Compressed SENSE in Pediatric Brain Tumor MR Imaging

Purpose To compare the image quality, examination time, and total energy release of a standardized pediatric brain tumor magnetic resonance imaging (MRI) protocol performed with and without compressed sensitivity encoding (C-SENSE). Recently introduced as an acceleration technique in MRI, we hypothesized that C‑SENSE would improve image quality, reduce the examination time and radiofrequency-induced energy release compared with conventional examination in a pediatric brain tumor protocol. Methods This retrospective study included 22 patients aged 2.33–18.83 years with different brain tumor types who had previously undergone conventional MRI examination and underwent follow-up C‑SENSE examination. Both examinations were conducted with a 3.0-Tesla device and included pre-contrast and post-contrast T1-weighted turbo-field-echo, T2-weighted turbo-spin-echo, and fluid-attenuated inversion recovery sequences. Image quality was assessed in four anatomical regions of interest (tumor area, cerebral cortex, basal ganglia, and posterior fossa) using a 5-point scale. Reader preference between the standard and C‑SENSE images was evaluated. The total examination duration and energy deposit were compared based on scanner log file analysis. Results Relative to standard examinations, C‑SENSE examinations were characterized by shorter total examination times (26.1 ± 3.93 vs. 22.18 ± 2.31 min; P = 0.001), reduced total energy deposit (206.0 ± 19.7 vs. 92.3 ± 18.2 J/kg; P < 0.001), and higher image quality (overall P < 0.001). Conclusion C‑SENSE contributes to the improvement of image quality, reduction of scan times and radiofrequency-induced energy release relative to the standard protocol in pediatric brain tumor MRI.

Comparison of four methods of inducing pseudopregnancy in rabbits

This study was conducted to compare several methods for inducing pseudopregnancy in local rabbits. The study used 25 clinically healthy rabbits of local breeds, aged 1-1.5 years, with a bodyweight of 1.8-2.2 kg. The rabbits were divided into five treatment groups (n = 5): R1, R2, R3, R4, and R5. Each group was given a different treatment. Group R1 was injected intramuscularly with 100 IU PMSG and mated with males three days later, which was followed by an intravenous injection of 75 IU hCG. Pseudopregnancy in group R2 was induced through artificial copulation by inserting a 1 cm long cotton bud into vaginal lumen at 5 a.m. Pseudopregnancy in group R3 was induced using 50 IU hCG intramuscularly. Group R4 was injected intravenously with 5 g GnRH and then intramuscularly with 100 IU PMSG and three days later with 75 IU hCG. Blood samples were collected on days 2, 4, 6, and 8 for estrogen and progesterone measurement, whereas an ovarian histological observation of all groups was performed on day 8. The results show that the highest concentration of estrogen was obtained in group R2, which was significantly different from the other groups (P <0.05), but the difference in examination time was not statistically significant (P > 0.05). Furthermore, the concentration of progesterone in all groups fluctuated at various times of the day. Progesterone concentrations were higher in group R5, in which pseudopregnancy was induced with PMSG and hCG. Group R5 showed a significant difference (P <0.05) with R2, R3, and R4, but the difference with the positive control group (R1) was not significant (P > 0.05). The numbers of corpora lutea in groups R1, R2, R3, R4, and R5 were, respectively, 6.87 ± 1.58, 6.22 ± 2.71, 6.74 ± 1.94, 5.98 ± 2.04, and 8.8 ± 1.90, and the largest diameter was obtained in R5 (1.65 ± 0.37 mm). In conclusion, the best method of inducing pseudopregnancy in local rabbits is the administration of PMSG and hCG.

Combined acquisition of diffusion and T2*-weighted measurements using simultaneous multi-contrast magnetic resonance imaging

Object In this work, we present a technique called simultaneous multi-contrast imaging (SMC) to acquire multiple contrasts within a single measurement. Simultaneous multi-slice imaging (SMS) shortens scan time by allowing the repetition time (TR) to be reduced for a given number of slices. SMC imaging preserves TR, while combining different scan types into a single acquisition. This technique offers new opportunities in clinical protocols where examination time is a critical factor and multiple image contrasts must be acquired. Materials and methods High-resolution, navigator-corrected, diffusion-weighted imaging was performed simultaneously with T2*-weighted acquisition at 3 T in a phantom and in five healthy subjects using an adapted readout-segmented EPI sequence (rs-EPI). Results The results demonstrated that simultaneous acquisition of two contrasts (here diffusion-weighted imaging and T2*-weighting) with SMC imaging is feasible with robust separation of contrasts and minimal effect on image quality. Discussion The simultaneous acquisition of multiple contrasts reduces the overall examination time and there is an inherent registration between contrasts. By using the results of this study to control saturation effects in SMC, the method enables rapid acquisition of distortion-matched and well-registered diffusion-weighted and T2*-weighted imaging, which could support rapid diagnosis and treatment of acute stroke.

