; 11: 100375, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38827634

RESUMEN

Objectives: We aimed to determine epidemiological characteristics and serologic markers among chronically hepatitis B virus (HBV)-infected pregnant women during the assessment of tenofovir disoproxil fumarate (TDF) prescription in Vietnam. Methods: We consecutively recruited 375 pregnant women with chronic HBV (cHBV) infection at week 25±2 of pregnancy, at which time they were assessed for TDF use as pre-prophylaxis and/or pre-treatment at the Hospital for Tropical Diseases in southern Vietnam during December 2019-April 2021. Demographic characteristics, serological biomarkers, and prenatal liver ultrasounds were obtained through interviews and reviews of medical records. Results: The median age of pregnant women was 29 years (interquartile range: 26-32). More than half of pregnant women (208/375; 55.5%) started TDF for prevention of mother-to-child transmission of HBV and/or treatment of chronic hepatitis B (CHB). Among the pregnant women initiating TDF, 96.1% (198/206) tested positive for hepatitis B e antigen, and 21.6% (45/208) had quantitative hepatitis B surface antigen (qHBsAg) ≤104 IU/mL. A relatively strong correlation between qHBsAg and HBV deoxyribonucleic acid (DNA) (r = 0.81; 95% CI: 0.76-0.85) was observed in pregnant women starting TDF. Conclusions: Our results demonstrate the high need for TDF prescription for prevention and/or treatment purposes in pregnant women with cHBV infection. Pregnant women with qHBsAg levels ≤104 IU/mL may prioritize HBV DNA testing over qHBsAg to decide on TDF prescription.

10.
Neural Netw ; 178: 106393, 2024 May 18.
Artículo en Inglés | MEDLINE | ID: mdl-38830300

RESUMEN

In this paper, we present CORING, which is short for effiCient tensOr decomposition-based filteR prunING, a novel filter pruning methodology for neural networks. CORING is crafted to achieve efficient tensor decomposition-based pruning, a stark departure from conventional approaches that rely on vectorized or matricized filter representations. Our approach represents a significant leap forward in the field by introducing tensor decompositions, specifically the HOSVD, which preserves the multidimensional nature of filters while providing a low-rank approximation, thus substantially reducing complexity. Furthermore, we introduce a versatile method for calculating filter similarity by using the low-rank approximation offered by the HOSVD. This obviates the need for using full filters or reshaped versions and enhances the overall efficiency and effectiveness of our approach. Extensive experimentation across diverse architectures and datasets spanning various vision tasks, including image classification, object detection, instance segmentation, and keypoint detection, validates CORING's prowess. Remarkably, it outperforms state-of-the-art methods in reducing MACs and parameters, consistently enhancing validation accuracy. Furthermore, we supplement our quantitative results with a comprehensive ablation study, providing substantial evidence of the efficiency of our tensor-based approach. Beyond quantitative outcomes, qualitative results vividly illustrate CORING's ability to retain essential features within pruned neural networks. Our code is available for research purposes.

11.
Ann Med Surg (Lond) ; 86(6): 3211-3215, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38846863

RESUMEN

Introduction: Laparoscopic spleen-preserving distal pancreatectomy (LSPDP) with conservation of the splenic artery and vein (Kimura' technique) is considered a technically challenging procedure that requires a high level of expertise in laparoscopic and pancreatic surgery. Methods: A prospective descriptive study on 18 patients with laparoscopic "antegrade" spleen-preserving distal pancreatectomy with Kimura' technique from 2018 to 2023. The perioperative indications, clinical data, intraoperative index, pathological postoperative specimens, postoperative complications, and follow-up results were retrospectively evaluated. Results: The mean age was 39.4±13.3. Only 2 male patients accounted for 11.1%. The average operating time is 171±23 min. The average blood loss is 65.7±43 ml. The average tumor size is 4.1 cm. The average hospitalization is 9.4 days. The rate of pancreatic fistula is 66.7%. There is no case of transferring open surgery or blood transfusion during surgery. The results of pathological after surgery there were eight cases of solid pseudopapillary tumors, four cases of mucinous cystadenoma, six cases of neuroendocrine tumors. Conclusion: Kimura's technique for laparoscopic spleen-preserving distal pancreatectomy is safe and feasible, which can be applied to benign tumors in the body and tail of the pancreas. However, this is a difficult technique in laparoscopic surgery that requires surgeons to have a lot of experience and equipment need to be adequate.

