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Diagnosis of critical congenital heart defects in Iceland 2000-2014

Published on: 4th November, 2019

OCLC Number/Unique Identifier: 8301342754

Critical congenital heart defects (CCHDs) are preferably diagnosed prenatally or soon after birth. Late diagnosis has been related to poorer prognosis. The aim of this study is to assess when CCHDs are diagnosed in Iceland and whether late diagnosis is a problem. All live born children in Iceland and foetuses diagnosed with CCHDs during the years 2000-2014 were included. CCHD was defined as a defect requiring intervention or causing death in the first year of life, or leading to abortion. The total number of pre- and postnatal diagnosis of CCHDs was 188. Prenatal diagnosis was made in 69 of 188 (36.7%). Of 69 diagnosed prenatally 33 were terminated due to CCHD. Of the 155 live born children with CCHD, 36 (23.2%) had a prenatal diagnosis and 100 (64.5%) were diagnosed shortly after birth, before discharge from birth facility. 19 children (12.3%) were diagnosed late, that is after discharge from birth facility. Coarctation of the aorta was the most common CCHD diagnosed late (6/19). Prenatal screening and newborn examination give good results in diagnosis of CCHDs in Iceland. Late diagnosis are relatively few, but both the number of prenatally diagnosed CCHDs and CCHDs diagnosed shortly after birth can be further improved.
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A Novel Strategy to Improve Radiotherapy Effectiveness: First-in-Human MR-guided Focused Ultrasound-Stimulated Microbubbles (MRgFUS+MB) Radiation Enhancement Treatment

Published on: 24th August, 2023

Background and aim: Preclinical in vitro and in vivo experiments suggest that radiation-induced tumour cell death can be enhanced 10- to 40-fold when combined with focused-ultrasound (FUS)-stimulated microbubbles (MB). The acoustic exposure of MB in the tumour volume causes vasculature perturbation, activation of the acid sphingomyelinase (ASMase) ceramide pathway, and resultant endothelial cell apoptosis. When the tumour is subsequently treated with radiation, there is increased endothelial cell death and anoxic tumour killing. Here we describe a first-in-human experience treating patients with magnetic resonance (MR)-guided FUS-stimulated MB (MRgFUS+MB) radiation enhancement.Case presentation: A head and neck cancer patient with recurrent disease underwent radiotherapy for 5 separate sites of locoregional disease followed by systemic therapy. The first consisted of a course of 45 Gy in 5 fractions alone, the second of 30 Gy in 5 fractions with hyperthermia, and the three others of 20-30 Gy in 5 fractions along with MRgFUS+MB treatment. The treatment methodology used an MR-coupled FUS-device operating at 500 KHz and 540 kPa peak negative pressure with an insonification time of 750 ms spread over 5 minutes to stimulate intravenously administered MB within tumour target. All sites treated with stimulated MB had a complete radiological response, and subsequently, the patient’s other cutaneous metastatic disease disappeared. The patient has been under surveillance for over two years without active treatment or disease progression.Discussion: MRgFUS+MB was well-tolerated with no reported treatment-related adverse events, which can be attributed to the capability of FUS to selectively stimulate MB within the tumour volume while sparing the surrounding normal tissue. Sustained local control at all target sites aligns with earlier preclinical findings suggesting the radiation enhancement potential of FUS+MB.Conclusion: MRgFUS+MB represents a novel and promising therapy for enhancing radiation efficacy and improving therapeutic index with potential improvements in disease control.
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Environmental Modeling for Radiation Safety

Published on: 28th August, 2023

The newly launched IAEA project MEREIA (MEthods for Radiological and Environmental Impact Assessment; 2021- 2025), MEREIA continues some activities of previous IAEA exercises in the field of radioecological modelling and focuses on areas where the probabilistic approach determines the predictive capability of environmental models. The program offered the opportunity to set up well-designed and verified scenarios to collect and compare exposures predicted by particular models based on this scenario and then perform a validation study of contributing models. It consists of the comparison of model prediction with observed data or in the case where there is a lack of measurement data to perform a comparison within model prognoses.  The previous international works have brought significant improvement in environmental modeling in terms of better understanding and mathematical description of complex physical and chemical phenomena that occur in various environmental media and also have promoted new areas for experimental investigations. The new experimental results yielded updated handbooks of a large number of environmental parameters for less-known elements. Moreover, the principal objective of the activities in environmental modelling was an integrated risk assessment of the reference group of population and biota associated with radionuclides releases from various kinds of nuclear facilities as from different types and power nuclear reactors, radioactive waste disposal and more complex nuclear research facility. This reflects recent international recommendations to extend protection against radiation hazards of humans to wildlife flora and fauna. However, the statistics supported knowledge on some essential environmental parameters still remain small. Therefore, one could be aware of some limitations of the probabilistic approach that required advanced methods of probabilistic prognosis Monte Carlo.
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Baxter’s nerve injury: an often overlooked cause of chronic heel pain: a case report

