The antenatal evaluation of the fetal central nervous system (CNS) is among the most difficult tasks of prenatal ultrasound (US), requiring technical skills in relation to ultrasound and image ...acquisition as well as knowledge of CNS anatomy and how this changes with gestation. According to the International Guidelines for fetal neurosonology, the basic assessment of fetal CNS is most frequently performed on the axial planes, whereas the coronal and sagittal planes are required for the multiplanar evaluation of the CNS within the context of fetal neurosonology. It can be even more technically challenging to obtain “nonaxial” views with 2-dimensional (2D) US. The modality of 3-dimensional (3D) US has been suggested as a panacea to overcome the technical difficulties of achieving nonaxial views. The lack of familiarity of most sonologists with the use of 3D US and its related processing techniques may preclude its use even where it could play an important role in complementing antenatal 2D US assessment. Furthermore, once a 3D volume has been acquired, proprietary software allows it to be processed in different ways, leading to multiple ways of displaying and analyzing the same anatomical imaging or plane. These are difficult to learn and time consuming in the absence of specific training. In this article, we describe the key steps for volume acquisition of a 3D US volume, manipulation, and processing with reference to images of the fetal CNS, using a newly developed context-preserving rendering technique.
The aim of the paper is to compare the performance of popular JavaScript frameworks Angular and Vue.js in the context of game development. The comparative criteria are as follows: time of data ...exchanging with server and rendering of various application components, memory consumption during refreshing the current game information and restoring the user to the current game, browser load level and size of the final application files. The test results show that the Vue.js framework is more efficient.
The increasing demand for massive connectivity and high data rates has made the efficient use of existing spectrum resources an increasingly challenging problem. Non-orthogonal multiple access (NOMA) ...is a potential solution for future heterogeneous networks (HetNets) due to its high capacity and spectrum efficiency. In this study, we analyze an uplink NOMA-enabled vehicular-aided HetNet, where multiple vehicular user equipment (VUEs) share the access link spectrum, and a high-altitude platform (HAP) communicates with roadside units (RSUs) through a backhaul communication link. We propose an improved algorithm for user association that selects VUEs for HAPs based on channel coefficient ratios and terrestrial VUEs based on a caching-state backhaul communication link. The joint optimization problems aim to maximize a utility function that considers VUE transmission rates and cross-tier interference while meeting the constraints of backhaul transmission rates and QoS requirements of each VUE. The joint resource allocation optimization problem consists of three sub-problems: bandwidth allocation, user association, and transmission power allocation. We derive a closed-form solution for bandwidth allocation and solve the transmission power allocation sub-problem iteratively using Taylor expansion to transform a non-convex term into a convex one. Our proposed three-stage iterative algorithm for resource allocation integrates all three sub-problems and is shown to be effective through simulation results. Specifically, the results demonstrate that our solution achieves performance improvements over existing approaches.
We describe the utilization of SpaceOAR Vue™, a new iodinated rectal spacer, during Robotic Stereotactic Body Radiation Therapy (SBRT) for a Prostate Cancer Patient with a contraindication to ...Magnetic Resonance Imaging. A 69-year-old Caucasian male presented with unfavorable intermediate risk prostate cancer and elected to undergo SBRT. His medical history was significant for atrial fibrillation on Rivaroxaban with a pacemaker. He was felt to be at increased risk of radiation proctitis following SBRT due to the inability to accurately contour the anterior rectal wall at the prostate apex without a treatment planning MRI and an increased risk of late rectal bleeding due to prescribed anticoagulants. In this case report, we discuss the technical aspects of appropriate placement and treatment planning for utilizing SpaceOAR Vue™ with Robotic SBRT.
Tout psychiatre peut être requis par l’autorité judiciaire pour examiner une personne placée en garde à vue (GAV). Au vu des enjeux de santé publique que cet examen soulève (protéger la santé des ...personnes placées en GAV, maintenir la continuité des soins, éviter l’incarcération de personnes présentant des troubles psychiatriques décompensés), cet examen revêt une importance particulière. Il demeure pourtant difficile, et parfois piégeux. L’objectif de cette étude descriptive est d’évaluer les connaissances des psychiatres français sur les conditions de cet examen, ses objectifs et ses limites, ainsi que sur les règles de rédaction du certificat médical à délivrer à l’autorité judiciaire. L’objectif secondaire est de dégager les variables associées à la bonne connaissance de cet examen.
Un autoquestionnaire a été diffusé par mail à un échantillon de psychiatres français, entre février et mai 2021, pour évaluer leurs connaissances sur l’examen psychiatrique d’une personne placée en GAV, leur expérience dans ce domaine et leur niveau de compétence estimé. Un score de performance, basé sur la réponse aux questions de connaissances, a été calculé. Les caractéristiques des participants ayant un « haut score de performance » ont été comparées à ceux ayant un « bas score de performance ». Une analyse bivariée, puis une régression logistique ont été réalisées.
