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OBJECTIVES AND METHODS: We analyzed upper endoscopic and histological findings in 3 cohorts of children undergoing upper gastrointestinal endoscopy over a 10-year period. Five hundred seventy-nine patients were identified, with 244 (42%), 199 (35%), and 136 (23%) in the 2011, 2015, and 2019 cohorts, respectively. The most common symptoms and signs were abdominal pain, vomiting, failure to thrive, and diarrhea. RESULTS: The number of patients who had histological evidence of chronic gastritis increased from 2011 (n = 70, 29%) to 2015 (n = 106, 53%) and 2019 (n = 92, 68%; P < .001). The prevalence of "normal" endoscopic gastric findings was higher in controls (n = 247, 90%) compared to cases (n = 201, 76%; P < .001). There was a small but statistically significant difference in endoscopic esophageal grading (P = .008) over time, with lower grades being more prevalent in 2011 compared to 2015 (P = .026) and 2019 (P = .001). Crude comparisons of the predictors (sex, weight percentile, payor type, month of endoscopy, symptom duration, PPI exposure, and endoscopic stomach findings) yielded no difference between cases and controls. CONCLUSIONS: There has been a significant rise in the prevalence of mild chronic gastritis or non-specific gastritis over the last decade in our population.
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Gastritis , Humanos , Gastritis/epidemiología , Gastritis/patología , Gastritis/diagnóstico , Femenino , Masculino , Prevalencia , Niño , Enfermedad Crónica , Preescolar , Adolescente , Lactante , Estudios Retrospectivos , Endoscopía GastrointestinalRESUMEN
Non-invasive prenatal screening provides a risk assessment for aneuploidies by utilizing cell-free DNA (cfDNA). It is recommended that cell-free DNA screening (cfDNA screening) be offered to all pregnant people regardless of a priori risk for aneuploidy. In the absence of an increased risk, alternative motives for electing cfDNA screening and different levels of informed decision making may arise. Therefore, our study aimed to characterize low-risk patients' motivations for cfDNA screening election, determine how often informed decisions are being made, and compare motivations between informed and uninformed decision makers. A survey that included a modified, validated measure of informed choice (MMIC) and questions to assess patients' motivations for cfDNA screening was offered at four MFM clinics following genetic counseling. It was found that 44% of participants (n = 100) made an uninformed decision about testing. Participants with private insurers were 4.25 times more likely to make an informed decision (95% CI = 1.10-16.37). Informed decision makers scored avoiding invasive procedures higher (p = 0.007) and ranked doing what family/friends desire lower (p = 0.005) than uninformed decision makers. While most participants scored receiving information about genetic conditions highest, 12% of participants reported fetal sex disclosure as a priority. However, this was not found to be associated with uninformed decision making. This study ultimately established that following genetic counseling, a low-risk population shared motivations with high-risk populations which highlights the importance of complete pre-test counseling for all. Future research should investigate the effect of modifying variables, such as socioeconomic status, on the performance of informed choice measures and critically evaluate the parameters that determine informed choice.
