Cold polypectomy techniques (without electrocautery) by means of biopsy forceps or snare are widely adopted for the removal of subcentimetric polyps. However, few data are available on the safety of ...this approach. The aim of this study was to assess the safety of cold polypectomy for subcentimetric polyps, as well as the rate of advanced neoplasia in these lesions.
In a prospective multicenter trial, consecutive patients with at least one < 10-mm polyp at colonoscopy were prospectively included. All of the < 10-mm polyps detected within the study period were removed by cold polypectomy. The rates of immediate or delayed bleeding and other complications were assessed at 7 and 30 days after cold polypectomy by telephone calls. The rate of advanced histology was also assessed. Predictive variables of postpolypectomy bleeding or advanced neoplasia were identified by multivariate analysis.
A total of 1015 < 10-mm polyps in 823 patients (15.5 % on antiplatelet agents) were removed. Of these, 822 (81 %) were ≤ 5 mm and 193 (19 %) were 6 - 9 mm. Immediate postpolypectomy bleeding occurred in 18 patients, corresponding to a per-patient and per-polyp bleeding rate of 2.2 % (95 % confidence interval CI 1.2 % - 3.2 %) and 1.8 % (95 %CI 1 % - 2.6 %), respectively. Therapy with antiplatelet agents (odds ratio OR 4; 95 %CI 1.5 - 10.6) and larger polyp size (OR 2; 95 %CI 1.1 - 6.9) were independent predictors of bleeding. Bleeding was successfully treated by endoscopic hemostasis in all cases and required no further medical intervention. Advanced neoplasia prevalence in polyps ≤ 5 mm was as high as 8.7 %.
The results from this study showed the high safety of a cold polypectomy approach for subcentimetric polyps. This was due to the low rate of postpolypectomy bleeding and to the high efficacy of endoscopic hemostasis in its treatment. The high rate of advanced neoplasia in polyps ≤ 5 mm should prompt some caution on the management of these lesions following detection at computed tomography colonography or colon capsule endoscopy.
We conducted a survey to investigate to what extent the fear of COVID-19 has influenced the patients decision to undergo or to cancel endoscopic procedures. We collected data from 847 patients from ...13 centres. The main indication for endoscopy was anemia, followed by pain and unexplained weight loss. The percentage of not presenters progressively increased throughout the three weeks of study, from 15.1% at the beginning to 48.2% at the end. 37 (34.2%) upper GI endoscopies and 112 (56.3 %) colonoscopies showed an organic cause explaining the symptoms presented by the patients, respectively; 5 cases of gastric cancer (4.6%) and 16 cases of colorectal cancer (CRC) (6.0%), respectively, were detected; during the second week the percentage of organic diseases found at upper endoscopy was 19 (33.3%) with 5 cancer (8.7%), and 61 (49.1% ) at colonoscopy, with 2 CRC (1.6%); finally, during the third week the corresponding figures were 19 (48.7%) for upper GI examinations, with 3 gastric cancers (7.7%), and 43 (60.5%) with 4 (6.5%) CRC cases found.We conclude that patients weighted the fear of having a clinically relevant disease with the fear of becoming infected by coronavirus, and a relevant percentage of them (29.4%) decided not to attend the endoscopy suites at the scheduled date.
This paper presents the theoretical analysis and the experimental evaluation of a new switched beam antenna designed to operate at 2.45 GHz. The antenna enables direction of arrival estimation using ...six directional planar elements arranged to form a platonic solid geometry. It also supports polarization diversity, and it is suitable for single-anchor indoor positioning applications. We adopt the Cramer-Rao bound to study the estimation accuracy of the proposed antenna in absolute 2-D target positioning using received signal strength measurements. First, we describe the design principles for the radiators, we provide an extensive characterization of the switched antenna prototype, and we discuss positioning applications. We then report experimental data that support the results of the theoretical analysis and show consistency between theoretical expectation and the measurements. Finally, we discuss results from proof-of-concept operative indoor positioning example, showing an average localization error as low as 1.7 m.
Although split regimen is associated with higher adenoma detection and is recommended for elective colonoscopy, its adoption remains suboptimal. The identification of patient-related barriers may ...improve its implementation. Our aim was to assess patients' attitude towards split regimen and patient-related factors associated with its uptake.
In a multicentre, prospective study, outpatients undergoing colonoscopy from 8:00 to 14:00 were given written instructions for 4 L polyethylene glycol bowel preparation, offering the choice between split-dose and day-before regimens and emphasising the superiority of split regimen on colonoscopy outcomes. Uptake of split regimen and association with patient-related factors were explored by a 20-item questionnaire.
