Optimization of extreme ultra-violet light emitted from the CO2 laser-irradiated tin plasmas using 2D radiation hydrodynamic simulations.

We studied Extreme Ultra-Violet (EUV) emission characteristics of the 13.5 nm wavelength from CO2 laser-irradiated pre-formed tin plasmas using 2D radiation hydrodynamic simulations. Our results indicate that when a CO2 laser irradiates pre-formed tin plasma, the heated plasma expands towards the surrounding plasma, steepening the density at the ablation front and lowering the density near the laser axis due to the transverse motion of the plasma. Consequently, the laser absorption fraction decreases, and the contribution to EUV output from the ablation front becomes dominant over that from the low-density plasmas. We estimated that an EUV conversion efficiency of 10% from laser to EUV emission could be achieved with a larger laser spot size, shortened laser pulse width, and longer pre-formed plasma density scale length. Our results offer one optimizing solution to achieve an efficient and powerful EUV light source for the next-generation semiconductors.

Trends and Outcome of Aggressive Fascial Space Infections.

Background: Odontogenic infections are common and self-limiting in most cases; however, they can lead to severe consequences, considerable morbidity and can even be fatal despite modern medical therapy. Patients and Methods: This retrospective study included patients with severe deep fascial space infections treated in the Maxillofacial Surgery Unit, General Surgery Department, Faculty of Medicine, Sohag University, Sohag Governorate, Egypt, and the Department of Oral and Maxillofacial Surgery, King Fahd Specialist Hospital (tertiary referral center), Burayda City, Qassim Province, Saudi Arabia, from June 2017 to June 2022. Results: This study included 296 patients, 161 (54.4%) males, 135 (45.6%) females. The fifth decade of life was the most common vulnerable age group. Forty-three percent of patients had diabetes mellitus, 26.6% were hypertensive, and 13.3% were on long-term steroid therapy. In 83% of patients, the offending tooth was identified but in 17% of patients no dental cause was identified. The lower third molar tooth was most commonly involved. Sixty-nine (23.3%) patients had submandibular space infections. Fifty-three (17.9%) patients had canine space infections. Thirty (10.1%) patients had submasseteric space infection. Twenty-eight (9.5%) patients had submental space infections. Twenty-three (7.8%) patients had combined infection of the submasseteric, submandibular, and pterygomandibular spaces, whereas 19 (6.4%) patients presented with Ludwig's angina. Conclusions: Odontogenic infections are common. The submandibular space is the most commonly affected single space. These infections could lead to lethal complications in immunocompromised patients, especially patients with diabetes mellitus. These infections require urgent surgical intervention to decrease hospital stays and avoid potentially lethal complications.

Characteristics and Management of Pediatric Benign Intraosseous Mandibular Tumors: A 10-Years Prospective Study.

Background: The management of intraosseous mandibular tumors in children is challenging. This study investigated clinical and pathological characteristics, surgical treatment, and outcome of pediatric benign intraosseous mandibular tumors. Materials and Methods: A prospective study included patients under 18 years presenting with benign intraosseous mandibular tumors that were surgically managed. Clinical and surgical data were collected and statistically analyzed. Results: The study included 84 patients (38 males and 46 females): 66.7% had non-odontogenic tumors and 33.3% had odontogenic tumors. The most common non-odontogenic tumors were central giant cell granulomas (31%). The most common odontogenic tumors were odontomas (9.5%). Conservative surgery and radical resection were performed equally. Curettage was the commonest treatment modality (27.4%). Fifty percentage of cases required reconstruction, which was done by costochondral rib graft (42.9%) and free fibula flap (7.1%). One patient had recurrence. All cases got good functional and aesthetic results. Conclusion: Non-odontogenic tumors were more common than odontogenic tumors. Central giant cell granulomas were the most common non-odontogenic tumors, while odontomas were the most common odontogenic tumors. Treatment depended on type, size, and aggressiveness. Pediatric mandibular reconstruction with costochondral rib grafts was simple and satisfactory. Microsurgical reconstruction had high success rates. Appropriate management achieved good aesthetic and functional outcomes.

Regional Analgesia for Laparoscopic Cholecystectomy Using Ultrasound-guided Quadratus Lumborum Block or Erector Spinae Block: A Randomized Controlled Trial.

