Electroconvulsive Therapy in a Left Ventricular Assist Device Recipient With Treatment-Resistant Depression.

Depression and heart failure are highly comorbid, with up to 35% of heart failure patients suffering from comorbid depression. Left ventricular assist devices (LVADs) serve as a major lifeline for patients with heart failure; however, despite the drastic improvement in cardiac function following LVAD implantation, up to 24% of LVAD recipients suffer from depression. Depression management in LVAD recipients is often complicated by the recipient's increased risk for antidepressant side effects, adverse drug reactions, and inability to safely receive certain interventional psychiatry therapies, as the LVAD is either a relative or absolute contraindication.

A single centre intercomparison between commercial treatment planning systems for Y radioembolization using virtual and experimental phantoms.

Introduction: Dedicated Treatment Planning Systems (TPSs) were developed to personalize Y-transarterial radioembolization. This study evaluated the agreement among four commercial TPSs assessing volumes of interest (VOIs) volumes and dose metrics.

Methods: A homogeneous (EH) and an anthropomorphic phantom with hot and cold inserts (EA) filled with Tc-pertechnetate were acquired with a SPECT/CT scanner.

The Role of Decision-Making Capacity in Gathering Collateral Information.

AbstractPsychiatric disorders usually do not have characteristic physical exam findings, imaging, or lab values. Psychiatrists therefore diagnose and treat patients largely based on reported or observed behavior, which makes collateral information from a patient's close contacts especially pertinent to an accurate diagnosis. The American Psychiatric Association considers communication with patients' supports a best practice when the patient provides informed consent or does not object to the communication.

A novel tool for predicting the dose distribution of non-sealed Re (Rhenium) resin in non-melanoma skin cancers (NMSC) patients.

Background: High-dose rate brachytherapy using a non-sealed Rhenium resin ( Re) is a recently approved treatment option for non-melanoma skin cancer (NMSC). The treatment goal is to deliver a personalized absorbed dose to the deepest point of neoplastic infiltration corresponding to the minimal target dose. The treatment consists of the application of a Re-based resin over a plastic foil placed on the target skin surface.

A novel figure of merit to investigate Ga PET/CT image quality based on patient weight and lesion size using Q.Clear reconstruction algorithm: A phantom study.

Introduction: Q.Clear is a Bayesian penalised-likelihood algorithm that uses a β-value for positron emission tomography(PET)/computed tomography(CT) image reconstruction(IR). Our study proposes a novel figure of merit, named CRBV, to compare the Q.

A novel tool for motion-related dose inaccuracies reduction in Tc-MAA SPECT/CT images for SIRT planning.

Introduction: In Selective Internal Radiation Therapy (SIRT), Y is administered to primary/secondary hepatic lesions. An accurate pre-treatment planning using Tc-MAA SPECT/CT allows the assessment of its feasibility and of the activity to be injected. Unfortunately, SPECT/CT suffers from patient-specific respiratory motion which causes artifacts and absorbed dose inaccuracies.

Strategies utilized to prevent and control SARS-CoV-2 transmission in two congregate, psychiatric healthcare settings during the pandemic.

Background: The COVID-19 pandemic has had a substantial effect on the delivery of psychiatric health care. Inpatient psychiatric health care facilities have experienced outbreaks of COVID-19, making these areas particularly vulnerable.

Methods: Our facility used a multidisciplinary approach to implement enhanced infection prevention and control (IPC) interventions in our psychiatric health care areas.

Overview of commercial treatment planning systems for targeted radionuclide therapy.

Introduction: Targeted Radionuclide Therapy (TRT) is a branch of cancer medicine dealing with the therapeutic use of radioisotopes associated with biological vectors accumulating in the tumors/targets, indicated as Molecular Radiotherapy (MRT), or directly injected into the arteries that supply blood to liver tumour vasculature, indicated as Selective RT (SRT). The aim of this work is to offer a panoramic view on the increasing number of commercially-available TRT treatment planning systems (TPSs).

Materials And Methods: A questionnaire was sent to manufacturers' representatives.

A novel tool for assessing the correlation of internal/external markers during SGRT guided stereotactic ablative radiotherapy treatments.

Introduction: An in-house developed tool was implemented and validated to investigate the skin surface, hepatic dome, and target displacement for stereotactic ablative radiotherapy (SABR) of thoracic/abdominal lesions using a Surface Guided Radiation Therapy (SGRT) system combined with 4D- images.

Materials And Methods: Fourteen consecutive patients with tumors near the hepatic dome undergoing SABR treatments were analyzed. For each patient, a planning 4D-CT and five 4D-CBCT images were acquired.

Implementation of a Psychiatry Consultation-Liaison Service "Conseminar".

Background: The field of consultation-liaison psychiatry has generated a relatively small number of rigorous clinical trials that guide clinical care. Consequently, there is a need for a consensus-building process to inform best practices for common clinical dilemmas in consultation-liaison psychiatry.

Objective: We review several consensus-building approaches in academic medicine and describe a novel educational process called a "conseminar," which is intended to minimize the variability in teaching and practice on a service staffed by multiple faculty members.

Comprehensive Analysis of Radiomic Datasets by RadAR.

Quantitative analysis of biomedical images, referred to as radiomics, is emerging as a promising approach to facilitate clinical decisions and improve patient stratification. The typical radiomic workflow includes image acquisition, segmentation, feature extraction, and analysis of high-dimensional datasets. While procedures for primary radiomic analyses have been established in recent years, processing the resulting radiomic datasets remains a challenge due to the lack of specific tools for doing so.

State Preparation and Tomography of a Nanomechanical Resonator with Fast Light Pulses.