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The acquisition, processing, mining, and visualization of sensory data for knowledge discovery and decision support has recently been a popular area of research and exploration. Its usefulness is paramount because of its relationship to the continuous involvement in the improvement of healthcare and other related disciplines. As a result of this, a huge amount of data have been collected and analyzed. These data are made available for the research community in various shapes and formats; their representation and study in the form of graphs or networks is also an area of research which many scholars are focused on. However, the large size of such graph datasets poses challenges in data mining and visualization. For example, knowledge discovery from the Bio-Mouse-Gene dataset, which has over 43 thousand nodes and 14.5 million edges, is a non-trivial job. In this regard, summarizing the large graphs provided is a useful alternative. Graph summarization aims to provide the efficient analysis of such complex and large-sized data; hence, it is a beneficial approach. During summarization, all the nodes that have similar structural properties are merged together. In doing so, traditional methods often overlook the importance of personalizing the summary, which would be helpful in highlighting certain targeted nodes. Personalized or context-specific scenarios require a more tailored approach for accurately capturing distinct patterns and trends. Hence, the concept of personalized graph summarization aims to acquire a concise depiction of the graph, emphasizing connections that are closer in proximity to a specific set of given target nodes. In this paper, we present a faster algorithm for the personalized graph summarization (PGS) problem, named IPGS; this has been designed to facilitate enhanced and effective data mining and visualization of datasets from various domains, including biosensors. Our objective is to obtain a similar compression ratio as the one provided by the state-of-the-art PGS algorithm, but in a faster manner. To achieve this, we improve the execution time of the current state-of-the-art approach by using weighted, locality-sensitive hashing, through experiments on eight large publicly available datasets. The experiments demonstrate the effectiveness and scalability of IPGS while providing a similar compression ratio to the state-of-the-art approach. In this way, our research contributes to the study and analysis of sensory datasets through the perspective of graph summarization. We have also presented a detailed study on the Bio-Mouse-Gene dataset, which was conducted to investigate the effectiveness of graph summarization in the domain of biosensors.
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There are several promising radiotracers used for both staging and restaging of primary and recurrent brain tumours based on various mechanisms of tracer localization in tumour cells. 68Ga-PSMA PET has extremely low background uptake in normal brain tissue and consequently high tumour-to-brain ratio making it a promising imaging radiotracer for gliomas. 68Ga-PSMA demonstrates utility in evaluating high grade glioma during both initial workup or when suspecting recurrence. Herein the authors evaluate the role of this imaging modality and the potential future it holds in the management of high grade gliomas.
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Neoplasias Encefálicas , Glioma , Imagen Molecular , Neovascularización Patológica , Tomografía Computarizada por Tomografía de Emisión de Positrones , Radiofármacos , Humanos , Angiogénesis , Biomarcadores de Tumor/metabolismo , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/patología , Ácido Edético/análogos & derivados , Radioisótopos de Galio/administración & dosificación , Glioma/diagnóstico por imagen , Glioma/patología , Imagen Molecular/métodos , Clasificación del Tumor , Neovascularización Patológica/diagnóstico por imagen , Oligopéptidos , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Radiofármacos/administración & dosificaciónRESUMEN
OBJECTIVES: Eosinophilic esophagitis (EoE) is a chronic disease which requires endoscopy with biopsies for diagnosis and monitoring. We aimed to identify a panel of non-invasive markers that could help identify patients with active EoE. METHODS: In this prospective cohort study, we enrolled 128 children aged 5-18 years old, scheduled for endoscopy for suspected esophageal or peptic disease. On the day of the endoscopy, fractionated exhaled nitric oxide (FeNO) was measured; and blood was collected for peripheral absolute eosinophil count (AEC), plasma amino acids, and plasma polyamine analysis. Patients were grouped into controls (n = 91), EoE in remission (n = 16), or active EoE (n = 21), based on esophageal eosinophilia and history of EoE. RESULTS: AEC was not statistically significant different among the groups compared ( P = 0.056). Plasma amino acids: citrulline (CIT), ß-alanine (ß-ALA), and cysteine (CYS) were higher in active EoE compared to controls ( P < 0.05). The polyamine spermine was lower in active EoE versus controls ( P < 0.05). Receiver operator characteristic (ROC) curve to assess the predictive capability of a combined score made of FeNO, ß-ALA, CYS, and spermine had an area under curve (AUC) of 0.90 (95% CI: 0.80-0.96) in differentiating active EoE from controls and 0.87 (95% CI: 0.74-1.00) when differentiating active EoE from EoE in remission. CONCLUSION: A panel comprising FeNO, 2 plasma amino acids (ß-ALA, CYS) and the polyamine spermine can be used as a non-invasive tool to differentiate active EoE patients from controls.