BACKGROUND: Postoperative pain increases the incidence of venous thrombosis and respiratory complications, prevents early postoperative ambulation, and prolongs hospital stay. Fascial plane injections such as erector spinae plane (ESP) block and quadratus lumborum (QL) blocks are popular methods for postoperative pain control and reducing opioid consumption. OBJECTIVES: We aimed to evaluate the analgesic effects of ultrasound-guided ESP versus QL block during laparoscopic cholecystectomy for the reduction of pain and analgesic consumption. STUDY DESIGN: Prospective, double-blind, single-center, randomized controlled clinical trial. SETTING: Minia University Hospital, Minia Governorate, Egypt. METHODS: Patients scheduled for laparoscopic cholecystectomy from April 2019 through December 2019 were randomly allocated into 3 groups. After induction of general anesthesia, Group A received an ESP block, group B received a QL block, and group C didn't receive any block (control). The main outcome was the time to the first analgesic request. Secondary outcomes were the pain intensity measured by the Visual Analog Scale at one, 2, 4, 6, 8, 12, 16, 20, and 24 hours postoperatively at rest and cough. The total analgesic requirement during the first 24 postoperative hours, hemodynamics, and any complications were recorded. RESULTS: Sixty patients scheduled for elective laparoscopic cholecystectomy were enrolled; the clinical and demographic data were similar in the 3 groups. Groups A and B had lower VAS scores at cough than Group C in the first postoperative 2 hours. Compared to Group C, a higher score was reported at 8, 12, and 16 hours in Group A, and at 8 and 16 hours in Group B. Group B had a higher score at 4 hours than Group A. At rest, Group C showed higher scores than Groups A and B in the first 2 hours, while higher scores were noted at 16 hours in Group A and 12 hours in Group B. Time to first request of analgesia was significantly prolonged in Group A than in Groups B and C (P < 0.001). Our study showed that Groups A and B had lower postoperative analgesic requirements than Group C (P < 0.05). LIMITATIONS: This study had a small number of patients enrolled. CONCLUSIONS: Both ESP and QL blocks effectively reduced VAS scores at both cough and rest. There was a decreased total consumption of analgesics in the first postoperative 24 hours with a longer duration of analgesia, which lasted 16 hours in the ESP group and 12 hours in the QL group.

Monotherapy versus polytherapy of enoxaparin and hydroxychloroquine for the treatment of COVID-19: A randomized controlled clinical trial.

Objectives: The current study aims to assess the efficacy and safety of Enoxaparin and hydroxychloroquine (HCQ) used as monothrapy or polytherapy versus standard care alone in Coronavirus 2019 (COVID-19) infected patients. Methods: The current study included two hundred patients with laboratory confirmed COVID-19 infection. Patients admitted to hospital were randomly allocated into four groups: group I: received standard COVID-19 therapy, group II: received Enoxaparin 40mg/day subcutaneously (SC) plus standard therapy, group III: received 400 mg/day HCQ plus standard therapy & group IV: received a combination of 400 mg/day HCQ and Enoxaparin plus standard COVID-19 therapy. The disease progression was evaluated by duration to a negative polymerase chain reaction (PCR), length of hospital or Intensive Care Unit (ICU) stay, and mortality rate. The safety of treatments was evaluated by measuring adverse effects. Results: The length of hospital stay, ICU admission and mortality were significantly decreased in Enoxaparin plus standard COVID-19 therapy group versus other groups. Conclusion: These findings suggest that Enoxaparin was safe, effective, and well tolerated and has a role in decreasing the progression of the disease and its complications while HCQ did not discover any evidence of extra therapeutic benefits.