12.
Clin Oral Investig ; 28(7): 358, 2024 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-38842694

RESUMEN

OBJECTIVES: To establish an analysis pipeline for the volumetric evaluation of the osteotomy site after bilateral sagittal split osteotomy (BSSO). PATIENTS AND METHODS: Cone-beam computed tomography (CBCT) was performed before, directly after BSSO, and 6-12 months after surgery. Image segmentations of each osteotomy gap data set were performed manually by four physicians and were compared to a semi-automatic segmentation approach. RESULTS: Five patients with a total of ten osteotomy gaps were included. The mean interclass correlation coefficient (ICC) of individual patients was 0.782 and the standard deviation 0.080 when using the manual segmentation approach. However, the mean ICC of the evaluation of anatomical sites and time points separately was 0.214, suggesting a large range of deviation within the manual segmentation of each rater. The standard deviation was 0.355, further highlighting the extent of the variation. In contrast, the semi-automatic approach had a mean ICC of 0.491 and a standard deviation of 0.365, which suggests a relatively higher agreement among the operators compared to the manual segmentation approach. Furthermore, the volume of the osteotomy gap in the semi-automatic approach showed the same tendency in every site as the manual segmentation approach, but with less deviation. CONCLUSION: The semi-automatic approach developed in the present study proved to be valid as a standardised method with high repeatability. Such image analysis methods could help to quantify the progression of bone healing after BSSO and beyond, eventually facilitating the earlier identification of patients with retarded healing.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Osteotomía Sagital de Rama Mandibular , Humanos , Tomografía Computarizada de Haz Cónico/métodos , Proyectos Piloto , Osteotomía Sagital de Rama Mandibular/métodos , Femenino , Masculino , Adulto , Resultado del Tratamiento
13.
Nat Prod Res ; : 1-7, 2024 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-38824678

RESUMEN

Three new dihydrophenanthrenes were isolated from the whole plant of Elatostema tenuicaudatum collected in Vietnam. These compounds were identified as 2,3,5-trihydroxy-9,10-dihydrophenanthrene (1), 2-methoxy-5-hydroxy-9,10-dihydrophenanthrene 3-O-ß-D-glucopyranoside (2), and 2,5-dihydroxy-9,10-dihydrophenanthrene 3-O-ß-D-glucopyranoside (3). Their structures were determined by HR-ESI-MS and 1D, 2D NMR spectroscopy. Furthermore, the inhibitory activities of these compounds against nitric oxide (NO) production in lipopolysaccharide-activated RAW264.7 cells were evaluated. Compound 1 exhibited significant inhibition of NO production, with an IC50 value of 15.8 ± 1.2 µM. This study represents the first report on the chemical compositions and biological activities of E. tenuicaudatum.

14.
Osteoarthr Cartil Open ; 6(3): 100483, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38832051

RESUMEN

Objective: To identify the efficacy and tolerability of Proteoglycan F in patients with primary knee OA.Design: A 24-week randomized, placebo-controlled, double-blind clinical trial with two arms: (1) Proteoglycan F (received 10 â€‹mg proteoglycan daily, for 24 weeks) and (2) control group (received placebo). Knee symptoms and joint cartilage status (evaluated by ultrasound and MRI of knee joints), quality of life, serum cytokine levels (IL-1ß and TNF-α), and safety evaluation were measured before, during, and after the treatment. Results: After 24-week treatment, pain reduction (in the KOOS pain score) of at least 20% and at least 50% (NRS scale) compared to baseline in the PGF group was significantly higher than those in the control group. The PGF group had greater reductions in the total scores of subchondral bone marrow edema, and bone cocoon under cartilage on knee MRI (classification according to WORMs), which were -2.27 (-4.0; -0.51) and -1.77 (-3.08; -0.46), respectively (p â€‹< â€‹0.05). The two groups had no statistically significant difference in knee ultrasound characteristics. After 4 weeks, 12, and 24 weeks compared to baseline, there was no statistically significant difference in levels of urea, creatinine, aspartate aminotransferase, and alanine aminotransferase within the group and between the two study groups. Conclusions: Salmon cartilage PG with 10 â€‹mg per day has potential to improve pain symptoms and subchondral bone marrow edema and bone cocoon under cartilage lesions in primary knee OA. However, the efficacy of PGF should be viewed with caution, and future studies are needed for more specific evaluation.

16.
J Environ Health Sci Eng ; 22(1): 313-327, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38887776

RESUMEN

This study applied an electro-Fenton process using chemically modified activated carbon derived from rubber seed shells loaded with α-FeOOH (RSCF) as catalyst to remove tetracycline residues from aquatic environment. Catalyst characteristics were evaluated using SEM, EDS, XRD, and XPS, showing successful insertion of iron onto the activated carbon. The effects of the parameters were investigated, and the highest treatment efficiency was achieved at pH of 3, Fe: H2O2 ratio (w/w) of 500:1, catalyst dose of 1 g/L, initial TCH concentration of 100 mg/L, and electric current of 150 mA, with more than 90% of TCH being eliminated within 30 min. Furthermore, even after five cycles of use, the treatment efficiency remains above 90%. The rate constant is calculated to be 0.218 min-1, with high regression coefficients (R 2 = 0.93). The activation energy (Ea) was found to be 32.2 kJ/mol, indicating that the degradation of TCH was a simple reaction with a low activation energy. These findings showed that the RSCF is a highly efficient and cost-effective catalyst for TCH degradation. Moreover, the use of e-Fenton process has the advantage of high efficiency, low cost thanks to the recyclability of the catalyst, and environmental friendliness thanks to less use of H2O2.

