Contrast enhanced ultrasound (CEUS) is increasingly used in the evaluation of renal lesions, however, its availability remains limited. Thus, sensitive noncontrast ultrasound evaluation of renal lesion vascularity is an unmet need.
In this single-center, retrospective study we assessed microvascular flow imaging (MV-flow) compared to CEUS in the evaluation of complex renal cysts and solid lesions. Out of 92 patients 28 were evaluated with both CEUS and MV-flow. Color Doppler, CEUS, and MV-flow was performed in 13 cases, whilst MV-flow, CEUS, and contrast-enhanced MV-flow (CE-MV-flow) was done in 16 cases. The CEUS diagnosis was considered gold standard.
MV-flow showed a substantial agreement with the CEUS diagnosis (weighted Kappa = 0.806), excluding equivocal lesions (Bosniak 2F). MV-flow substantially outperformed color Doppler (weighted Kappa = 0.77 vs. 0.133). The agreement of CE-MV-flow and MV-flow was comparable (weighted Kappa = 0.79 vs. 0.69).
MV-flow significantly improves evaluation of renal lesion vascularity compared to conventional techniques. However, the sensitivity is limited for equivocal lesions (e.g. Bosniak 2F cysts). Thus, MV-flow should be used as an ancillary technique, not as a substitute to CEUS. Current MV-flow presets are ill-suited for postcontrast imaging, therefore specific presets optimized for this purpose are needed to establish its potential.
According to current protocol, the separation of pancreatic head and body is performed at the level of superior mesenteric vein (SMV). Previous data indicate that the resection plane should be modified in portal annular pancreas. We presumed that the optimal line of pancreatic resections could also be different in other cases. Our aim is to simulate pancreatic resections in different planes and find the optimal resection line with the minimum number of cut vessels.
25 abdominal vascular corrosion casts were prepared, the aorta and the portal vein were cannulated. CT scans were taken on the casts, and specific planes were reconstructed simulating different resection lines. The total amount of cross sections of vessels were calculated in the different planes.
In our series, the optimal plane is the SMV in 11/25, 2 cm left in 10/25, 1 cm left in 4/25, 1 cm right in 1/25 and 2 cm right in none of our cases. The group of left sided extension contain more than half of the cases. With left sided resections, the cut surface of the vessels may be lowered to even 29% compared to the SMV plane.
Our study revealed that pancreatic resections should be extended to the left side of the SMV in more than half of our cases. Therefore, the resection plane should be determined by preoperative imaging methods. Using DICOM viewer with multiplanar reconstruction, the resection planes can be simulated in clinical practice, which would reduce the risk of postoperative bleeding.
The experiment was conducted within a framework of a two-factor long-term trial at the Research Institute for Fisheries, Aquaculture and Irrigation, in Szarvas, Hungary. This was a special field experiment, in which lysimeters have been installed in the middle of 32 m2 field plots. The main factor was the water supply with 4 levels: i1: non-irrigated control; i2: irrigated with one third of the optimal water supply; i3: irrigated with two thirds of the optimal water supply; i4: optimum irrigated plot, according to the requirement of sweet corn test plant. The amount of released irrigation water was 0, 54, 106 and 158 mm per year on average over 5 years. Within every water supply treatment there were 4 nutrient supply rates (N): N1, N2, N3, N4 = 100, 200, 300 and 400 kg ha−1 NPK fertiliser substance in ratio 2:1:1. The number of replications was 4, and the experiment was arranged in split-plot design. In the studied years, the amount of precipitation varied between 92 and 264 mm from sowing to harvesting.
The effect of fertiliser was less in the non-irrigated treatments compared to that of the irrigated ones, and the yield was increased only up to 200 kg ha−1 NPK treatment level. The NPK dose of 300 kg ha−1 proved to be optimal in the irrigated treatments in which the utilization of fertilizer doses increased parallel to the improving water supply. In addition, the ratio of first class products (cobs longer than 20 cm) increased to a greater extent than the yield as a result of irrigation and fertilization. Water requirement of sweet corn proved to be between 400–450 mm resulting in an average yield of 20–24 t ha−1, of which 18–20 t ha−1 came from marketable cobs. The amount of evapotranspiration fluctuated between 270–440 mm during the five years, depending on the quantity of water supply, but it changed to a lesser extent than the amount of the yield. Increasing the fertilizer dose practically did not affect ET in non-irrigated plants, but increased it by 20–30 mm in irrigated ones. The change was not significant.
