Chogreer8926

All genotype C patients and only one genotype B pair had a πN/πS greater than 1 ratio, indicating that positive selection had occurred. In addition, quasispecies were found to be different between the twin children despite having the same mother, indicating that virus evolution is host-specific.We propose a de-identification system which runs in a standalone mode. The system takes care of the de-identification of radiation oncology patient's clinical and annotated imaging data including RTSTRUCT, RTPLAN, and RTDOSE. The clinical data consists of diagnosis, stages, outcome, and treatment information of the patient. The imaging data could be the diagnostic, therapy planning, and verification images. Archival of the longitudinal radiation oncology verification images like cone beam CT scans along with the initial imaging and clinical data are preserved in the process. During the de-identification, the system keeps the reference of original data identity in encrypted form. These could be useful for the re-identification if necessary.Thermal power plants (TPPs) have emerged as a major source of air, water, and soil pollution because of the presence of many toxic metals. The presence of mercury (Hg) in fly ash has proven to be toxic in nature because of its tendency to get bioaccumulated and biomagnified in the food chain. The aim of the present study was to understand the presence of toxic Hg in the feathers of wetland birds undertaking the study around a TPP located in Nagpur, India. Local wetland birds especially cattle egrets, heron, and Moorhen were commonly observed dwelling close to fly ash ponds for various purposes (roosting, breeding, feeding, etc.). Samples of fly ash, soil, water, plants, and bird feather were collected, cleaned, and processed for Hg analysis. A mercury analyzer was used to assess the concentration of toxic levels of Hg in samples. Our results reflect leaching of Hg in soil and uptake by plant samples, whereas in water, ash, and bird feather samples concentrations of Hg were fairly below the prescribed limits (World Health Organization). A non-invasive method for understanding the mercury concentration in wetland birds has been established as a potential important monitoring tool to track the fate of toxic metal Hg in the food chain. In summary, our results indicate fairly low Hg levels in feather samples projecting non-invasive biomonitoring as a promising strategy. The study also suggests that a comprehensive monitoring action plan in place for Hg and other toxic metals in the food chain that comes from TPP will be efficient to avoid any pitfalls. Graphical abstract.PURPOSE To evaluate voice outcome after bilateral medialization thyroplasty in patients with non-paralytic glottic insufficiency due to vocal fold atrophy with or without sulcus. METHODS Retrospective cohort study on 29 patients undergoing bilateral medialization thyroplasty for vocal fold atrophy (14 procedures) or atrophy with sulcus (15 procedures) between October 2012 and November 2017. Voice data were collected and analyzed for the preoperative and the 3- and 12-month postoperative time point according to a standardized protocol, including Voice Handicap Index (VHI)-30 and perceptual, acoustic and aerodynamic parameters. Failure rate was based on number of revisions within 12 months and non-relevant improvement ( less then  10 points) in VHI-30 at 12 months. RESULTS There was a clinically relevant (≥ 15 points) and statistically significant improvement (p  less then  0.0001) in the VHI-30 (preoperative 55.8 points; postoperative at 12 months 30.9 points). read more Fundamental frequency for male subjects decreased significantly from 175 to 159 Hz (p = 0.0001). The pre- and post-operative grade of dysphonia was significantly lower in patients with atrophy compared to atrophy and sulcus (mean difference 0.70, p = 0.017). CONCLUSION Bilateral medialization thyroplasty is a valid treatment option for patients with atrophy with or without sulcus. Outcomes are comparable to other methods reported in literature. However, there is a great need for larger, prospective studies with long-term follow-up to gain more insight into the comparative voice outcomes for the different forms of surgery for patients with glottic incompetence due to atrophy with or without sulcus.INTRODUCTION The ATA guidelines for differentiated thyroid cancer (DTC) are one of the most widely referred to. Their 2015 edition proposed a new risk stratification system and modified the indications for radioactive iodine (RAI) ablation especially for the low risk category. We attempted to analyze whether the new guidelines altered referral practices for RAI ablation at our institute. METHODOLOGY Patients who underwent total or completion thyroidectomy for DTC during 2016-2017 were included. Relevant demographical and pathological data was tabulated. Patients were classified as per the new stratification system and referral practice for RAI ablation documented. RESULTS 238 patients were included. Of these 20.6% were low risk, 44.1% were intermediate and 35.3% were high risk as per modified guidelines. All patients within the intermediate and high-risk group and 77.8% of the low risk group were referred for RAI ablation. Analysis of risk factors revealed that within the low risk group there were three patients with  less then  5 metastatic nodes, all within 3 cm in size-a category that the ATA failed to stratify appropriately. Among those labeled as Intermediate risk due to microscopic extra thyroidal extension (ETE), 85% had no other risk factors and were upstaged solely due to microscopic ETE, which is interestingly no longer included in the TNM staging. CONCLUSION Majority of low risk patients continue to receive RAI ablation due to persistent belief emanating from literature that remnant ablation improves outcomes and aids in follow up. The issue of RAI ablation for low risk group and prognostic implications of microscopic ETE and limited nodal disease need to be revisited.PURPOSE Cervical lymph-node (CLN) metastasis commonly occurs in patients with nasopharyngeal carcinoma (NPC) metastasis. The presence of Epstein-Barr virus (EBV) genomes in neck lymph nodes may diagnose CLN. This research was designed to appraise the diagnostic value of EBV concentration for cervical lymph nodes in NPC. METHODS Two hundred and fifty-three NPC patients with 276 CLNs were enrolled. MRI was performed to detect CLN metastasis, and plasma EBV concentration was measured by quantitative PCR before treatment. Ultrasonography (US) and US-FNA were subsequently performed in the suspicious lymph nodes. Fifteen patients (22 lymph nodes) underwent fine-needle aspiration cytology (FNAC), and the remaining 242 patients (254 lymph nodes) underwent core needle biopsy (CNB) for CLNs at the clinician's demand. The aspiration needle was rinsed with 1 ml of normal saline for EBV detection. The method of lymph-node EBV measurement was consistent with that for plasma. The MRI results and EBV concentrations in plasma and lymph nodes were recorded and analyzed.