Published on: 7th February, 2023

Chronic foot and heel pain is a clinical dilemma that Pain Physicians often encounter in their daily practice. In the younger active patients, this is often attributed to plantar fasciitis but other rarer etiologies should also be considered. In patients who present with pain over the medial calcaneus, entrapment neuropathy of the inferior calcaneal nerve, the first branch of the lateral plantar nerve (FBLPN), also known as “Baxter’s nerve” must be considered [1,2]. Initially described in 1984 by Baxter and Thigpen, it is often overlooked as a cause of medial heel pain, particularly in athletes, where it may coexist with plantar fasciitis [3]. The nerve has a tortuous course in the foot and can be entrapped as it passes through the fascia of the abductor hallucis, travels in close proximity to a plantar spur or the medial calcaneal tuberosity, or gets enmeshed in scar tissue from prior surgery [1,3].
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Neuroanatomical profile of hemineglect in patient’s body image modification

Published on: 26th March, 2020

OCLC Number/Unique Identifier: 8560711773

Background: NSU is generally caused by right cerebral hemisphere lesions with a preeminent localization on the frontoparietal lobe. Aim: To assess the correlation between the typology and the brain lesion site and the consensual consent modality of body image modification after an integrated rehabilitative and neuropsychological treatment. Setting: A rehabilitation institute for the treatment of neurological gait disorders and neuropsichological failures. methods: Patients recruited were divided according to the brain lesion site into 3 groups (IG = ischemic group = 5 patients; HG = hemorrhagic group = 4 patients; IG + HG = ischemic + hemorrhagic group = 3 patients) based on CT brain performed in the post-acute phase. At time T0, the patients recruited underwent a systematic review of their current neuroradiological profile (location delineation and type of brain injury) compared with a consensual framing of the neuromotor and neuropsychological profile acquired at the time of taking charge in the ward. At time T1 and after the drafting and implementation of the rehabilitation treatment plan foreseen in the study (1 to 4 months after T0), the patients in our sample underwent a re-evaluation of their neuromotor and neuropsychological profile with controls of the same outcome parameters considered at time T0. Results: A parametrically but not statistically significant modification of the results obtained was observed by measuring the MI ULl, MI LLl and TCT scales in the group with hemorrhagic brain injury; the analysis of variance did not show any statistical significance in the relationship between the type of stroke (ischemic, hemorrhagic or both) and the motor impairment passing from time T0 to time T1. The analysis of variance did not reveal a statistically or parametrically significant relationship between the type (ischemic, hemorrhagic and ischemic + hemorrhagic) of cerebral stroke and the variations of the neuropsychological profile. The T-Student test showed statistically significant changes in the importance of the lesion site in defining the degree of motor disability. In particular, we observed, about the presence of frontal lobe lesions, a statistically significant variation passing from the T0 time to the T1 time for the following motor scales in 9 of 12 recruited patients: MI LLl (26.4 vs. 62, with p < 0.05), TCT (43.6 vs. 80.6, with p < 0.01 for equal variance assumed and p < 0.05 for equal variance not assumed), FAC (0.8 vs. 2.3 with p < 0,01 for equal variance assumed and p < 0.05 for equal variance not assumed). Conclusion: We have confirmed the importance of the anatomical-dysfunctional correlation as a key concept from which to start in any neurorehabilitative treatment approach. Our work has highlighted the basic role of the right frontal lobe in the programming and execution of the gesture and its kinesthetic control as regards the left lower limb and the trunk.
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Social Implementation and Measurement Accuracy Verification of Non-contact Biological Monitors

Published on: 25th March, 2024

In this research, for the purpose of social implementation, we conducted a near-miss demonstration experiment using a car driving in the city and a drive-simulator. Next, we conducted a demonstration experiment to evaluate the reliability of biometric information measured on patients in a medical facility's recuperation ward and residents of a special nursing home. NBC-1100 emits radar waves from a distance of up to 3 meters from an object and uses the reflected waves to measure biological information such as pulse waves and breathing waves. The multi-element pyroelectric effect was used to measure body temperature by detecting infrared radiation emitted from distant objects. This device is unique in that it can measure biological information without being restrained while wearing clothes. In the demonstration test, simultaneous measurements were conducted on nine healthy men aged 45 to 65 using a pharmaceutically approved product (μBP-mp) and a prototype non-contact biological monitor (NBC-1100 manufactured by K&S Co., Ltd.). The demonstration experiments at medical institutions and nursing care facilities were conducted with the consent of residents and their families and were conducted on 30 men and women between the ages of 70 and 94 who were undergoing treatment or in need of care. The tests were conducted on residents with chronic diseases such as dilated gastrostomies, symptomatic epilepsy, hypertension, Alzheimer's disease, and progressive supranuclear palsy. The evaluation method was simultaneous measurement using a master meter (μBP-mp) and a test meter (NBC-1100).
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Physicochemical and microbiological quality of tanker waters in Bengaluru urban for safe water supply

