- Malignant mesothelioma (MM) is an uncommon tumor that can be difficult to diagnose.
- To provide updated, practical guidelines for the pathologic diagnosis of MM.
- Pathologists involved in the ...International Mesothelioma Interest Group and others with an interest and expertise in the field contributed to this update. Reference material included up-to-date, peer-reviewed publications and textbooks.
- There was discussion and consensus opinion regarding guidelines for (1) distinguishing benign from malignant mesothelial proliferations (both epithelioid and spindle cell lesions), (2) cytologic diagnosis of MM, (3) recognition of the key histologic features of pleural and peritoneal MM, (4) use of histochemical and immunohistochemical stains in the diagnosis and differential diagnosis of MM, (5) differentiating epithelioid MM from various carcinomas (lung, breast, ovarian, and colonic adenocarcinomas, and squamous cell and renal cell carcinomas), (6) diagnosis of sarcomatoid MM, (7) use of molecular markers in the diagnosis of MM, (8) electron microscopy in the diagnosis of MM, and (9) some caveats and pitfalls in the diagnosis of MM. Immunohistochemical panels are integral to the diagnosis of MM, but the exact makeup of panels employed is dependent on the differential diagnosis and on the antibodies available in a given laboratory. Depending on the morphology, immunohistochemical panels should contain both positive and negative markers for mesothelial differentiation and for lesions considered in the differential diagnosis. Immunohistochemical markers should have either sensitivity or specificity greater than 80% for the lesions in question. Interpretation of positivity generally should take into account the localization of the stain (eg, nuclear versus cytoplasmic) and the percentage of cells staining (>10% is suggested for cytoplasmic and membranous markers). Selected molecular markers are now being used to distinguish benign from malignant mesothelial proliferations. These guidelines are meant to be a practical diagnostic reference for the pathologist; however, some new pathologic predictors of prognosis and response to therapy are also included.
LANGUAGE= "English" INTRODUCTION: This study aimed to evaluate the effect of an interventional package on soft skills and perceived needs among nursing students.METHODS: A quasi-experimental study ...with a non-equivalent control group design was conducted on 112 nursing students (56 in the experimental group and 56 in the control group) using a simple random method at selected nursing colleges. The data were collected using a descriptive characteristics form, soft skills scale, and perceived need scale. The experimental group received a 4-session intervention package (120 minutes per day), and then the scales were re-administered to both groups after one month. Descriptive analysis was used to evaluate qualitative data, including frequency and percentage distribution, and quantitative data were evaluated using the t-test for dependent and independent groups.RESULTS: The mean soft skills score of nursing students in the experimental group before the interventional package was 178.86±23.34, and after the intervention was 241.02±23.01. The mean perceived need score before the interventional package was 36.29±3.41, and after was 44.70±3.15. In the experimental group, there was a statistically significant difference (p<0.05) between the mean scores on both scales before and after the intervention, but not in the control group (p>0.05). A statistically significant difference (p<0.05) was observed in the mean post-test scores on both scales between the experimental and control groups.DISCUSSION AND CONCLUSION: The interventional package used in the study significantly improved the soft skills and perception of nursing students. More importantly, separate soft skills programs in nursing curricula could help them enhance their careers in today's competitive world. More experimental studies with additional soft skills variables are recommended.
The planning of flight operations and maintenance is a crucial activity for both commercial and military aircraft. Military aircraft have to be always mission-ready. The task of ensuring this can ...become quite challenging when several operational requirements and maintenance constraints are to be fulfilled simultaneously. This paper, therefore, addresses the optimisation of flight and maintenance planning (FMP) when several diverse factors such as aircraft flying hours (AFH), flight cycles (FC), calendar life, annual flying requirement (AFR), etc. are to be factored in. Such a problem has not been considered previously. Because the problem can become unwieldy to solve by other methods, two schemes, that is, the genetic algorithm (GA) and modified artificial bee colony (ABC) algorithm for constrained optimisation have been utilised. The objective is to maximise the utilisation rate (UR) of aircraft, while also satisfying other operational and maintenance constraints. The algorithm is tested on a fleet of eight aircraft. In addition to a one-year planning period, a planning horizon of ten years has also been simulated. The results show that both the GA and modified ABC algorithm can be effectively used to solve the FMP problem.
Health monitoring of an aero-engine assumes importance in the light of primary requirements of flight safety and reliability. This paper proposes a novel, simple method for monitoring aircraft engine ...health using Whale Optimization Algorithm based Artificial Neural Network (WOANN) technique, for analyzing the data downloaded from the health and usage monitoring system (HUMS) of a military aircraft. The actual engine data recorded during 47 different flights of eight different engines (of the same type) have been considered in this work. Thirteen engine parameters have been used to determine and monitor the health of the engine. The efficiency of the WOANN technique for engine health monitoring, is compared with that of three other common machine learning algorithms: Probabilistic based Neural Network (PNN), K-Nearest Neighbour (KNN), and Back propagation based Artificial Neural Network (BPANN). The results show that WOANN algorithm classifies and predicts engine health far more accurately as compared to PNN, KNN and BPANN. The values obtained for the metrics of Accuracy, Error, False Positive Rate, F1 score, Mathews Correlation Coefficient, Specificity, Kappa coefficient are found to be the best for WOANN algorithm. The WOANN achieved overall prediction accuracy of 95%, thus presenting itself as a very useful tool for day-to-day monitoring of aircraft engine health using the data downloaded from the aircraft’s HUMS.