Pulsed optomechanical measurements enable squeezing, nonclassical state creation, and backaction-free sensing. We demonstrate pulsed measurement of a cryogenic nanomechanical resonator with record precision close to the quantum regime. We use these to prepare thermally squeezed and purified conditional mechanical states, and to perform full state tomography.

Burn recidivism: a 10-year retrospective study characterizing patients with repeated burn injuries at a large tertiary referral burn center in the United States.

Background: Psychiatric and substance use disorders are common among trauma and burn patients and are known risk factors for repeat episodes of trauma, known as trauma recidivism. The epidemiology of burn recidivism, specifically, has not been described. This study aimed to characterize cases of burn recidivism at a large US tertiary care burn center and compare burn recidivists (RCs) with non-recidivists (NRCs).

A comparative study of physical image quality in digital and synthetic mammography from commercially available mammography systems.

We present a comparison between full field digital mammography and synthetic mammography, performed on several mammography systems from four different manufacturers. The analysis is carried out on both the digital and synthetic images of two commercially available mammography phantoms, and focuses on a set of objective metrics that encode the geometrical appearance of imaging features of diagnostic interest. In particular, we measured sizes and contrasts of several clusters of microcalcification specks, shapes and contrasts of circular masses, and the power spectrum of background regions mimicking the heterogeneous texture of the breast parenchyma.

Nonlinear cavity optomechanics with nanomechanical thermal fluctuations.

Although the interaction between light and motion in cavity optomechanical systems is inherently nonlinear, experimental demonstrations to date have allowed a linearized description in all except highly driven cases. Here, we demonstrate a nanoscale optomechanical system in which the interaction between light and motion is so large (single-photon cooperativity C≈10) that thermal motion induces optical frequency fluctuations larger than the intrinsic optical linewidth. The system thereby operates in a fully nonlinear regime, which pronouncedly impacts the optical response, displacement measurement and radiation pressure backaction.

Fully automated VMAT treatment planning for advanced-stage NSCLC patients.

Purpose: To develop a fully automated procedure for multicriterial volumetric modulated arc therapy (VMAT) treatment planning (autoVMAT) for stage III/IV non-small cell lung cancer (NSCLC) patients treated with curative intent.

Materials And Methods: After configuring the developed autoVMAT system for NSCLC, autoVMAT plans were compared with manually generated clinically delivered intensity-modulated radiotherapy (IMRT) plans for 41 patients. AutoVMAT plans were also compared to manually generated VMAT plans in the absence of time pressure.

Treatment outcome variation between depression symptom combinations in the STAR*D study.

Background: In response to recent documentation of symptom and subtype heterogeneity in major depressive disorder, we report on exploratory analyses of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) clinical-trial data to further describe heterogeneity in depression and test the hypothesis that citalopram treatment-outcome patterns differ as a function of depression symptom combinations.

Methods: Combinatorial algorithms, latent profile analysis, and repeated-measures multivariate analysis of variance were employed to characterize heterogeneity and depression outcome-measure profile variability in the most prevalent symptom combinations with full data (26% of baseline and 13% of endpoint total sample).

Results: Descriptive results suggest that substantial heterogeneity and moderate coherence characterize major depressive disorder; as in previous analyses, pairs of individuals sharing no symptoms in common were observed.

Delirium is a robust predictor of morbidity and mortality among critically ill patients treated in the cardiac intensive care unit.

Background: Delirium is common in the medical and surgical intensive care unit (ICU), and its association with morbidity and mortality is well described. Despite emerging data, which have highlighted a growing critical care burden in the contemporary cardiac ICU (CICU), much less is known about delirium in this specialized setting.

Methods And Results: Records for consecutive CICU patients aged ≥18 years who were admitted to our academic, tertiary care institution from December 2012 to March 2014 for a primary cardiovascular diagnosis were reviewed.

How many cancer deaths could New Zealand avoid if five-year relative survival ratios were the same as in Australia?

Aim: To determine how many Māori and non-Māori deaths might have been avoidable if cancer survival in New Zealand were as high as in Australia.

Methods: Age-sex-tumour specific five-year relative survival ratios were calculated for cancer patients diagnosed with 27 tumour sites (representing about 92% of all cancers) in 2006-10. These were used to estimate the number of Māori, non-Māori and total deaths (and proportion of excess deaths) that would have been avoidable within five years of diagnosis had New Zealand's relative survival been equivalent to Australia's.

Serotonin syndrome caused by fentanyl and methadone in a burn injury.

Serotonin syndrome is a syndrome identified by a triad of altered mental status, neuromuscular overactivity, and autonomic instability caused by the overstimulation of serotonin in the central nervous system and periphery. Serotonin syndrome may be provoked with the addition or increase in serotonergic agents such as selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants, and monoamine oxidase inhibitors as well as other agents with serotonergic properties. Some narcotics, including fentanyl and methadone, have these properties and may be associated with the development of serotonin syndrome when used in conjunction with other agents.

Quantifying heterogeneity attributable to polythetic diagnostic criteria: theoretical framework and empirical application.

Heterogeneity within psychiatric disorders is both theoretically and practically problematic: For many disorders, it is possible for 2 individuals to share very few or even no symptoms in common yet share the same diagnosis. Polythetic diagnostic criteria have long been recognized to contribute to this heterogeneity, yet no unified theoretical understanding of the coherence of symptom criteria sets currently exists. A general framework for analyzing the logical and mathematical structure, coherence, and diversity of Diagnostic and Statistical Manual diagnostic categories (DSM-5 and DSM-IV-TR) is proposed, drawing from combinatorial mathematics, set theory, and information theory.

Analysis of mite allergic patients in a diverse territory by improved diagnostic tools.

Background: There are few studies comparing the sensitization with mite allergens from different mite species which could potentially be the cause of allergy.

Objective: To improve the diagnosis of mite allergic patients from a diverse territory in which D. pteronyssinus/D.