Using Scorecards to Tune Ethos Directive Templates: An Adaptive Radiation Therapy Individualized Approach-Cervix Dosimetric Planning Study.

Purpose: The Adaptive Radiation Therapy Individualized Approach-Cervix clinical trial uses predefined clinical directive templates (CDTs) combined with RapidPlan dose-volume histogram estimations (DVHe) to guide plan optimization in the Ethos treatment planning system. The dosimetric scorecard is a scoring tool that quantifies improvements in plan quality after physicians have precisely expressed their complete clinical intent. To our knowledge, this is the first study to use the dosimetric scorecard tool to tune an Ethos CDT to improve resulting plan quality.

Advanced Large-Scale Nanofabrication Route for Ultrasensitive SERS Platforms Based on Precisely Shaped Gold Nanostructures.

One of the key issues for SERS-based trace applications is engineering structurally uniform substrates with ultrasensitivity, stability, and good reproducibility. A label-free, cost-effective, and reproducible fabrication strategy of ultrasensitive SERS sensors was reported in this work. Herein, we present recent progress in self-assembly-based synthesis to elaborate precisely shaped and abundant gold nanoparticles in a large area.

Primary Retention of Molars and RANKL Signaling Alteration during Craniofacial Growth.

The primary retention of molars observed in clinic corresponds to a still-unexplained absence of molar eruption despite the presence of an eruption pathway, resembling the experimental transient inhibition of RANKL signaling in mice. The aim of the present study was to confront the hypothesis according to which the primary retention of molars is associated with transitory perturbations to RANKL signaling during growth as part of a wider craniofacial skeleton pattern. The experimental strategy was based on combining a clinical study and an animal study corresponding to the characterization of the craniofacial phenotypes of patients with primary retention of molars and analyses in mice of the consequences of transient inhibition of RANKL signaling on molar eruption and craniofacial growth.

Precise control of the size and gap between gold nanocubes by surface-based synthesis for high SERS performance.

The optical properties of a monolayer of nanocomposite film (PMMA/gold nanocubes) were provided by fitting a proposed theoretical model to spectroscopic ellipsometry (SE) measurements. For such a thin film, these features cannot be successfully determined by means of experimental and conventional effective medium theory such as Maxwell-Garnett or Bruggeman. To make it possible, we developed a model of two classical Lorentz oscillators; one for a PMMA layer and the other for GNCs, revealing one homogeneous layer and rapid analysis without the need for large computational resources.

Adjunctive strategies in the management of resistant, 'undilatable' coronary lesions after successfully crossing a CTO with a guidewire.

Successful revascularisation of chronic total occlusions (CTOs) remains one of the greatest challenges in the era of contemporary percutaneous coronary intervention (PCI). Such lesions are encountered with increasing frequency in current clinical practice. A predictable increase in the future burden of CTO management can be anticipated given the ageing population, increased rates of renal failure, graft failure and diabetes mellitus.

Does routine pressure wire assessment influence management strategy at coronary angiography for diagnosis of chest pain?: the RIPCORD study.

Background: The use of coronary angiography (CA) for diagnosis and management of chest pain (CP) has several flaws. The assessment of coronary artery disease using fractional flow reserve (FFR) is a well-validated technique for describing lesion-level ischemia and improves clinical outcome in the context of percutaneous coronary intervention. The impact of routine FFR at the time of diagnostic CA on patient management has not been determined.

Infantile-onset ascending hereditary spastic paraplegia with bulbar involvement due to the novel ALS2 mutation c.2761C>T.

Recessive mutations in the alsin gene cause three clinically distinct motor neuron diseases: juvenile amyotrophic lateral sclerosis (ALS2), juvenile primary lateral sclerosis (JPLS) and infantile-onset ascending hereditary spastic paraplegia (IAHSP). A total of 23 different ALS2 mutations have been described for the three disorders so far. Most of these mutations result in a frameshift leading to a premature truncation of the alsin protein.

Intensive glucose control and hypoglycaemia: a new cardiovascular risk factor?

Intensive glucose control is widely practiced in patients with diabetes mellitus and patients acutely admitted to hospitals with concomitant stress-induced hyperglycaemia. Such a strategy increases the risk of hypoglycaemia by several-fold. Hypoglycaemia leads to a surge in catecholamine levels with a profound haemodynamic response.

Acute hypoglycemia decreases myocardial blood flow reserve in patients with type 1 diabetes mellitus and in healthy humans.

Background: Hypoglycemia is associated with increased cardiovascular mortality, but the reason for this association is poorly understood. We tested the hypothesis that the myocardial blood flow reserve (MBFR) is decreased during hypoglycemia using myocardial contrast echocardiography in patients with type 1 diabetes mellitus (DM) and in healthy control subjects.

Methods And Results: Twenty-eight volunteers with DM and 19 control subjects underwent hyperinsulinemic clamps with maintained sequential hyperinsulinemic euglycemia (plasma glucose, 90 mg/dL [5.

Intensive insulin therapy in the intensive care unit, hypoglycemia, and cardiovascular mortality.

Several studies have shown that elevated glucose concentrations in patients with acute coronary syndrome and other acute severe illnesses are associated with increased short- and long-term all-cause and cardiovascular mortality (CVM). This has subsequently led to the use of intensive insulin therapy (IIT) to control hyperglycemia. Earlier studies have shown that the prevention of hyperglycemia in acute illness through the use of IIT reduces mortality.

Saphenous vein graft aneurysm: an incidental finding.

Saphenous vein graft aneurysm (SVGA) is an uncommon complication of coronary artery bypass graft surgery (CABG). An 82-year-old man underwent contrast-enhanced computed tomography to investigate aorto-iliac disease. He was coincidentally noted to have an aneurysm of the saphenous vein graft to his right coronary artery.

Detection of myocardial ischaemia caused by coronary artery-left ventricular fistulae using myocardial contrast echocardiography.

A coronary artery-left ventricular fistula (CAF) is an extremely rare anatomical abnormality in which blood drains directly from a coronary artery into the left ventricle. CAF may cause myocardial ischaemia and angina. Myocardial contrast echocardiography (MCE) is a non-invasive technique which assesses myocardial perfusion.