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Esofagitis Eosinofílica , Niño , Humanos , Preescolar , Adolescente , Esofagitis Eosinofílica/patología , Prueba de Óxido Nítrico Exhalado Fraccionado , Estudios Prospectivos , Espermina , Biomarcadores , Aminoácidos , Eosinófilos/metabolismoRESUMEN
This paper analyzes patient-provider interaction (PPI). More precisely, it deals with the form-function relationship in questions used in counselor-patient interaction. The study is based on naturally occurring primary data collected at the Department of Pediatrics and the Department of Community Medicine, Jawaharlal Nehru Medical College and Hospital (JNMCH), located in Aligarh Muslim University, India. The data are composed of audio-visual recordings of Hindi-Urdu interaction between 8 counselors and 27 patients. We identified compliance and condescension as the two unique functions the counselors seeks to accomplish and/or fulfill through the use of questions in their interaction with the patients. We also found four other functions - information seeking, recall, greeting, and diagnosis, which are sought by the counselors through their use of questions. The findings also suggest that these functions maintain and promote what can be termed as a counselor-centered interaction, and thus reflect asymmetrical power relationship between counselors and their patients.
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Hospitales , Islamismo , Humanos , Niño , Encuestas y Cuestionarios , IndiaRESUMEN
The aim of the study was to compare three moulting procedures and their effect on productive performance, egg quality, and antibody response of leghorn hens. For this, a total of 324 laying hens were distributed into three treatment groups having 12 replicates of 9 birds each according to completely randomized design. Treatments consisted of three moulting procedures based on feed and light restriction. The targeted weight at the end of moulting was 1450-1470 g. As soon as the moulting procedure is complete, the comparative analysis of post-moult productive performance (feed intake, egg production, egg weight, egg mass, feed per dozen eggs, feed per kg egg mass, livability), egg quality characteristics (egg weight, egg length and width, shape index, surface area, volume, albumen height, weight, Haugh unit score, yolk width, height, index, egg shell pore number, shell weight, thickness, breaking strength), and antibody response against Newcastle disease and avian influenza (H-9) were evaluated. Birds subjected to moulting procedure 3 (8 days fasting and gradual decrease in light) showed improvement in productive performance, egg geometry and quality traits, and antibody response against Newcastle disease virus. Birds experienced moulting procedure 1 (11 days fasting) had improved feed intake, egg production, and livability. However, birds moulted with procedure 2 (6 days fasting) revealed intermediate result in all the studied parameters. In conclusion, moulting through feed and light restriction with 8 days fasting and gradual reduction in light has potential to improve performance of leghorn hens.
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Formación de Anticuerpos , Pollos , Animales , Femenino , Albúminas , Muda , ÓvuloRESUMEN
Meningiomas overexpress somatostatin receptors (SSTR). PET imaging with SSTR ligands such as 68Ga-DOTA-peptide has recently shown high diagnostic accuracy in identification of meningiomas due to lack of normal bone and brain activity. PET-derived parameters, especially gross tumour volume (GTV) delineation improves inter-observer variability and appears to be particularly promising for RT planning. The potential strength of 68Ga-DOTA in the ongoing assessment of treatment response and disease progression in meningioma, particularly in the post-surgical and post-radiation settings is encouraging. More prospective randomized studies with large cohorts of patients are required to define the effective role of this modality.
