The discovery of insulin by Frederick G Banting and his colleagues in 1921 marked a pivotal moment in medical history. Born in Ontario, Canada, in 1891, Banting's childhood was impacted by the death of his closest friend, Jane, who died of diabetes mellitus at a young age. This personal tragedy profoundly influenced him to choose a career in medicine and fueled his determination to find a cure for diabetes.
View Article and Find Full Text PDFReference dosimetry measurement in a pencil beam scanning system can exhibit dose fluctuation due to intra-spill spot positional drift. This results in a noisy reference dosimetry measurement against energy which could introduce errors in monitor unit calibration. The aim of this study is to investigate the impact of smoothing the reference dosimetry measurements on the type A uncertainty.
View Article and Find Full Text PDFObjective: The field of endocrine surgery has been expanding its minimally invasive techniques to treat a wide range of thyroid pathologies. Radiofrequency ablation (RFA) is one targeted thermal therapy that has been identified as safe and effective for the treatment of benign pathologies as an alternative to surgery. We have employed RFA at our institution and are reporting our experience with this techniques safety, efficacy, and considerations in the treatment of toxic adenomas and multinodular goiters.
View Article and Find Full Text PDFPurpose: Optimal approaches for tobacco treatment counseling among individuals who currently smoke and are undergoing shared decision-making (SDM) and lung cancer screening (LCS) are unknown. The objective of this cross-sectional study was to determine the rate of reported interest in tobacco treatment counseling and pharmacotherapy among individuals who currently smoke and are receiving integrated nurse navigation for LCS and tobacco treatment in a centralized LCS Program.
Methods: We identified individuals undergoing SDM through our centralized LCS Program between March 2021 and March 2022.
J Soc Cardiovasc Angiogr Interv
November 2024
Background: For small papillary thyroid cancers (PTCs) with no lateral nodal involvement, American Thyroid Association guidelines recommend performing prophylactic central lymph node dissection (pCLND) if it influences further management. Our cohort study explored to what extent performing pCLND for small PTCs can de-escalate subsequent therapy including completion thyroidectomy and adjuvant radioactive iodine (RAI) ablation.
Methods: Adults with T1, T2, and cN0 PTCs were identified from 42 centers across the prospectively maintained Australian and New Zealand Thyroid Cancer Registry (ANZTCR) between 2017 and 2023.
Alois Alzheimer was a German psychologist and neuropathologist who significantly advanced the study of dementia with his discovery of Alzheimer's disease (AD). Based on his assessment of a 51-year-old female patient with symptoms of presenile dementia and after conducting a postmortem autopsy of her brain, Alzheimer distinguished two neurological substances - senile plaques and neurofibrillary tangles - as unique markers of what was later deemed as AD. He recognized that dementia is not a natural consequence of age but rather a recognizable neurocognitive disorder.
View Article and Find Full Text PDFLeft atrial veno-arterial extracorporeal membrane oxygenation (LAVA-ECMO) in cardiogenic shock (CS) is a novel mechanical cardiocirculatory support strategy that provides robust cardiocirculatory support and simultaneous left and right atrial venting by way of a multifenestrated transeptal catheter. We performed a single-center retrospective analysis of all patients aged ≥18 years with CS who underwent LAVA-ECMO at a quaternary care institution from 2018 to 2023. Clinical outcomes and prehemodynamics and posthemodynamics were evaluated.
View Article and Find Full Text PDFArtificial intelligence (AI) has significantly influenced various sectors, including healthcare, by enhancing machine capabilities in assisting with human tasks. In surgical fields, where precision and timely decision-making are crucial, AI's integration could revolutionize clinical quality and health resource optimization. This study explores the current and future applications of AI technologies in reconstructive breast surgery, aiming for broader implementation.