Monotherapy versus polytherapy of enoxaparin and hydroxychloroquine for the treatment of COVID-19: A randomized controlled clinical trial

Objectives: The current study aims to assess the efficacy and safety of Enoxaparin and hydroxychloroquine (HCQ) used as monothrapy or polytherapy versus standard care alone in Coronavirus 2019 (COVID-19) infected patients. Methods: The current study included two hundred patients with laboratory confirmed COVID-19 infection. Patients admitted to hospital were randomly allocated into four groups: group I: received standard COVID-19 therapy, group II: received Enoxaparin 40mg/day subcutaneously (SC) plus standard therapy, group III: received 400 mg/day HCQ plus standard therapy & group IV: received a combination of 400 mg/day HCQ and Enoxaparin plus standard COVID-19 therapy. The disease progression was evaluated by duration to a negative polymerase chain reaction (PCR), length of hospital or Intensive Care Unit (ICU) stay, and mortality rate. The safety of treatments was evaluated by measuring adverse effects. Results: The length of hospital stay, ICU admission and mortality were significantly decreased in Enoxaparin plus standard COVID-19 therapy group versus other groups. Conclusion: These findings suggest that Enoxaparin was safe, effective, and well tolerated and has a role in decreasing the progression of the disease and its complications while HCQ did not discover any evidence of extra therapeutic benefits. (AU)

Bibliometric network analysis of thirty years of islamic banking and finance scholarly research.

This study utilizes bibliometric analyses to map and visualize the development, conceptual structure, and thematic evolution of the Islamic Banking and Finance (IB&F) scholarly research. It analyses 464 WoS IB&F research publications of 921 authors comprising 58 countries published over three decades from 1990 to 2019. The results reveal that (i) collaboration among countries is limited and institutional collaboration can be described as a "locally concentrated and globally isolated," (ii) the IB&F research is a type of "small-world-network" where few authors and journals dominate the networks and play a central role in the diffusion of knowledge and the "homophily impact" is present among the leading authors of the IB&F research, (iii) the networks in IB&F research reflects the "Matthew Effect," implying that few authors have a more significant number of networks compared to the rest of authors. The study has also identified the conceptual structure and thematic trends in the IB&F research and provides avenues for future research.

A Multicentric Prospective Study on Maxillofacial Trauma Due to Road Traffic Accidents: The World Oral and Maxillofacial Trauma Project.

ABSTRACT: The purpose of this prospective multicenter study was to analyze the epidemiology, patterns, and management of maxillofacial fractures due to road traffic accidents (RTAs) worldwide.Between Monday September 30, 2019 and Sunday October 4, 2020,1066 patients with RTAs related fractures were admitted to 14 maxillofacial surgery departments. The following data were analyzed: age, gender, mechanism of injury, alcohol or drug abuse at the time of trauma, maxillofacial fracture site, facial injury severity scale (FISS) score, associated injuries, day and month of trauma, time of treatment, type of treatment and length of hospital stay. Data were analyzed using bivaried and multivaried statistical analysis.Eight hundred seventy patients were male, and 196 were female. The most common mechanism of injury was motorcycle accidents (48%). More than half of the patients had fractures of the middle third of the maxillofacial skeleton. In total, 59% of the study sample underwent open reduction internal fixation. The median facial injury severity scale (3 points) and the medial hospital stay (3 days) were significantly lower in patients with seatbelts and helmet (P  < 0.001).This first prospective, multicenter epidemiological study shows that motorcycle accidents are the leading cause of RTAs related fractures, mostly in young males. Particularly in Australia and Europe, the incidence of RTAs was significantly lower. Moreover, this study found that the severity of maxillofacial lesions was significantly higher in patients without safety devices, with consequent longer hospital stay demonstrating the efficacy of road safety policies in preventing maxillofacial injury.

Clinico-Pathological Characteristics, Management, and Outcome of Benign Intraosseous Maxillary Tumors in Adolescents: A Prospective Study.