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Neoplasias Meníngeas , Meningioma , Compuestos Organometálicos , Humanos , Meningioma/diagnóstico por imagen , Meningioma/radioterapia , Tomografía Computarizada por Tomografía de Emisión de Positrones , Neoplasias Meníngeas/diagnóstico por imagen , Neoplasias Meníngeas/radioterapia , Estudios Prospectivos , Octreótido , Tomografía Computarizada por Rayos X/métodos , Tomografía de Emisión de Positrones/métodos , Compuestos Organometálicos/uso terapéutico , Radiofármacos/uso terapéuticoRESUMEN
Present study evaluated the effect of lighted incubation on pre- and post-hatch performance of Japanese quail. In a completely randomized design, 1200 eggs were evenly divided into 4 treatments groups having six replicates (each tray was considered as replicate), 50 eggs each. Different dichromatic lights (Green + Red; GR, Green + Blue; GB, and Blue + Red; BR) of 250 lux were provided during incubation for 12 h daily and effects of these lights very evaluated on hatching results and post-hatch growth. After hatch, 600 quail chicks were divided into 4 treatments, 6 replicates, and 25 birds each. Regarding hatching traits, better hatchability was found in the GR group compared to GB, BR, and dark group; while early embryonic mortality was lower in BR, GB, and dark group than GR; mid embryonic mortality was lower in dark group and late embryonic mortality was noted in the GR group than those of other treatment groups. In addition, moisture loss during incubation was minimum in BR and dark groups; however, chick spread was better in the GR group. In terms of growth performance, weight gain was better in the GR group; feed intake in dark, feed conversion ratio in BR, and livability were better in BR and GR group. In morphometrics, keel and shank length were higher in all the colored groups (GB, BR, and GR) whereas body length, wing spread, shank circumference, drumstick length, and circumference were higher in the GR group. Regarding serum chemistry, glucose, albumin, and globulin levels were higher in the GR group. It was concluded that under the experimental conditions, GR light at the prenatal stage to Japanese quail eggs positively influenced hatching performance and post-hatch growth.
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Coturnix , Óvulo , Animales , Pollos , Aumento de PesoRESUMEN
OBJECTIVES: This study discusses the experience at our centre with treating traumatic thoracolumbar fractures using percutaneous pedicle screw fixation. METHODS: We reviewed the case notes and imaging retrospectively between January 2013 and June 2019. RESULTS: A total of 257 patients were included, 123 males and 134 females aged between 17 and 70; the mean age was 47.6 years. The majority of injuries were from fall from significant height. The fractures involved the thoracic and lumbar vertebra in 98 and 151 of the cases respectively. Percutaneous pedicle screw fixation was performed either one or two levels above and below the fracture depending on the level of injury. Forty two cases were treated with additional short pedicle screws at the level of fracture. More than 15% (39) of the patients presented with a neurological deficit; more than 80% (32) of those showed post-operative improvement in their neurology as per Frankel Grading system. The mean operative time was 117 min ± 45 min; mean length of hospital stay was 7.2 days ± 3.8 days, with significant improvement in pain. CONCLUSIONS: Percutaneous pedicle screw fixation is a safe surgical option with comparable outcomes to open surgery and a potential reduction in perioperative morbidity.
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OBJECTIVE: To determine the age, gender and sites of vestibular schwannoma cases using contrast-enhanced magnetic resonance imaging. METHOD: The retrospective descriptive study was conducted at the Department of Cyberknife Robotic Radiosurgery, Jinnah Postgraduate Medical Centre, Karachi, and comprised data of patients with vestibular schwannomas from January 2016 to September 2018. Some of them were histologically proven and rest were radiologically proven. Cases were reviewed on contrast-enhanced magnetic resonance imaging of the brain. Statistical Package for the Social Sciences version 20 (SPSS) was applied. RESULTS: Of the 500 cases of vestibular schwannomas identified with 515 tumours, 300(60%) were males and 200(40%) were female. The overall mean age was 42.7±14.4 years (range: 17-85 years). Out of 515 tumours, the commonest site was the right cerebellopontine angle in 340(66%) cases. There were 15(3%) cases of radiologically-proven neurofibromatosis type 2. Overall, 490(98%) patients had main clinical complaint of progressive unilateral hearing loss, 5(1%) had vertigo and 5(1%) had facial palsy. CONCLUSIONS: Vestibular schwannomas were found to be more common among adults, with male preponderance and right cerebellopontine angle being the common site.