The productivity of ET was only 30–45 kg ha−1 mm−1 in the non-irrigated treatment, while it was 50–55 kg ha−1 mm−1 in the irrigated treatments, with higher values at the higher fertiliser rates. The productivity of irrigation water exceeded far over the productivity of ET at adequate nutrient supply. The yield increase per 1 mm of irrigation water was on average 60 kg ha−1 mm−1, which was considerably higher than the productivity of ET of non-irrigated plants (39 kg ha−1 mm−1). There was a positive correlation between the yield and ET, and a negative correlation between the yield and specific water consumption. Irrigation and fertilization increased the average yield to a greater extent than evapotranspiration, so as the average yield increased, the ET per unit of yield decreased, i.e. the productivity of evapotranspirated water increased.
The high demand for COVID-19 diagnosis overwhelmed reference hospitals. Regional laboratories had to incorporate molecular technology to respond to the emergency. This work described the implementation of molecular diagnostic tools and the detection of SARS-CoV-2, in a regional hospital with no previous experience, from October 2020 to March 2022. The laboratory structure was significantly modified. The staff grew from 3 to 4 clinical microbiologists, and from 7 to 17 laboratory technicians to provide 24/7 coverage. A total of 144,442 samples were processed during the period of study. The highest peaks were reached in July 2021 with 25,285 samples processed, and between December 2021 and January 2022, with 32,245. COVID-19 pandemic has represented not only the challenge, but the opportunity to introduce Nucleic Acid Amplification Techniques (NAAT) in inexperienced laboratories. These secondary settings have shown an extraordinary ability to adapt and cannot be left behind in the progress of diagnostic techniques.
Photovoltaic energy is a well-known term nowadays, and with the continuous increase in PV demand, it has become necessary to consider the other sides that may affect the success of it, which is considered one of the real effects on the environment. The PV waste has started to create a large issue with the absence of administrative procedures in many countries. Despite the estimated life of photovoltaic panels being between 20 and 30 years, many units have already started to stop working. However, research indicates the total cost of new materials to manufacture a PV panel is around USD 90 per square meter, compared to USD 13.62 for the costs of recycling a PV module. The regulations disclosed that the problem of EoL for PV modules and their management is still not considered an issue in many countries. Therefore, SWOT analysis was used to evaluate the EoL management of waste PV modules in three regions in Washington, California, and the European Union's WEEE Directive. This study presents recommendations to strengthen regulations to manage the problems of the EoL waste, and open the way for countries and the private sector to realize the responsibility that may affect the environment.
Pregabalin is a gabapentinoid approved for the treatment of general anxiety disorder, neuropathic pain and as adjunctive therapy for focal seizures in patients with epilepsy. In addition, there are a number of conditions for which pregabalin is prescribed off-label. Along with the widespread use there are a significant number of reports describing the misuse of pregabalin over the last decade. Over time, it became clear that pregabalin should become part of routine testing in toxicology laboratories. The aim of this paper was to present validation of a LC-MS/MS method for the quantification of pregabalin in plasma of acutely poisoned patients. Simple sample preparation step and rapid chromatographic separation shortened the overall analysis time, which was the goal of method development. The presence of pregabalin was confirmed with three ion transitions, ensuring high selectivity of the validated method. The statistical data obtained showed good precision and accuracy over a wide concentration range. No endogenous or other interference was detected, and there was no matrix effect influence with this method. The LC-MS/MS method was applied to quantify pregabalin in plasma samples of patients admitted to the emergency department due to a possible acute pregabalin overdose. Different concentrations were found, and we report, to the best of our knowledge, the highest plasma concentration of pregabalin in the plasma of a patient with acute poisoning. In conclusion, we developed a fast and simple LC-MS/MS method for reliable determination of pregabalin and demonstrated the developed method was suitable for routine use in clinical toxicology setting.
For a graph G, we define the lower bipartite number LB(G) as the minimum order of a maximal induced bipartite subgraph of G. We study the parameter, and the related parameter bipartite domination, providing bounds both in general graphs and in some graph families. For example, we show that there are arbitrarily large 4-connected planar graphs G with LB(G) = 4 but a 5-connected planar graph has linear LB(G). We also show that if G is a maximal outerplanar graph of order n, then LB(G) lies between (n + 2)/3 and 2 n/3, and these bounds are sharp.