INTRODUCTION: Benign intraosseous maxillary tumors, although uncommon among the adolescents, represent a major challenge to the maxillofacial surgeons. Treatment ranges from conservative surgery to radical resection and reconstruction. Maxillary defect reconstruction in adolescents is uncommon. it can be achieved by prosthetic obturators, local and regional flaps, and free-tissue transfer. AIM OF THE WORK: To investigate the clinical and pathological patterns, treatment, and outcome of benign intraosseous maxillary tumors in adolescents. PATIENTS AND METHODS: A 10-years prospective study included patients between 12-18 years who presented with benign intraosseous maxillary tumors and surgically treated (conservative surgery or radical resection) with immediate reconstruction. Cases were followed up to assess functional and aesthetic outcomes and detect complications. RESULTS: Study included 38 patients; 63.2% had non-odontogenic tumors and 36.8% had odontogenic tumors. The most common non-odontogenic tumor was central giant cell granuloma (31.6%). The most common odontogenic tumors were adenomatoid odontogenic tumor and ameloblastoma (10.5% each). Treatment included Conservative surgery (55.3%) and radical resection (44.7%). Reconstruction was performed in 17 cases by temporalis muscle flap (9.83%), obturator (2.46%), and free fibula flap (1.64%). All cases gained accepted functional and esthetic results. CONCLUSIONS: Non-odontogenic tumors were more common than odontogenic tumors. Central giant cell granulomas and ossifying fibromas were the most common non-odontogenic tumors. Ade-nomatoid odontogenic tumor and ameloblastoma were the most common odontogenic tumors. Maxillary reconstructions with tem-poralis muscle flap and obturator were simple and satisfactory. Microsurgical reconstruction had high success rates. Aesthetic, and functional results were satisfactory when appropriate reconstruction was performed.

World Oral and Maxillofacial Trauma (WORMAT) project: A multicenter prospective analysis of epidemiology and patterns of maxillofacial trauma around the world.

BACKGROUND/AIM: The World Oral Maxillofacial Trauma (WORMAT) project was performed to analyze the causes and characteristics of maxillofacial fractures managed in 14 maxillofacial surgery divisions over a 1-year period. METHODS: The following data were collected: age, sex, cause and mechanism of maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score (FISS), associated injury, day of trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software. RESULTS: Between 30 September 2019 and 4 October 2020, 2,387 patients (1,825 males and 562 females [ratio 3.2:1], 47.6% aged 20-39 years [mean age 37.2 years, median 33.0 years]) were hospitalised. The main cause of maxillofacial fracture was road traffic accidents (RTA), which were statistically associated with male adults as like as assault, sport, and work (p<0,05). Half of the fractures involved the middle third of the face, statistically associated with fall and assault (p<0.05). Trauma in multiple locations was significantly associated with longer hospital stay (p<0.05). The mean length of hospitalization was 3.9 days (95% Confidence Interval 3.7-4.2). CONCLUSIONS: This prospective, multicenter epidemiological study confirmed that young adult males were the ones most commonly affected by maxillofacial fracture. RTAs and assaults are statistically associated with the adult population, while falls are associated with females and older population.

A multicentric, prospective study on oral and maxillofacial trauma in the female population around the world.

BACKGROUND/AIMS: Approximately 20% of patients with maxillofacial trauma are women, but few articles have analysed this. The aim of this multicentric, prospective, epidemiological study was to analyse the characteristics of maxillofacial fractures in the female population managed in 14 maxillofacial surgery departments on five continents over a 1-year period. METHODS: The following data were collected: age (0-18, 19-64, or ≥65 years), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injury, day of trauma, timing and type of treatment, and length of hospitalization. RESULTS: Between 30 September 2019 and 4 October 2020, 562 of 2387 patients hospitalized with maxillofacial trauma were females (24%; M: F ratio, 3.2:1) aged between 1 and 96 years (median age, 37 years). Most fractures occurred in patients aged 20-39 years. The main causes were falls (43% [median age, 60.5 years]), which were more common in Australian, European and American units (p < .001). They were followed by road traffic accidents (35% [median age, 29.5 years]). Assaults (15% [median age, 31.5 years]) were statistically associated with alcohol and/or drug abuse (p < .001). Of all patients, 39% underwent open reduction and internal fixation, 36% did not receive surgical treatment, and 25% underwent closed reduction. CONCLUSION: Falls were the main cause of maxillofacial injury in the female population in countries with ageing populations, while road traffic accidents were the main cause in African and some Asian centres, especially in patients ≤65 years. Assaults remain a significant cause of trauma, primarily in patients aged 19-64 years, and they are related to alcohol use.

Interaction between Growth Regulators Controls In Vitro Shoot Multiplication in Paulownia and Selection of NaCl-Tolerant Variants.

