Patient acceptance of transvaginal sonographic endometrial thickness assessment compared with hysteroscopy and biopsy for exclusion of endometrial cancer in cases of postmenopausal bleeding.

INTRODUCTION: Available examinations for women with postmenopausal bleeding include transvaginal sonography to measure endometrial thickness (TVS-ET), and invasive endometrial assessment using hysteroscopy/endometrial biopsy. However, selection of the examination method seldom involves consideration of patient preferences. The aim of this study was to examine patient preferences for the method used to investigate postmenopausal bleeding. METHODS: Women were asked to complete an interviewer-administered structured survey before they underwent clinical investigations at a university gynaecology unit from June 2016 to June 2017. Using the standard gamble approach, women were asked to choose between invasive assessment by hysteroscopy/endometrial biopsy (gold standard) or TVS-ET with a risk of missing endometrial cancer. The risk of missing endometrial cancer during TVS-ET was varied until each woman was indifferent to either option. RESULTS: The median detection rate for endometrial cancer required using TVS-ET was 95% (interquartile range=80%-99.9%). In total, 200 women completed the survey, and 77 (38.5%) women required TVS-ET to have a 99.9% detection rate for endometrial cancer. Prior hysteroscopy experience was the only factor that influenced the women's decisions: a significantly higher detection rate was required by this patient group than by patients without previous hysteroscopy experience (P=0.047). CONCLUSION: A substantial proportion of women would accept TVS-ET alone for the investigation of postmenopausal bleeding. In the era of patientcentred care, clinicians should incorporate patient preferences and enable women to make informed choices concerning the management of postmenopausal bleeding.

Reappraisal of endometrial thickness for the detection of endometrial cancer in postmenopausal bleeding: a retrospective cohort study.

OBJECTIVE: To estimate the accuracy of transvaginal ultrasound (TVS) measurement of endometrial thickness (ET) in diagnosing endometrial cancer in postmenopausal women with vaginal bleeding (PMB). DESIGN: Retrospective cohort study. SETTING: One-stop PMB clinic in a Hong Kong teaching hospital. POPULATION: A cohort of 4383 women with PMB. METHODS: Transvaginal ultrasonic measurement of ET and endometrial biopsies were obtained in women presenting with PMB between 2002 and 2013. Endometrial histology was used as the reference standard to calculate accuracy estimates. MAIN OUTCOME MEASURES: Accuracy data for TVS ET presented as sensitivity, specificity, and area under the receiver operator characteristic (ROC) curve. RESULTS: Endometrial cancer was diagnosed in 3.8% of women. The median ET in those with endometrial cancer was significantly higher than those with benign conditions (15.7 versus 3.2 mm, P < 0.001). The area under the ROC curve was 0.92 (95% CI 0.89-0.94). The sensitivity for the detection of endometrial cancer at 3-, 4-, and 5-mm cut-offs were 97.0% (95% CI 94.5-99.6%), 94.1% (95% CI 90.5-97.6%), and 93.5% (95% CI 89.7-97.2%), respectively. The corresponding estimates of specificity at these thresholds were 45.3% (95% CI 43.8-46.8%), 66.8% (65.4-68.2%), and 74.0% (72.7-75.4%). CONCLUSIONS: Transvaginal ultrasound using a 3-mm cut-off has high sensitivity for detecting endometrial cancer and can identify women with PMB who are highly unlikely to have endometrial cancer, thereby avoiding more invasive endometrial biopsy.

A novel maskless approach towards aligned, density modulated and multi-junction ZnO nanowires for enhanced surface area and light trapping solar cells.

A maskless method of employing polymer growth inhibitor layers is used to modulate the conflicting parameters of density and alignment of multi-junction nanowires via large-scale low temperature chemical route. This low temperature chemical route is shown to synthesize multi-junction nanostructures without compromising the crystal quality at the interfaces. The final morphology of optimized multi-junctions nanowire arrays can be demonstrated on various substrates due to substrate independence and low temperature processing. Here, we also fabricated devices based on density modulated multi-junction nanowires tuned to infiltrate nanoparticles. The fabrication of hierarchically structured nanowire/nanoparticles composites presents an advantageous structure, one that allows nanoparticles to provide large surface areas for dye adsorption, whilst the nanowires can enhance the light harvesting, electron transport rate, and also the mechanical properties of the films. This work can be of great scientific and commercial interest since the technique employed is of low temperature (<90 degrees C) and economical for large-scale solution processing, much valued in today's flexible display and photovoltaic industries.

Controlled synthesis and application of ZnO nanoparticles, nanorods and nanospheres in dye-sensitized solar cells.

