Garnerbanke7513

Hypofractionated stereotactic body radiotherapy treatments (SBRT) have demonstrated impressive results for the treatment of a variety of solid tumors. find more The role of tumor supporting vasculature damage in treatment outcome for SBRT has been intensely debated and studied. Fast, non-invasive, longitudinal assessments of tumor vasculature would allow for thorough investigations of vascular changes correlated with SBRT treatment response. In this paper, we present a novel theranostic system which incorporates a fluorescence molecular imager into a commercial, preclinical, microCT-guided, irradiator and was designed to quantify tumor vascular response (TVR) to targeted radiotherapy. This system overcomes the limitations of single-timepoint imaging modalities by longitudinally assessing spatiotemporal differences in intravenously-injected ICG kinetics in tumors before and after high-dose radiation. Changes in ICG kinetics were rapidly quantified by principle component (PC) analysis before and two days after 10 Gy targeted tumor irradiation. A classifier algorithm based on PC data clustering identified pixels with TVR. Results show that two days after treatment, a significant delay in ICG clearance as measured by exponential decay (40.5±16.1% P=0.0405 Paired t-test n=4) was observed. Changes in the mean normalized first and second PC feature pixel values (PC1 & PC2) were found (P=0.0559, 0.0432 paired t-test), suggesting PC based analysis accurately detects changes in ICG kinetics. The PC based classification algorithm yielded spatially-resolved TVR maps. Our first-of-its-kind theranostic system, allowing automated assessment of TVR to SBRT, will be used to better understand the role of tumor perfusion in metastasis and local control.In this paper, we introduce REDN A Recursive Encoder-Decoder Network with Skip-Connections for edge detection in natural images. The proposed network is a novel integration of a Recursive Neural Network with an Encoder-Decoder architecture. The recursive network enables iterative refinement of the edges using a single network model. Adding skip-connections between encoder and decoder helps the gradients reach all the layers of a network more easily and allows information related to finer details in the early stage of the encoder to be fully utilized in the decoder. Based on our extensive experiments on popular boundary detection datasets including BSDS500 [1], NYUD [2] and Pascal Context [3], REDN significantly advances the state-of-the-art on edge detection regarding standard evaluation metrics such as Optimal Dataset Scale (ODS) F-measure, Optimal Image Scale (OIS) F-measure, and Average Precision (AP).Infective endocarditis (IE) is a well-known complication of bacteremia with high-risk microorganisms such as Staphylococcus and Streptococcus. Skin and soft tissue infections with Staphylococcus remain a significant cause of bacteremia and IE, even with proper prompt management of the source of infection and the absence of risk factors. Although methicillin-resistant Staphylococcus aureus is a well-known etiology for osteoarticular septic emboli in IE, healthcare providers should be aware of the hidden virulence of methicillin-sensitive Staphylococcus aureus for metastatic osteoarticular infection. We report a case of IE with septic vertebral embolic lesion complicating a properly managed acute paronychia.A double-chambered right ventricle is an uncommon form of congenital heart disease that is characterized by the division of the right ventricle into a proximal high-pressure chamber and a distal low-pressure chamber. A 70-year-old male presented to the emergency room from his outpatient doctor's office with unstable wide complex ventricular tachycardia with right axis deviation. His ventricular tachycardia was terminated using external cardioversion and intravenous amiodarone. He was subsequently found to have new-onset heart failure with a reduced ejection fraction and a right ventricular tract outflow obstruction on transthoracic echocardiography. A diagnosis of the double-chambered right ventricle was made. The patient was offered surgery to fix the anomalous tissue but he refused. He did agree to subcutaneous implantable cardioverter-defibrillator placement and was then discharged home.Introduction Bed bugs are commonly encountered by emergency medical service (EMS) providers. The objective of this study was to determine the frequency with which EMS providers encountered bed bugs, assess their knowledge about bed bugs, and analyze the actions they take after finding bed bugs. Methods We anonymously surveyed 407 EMS providers from 180 EMS agencies in northeast Ohio between September 1, 2018, through March 31, 2019. Results Among the providers surveyed, 21% (n = 84) of the EMS providers reported seeing bed bugs at least monthly, and 6% (n = 24) reported seeing bed bugs at least weekly. Being younger, male, and working in an urban environment (vs. rural) were associated with EMS providers reporting more frequent bed bug encounters (p ≤.05). The mean level of concern for encountering bed bugs among EMS providers was 3.54 (SD 1.15; scale 1 = no concern, 5 = very concerned). Among the EMS providers who reported seeing bed bugs at least monthly, 30% took the affected EMS stretcher out of service when they encounter a bed bug, 43% took the EMS rig out of service, 83% cleaned the EMS stretcher with a disinfectant, and 88% notified the ED that their patient has bed bugs. EMS providers scored poorly (mean 69% correct responses) in a seven-question assessment of basic bed bug biology and public health. Conclusion Based on our findings, we concluded that EMS knowledge and behavior related to bed bugs are suboptimal.Background Surgical outcomes of adolescent idiopathic scoliosis (AIS) patients have been well studied. However, few studies have examined the surgical outcomes of young adult idiopathic scoliosis (YAdIS) patients. This study analyzed and compared the surgical outcomes of young adult (19-30 years) and adolescent (10-18 years) idiopathic scoliosis patients. Methods This is a retrospective, comparative two-center study. Reviewed data of consecutive AIS and YAdIS patients who had undergone posterior spinal deformity surgery (n=56) by two spine surgeons from 2010 to 2014. Inclusion criteria were age between 10 to 30 years and preoperative coronal Cobb angle >40o. We excluded patients with previous correction surgery. Demographic data (age at time of surgery, gender, body mass index (BMI)), surgical data (preoperative diagnosis, number of levels fused, blood loss, duration of surgery, peri- and postoperative complications, duration of surgery, length of stay, revision surgery, and final follow-up) and radiographic data collected, reviewed, and analyzed.