View Article and Find Full Text PDFEnviron Sci Process Impacts
December 2024
This study uses mobile monitoring to gain a better understanding of particulate matter (PM) sources in two areas of Central and Outer London, UK. We find that, unlike emissions of nitrogen oxides (NO + NO = NO), which are elevated in Central London due to the high number of diesel vehicles and congestion, fine particulate matter (PM) emissions are well-controlled. This finding provides evidence for the effectiveness of vehicle particulate filters, supporting the view that their widespread adoption has mitigated PM emissions, even in the highly dieselized area of Central London.
View Article and Find Full Text PDFObjective: Many patients with melanoma treated with immune checkpoint inhibitors (ICIs) do not derive response. Preclinical and retrospective studies identified that inhibition of the cyclooxygenase (COX) pathway may improve response to ICI treatment.
Methods: This prospective single site phase II trial accrued patients with advanced/metastatic melanoma.
This document assesses the appropriateness of various imaging studies for acute penetrating trauma to the torso. Penetrating trauma most commonly occurs from gunshots and stabbings, although any object can impale the patient. Anatomic location, type of penetrating trauma, and hemodynamic status are among the many important factors when deciding upon if, what, and when imaging is needed to further evaluate the patient.
View Article and Find Full Text PDFPharmacogenetics promises to optimize treatment-related outcomes by informing optimal drug selection and dosing based on an individual's genotype in conjunction with other important clinical factors. Despite significant evidence of genetic associations with drug response, pharmacogenetic testing has not been widely implemented into clinical practice. Among the barriers to broad implementation are limited guidance for how to successfully integrate testing into clinical workflows and limited data on outcomes with pharmacogenetic implementation in clinical practice.
View Article and Find Full Text PDFPurpose: To train and validate machine learning-derived clinical decision algorithm (CDA) for the diagnosis of hyperfunctioning parathyroid glands using preoperative variables to facilitate surgical planning.
Methods: This retrospective study included 458 consecutive primary hyperparathyroidism (PHPT) patients who underwent combined 4D-CT and sestamibi SPECT/CT (MIBI) with subsequent parathyroidectomy from February 2013 to September 2016. The study cohort was divided into training (first 400 patients) and validation sets (remaining 58 patients).
J Autism Dev Disord
October 2024
Challenging behaviors of young autistic children remain a major parenting challenge for many of their family members, including caregivers. Caregivers from underrepresented cultural or linguistic backgrounds may experience exacerbated difficulties related to challenging behaviors due to limited access to culturally sustaining and responsive interventions. Evidence-based behavior parent training programs, such as RUBI, are highly effective in increasing caregivers' capacity in preventing and responding to these behaviors in naturalistic settings using behavior analytic principles.
View Article and Find Full Text PDFJ Plast Reconstr Aesthet Surg
December 2024
Background: The volume of facial feminization surgery (FFS) performed has increased tremendously over the last decade as new gender affirmation programs have formed. Advancements in surgical planning and treatment protocols have resulted in complex, multiprocedural FFS operations. This study examines the characteristics and outcomes of a large-scale FFS program over a 5-year lifespan.
View Article and Find Full Text PDFObjective: Provide an in-depth examination of consumers' food safety beliefs and practices to draw implications for interventions to improve nutrition and food safety in Ethiopia.
Design: Adapted Focused Ethnographic Study approach using in-person semi-structured interviews and free-listing exercises, in two iterative phases.
Setting: A traditional food market in Hawassa, a mid-sized city.
The establishment of the Liver Imaging Reporting and Data System (LI-RADS) in 2011 provided a comprehensive approach to standardized imaging, interpretation, and reporting of liver observations in patients diagnosed with or at risk for hepatocellular carcinoma (HCC). Each set of algorithms provides criteria pertinent to the various components of HCC management including surveillance, diagnosis, staging, and treatment response supported by a detailed lexicon of terms applicable to a wide range of liver imaging scenarios. Before its widespread adoption, the variability in the terminology of diagnostic criteria and definitions of imaging features led to significant challenges in patient management and made it difficult to replicate findings or apply them consistently.
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