Nous avons obtenu 183 réponses (50,8 % de femmes et 49,2 % d’hommes, âge moyen : 47,6 ans, 18,1 années d’expérience en moyenne). Le cadre légal de la réquisition était globalement bien connu des psychiatres (>70 % de bonnes réponses), de même que l’application du secret professionnel (>80 % de bonnes réponses). Ce n’était pas le cas des objectifs de la réquisition : pour 59 % seulement la compatibilité de l’état de santé mentale de la personne examinée en GAV était l’objectif principal de la réquisition. Si pour la grande majorité des psychiatres interrogés (93 %), il était possible d’instaurer une hospitalisation sans consentement sur décision du représentant de l’État, les autres modalités d’hospitalisation n’étaient possibles que pour une proportion moindre de répondants (<58 %). Peu de psychiatres connaissaient les destinataires (et probablement l’existence) du deuxième volet du certificat médical. La médiane du score de performance était de 9,3/12 (min : 3,8 ; max : 12). Le fait d’avoir une formation en psychiatrie légale était le seul facteur significativement associé à un haut score de performance (OR=2,90 ; p=0,006). La variable associée à un moins bon score de performance était l’expérience du clinicien (OR=0,94 ; p<0,001).
Les modalités de réponse à une réquisition de l’autorité judiciaire pour examiner une personne placée en GAV sont encore imparfaitement connues. À la lumière de nos résultats, sous réserve de la petite taille de notre échantillon, il paraît important de proposer à tous les psychiatres français une formation en psychiatrie légale, dès les premières années de l’internat et tout au long de leur carrière.
Any French psychiatrist can be appointed by the district prosecutor or the judicial police officer to perform medical examination of people kept in police custody. After this examination, the doctor decides whether the person's state is compatible or not with detention in a police station. A medical certificate is attached to the case file. Regarding the high prevalence of psychiatric disorders among people kept in police custody and the large number of mentally ill people imprisoned without having been properly examined, this examination is of particular importance. However, it remains difficult and sometimes tricky. The main objective of this descriptive study is to evaluate knowledge of French psychiatrists about this examination, its goals and limits, and about how to produce a suitable medical certificate. The secondary objective is to identify the variables associated with a good knowledge of this examination.
A questionnaire was submitted by e-mail to a sample of French psychiatrists from March to May 2021. It allowed us to collect data on their socio-demographic and professional characteristics. Then 12 questions were specially conceived to evaluate their knowledge about the psychiatric examination of people kept in custody. Finally, participants were also questioned about their experience in the area of medical intervention in police custody and how they felt confident about performing such an examination. Based on their responses to the 12 knowledge questions, participants have been separated into two groups (“high level of knowledge” versus “low level of knowledge”). The two groups’ characteristics have been compared through a bivariate then a multivariate analysis.
183 psychiatrists completed the questionnaire (50.8% women and 49.2% men; mean age 47.6; mean experience 18.1 years). The legal frame of the examination in police custody was well known by the participants (>70% good answers), as well as the rules of confidentiality (>80% good answers). By contrast, only 59% of participants knew that the determination of the person's state compatibility with detention in a police station was the main objective of this examination. Nearly all participants knew that it is possible to decide involuntary hospitalizations of people kept in custody (93%), but a less proportion of them knew that all means of hospitalizations, voluntary and involuntary, are possible if needed. Few participants knew the addresses (or even probably the existence) of the second page of the document they need to complete after the examination (the first page consisting in the medical certificate transmitted to the police and the second page constituting the confidential medical record). Having received a specific teaching about forensic psychiatry was the only variable significantly associated with good knowledge of the specificities of the examination in police custody (OR=2.90; P=0.006). The variable significantly associated with poor knowledge was the doctor's experience (OR=0.94; P<0.001).
The rules of good practice regarding psychiatric examination of people kept in police custody are not fully known by French psychiatrists. According to the results of our survey (even if these results cannot be generalized due to a small sample size), it appears essential to provide specific education about forensic psychiatry, not only to young doctors but also to all doctors throughout their careers.
Protecting the aging eye with hydrogen sulfide1 George, Akash K; Homme, Rubens P; Stanisic, Dragana ...
Canadian journal of physiology and pharmacology,
2021, Volume:
99, Issue:
2
Journal Article
Peer reviewed
Research demonstrates that senescence is associated with tissue and organ dysfunction, and the eye is no exception. Sequelae arising from aging have been well defined as distinct clinical entities ...and vision impairment has significant psychosocial consequences. Retina and adjacent tissues like retinal pigmented epithelium and choroid are the key structures that are required for visual perception. Any structural and functional changes in retinal layers and blood retinal barrier could lead to age-related macular degeneration, diabetic retinopathy, and glaucoma. Further, there are significant oxygen gradients in the eye that can lead to excessive reactive oxygen species, resulting in endoplasmic reticulum and mitochondrial stress response. These radicals are source of functional and morphological impairment in retinal pigmented epithelium and retinal ganglion cells. Therefore, ocular diseases could be summarized as disturbance in the redox homeostasis. Hyperhomocysteinemia is a risk factor and causes vascular occlusive disease of the retina. Interestingly, hydrogen sulfide (H
2
S) has been proven to be an effective antioxidant agent, and it can help treat diseases by alleviating stress and inflammation. Concurrent glutamate excitotoxicity, endoplasmic reticulum stress, and microglia activation are also linked to stress; thus, H
2
S may offer additional interventional strategy. A refined understanding of the aging eye along with H
2
S biology and pharmacology may help guide newer therapies for the eye.
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