Orthogonal frequency division multiple access (OFDMA) is a promising technique, which can provide high downlink capacity for future wireless systems. The total capacity of OFDMA can be maximized by ...adaptively assigning subchannels to the user with the best gain for that subchannel, with power subsequently distributed by water-filling algorithm. In this paper we have proposed the use of a customized particle swarm optimization (PSO) aided algorithm to allocate the subchannels. The PSO algorithm is population-based: a set of potential solutions evolves to approach a near-optimal solution for the problem under study. The customized algorithm works for discrete particle positions unlike the classical PSO algorithm which is valid for only continuous particle positions. It is shown that the proposed method obtains higher sum capacities as compared to that obtained by previous works, with comparable computational complexity.
In the USA, ∼300 000 people are affected by Chagas heart disease, a growing, but commonly overlooked, public health issue. Chagas as a potential aetiology of dilated cardiomyopathy remains ...under-recognized. We present a case where multimodality imaging was essential in the diagnosis and management of Chagas heart disease.
A 54-year-old man, originally from Mexico, presented to the emergency department with chest pain and recurrent syncopal episodes, found to be in haemodynamically unstable ventricular tachycardia (VT) requiring urgent cardioversion. Urgent coronary angiography revealed no obstructive disease. A transthoracic echocardiogram revealed moderately reduced left ventricular systolic function (left ventricular ejection fraction 35-40%) with apical akinesis and an aneurysm of the apical septum. Cardiac magnetic resonance (CMR) confirmed a prominent apical aneurysm with dyskinesis of the apical septum, with the evidence of transmural myocardial late gadolinium enhancement of the entire left ventricular apex and a small apical thrombus. Serologic testing was positive for
IgG antibody, which was confirmed on repeat testing at the Centers for Disease Control and Prevention. Patient underwent VT ablation and was discharged on guideline-directed medical therapy including a regimen of anticoagulation, beta-blocker, and angiotensin-converting enzyme inhibitor therapies. He has had no subsequent syncope or VT.
Chagas heart disease remains under-recognized and under-diagnosed despite the growing burden of
infection in the USA. Suspicion for Chagas heart disease should be considered in patients presenting with heart failure symptoms and ventricular arrhythmias with the right corresponding history and imaging findings on echocardiogram and CMR.
This paper investigates the problem of dynamic subcarrier and bit allocation in downlink of Multiple Input Multiple Output (MIMO) Orthogonal Frequency Division Multiple Access (OFDMA) Systems. Using ...Singular Value Decomposition, the MIMO fading channel of each subcarrier is transformed into an equivalent bank of parallel Single Input Single Output sub-channels. To achieve the capacity bound, one must solve a multiuser subcarrier allocation and the optimal bit allocation jointly. To alleviate the computational complexity of joint subcarrier and bit allocation, several suboptimal solutions have been proposed. These suboptimal solutions handle subcarrier and bits individually. We propose the use of Non-dominated Sorting Genetic Algorithm (NSGA)-II, which is a multi-objective Genetic Algorithm, for joint allocation of bits and subcarriers, in the downlink of MIMO-OFDMA system. NSGA-II is intended for optimization problems involving multiple conflicting objectives. Here the two conflicting objectives are Rate Maximization and Transmit Power Minimization. The simulation results indicate remarkable improvement in terms of convergence over previous approaches involving Evolutionary algorithms. At the same time capacity achieved by the proposed algorithm is found to be comparable with that of previous algorithms.
Background: Drug addiction is one of the major problems across the globe. It is seen in various forms like marijuana, tobacco, hashish, cannabis and heroine etc. especially tobacco being the most ...common. The objective of the study was to assess the knowledge regarding tobacco use and its ill effects among school children of district Sirmour Himachal Pradesh. The objective of this study was to assess the knowledge regarding use of tobacco and ill effects among school children.Methods: The school going (9th-12th standard) boys and girls were taken as study sample. The convenient sampling technique was used.Results: The study findings showed that the pre-test score of girls and boys are different i.e. 49% of girls had excellent pretest score while 56% boys are had excellent pretest knowledge and 51% of girls and 39% of boys had good knowledge where as 5% of boys had average knowledge score. The post-test score findings shows that 43.1% of girls had excellent knowledge, 27.5% of girls had good knowledge and 4.6% of girls had average knowledge while the post-test score of 53.2% of boys had excellent, 16.5% of boys had good and 5.5% of boys had average level of knowledge. The t value 4.264 was found to be highly significant among adolescent boys.Conclusions: This study provides insight into the factors to consider while planning adolescent anti-smoking programs in this and similar settings.
Background: The coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by novel coronavirus and hence this pandemic has a great impact on the education system. Nursing students ...as part of the health team should know the coronavirus like other communicable diseases. Methods: A quantitative approach and cross-sectional survey research design used to assess the knowledge of Coronavirus among 145 nursing students of district Sirmaur selected through the convenient sampling technique. An online self-structured questionnaire used as a tool for data collection. Descriptive data analysis was done with SPSS (version 23).Results: The result of the study revealed that only 31.7% of students had good knowledge about COVID-19, and 68.3% had average knowledge. Conclusions: There is a need for intervention such as educational programs or pieces of training to educate about the pandemic and its prevention practices to undergraduate students to make our society more secure.
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