Of the 1447 patients (mean age 59.2±13.5 years, men 54.3%), 61.7% and 38.3% chose a split-dose and day-before regimens, respectively. A linear correlation was observed between time of colonoscopy appointments and split-dose uptake, from 27.3% in 8:00 patients to 96% in 14:00 patients (p<0.001, χ
for linear trend). At multivariate analysis, colonoscopy appointment before 10:00 (OR 0.14, 95% CI 0.11 to 0.18), travel time to endoscopy service >1 h (OR 0.55, 95% CI 0.38 to 0.79), low education level (OR 0.72, 95% CI 0.54 to 0.96) and female gender (OR 0.74, 95% CI 0.58 to 0.95) were inversely correlated with the uptake of split-dose. Overall, the risk of travel interruption and faecal incontinence was slightly increased in split regimen patients (3.0% vs 1.4% and 1.5% vs 0.9%, respectively; p=NS). Split regimen was an independent predictor of adequate colon cleansing (OR 3.34, 95% CI 2.40 to 4.63) and polyp detection (OR 1.46, 95% CI 1.11 to 1.92).
Patient attitude towards split regimen is suboptimal, especially for early morning examinations. Interventions to improve patient compliance (ie, policies to reorganise colonoscopy timetable, educational initiatives for patient and healthcare providers) should be considered.
NCT02287051; pre-result.
A tractor operated paddy straw bale shredder cum mulcher was designed and developed at Punjab Agricultural University, Ludhiana during 2018-19 to use baled paddy straw as mulch. Mulching reduces weed ...emergence, increases available water capacity and improves soil properties that results in yield increment. Paddy straw size is generally more than row to row and plant to plant spacing of vegetable crops. Its size was reduced using developed machine. Theoretical design of the machine was followed by development of 3D model and fabrication. The developed machine comprised a shredding rotor for shredding paddy straw bales, a bale drum to handle the bales, a concave grate to control the feeding of bales, a deflector unit for uniform spreading of shredded paddy straw bales and power transmission unit. It has overall dimensions of 1800×1300×1400 mm. The developed machine was run in lab to select operational parameters of the machine. It was further evaluated for mat thickness and uniformity of spread. Effect of forward speed and rotor speed was significant on mat thickness as well as uniformity of spread at 5% level of significance. However, effect of deflector angle on both dependent parameters was non-significant. Mat thickness decreased with increase in forward speed and decrease in rotor speed. Its maximum value was 64 mm for forward speed of 2.7 km/h, rotor speed of 30.7 m/s and deflector angle of 25°. Uniformity of spread was determined using coefficient of variation and its minimum value was 34.38% for forward speed of 2.7 km/h, rotor speed of 30.7 m/s and deflector angle of 25°.
Field evaluation of an auto-rotate gun sprayer and comparison with a knapsack sprayer was carried out to control whitefly Bemisia tabaci (Genn.) in the cotton crop. Two experiments were conducted at ...six locations of farmers' fields in southwestern (cotton-growing region) of Punjab state. The number of adult whiteflies was counted before and 3, 7 and 10 days after spray. Water-sensitive papers were attached at upper and under side of the leaves at three different points (top, middle and bottom) of plant canopy to find sprayers performance parameters, viz. droplet diameter, droplet density, per cent area covered and volume of spray deposition. Droplet density, area covered and volume of spray deposition were found significantly higher in case of the auto-rotate gun sprayer as compared to that of a knapsack sprayer. However, the volume median diameter of droplets was found significantly lesser in case of an auto-rotate gun sprayer, i.e. 286.95 µm as compared to the knapsack sprayer, i.e. 347.85 µm. The per cent whitefly control in the cotton crop in first experiment was found as 68.06 % and 65.90 % for auto-rotate gun and knapsack sprayer, respectively, by using pyriproxyfen 100 g active ingredient (g a.i.)/ha. Although in the second experiment the per cent whitefly control for auto-rotate gun sprayer was significantly higher, i.e. 83.27 % as compared to knapsack sprayer having 70.87 % control by using flonicamid 75 g a.i./ha. However, the bio-efficacy of auto-rotate gun sprayer was found higher for the both experiments as compared to the knapsack sprayer. The cost of operation of the auto-rotate gun sprayer was found to be US$4.11/ha as compared to knapsack sprayer with $6.85/ha. The cost, labour and time-saving in the spraying with the auto-rotate gun sprayer as compared to the knapsack sprayer was found to be 39.98, 93.44 and 96.64 %, respectively.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