Coinciding with and responding to a growing crisis in the diagnostic, explanatory and treatment systems of psychiatry, the last couple of decades have seen a growing amount of evidence regarding the therapeutic potential of psychedelic drugs to treat a variety of mental health conditions. Broadly, this crisis can be construed as that of “indivi/dualist” approaches which aim to treat patients who are construed as separated from their social and material contexts, which are taken as given. The implicit premise: the self, but not the world, is the site of therapeutic intervention. By contrast, researchers insist that psychedelic therapy functions by on producing an experience of “connectedness” to self, world, and others, which is heavily influenced by context. However, by remaining in an indivi/dualist thoughtspace, neurological and psychological perspectives betray these recurring themes. In this essay, I approach psychedelic therapy for depression through the lens of phenomenological psychiatry to take these themes seriously–a task which passes by considering experience as embodied, and therefore embedded. Starting off from an analysis of depression as a bodily detunement (disconnection), I argue that, through a process of “immersive reflection”, psychedelic therapy transforms not only the self, but patients’ sense of reality. This will allow me to answer several questions pertaining to psychedelic therapy regarding its therapeutic mechanism, why it transforms reality and not only the self, why it transforms and not merely amplifies experience, why its effects last beyond the drugs’ psychoactive duration, and in what their paradigm-shifting potential for mental health consists of.
Entheogen use is becoming increasingly popular and a potential option for treatment or adjuvant treatment for various medical conditions. Clinical studies are needed to determine the efficacy, safety, and possible role of these traditional medicines in the context of modern society and the Western medicine paradigm. The willingness of patients to participate in such studies is currently unknown.
Materials and Methods
In September 2021 we implemented an anonymous, observational pilot survey to determine the general public's willingness to participate in future entheogen research. All participants were English-speaking adults and had participated in therapy or a retreat utilizing entheogens in a naturalistic setting in the last five (5) years. Participants were recruited through community outreach via email.
The response rate for this data set was estimated to be 48.3% (n = 84/174). Nearly all (95.5%) participants believed this research should be done and 86.9% said they would participate in entheogen research that lasted longer than one year. A greater proportion of participants were willing to participate in remote interviews (73.5%) rather than in-person surveys (64.7%). A majority of participants (78%) also noted the importance of financial compensation for their time influencing the willingness to participate in future entheogen studies.
The willingness to participate in research involving traditional entheogens is not the limiting factor in facilitating further studies. Participants held overwhelmingly positive perceptions indicating that they believed this research should be done. Future longitudinal clinical studies with financial compensation and controlled set and settings will be necessary to expand the evidence base for naturalistic entheogen use.
Social network use is widespread, and the study of Instagram seems to have captured more attention in recent years. However, scale development and validation in the field has fallen short of providing sound scales of Instagram motives and usage patterns that consider the uniqueness of Instagram-related behavior. This paper describes the development, psychometric and cross-cultural validation of two new measurement instruments: the “Instagram Motives Questionnaire” (IMQ) and the “Instagram Uses and Patterns Questionnaire” (IUPQ).
Methods and results
A preliminary set of items was developed for each questionnaire based on a previous qualitative interview study on Instagram motives, uses, and consequences. In the first study, the questionnaires were distributed to a sample of 312 participants aged 18–35 years (M = 23.81; SD = 4.49), and an exploratory factor analysis was performed. A parsimonious and interpretable 6-factor solution that displayed adequate factor loadings and adequate Omega coefficients for both instruments were found. In a second study, the two instruments and other measures of known social network usage correlates and mental health consequences were administered online to 1,418 English-speaking participants aged 18–34 years (M = 21.35; SD = 3.89). Both scales showed good psychometric properties and the factor structure identified in study 1 was reproduced through confirmatory factor analysis. Omega reliability coefficients were adequate. Finally, when performing multi-group CFA along with a French (n = 1,826) and a Spanish (n = 3,040) sample, language and gender invariance were supported. Correlations with other relevant measures indicate good convergent validity of both scales.
The present research provides psychometrically sound instruments for further investigations on Instagram use behaviors.