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Neuroma Acústico , Radiocirugia , Procedimientos Quirúrgicos Robotizados , Adulto , Demografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neuroma Acústico/diagnóstico por imagen , Neuroma Acústico/epidemiología , Neuroma Acústico/cirugía , Estudios RetrospectivosRESUMEN
This study evaluated the effect of environmental enrichment on the performance, behaviour and welfare aspects; blood biochemistry; carcass and meat quality traits of broiler chickens. A total of 450 straight run broiler chicks (Ross-308) were divided into 5 treatment groups having 6 replicates of 15 birds each under a completely randomised design. Treatments were environmental enrichment (EE) tools and consisted of C = control group; R = red ball for EE; G = green ball for EE; B = blue ball for EE and M = mirror for EE. These environmental enrichment tools were provided throughout the experimental period (0 to 35 days). Mean feed intake per bird was higher in all treatment groups except the blue balls group; weight gain and feed conversion ratio were better in the green and blue ball groups. Broiler chickens reared under different environmental enrichment were more active and they exhibited maintenance behaviour (preening, dust bathing and wing stretching, or scratching) more frequently. Regarding welfare traits, lower incidence of toe damage, footpad dermatitis and hock burn was observed in birds having different environmental enrichment tools as compared to the control group. The birds reared with red balls as environmental enrichment showed the lowest values for glucose, cholesterol, total protein, albumin and globulin amongst all the treatment groups. Birds reared with green balls had the highest body weight at slaughter, dressed weight, carcass yield and liver weight. Breast meat of environmentally enriched treated groups was lighter and had lower ultimate pH. It was concluded that the addition of environmental enrichment tools (visual, structural and plastic) motivates the birds for physical activities and improves the performance of broiler chickens.
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Pollos , Carne , Animales , Ingestión de Alimentos , Carne/análisis , Fenotipo , Aumento de PesoRESUMEN
OBJECTIVE: To determine the yield of prenatal testing and screening options after identification of fetal structural abnormalities using a novel mathematical model. METHOD: A retrospective chart review was conducted to collect structural abnormality and genetic testing data on infants who were evaluated postnatally by a medical geneticist. A novel mathematical model was used to determine and compare the predicted diagnostic yields of prenatal testing and screening options. RESULTS: Over a quarter of patients with at least one structural abnormality (28.1%, n = 222) had a genetic aberration identified that explained their phenotype. Chromosomal microarray (CMA) had the highest predicted diagnostic yield (26.8%, P < .001). Karyotype (20.8%) had similar yields as genome wide NIPT (21.2%, P = .859) and NIPT with select copy number variants (CNVs) (17.9%, P = .184). Among individuals with an isolated structural abnormality, whole exome sequencing (25.9%) and CMA (14.9%) had the highest predicted yields. CONCLUSION: This study introduces a novel mathematical model for predicting the potential yield of prenatal testing and screening options. This study provides further evidence that CMA has the highest predicted diagnostic yield in cases with structural abnormalities. Screening with expanded NIPT options shows potential for patients who decline invasive testing, but only in the setting of adequate pre-test counseling.