Effective Doses of Nalbuphine Combined With Propofol for Painless Gastroscopy in Adults: A Randomized Controlled Trial

Objective: This prospective study evaluated the 50% effective dose (ED50) and 95% effective dose (ED95) of nalbuphine combined with propofol during painless gastroscopy.Methods: Seventy-five patients who underwent painless gastroscopy were randomly divided into five groups (group N0, N0.05, N0.1, N0.15, and N0.2), with doses of 0, 0.05, 0.1, 0.15, or 0.2 mg/kg nalbuphine in each group. Propofol was given to all groups as the sedative. The bispectral index (BIS) value, propofol dose, examination time, and awakening time were recorded. The number of patients with intolerance indexes (coughing, retching, swallowing, or limb movement) was recorded in each group. The ED50/ED95 of nalbuphine combined with propofol for gastroscopy were calculated.Results: Compared with those of groups N0, N0.05, or N0.1, the propofol dose and awakening time were significantly reduced in group N0.15 or N0.2 (p &lt; 0.05). The successful rate of painless gastroscopy in group N0.15 or N0.2 significantly increased compared to that of group N0 or N0.05 (p &lt; 0.05). When combined with propofol, nalbuphine had an ED50 and ED95 for painless gastroscopy of 0.078 mg/kg (95% CI, 0.056–0.098 mg/kg) and 0.162 mg/kg (95% CI, 0.134–0.217 mg/kg), respectively.Conclusion: The ED50/ED95 of nalbuphine combined with propofol are 0.078 and 0.162 mg/kg, respectively, for painless gastroscopy. Nalbuphine at 0.162 mg/kg combined with propofol is effective and safe for painless gastroscopy in adults.

How reliable is assessment of joint swelling and tenderness over socks or stockings in patients with established rheumatoid arthritis?

ABSTRACT Objectives Physicians tend to omit examinations of the foot and ankle in routine practice because it consumes a lot of time when working within tight time constraints. Although barefoot examination is critical to assess disease activity of rheumatoid arthritis (RA), we think occasional examination of foot over socks or stockings is better than not examining foot at all. The aim of this study was to assess the accuracy of foot examinations over socks or stockings in patients with RA. Methods Sixty patients with RA were enrolled in this study. A rheumatologist and a senior resident performed foot examinations on each patient over socks, over stockings, and on bare foot to assess swelling and tenderness. Concordance rates between the barefoot examination and the examinations over socks or stockings by each examiner were investigated. Results The rheumatologist had a concordance rate of 94.4% over socks and 98.8% over stockings. The senior resident had a concordance rate of 95.6% over socks and 98.5% over stockings. Conclusions Foot examinations over socks and stockings had high concordance rates with the barefoot examination, and it may be an option for decreasing foot and ankle examination time in RA patients.

Possibility of new shielding device for upper gastrointestinal endoscopy

Background and study aims Infection control is essential when performing endoscopic procedures, especially during the COVID-19 pandemic. Therefore, we have developed a new shielding device called STEP for infection control in upper gastrointestinal endoscopy. Patients and methods STEP consists of a mask worn by the patient and a drape that is connected to the mask and covers the endoscope. A suction tube attached to the mask prevents aerosols from spreading. The endoscopist operates the endoscope through the drape. Three endoscopists performed a total of 18 examinations using an upper endoscopy training model with and without STEP. Endoscopic images were evaluated by three other endoscopists, using a visual analog scale. We also simulated contact, droplet, and aerosol infection and evaluated the utility of STEP. Results All examinations were conducted without a problem. Mean procedure time was 126.3 ± 11.6 seconds with STEP and 122.3 ± 10.0 seconds without STEP. The mean visual analog score was 90.7 ± 10.1 with STEP and 90.4 ± 10.0 without STEP. In the contact model, adherence of simulated contaminants was 4.9 ± 1.4 % without STEP and 0 % with STEP. In the droplet model, the number of simulated contaminants attached to the paper was 338 273 ± 90 735 pixels without STEP and 0 with STEP. In the aerosol model, the total number of particles was 346 837 ± 9485 without STEP and was significantly reduced to 222 ± 174 with STEP. Conclusions No effect on examination time or endoscopic image quality was observed when using STEP in upper gastrointestinal endoscopy. Using STEP reduced the diffusion of simulated contaminants in all three infection models.