Several important synthetic parameters such as precursor concentration, rate of evaporation and reaction time are found to determine the growth of ZnO nanostructures. These reaction parameters can be tailored and tuned to produce a variety of nanostructures ranging from nanoparticles, nanorods and nanospheres. The nanorods are structurally uniform made up of crystallographically oriented attached nanoparticles while the nanospheres are made up of several closely packed and randomly aligned nanocrystallites. XRD spectra of both the nanoparticles and nanorods exhibit typical diffraction peaks of a well-crystalline wurtzite ZnO structure. Finally, solar cells made up of ZnO nanoparticles and nanorods electrodes with absorbed ruthenium dye (N3) were measured to have a power conversion efficiency of 0.87% and 1.32%, respectively.

Mesophase ordering of TiO2 film with high surface area and strong light harvesting for dye-sensitized solar cell.

Mesophase ordering and structuring are carried out to attain optimized pore morphology, high crystallinity, stable porous framework, and crack-free mesoporous titanium dioxide (TiO(2)) films. The pore structure (quasi-hexagonal and lamellar) can be controlled via the concentration of copolymer, resulting in two different types of micellar packing. The calcination temperature is also controlled to ensure a well-crystalline and stable porous framework. Finally, the synthesized mesoporous TiO(2) film is modified by adding P25 nanoparticles, which act as scattering centers and function as active binders to prevent formation of microcracks. Adding P25 nanoparticles into mesoporous structure helps to provide strong light-harvesting capability and large surface area for high -efficiency dye-sensitized solar cells (DSSC). The short-circuit photocurrent density (J(sc)) of the cell made from mixture of mesoporous TiO(2) and P25 nanoparticles displays a higher efficiency of approximately 6.5% compared to the other homogeneous films. A combination of factors such as increased surface area, introduction of light-scattering particles, and high crystallinity of the mesoporous films leads to enhanced cell performance.

Gas sensing properties of tin oxide nanostructures synthesized via a solid-state reaction method.

A high-yield synthesis of SnO(2) nanoparticles via a facile, economical and easily scalable solid-state molten salt synthesis method has been demonstrated. The inorganic additive, molar ratios of chemicals and annealing temperature were found to control the size and porosity of the SnO(2) nanoparticles. The synthesized SnO(2) nanostructures were uniform, well dispersed and exhibited high crystallinity. Hydrogen sensors made from the SnO(2) nanoparticles were found to possess high sensitivity and stability. Other than tailoring the material's structure in terms of size and porosity, another potential method of enhancing the gas sensitivity is functionalization with noble Pd metal.

Effects of wearing N95 and surgical facemasks on heart rate, thermal stress and subjective sensations.

AIM: The study was aimed at investigating the effects of wearing N95 and surgical facemasks with and without nano-functional treatments on thermophysiological responses and the subjective perception of discomfort. METHOD: Five healthy male and five healthy female participants performed intermittent exercise on a treadmill while wearing the protective facemasks in a climate chamber controlled at an air temperature of 25 degrees C and a relative humidity of 70%. Four types of facemasks, including N95 (3M 8210) and surgical facemasks, which were treated with nano-functional materials, were used in the study. RESULTS: (1) The subjects had significantly lower average heart rates when wearing nano-treated and untreated surgical facemasks than when wearing nano-treated and untreated N95 facemasks. (2) The outer surface temperature of both surgical facemasks was significantly higher than that of both N95 facemasks. On the other hand, the microclimate and skin temperatures inside the facemask were significantly lower than those in both N95 facemasks. (3) Both surgical facemasks had significantly higher absolute humidity outside the surface than both N95 facemasks. The absolute humidity inside the surgical facemask was significantly lower than that inside both N95 facemasks. (4) Both surgical facemasks were rated significantly lower for perception of humidity, heat, breath resistance and overall discomfort than both N95 facemasks. The ratings for other sensations, including feeling unfit, tight, itchy, fatigued, odorous and salty, that were obtained while the subjects were wearing the surgical facemasks were significantly lower than when the subjects were wearing the N95 facemasks. (5) Subjective preference for the nano-treated surgical facemasks was the highest. There was significant differences in preference between the nano-treated and untreated surgical facemasks and between the surgical and N95 facemasks. DISCUSSION: We discuss how N95 and surgical facemasks induce significantly different temperature and humidity in the microclimates of the facemasks, which have profound influences on heart rate and thermal stress and subjective perception of discomfort.

Identification of HLA-B*1566.

A novel polymorphism was identified in a B*15 allele. B*1566 possesses a nucleotide substitution of C to G at nucleotide 272. This polymorphism encodes an amino acid difference from serine in B*1501101 to cysteine in B*1566 at residue 67. Residue 67 is a constituent of the B pocket and is situated on the alpha1 helix facing into the groove. This mutation may have arisen through interallelic recombination as it has been seen in other B*15 alleles and is also present in most B*14, B*27, B*38, B*39 alleles and in B*7301.