17.
Int J Pharm ; 660: 124356, 2024 Jun 17.
Artículo en Inglés | MEDLINE | ID: mdl-38897487

RESUMEN

In this work, filament-based 3D-printing, the most widely used sub-category of material extrusion additive manufacturing (MEAM), is presented as a promising manufacturing platform for the production of subcutaneous implants. Print nozzle diameters as small as 100 µm were utilized demonstrating MEAM of advanced porous internal structures at the given cylindrical implant geometry of 2 mm × 40 mm. The bottlenecks related to high-resolution MEAM of subcutaneous implants are systematically analyzed and the print process is optimized accordingly. Custom synthesized biodegradable phase-separated poly(ether ester) multiblock copolymers exhibiting appropriate melt viscosity at comparatively low printing temperatures of 135 °C and 165 °C were utilized as 3D-printing feedstock. The print process was optimized to minimize thermomechanical polymer degradation by employing print speeds of 30 mm∙s-1 in combination with a nozzle diameter of 150 µm at layer heights of 110 µm. These results portray the basis for further development of subcutaneous implantable drug delivery systems where drug release profiles can be tailored through the adaption of the internal implant structure, which cannot be achieved using existing manufacturing techniques.

18.
Can Assoc Radiol J ; : 8465371241259951, 2024 Jun 20.
Artículo en Inglés | MEDLINE | ID: mdl-38902978

RESUMEN

In the immunocompromised setting, there are distinct radiologic findings of primary central nervous system lymphoma (PCNSL), including necrotic ring-enhancing lesions, increased propensity for intralesional haemorrhage, and multiplicity. In this clinical context, advanced imaging with MR perfusion, spectroscopy, and diffusion-weighted imaging can be used to increase accuracy in the diagnosis of lymphoma over mimics such as high-grade glioma, metastases, or infection. This review summarizes the histology and pathophysiology of PCNSL in immunodeficient hosts, which provide a basis for its imaging appearances, prognosis, and treatment. This discussion is important for the general radiologist as the incidence of immunodeficiency-related PCNSL may be increasing.

19.
Neurosurgery ; 2024 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-38904392

RESUMEN

BACKGROUND AND OBJECTIVES: Intracranial atherosclerotic disease (ICAD) large vessel occlusion (LVO) is responsible for up to 30% of LVO. In this study, we aimed to determine the likelihood of favorable functional outcomes (modified Rankin Scale 0-3) in acute ICAD-LVO basilar occlusion compared with embolic basilar occlusion. METHODS: This is an analysis of the Posterior Circulation Ischemic Stroke Evaluation: Analyzing Radiographic and Intraprocedural Predictors for Mechanical Thrombectomy Registry in which patients with acute basilar artery occlusions from 8 comprehensive stroke centers were included from 2015 to 2021. Patients were dichotomized into with (ICAD-LVO) or without underlying ICAD (embolic). Descriptive statistics for each group and multivariate logistic analysis were performed on the primary outcome. RESULTS: Three hundred forty-six patients were included. There were 215 patients with embolic (62%) and 131 patients with ICAD-LVO (38%). Baseline demographics were equivalent between the 2 groups except for sex (male 47% vs 67%; P < .001), history of stroke (12% vs 25%; P = .002), and atrial fibrillation (31% vs 17%; P = .003). At 90 days, patients in the ICAD-LVO cohort were less likely to achieve favorable functional outcomes (odds ratio [OR] 0.41, 95% CI 0.22-0.72; P = .003) after adjusting for potentially confounding factors. In addition, ICAD-LVO strokes were less likely to achieve thrombolysis in cerebral infarction ≥2b (OR 0.29, 95% CI 0.14-0.57; P < .001). ICAD-LVO lesions were more likely to require stent placement (OR 14.94, 95% CI 4.91-45.49; P < .001). Subgroup analysis demonstrated favorable functional outcomes in patients who underwent stenting and angioplasty compared with failed recanalization cohort (OR 4.96, 95% CI 1.68-14.64; P < .004). CONCLUSION: Patients with acute basilar ICAD-LVO have higher morbidity and mortality compared with patients with embolic source. Lower rates of successful recanalization in the ICAD-LVO cohort support this finding. Our subgroup analysis demonstrates that stenting should be considered in patients with recanalization failure. Rates of symptomatic intracranial hemorrhage were similar between the ICAD-LVO and embolic cohorts.

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