Proctors Assignment at the University of Information Technology – VNU HCM

This paper is concerned with the proctor assignment problem. Although there have been many proposed models for solving this kind of problem, it turns out that those models perform well only in their context. Also, no models can solve all problems in any context. Hence, creating a model for a specific problem is essential. In this paper, we define the problem and challenges of assigning proctors at our university as an optimization model. We experiment on two methods: the Generic Algorithm and the Integer Programming, then compare the results. For the Integer programming, we proposed an objective loss called zero-min loss, which minimizes the spans of days the proctors must be at the university during the examination time. Our main result shows that the proposed Integer Programming gives a 2285 higher score in fitness value compare to the Generic Algorithm.

STUDYING THE INITIAL STABILITY OF A NEW TYPE OF HIP REPLACEMENT- SPIRON SHORT STEM

Objective: we perform this study with the following objective: Studying the initial stability of a new type of hip replacement-spiron short stem. Subjects and methods: Experiments to determine the deformability, elasticity and force capacity of the femur were used for the short stem and the long stem replacement corresponds to the original femur without the prosthesis. Along with that, we were evaluated short-term results of treatment for 70 patients with 92 Spiron hips replacement in the Institute of Trauma and Orthopedic-108 Military Central Hospital, from 2012 to 2016. Results: The analysis results showed that the Spiron short stem prosthetic had a significantly smaller displacement in the mid-frost bond than the Zweymuller long stem prosthesis. Clinical research: Harris’s score was 45.2 (± 2.4) before surgery. At the final examination time Harris’s score was 91.4 (± 2.5). The rate: very good (75.0%), good (17.4%), average (3.3%), poor (4.3%). There are 02 cases early stem loosening had to stem revision surgery (2.2%). Conclusion: These results show the good initial fixed ability as well as stability when replaced by the Spiron stem.

Simethicone administration improves gastric cleanness for esophagogastroduodenoscopy: a randomized clinical trial

Background Esophagogastroduodenoscopy is very useful in diagnosing and treating upper gastrointestinal mucosal disorders, but too much foam and water in stomach decrease its diagnostic efficiency. Simethicone administration can help remove excessive foam. Aims To determine the optimal simethicone administration strategies in a comparative randomized controlled clinical trial. Methods Adult outpatients with indications for esophagogastroduodenoscopy were enrolled and randomly divided into group 1 (simethicone solution intake 20–30 min before procedure, n = 110), group 2 (simethicone solution intake 31–60 min before procedure, n = 92), and group 3 (simethicone solution intake > 60 min before procedure). Primary and secondary outcomes were procedure time and the patients’ satisfaction after the examination. All symptoms like abdominal pain and distension were recorded. Results No statistically significant differences were found on the patients’ demographic and clinical features and mean examination time (all P values > 0.05). The distribution of patients with different endoscopic and pathological diagnosis was comparable among three groups, respectively (P = 0.607; P = 0.289). However, the proportion of patients with Gastric Cleanness Grade A was most in group 2 (n = 73, 79.3%), and patient proportion with Gastric Cleanness Grade C was most found in group 1 (n = 72, 65.5%), which was greatly different (P < 0.001). There was no statistically significant difference on the satisfaction scores [immediately 6 (3–8) vs. 6 (1–10) vs. 6 (1-9), P = 0.533; 2 h after 10 (8–10) vs. 10 (10–10) vs. 10 (8-10), P = 0.463]. Conclusion Simethicone solution intake 31–60 min before esophagogastroduodenoscopy can help obtain the best gastric cleanness, which is recommended in clinical practice (registered at ClinicalTrials.gov, NCT03776916 on December 13, 2018).

Use of Artificial Intelligence to Improve the Quality Control of Gastrointestinal Endoscopy

With the rapid development of science and technology, artificial intelligence (AI) systems are becoming ubiquitous, and their utility in gastroenteroscopy is beginning to be recognized. Digestive endoscopy is a conventional and reliable method of examining and diagnosing digestive tract diseases. However, with the increase in the number and types of endoscopy, problems such as a lack of skilled endoscopists and difference in the professional skill of doctors with different degrees of experience have become increasingly apparent. Most studies thus far have focused on using computers to detect and diagnose lesions, but improving the quality of endoscopic examination process itself is the basis for improving the detection rate and correctly diagnosing diseases. In the present study, we mainly reviewed the role of AI in monitoring systems, mainly through the endoscopic examination time, reducing the blind spot rate, improving the success rate for detecting high-risk lesions, evaluating intestinal preparation, increasing the detection rate of polyps, automatically collecting maps and writing reports. AI can even perform quality control evaluations for endoscopists, improve the detection rate of endoscopic lesions and reduce the burden on endoscopists.