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Modelos Teóricos , Pruebas Prenatales no Invasivas/normas , Resultado del Embarazo/epidemiología , Adulto , Femenino , Humanos , Análisis por Micromatrices/métodos , Pruebas Prenatales no Invasivas/métodos , Pruebas Prenatales no Invasivas/estadística & datos numéricos , Embarazo , Resultado del Embarazo/genética , Diagnóstico Prenatal/métodos , Diagnóstico Prenatal/estadística & datos numéricos , Estudios Retrospectivos , Texas/epidemiologíaRESUMEN
Pregnancy termination for fetal anomaly (TFA) is a unique experience that can cause women to develop long-term complicated grief. Although a woman's experience with her healthcare providers has been previously identified as an important factor in coping, studies have shown that many women report their health care as lacking to some extent. Given the overlap in women's needs and the practice scope of a genetic counselor (GC), this study aimed to examine how genetic counseling may impact coping and explore women's expectations of GCs pre- and post-TFA. An online survey, which included the brief COPE and the short version of the Perinatal Grief Scale, was distributed among private online support groups. Appropriate statistical analysis tools, such as the Wilcoxon rank-sum and t test, were utilized for quantitative analysis of the 124 responses, and inductive content analysis was utilized for qualitative analysis. Of those who underwent TFA within the last two years, women who saw a GC utilized active coping, planning, and positive reframing significantly more than women who did not see a GC (p = 0.001, p = 0.031, p = 0.027, respectively). GCs were perceived to have a positive impact on coping when providing information, objective care, emotional support, support resources, and follow-up care; these practices encouraged confidence in their personal decision-making and gave women hope for the future. This study not only identified key counseling roles for GCs prior to a TFA, but also demonstrated that genetic counseling prior to TFA may be beneficial to coping. Further studies are warranted to explore the needs of a more diverse population and to identify appropriate genetic counseling training methods to support women pursuing TFA.
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Aborto Inducido , Asesoramiento Genético , Adaptación Psicológica , Consejo , Femenino , Pesar , Humanos , EmbarazoRESUMEN
A standard lumbar puncture may be impossible for many anatomic or technical reasons. Previous accounts of caudal epidural anesthesia and other procedures via the sacral hiatus prompted us to test if image-guided percutaneous trans-sacral hiatus access to the lumbosacral subarachnoid cistern would be anatomically feasible. To study vertebral canal morphometry and curvature, we analyzed midsagittal computed tomography-myelogram images of 40 normal subjects and digitally measured sacral curvatures between S1 to S5 and S2 to S4 using two methods whereby a lower angle signifies a straighter sacrum. We measured midsagittal vertebral canal area, hiatus width, dural sac termination levels, and distance from sacral hiatus to the dural sac tip (needle distance). Subjects were F:M = 25:15, with a mean age of 44.9 years. The two S1-S5 full sacral curvature mean angles were 57.3° and 60.4°. Almost all sacral hiatuses were at S4, and dural sac terminations were at S1-S2. The mean S2-S4 sacral curvature was 25.1°, and the mean needle distance was 57.7 mm. Using two-way analysis of variance, there were significant sex differences for needle distances (p = .001), and full and limited sacral curvatures (p = .02, and p = .046, respectively). There were no significant linear regression correlations between age and sacral curvature, needle distance, canal area, or hiatus width. Therefore, despite a frequently prominent full sacral curvature, the combination of S1-S2 dural sac termination plus a relatively straight trajectory of the lower vertebral canal between S2 and S4 support the theoretical feasibility of percutaneous trans-sacral hiatus and vertebral canal access to the lumbosacral cistern using a standard spinal needle.