The interaction between cytokinin, auxin and GA controlled in vitro shoot multiplication in paulownia was influenced by a medium water potential (Ψ) modulation, where it was modulated using different textures or strengths of MS medium, media of different types (MS, WPM, SH and B5) or NaCl incorporation. The interaction between 2 mg/L BAP and 0.1 mg/L NAA expressed the highest shoot number on each media type, but it was better with media of lower water potential (MS and WPM), and MS medium was the best. Ψ of full-strength semisolid MS medium expressed the highest shoot multiplication. The opposite was detected when Ψ of MS medium was changed using half- or double-strength MS. Ψ of full-strength MS medium in semisolid form resulted in a valuable interaction between 2 mg/L BAP, 0.1 mg/L NAA and 0.1 mg/L GA, leading to efficient shoot formation, and it was associated with an increase in internode length and decrease in stem diameter, which facilitated obtaining synseeds with a high ability to convert. High genetic variation was recorded under long-term culture (14 subcultures). Polymorphism using the ISSR technique was higher than that of RAPD. A further increase in polymorphism was detected when NaCl was used, where five salt-tolerant lines were selected. Some salt-tolerant-selected lines showed one or more amplification products of a specific molecular weight that did not appear in the control. For example, with OPA-07 and OPG-02 RAPD primers, all the salt-tolerant-selected lines showed the appearance of amplification fragments (610 bp and 300 bp, respectively) that were not detected in control.

Characteristics and age-related injury patterns of maxillofacial fractures in children and adolescents: A multicentric and prospective study.

BACKGROUND/AIMS: Paediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric epidemiological study was to analyse the characteristics of maxillofacial fractures in paediatric patients managed in 14 maxillofacial surgery departments on five continents over a 1-year period. METHODS: The following data were collected: age (preschool [0-6 years], school age [7-12 years], and adolescent [13-18 years]), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injuries, day of the maxillofacial trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software. RESULTS: Between 30 September 2019 and 4 October 2020, 322 patients (male:female ratio, 2.3:1) aged 0-18 years (median age, 15 years) were hospitalized with maxillofacial trauma. The most frequent causes of the trauma were road traffic accidents (36%; median age, 15 years), followed by falls (24%; median age, 8 years) and sports (21%; median age, 14 years). Alcohol and/or drug abuse was significantly associated with males (p < .001) and older age (p < .001). Overall, 474 fractures were observed (1.47 per capita). The most affected site was the mandibular condyle in children <13 years old and the nose in adolescents. The proportion of patients who underwent open reduction and internal fixation increased with age (p < .001). CONCLUSION: The main cause of paediatric maxillofacial fractures was road traffic accidents, with the highest rates seen in African and Asian centres, and the frequency of such fractures increased with age. Falls showed an inverse association with age and were the leading cause of trauma in children 0-6 years of age. The choice of treatment varies with age, reflecting anatomical and etiological changes towards patterns more similar to those seen in adulthood.

A multicentric prospective analysis of maxillofacial trauma in the elderly population.

BACKGROUND/AIMS: The growth of the global elderly population will lead to an increase in traumatic injuries in this group, including those affecting the maxillofacial area, with a heavier load on health systems. The aim of this multicentric prospective study was to understand and evaluate the incidences, causes and patterns of oral and maxillofacial injuries in patients aged over 60 years admitted to 14 maxillofacial surgical departments around the world. METHODS: The following data were collected: gender, cause and mechanism of maxillofacial fracture, alcohol and drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injury, day of trauma, timing and type of treatment and length of hospitalization. Statistical analyses were performed using non-parametric and association tests, as well as linear regression. RESULTS: Between 30 September 2019 and 4 October 2020, 348 out of 2387 patients (14.6%), 197 men and 151 women (ratio 1.3:1; mean age 72.7 years), were hospitalized. The main causes of the maxillofacial fractures were falls (66.4%), followed by road traffic accidents (21.5%) and assaults (5.2%). Of the 472 maxillofacial fractures, 69.7% were in the middle third of the face, 28% in the lower third and 2.3% in the upper third. Patients with middle third fractures were on average 4.2 years older than patients with lower third fractures (95% CI 1.2-7.2). Statistical analysis showed that women were more involved in fall-related trauma compared with males (p < .001). It was also shown that road traffic accidents cause more fractures in the lower third (p < .001) and in the middle third-lower third complex compared with upper third (p < .001). CONCLUSIONS: Maxillofacial fractures in the elderly were more frequent in European and Australian centres and affected men slightly more than women. Falls were the leading cause of fractures, especially among women. The middle third of the face was most often affected, and conservative treatment was the most common choice for the management of such patients.