Published on: 11th May, 2020

OCLC Number/Unique Identifier: 8601971117

This study investigated the water quality of tanker waters that was collected from Bengaluru urban areas to assess its suitability for domestic purpose. A total of 50 samples were collected in dry (March 2019) season. All samples were analyzed for various hydrochemical parameters, such as pH, total dissolved solids (TDS), electrical conductivity (EC), turbidity, dissolved oxygen (DO), total hardness (as CaCO3), calcium (CaCO2+), chloride (CaCO−) and nitrate (NO3−). Bacteriological analyses of water samples were analyzed for total coliform count. A very high level of total hardness (186 - 434.6 mg L-1) was determined in 27 water samples tested in this study indicating the necessity of water treatment before used for domestic purpose. Of the 50 samples tested, 7 showed a most probable number (MPN) index of < 23 and 9 showed < 240 and the remaining 34 were unsatisfactory with an MPN index of > 1600 per 100 ml. In some locations, the presence of high MPN index, in particular, rings the bell before using the tanker water in houses and restaurants. Exploration of the mechanisms by which water quality deteriorates during supply chain and potential implication for regulatory policy for monitoring of tanker water while distribution is the need of the hour.
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Investigation of snow load reduction in the industrial sheds roof design with photovoltaic systems by mathematical modelling, solar system evaluation, X-steel simulation and thermodynamic practices

Published on: 8th September, 2021

OCLC Number/Unique Identifier: 9244772554

Since snow load is one of the loads of designing the industrial shed roof, this research presents a new system to reduce the industrial sheds roof design. In this system, sensitive units of moisture and temperature, which can be adjusted with different areas, are installed on the shed’s roof. The mechanism of system is that the sensors in the units detect the presence of snow on the shed roof and send an order to connect electricity to the elements; therefore, the snow on the roof melts by the heat generated. In this system, solar panels are used to supply electricity. As with the help of this mechanism, snow does not remain on the roof, it is possible to eliminate the snow load in the calculations of the shed and apply at least the live load of the sixth regulation (Due to having a one-story shed, minimum live load applied and it used only for the foundation design of the structure.), this issue will create an economic plan in shed designing. According to the study conducted in this research, it is shown that the dimensions of the sheet beam used in the shed are reduced, which will significantly reduce the cost of construction and installation to some extent. In the following, two samples of sheds with a span of 20 meters in the presence of snow and the absence of snow in the software were modelled, and the results were compared with each other.
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Causal Mediation Analysis for Childhood Cancer Survival Disparity in Texas, 2005 to 2014

Published on: 29th March, 2024

This study aimed to examine the disparities of childhood cancer survival among different racial and ethnic groups in Texas. The analysis was mediated by socioeconomic status (SES) and spatial accessibility to Children Oncology Group (COG) hospitals. The relationship between race-ethnicity and overall survival was measured using the Cox proportional hazards model with a robust variance estimator. The counterfactual model measures the total effect of race-ethnicity on survival through all mediating pathways while adjusting for baseline confounders (age, sex, and stage at diagnosis), which are then decomposed into natural direct and indirect effects. Considering all cancer site groups, African Americans showed a statistically significant higher hazard ratio in death (HR = 3.63; 95% CI = 1.87 - 6.62) compared with non-Hispanic White children. At the same time, the mortality hazard ratio among Hispanic children is not significant (HR = 1.23; 95% CI = 0.80 - 1.93) when compared with non-Hispanic White children. Analysis results also suggested that both mediators significantly contribute to racial-ethnic survival disparities for specific cancer site groups such as Leukemia for African American children. This study builds knowledge and understanding about underlying factors (mediators) responsible for the disparities in the outcomes among childhood cancer patients.
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A trial of conservative care for restoring scapular dyskinesis: A clinical series

Published on: 8th June, 2020

OCLC Number/Unique Identifier: 8628657543

The shoulder is the greatest movable joint in the human body. Its anatomical design allows a wide range of motion in all directions, leading to an insubstantial balance between stability and mobility. Conservative treatments are suggested by a number of authors for restoring the scapular dyskinesis. However, this condition can be overlapped by other clinical findings. Therefore, comprehensively analysing individual biomechanical rationale is central to design the ideal rehabilitation regimen to overcome scapular dyskinesis by restoring the scapular thoracic rhythm and preventing the associated problems. This study presents a brief clinical series of three patients with shoulder pain due to the alteration of their scapulahumeral rhythm and highlights a comprehensive examination and follow up an evidence-based rehabilitation algorithm to regain pain free functional ability in daily routine life.
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