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Anestesia Caudal , Región Sacrococcígea/anatomía & histología , Sacro/anatomía & histología , Canal Medular/anatomía & histología , Espacio Subaracnoideo/anatomía & histología , Adulto , Anciano , Puntos Anatómicos de Referencia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mielografía , Estudios Retrospectivos , Región Sacrococcígea/diagnóstico por imagen , Sacro/diagnóstico por imagen , Canal Medular/diagnóstico por imagen , Espacio Subaracnoideo/diagnóstico por imagenRESUMEN
The application of natural products and supplements has expanded tremendously over the past few decades. Clinacanthus nutans (C. nutans), which is affiliated to the Acanthaceae family, has recently caught the interest of researchers from the countries of subtropical Asia due to its medicinal uses in alternative treatment for skin infection conditions due to insect bites, microorganism infections and cancer, as well as for health well-being. A number of bioactive compounds from this plant's extract, namely phenolic compounds, sulphur containing compounds, sulphur containing glycosides compounds, terpens-tripenoids, terpens-phytosterols and chlorophyll-related compounds possess high antioxidant activities. This literature search yielded about one hundred articles which were then further documented, including the valuable data and findings obtained from all accessible electronic searches and library databases. The promising pharmacological activities from C. nutans leaves extract, including antioxidant, anti-cancer, anti-viral, anti-bacterial, anti-fungal, anti-venom, analgesic and anti-nociceptive properties were meticulously dissected. Moreover, the authors also discuss a few of the pharmacological aspect of C. nutans leaves extracts against anti-hyperlipidemia, vasorelaxation and renoprotective activities, which are seldom available from the previously discussed review papers. From the aspect of toxicological studies, controversial findings have been reported in both in-vitro and in-vivo experiments. Thus, further investigations on their phytochemical compounds and their mode of action showing pharmacological activities are required to fully grasp both traditional usage and their suitability for future drugs development. Data related to therapeutic activity and the constituents of C. nutans leaves were searched by using the search engines Google scholar, PubMed, Scopus and Science Direct, and accepting literature reported between 2010 to present. On the whole, this review paper compiles all the available contemporary data from this subtropical herb on its phytochemistry and pharmacological activities with a view towards garnering further interest in exploring its use in cardiovascular and renal diseases.
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Acanthaceae/química , Antineoplásicos/química , Antioxidantes/química , Fitoquímicos/química , Animales , Humanos , Hojas de la Planta/químicaRESUMEN
PURPOSE: Motion artifact limits the clinical translation of high-field MR. We present an optical prospective motion correction system for 7 Tesla MRI using a custom-built, within-coil camera to track an optical marker mounted on a subject. METHODS: The camera was constructed to fit between the transmit-receive coils with direct line of sight to a forehead-mounted marker, improving upon prior mouthpiece work at 7 Tesla MRI. We validated the system by acquiring a 3D-IR-FSPGR on a phantom with deliberate motion applied. The same 3D-IR-FSPGR and a 2D gradient echo were then acquired on 7 volunteers, with/without deliberate motion and with/without motion correction. Three neuroradiologists blindly assessed image quality. In 1 subject, an ultrahigh-resolution 2D gradient echo with 4 averages was acquired with motion correction. Four single-average acquisitions were then acquired serially, with the subject allowed to move between acquisitions. A fifth single-average 2D gradient echo was acquired following subject removal and reentry. RESULTS: In both the phantom and human subjects, deliberate and involuntary motion were well corrected. Despite marked levels of motion, high-quality images were produced without spurious artifacts. The quantitative ratings confirmed significant improvements in image quality in the absence and presence of deliberate motion across both acquisitions (P < .001). The system enabled ultrahigh-resolution visualization of the hippocampus during a long scan and robust alignment of serially acquired scans with interspersed movement. CONCLUSION: We demonstrate the use of a within-coil camera to perform optical prospective motion correction and ultrahigh-resolution imaging at 7 Tesla MRI. The setup does not require a mouthpiece, which could improve accessibility of motion correction during 7 Tesla MRI exams.
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Artefactos , Encéfalo , Encéfalo/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Movimiento (Física) , Neuroimagen , Estudios ProspectivosRESUMEN
BACKGROUND: Spinal cerebrospinal fluid (CSF) leak can lead to intracranial hypotension and is an important differential diagnosis to consider in patients with sudden-onset chronic daily headaches. Pars interarticularis (PI) fracture is a potential rare cause of suspected spinal CSF leak. METHODS: This is a retrospective case series of 6 patients with suspected spinal CSF leak evaluated between January 2016 and September 2019. All patients received a magnetic resonance imaging (MRI) of the brain with and without gadolinium, MRI whole spine and full spine computed tomography (CT) myelogram. Targeted epidural patches with fibrin sealant were performed. Treatment response at return visit (3 months post-patch) was documented. RESULTS: Six patients (4 females, 2 males) were diagnosed with a suspected spinal CSF leak and PI fracture. Mean age at the time of headache onset was 39 years old, and a range from 32 to 50 years old. Mean time to targeted epidural patches with fibrin sealant was 4.5 years. All 6 patients had PI fractures identified on CT myelogram and received targeted epidural patches with fibrin sealant at the site of the PI fracture. All patients had significant improvement in their headache intensity. CONCLUSION: Our study highlights: 1) the importance of PI fracture as a possible culprit of suspected spinal CSF leak in patients with intracranial hypotension; 2) the added benefit of CT imaging for detecting bony abnormalities such as fractures in patients with intracranial hypotension; and 3) the successful treatment of suspected spinal CSF leak when targeting the fracture site.