In vivo anti-inflammatory and hepatoprotective activities of Orobanche crenata (Forssk.) aerial parts in relation to its phytomolecules.

A total methanolic extract and its sub-extracts of Orobanche crenata (Forssk.) aerial parts were subjected to acute toxicity, anti-inflammatory, and hepatoprotective investigations. The methanolic extract was safe upto 3 g/kg on mice. The EtOAc fraction reduced the carrageenan-induced rat paw edema better than indomethacin. It also demonstrated a drop in the elevated ALT, AST, and TB at 300 mg/kg, better than silymarin. Histopathological examination of liver cells of rats given the EtOAc fraction showed a complete absence of the CCl4-induced cloudy swelling. A phytochemical investigation of the n-hexane and EtOAc fractions yielded 11 compounds [indole-3-carboxylic acid (1), n-butyl palmitate (2), tyrosol (3), L-rhamnonic acid-1,4-lactone (4), ß-sitosterol/stigmasterol mixture (5/5'), ß-sitosterol/stigmasterol glycosides mixture (6/6'), chrysoeriol (7), luteolin (8), apigenin (9), crenatoside (10), and verbascoside (11)] as identified by UV, 1D & 2D NMR and ESIMS techniques. Their reported biological actions were in relation to and supported our herein detected pharmacological findings.

Mechanics of guided growth of the distal femur for correction of fixed knee flexion deformities: an extra-articular technique.

INTRODUCTION: Anterior distal femoral hemiepiphysiodesis using intra-articular plates for correction of pediatric fixed knee flexion deformities (FKFD) has two documented complications: postoperative knee pain and implant loosening. The aim of this study is to investigate the mechanical properties of a novel extra-articular technique for anterior distal femoral hemiepiphysiodesis in patients with FKFD and to compare them to the conventional technique. MATERIALS AND METHODS: Sixteen femoral sawbones were osteotomized at the level of the distal femoral physis and fixed by rail frames to allow linear distraction simulating longitudinal growth. Each sawbone was tested twice: first using the conventional technique with eight plates placed anteriorly just medial and lateral to the femoral sulcus (group A) and then with plates inserted in the proposed novel location at the most anterior part of the medial and lateral surfaces of the femoral condyles with screws in the coronal plane (group B). Gradual linear distraction was performed, and the resulting angular correction was measured. Strain gauges were attached to the plates, and the amount of strain (and equivalent stress) over the plates in response to linear distraction was recorded. The two groups were compared using the Wilcoxon signed-rank test. RESULTS: The amount of angular correction was statistically higher in group B (extra-articular plates) at 5, 10-, and 15-mm of distraction (p < 0.001). As regards stress over the plates, the maximum stress and the area under the curve (sum of all stresses measured throughout the distraction process) were significantly higher when the plates were inserted at the conventional position (group A) (p < 0.001). CONCLUSIONS: During anterior distal femoral hemiepiphysiodesis, the fixation of the eight plates in the coronal plane at the anterior part of the femoral condyles may produce a greater amount of correction and a lower degree of stress over the implants as compared to the conventional technique.

Accuracy of shear wave elastography in characterization of thyroid nodules in children and adolescents.