A multi-purpose high clearance sprayer was developed with three types of spraying mechanism, viz. auto-rotate gun, drop-up boom and boom nozzles. The experiment was conducted during 2016 at Abohar in ...cotton growing region of South-western Punjab at six farm locations to evaluate sprayer performance and its bio efficacy against whitefly (Bemisia tabaci). It was observed that the auto-rotate gun sprayer produced lowest droplets VMD of 259.01 μm followed by boom type of 290.28 μm, drop-up boom type of 312.12 μm and knapsack sprayer of 328.50 μm, respectively. The maximum droplets density/cm2 was found to be 31.67 (drop-up boom sprayer), 26.29 (auto-rotate gun), 21.34 (boom sprayer) and 18.13 (knapsack sprayer). However, more leaf area coverage was observed as 31.67% in drop-up boom sprayer followed by 26.29% of auto-rotate gun type, 21.24% of boom-type and 16.86% of knapsack sprayer. The higher whitefly control was obtained with a drop-up boom sprayer of 80.69-88.65% followed by autorotate gun sprayer of 80.31-85.10%, boom-type of 72.81-86.27% as compared to knapsack sprayer of 63.37-75.45%. Lowest operation cost was found to be ₹ 150/ha for auto-rotate gun-type followed by ₹ `239/ha a for boom type and ₹ 291/ha for drop-up boom spraying system of multi-purpose high clearance sprayer, however, it was maximum ₹ 475/ha for knapsack sprayer. The similar, trend of cost saving was observed as 68.55, 49.82 and 38.80% per ha as compare to knapsack sprayer.
At present, the time-frame used for the quarantine of individuals with coronavirus disease 2019 (COVID-19) is the entire duration of symptoms plus 14 days after symptom recovery; however, no data ...have been reported specifically for healthcare workers (HCWs). In the study population of 142 HCWs with COVID-19, the mean time for viral clearance was 31.8 days. Asymptomatic subjects cleared the virus more quickly than symptomatic subjects (22 vs 34.2 days; P<0.0001). The presence of fever at the time of diagnosis was associated with a longer time to viral clearance (relative risk 11.45, 95% confidence interval 8.66–14.25; P<0.0001). These findings may have a significant impact on healthcare strategies for the future management of the COVID-19 pandemic.
Human case Hamel, C.; Bocquet, B.; Manes, G. ...
Acta ophthalmologica (Oxford, England),
September 2017, 2017-09-00, 20170901, Letnik:
95, Številka:
S259
Journal Article
Recenzirano
Summary
We will present two cases of early onset, possibly congenital, retinal dystrophies, in children, who do not have Leber congenital amaurosis. Visual acuity is decreased, and the fundus shows ...serpentine like images, most visible in infrared. OCT evidences abnormal retinal structure. ERG has been performed. Molecular genetics is undergoing.
Aim
The study compared the efficacy, safety and tolerability of a low‐volume picosulphate/magnesium citrate preparation with that of polyethylene glycol plus ascorbic acid (PEG + ASC) in a randomized ...clinical trial (RCT).
Method
A multicentre randomized, single‐blinded study was designed. Adult outpatients undergoing colonoscopy received either picosulphate/magnesium citrate (Group 1) or PEG + ASC (Group 2). Bowel cleansing was assessed using the Boston Bowel Preparation Scale (BBPS) and rated as adequate if ≥ 2 in each segment. Patient acceptance, satisfaction and related symptoms were recorded.
Results
Two‐hundred and eighty‐five patients were included. Preparation was adequate in 75.7% of patients in Group 1 and in 76.5% of patients in Group 2. The mean BBPS scores for the entire colon and for the right colon were comparable between groups. In addition, 97.1% patients in Group 1 and 84.8% in Group 2 reported no or mild discomfort (P < 0.0003) and 97.8% and 83.4% expressed their willingness to repeat the preparation (P < 0.0001). Palatability was better in Group 1, whereas related symptoms occurred more frequently in Group 2. Regardless of which preparation was used, the split regimen was associated with better cleansing compared with the same‐day method (OR = 3.39; 95% CI: 1.1–10.4; P = 0.03). Other predictors of poor cleansing were comorbidity, discomfort during preparation and incomplete (< 75%) preparation.
Conclusion
Both picosulphate/magnesium citrate and PEG + ASC are effective for bowel preparation. Tolerability and palatability are better for picosulphate/magnesium citrate. A split schedule is associated with higher cleansing quality also for low‐volume regimens.
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