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Pérdida de Líquido Cefalorraquídeo/diagnóstico por imagen , Fracturas de la Columna Vertebral/diagnóstico por imagen , Adulto , Pérdida de Líquido Cefalorraquídeo/complicaciones , Femenino , Adhesivo de Tejido de Fibrina/uso terapéutico , Gadolinio , Cefalea/complicaciones , Cefalea/tratamiento farmacológico , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Mielografía , Estudios Retrospectivos , Fracturas de la Columna Vertebral/complicaciones , Fracturas de la Columna Vertebral/tratamiento farmacológico , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
This study examined the analysis of personal and production performance of broiler farming in 10 cities of central Punjab (Lahore, Sheikhupura, Kasur, Okara, Sargodha, Sahiwal, Gujranwala, Gujrat, Nankana, and Kamalia) of Pakistan. These districts are densely populated and renowned for broiler production. Primary data were collected through a survey of 100 poultry farmers. Personal and production information were collected from the respondents. Descriptive statistics was employed in the form of averages and percentages. The comparison among different districts was made through one-way ANOVA technique followed by Tukey's HSD test. Parameters were observed significantly in experience of farmer, age, number of sheds, capacity of farm, and flock/annuum during the survey of Gujranwala and Kasur, while the high percentage of graduate farmers was observed in Lahore and Sheikhupura regions. Significant results were observed during the production performance feed efficiency and mortality in Okara and Kasur as well as maximum administration of both live and killed vaccine in Lahore through drinking water in Nankana. In the districts of Sheikhupura and Kamalia, farmers due to lake of education left their dead birds on the surface ground. In conclusion, this study pointed out the exact trend of modern broiler farming and its price fluctuation in Punjab (Pakistan) as well as the reason behind the losses to the farmers.
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Crianza de Animales Domésticos/estadística & datos numéricos , Pollos , Agricultores/estadística & datos numéricos , Crianza de Animales Domésticos/economía , Animales , PakistánRESUMEN
OBJECTIVE: To compare the efficacy and costs of three different strategies of antenatal rhesus immune globulin (RhIG) administration in a US population. METHODS: A decision tree analysis was undertaken for universal antenatal RhIG administration based on RhD serologic paternity testing, universal administration without paternity, and selective antenatal RhIG administration using cell free fetal DNA (cfDNA) for RHD fetal typing. Rates of alloimmunization were calculated. Charges were determined for laboratory testing and obstetrical and neonatal treatments for the first pregnancy and cases of alloimmunization in the following pregnancy. RESULTS: The largest number of new RhD alloimmunization cases resulted from a strategy of universal RhIG that included paternity. Fewer cases resulted from a selective strategy; the least number of cases were associated with a universal approach that discounted paternity. When the costs of first pregnancies and alloimmunized second pregnancies were combined, a universal strategy that excludes paternity had the least costs followed by a selective strategy followed by a universal strategy that included paternity. CONCLUSION: The use of cfDNA to determine the selective use of antenatal RhIG would not be cost-effective in the United States. Universal antenatal RhIG without paternity is more effective in preventing new cases of alloimmunization than the current ACOG guideline.