BACKGROUND: Thyroid nodules are an important health problem in children and adolescents. They possess a higher risk of malignancy in comparison to adults. This fact forms a great dilemma for clinicians. The aim of this study was to evaluate the reliability of shear wave elastography (SWE) as a non-invasive technique in the characterization of thyroid nodules in children and adolescents. METHODS: This prospective study included 56 patients with thyroid nodules. All the patients underwent clinical assessment, laboratory investigations, ultrasound, and Doppler examination, followed by an SWE assessment. Statistical analysis was performed and the best cut-off value to differentiate benign from malignant nodules was determined using the ROC curve and AUC. RESULTS: Seventy-two nodules were detected in the examined patients (ages ranged from 11 to 19 years, with mean age of 14.89 ± 2.3 years). Fifty-eight nodules (80.6%) were benign, and fourteen nodules (19.4%) were malignant (histopathologically proved). Highly suspicious criteria for prediction of malignancy by ultrasound and Doppler were hypoechoic echopattern, internal or internal and peripheral vascularity, microcalcifications, taller-than-wide dimensions, irregular outlines, and absence of halo (p < 0.05). The diagnostic performance for their summation was 70.69% sensitivity, 82.8% specificity, 80.45% accuracy, a 63.79% positive predictive value (PPV), and 87.9% negative predictive values (NPV). Regarding SWE, our results showed that 42.2 kPa was the best cut-off value, with AUC = 0.921 to differentiate malignant from benign nodules; the diagnostic performance was 85.71% sensitivity, 94.83% specificity, 93.06% accuracy, 76.9% PPV, and 93.2% NPV. CONCLUSION: Shear wave elastography is a non-invasive technique that can assist in the diagnosis of malignant thyroid nodules among children and adolescents.

Reliability of shear wave elastography in the evaluation of diffuse thyroid diseases in children and adolescents.

PURPOSE: Thyroid diseases are common yet serious in children that lead to many metabolic and growth disorders; the most common among these are diffuse thyroid diseases (DTD). This study aimed to evaluate the reliability of shear wave elastography (SWE) to differentiate and diagnose DTD from normal thyroid tissue. METHOD: This prospective study included normal participants and patients with DTD. The subjects were assessed by clinical evaluation, laboratory investigation, conventional ultrasound, and Doppler examination, followed by SWE assessments. Statistical analysis was performed using the t-test and one-way ANOVA test, as appropriate. Receiver operating characteristic (ROC) curves were used to determine the best cutoff values to differentiate healthy participants from those with DTD and to differentiate between different types of DTD. RESULTS: The study included 74 patients with DTD and 20 healthy participants. The mean SWE values were 10.9 ± 1.78, 12.8 ± 2.1, 15.31 ± 2.95, and 17.26 ± 4.2 kPa for the normal participants and for patients with simple goiter, Hashimoto's thyroiditis (HT), or Grave's disease (GD), respectively. Statistically significant differences were noted between the mean SWE of the normal participants and that of patients with DTD, as well as between the mean SWE of patients with different types of DTD (P < 0.05). The best SWE cutoff values to differentiate a normal thyroid from DTD, HT from GD, HT from simple goiter, and GD from simple goiter were 12.8, 17.8, 13.4, and 13.9 kPa, respectively. CONCLUSIONS: SWE is a reliable diagnostic tool for differentiating normal thyroid tissue from DTD, as well as for differentiating between different types of DTD.

Dynamics of laser produced plasma from foam targets for future nanolithography devices and X-ray sources.

Foam targets are expected to be more efficient candidates than solid targets for laser produced plasma (LPP) for extreme ultraviolet (EUV) and X-ray radiation sources due to the expected plasma conditions that can be optimized regarding plasma opacities, volumetrics heating effects, and the produced ions debris characteristics. In this paper, a comparison of ion dynamics between low-density foam and solid Ni plasma was systematically investigated at CMUXE. The foam Ni target (density 0.6 g/cm3) and solid Ni target (density 8.9 g/cm3) were irradiated with 1064 nm Nd:YAG laser in vacuum. A Faraday cup (FC) was used to record the ion flux and time-of-flight (TOF) signals. A lower and wider TOF signal was observed for foam Ni plasma on the time scale. The average ion energy and peak of the TOF signal of solid Ni plasma were much higher than that of the foam Ni plasma. However, the total charge values between foam and solid Ni plasma were comparable indicating a more volumetric absorption of laser energy for foam Ni. The average ion energy and peak of the TOF signal of solid Ni showed a stronger angular and laser energy dependence than that of foam Ni. The plume shape of the solid Ni plasma appeared as an oblong ellipse at each time, while that of foam Ni plasma tended to be more circular, especially at early times. The results of mass ablation rate were consistent with the FC signals and showed a more intense plasma shielding for solid Ni.