Novel starch-tungsten (VI) oxide biocomposites: Preparation, characterization, and comparisons between experimental and theoretical photon attenuation coefficients.

This study synthesized biocomposites containing starch and WO3 at varying ratios of 10 %, 20 %, 30 %, 40 %, and 50 % and assessed their thermal and radiation-shielding properties. These biocomposites were characterized using Fourier-transform infrared spectroscopy, X-ray diffraction (XRD) analysis, particle-size distribution assessments, scanning electron microscopy-energy dispersive X-ray spectroscopy, and thermogravimetric analysis-differential thermogravimetry measurements. Furthermore, the linear attenuation coefficients of the biocomposites were experimentally measured using an NaI(Tl) gamma spectrometry system and theoretically computed using XCOM and GAMOS simulations for comparisons. The XRD and particle-size distribution profiles of the WO3.2H2O powder, respectively, demonstrated evident diffraction peaks and favorable pore-size distributions. Morphological characterizations revealed that the WO3 particles were homogeneously dispersed throughout the starch matrix without any agglomeration. Comparisons of the thermal degradation rates revealed that the pure starch and starch +50%WO3 biocomposite began decomposing at approximately 200°Cand 300 °C, respectively, indicating that increasing WO3 proportions enhanced thermal stability. Furthermore, the starch +50%WO3 biocomposite demonstrated the highest experimental linear attenuation coefficient, with a value of 0.2510 ± 0.0848 cm-1 at a gamma energy of 662 keV. Meanwhile, XCOM and GAMOS simulations revealed theoretical attenuation coefficients of 0.1229 and 0.1213 cm-1 for pure starch and 0.2202 cm-1 and 0.2178 cm-1 for the starch +50%WO3 biocomposite at 662 keV, respectively.

Does It Matter the Fixation Method of The Posterior Malleolar Fragment in Trimalleolar Fractures?

PURPOSE OF THE STUDY The purpose of this study was to evaluate if the fixation method of a posterior fragment in trimalleolar ankle fractures affects the surgical outcomes. MATERIAL AND METHODS A retrospective evaluation was made of all the cases of trimalleolar fractures over a 9-year period in a trauma center. Patients aged 18 - 70 years were enrolled in the study. Patients were separated into 2 groups according to the fixation method (A - P percutaneous screw, and posterior open reduction - internal fixation). The fractures were classified according to the AO classification system and the Haraguchi posterior malleolar fracture classification system. The FAOS and SF-36 scores, postoperative reduction quality, arthritis scores and minor - major complications were evaluated. RESULTS 86 patients were found to eligible for the study. The PMF was fixed using anteroposterior percutaneous screw in 50 (58.1 %) patients and with posterior open reduction-internal fixation in 36 (41.9 %) patients. AO 44 B type fracture was determined in 89.5 % of the patients, AO 44 C type was seen in 10.5 %. There were 27 patients (31.4 %) with Haraguchi type 1 fracture and 59 patients (68.6 %) with type 2 fracture. The mean step-off of the articular surface was statistically greater in Group 1 than in Group 2. No statistically significant difference was determined between the two groups in respect of syndesmosis malreduction. The mean arthritis score was higher in Group 1 than in Group 2. Mean scores of the SF-36 and FAOS questionnaire was statistically significantly improved in the patients with open reduction and internal fixation. DISCUSSION Although there is no consensus on the treatment of posterior malleolar fractures, the indication for surgery is mainly based on posterior fragment size in the literature. The anatomic articular reduction has been emphasized recently. In this study, it was determined that the anatomic articular reduction was correlated with better surgical outcomes. CONCLUSIONS The study results demonstrated that better functional and radiological outcomes was observed with direct open reduction and fixation of the posterior fragment than indirect reduction and percutaneous fixation in the patients with trimalleolar fracture. The arthritis risk and patient satisfaction were seen to be correlated with the anatomic reduction of the articular surface. Key words: trimalleolar fracture, posterior malleolar fracture, percutaneous screw, open reduction and fixation, ankle fracture.

Cyanobacterial formation of intracellular Ca-carbonates in undersaturated solutions.

Cyanobacteria have long been thought to induce the formation of Ca-carbonates as secondary by-products of their metabolic activity, by shifting the chemical composition of their extracellular environment to conditions favoring mineral precipitation. Some cyanobacterial species forming Ca-carbonates intracellularly were recently discovered. However, the environmental conditions under which this intracellular biomineralization process can occur and the impact of cyanobacterial species forming Ca-carbonates intracellularly on extracellular carbonatogenesis are not known. Here, we show that these cyanobacteria can form Ca-carbonates intracellularly while growing in extracellular solutions undersaturated with respect to all Ca-carbonate phases, that is, conditions thermodynamically unfavorable to mineral precipitation. This shows that intracellular Ca-carbonate biomineralization is an active process; that is, it costs energy provided by the cells. The cost of energy may be due to the active accumulation of Ca intracellularly. Moreover, unlike cyanobacterial strains that have been usually considered before by studies on Ca-carbonate biomineralization, cyanobacteria forming intracellular carbonates may slow down or hamper extracellular carbonatogenesis, by decreasing the saturation index of their extracellular solution following the buffering of the concentration of extracellular calcium to low levels.

What hides behind the MASC: clinical response and acquired resistance to entrectinib after ETV6-NTRK3 identification in a mammary analogue secretory carcinoma (MASC).

BACKGROUND: Mammary analogue secretory carcinoma (MASC) is a recently described pathologic entity. We report the case of a patient with an initial diagnosis of salivary acinic cell carcinoma later reclassified as MASC after next-generation sequencing revealed an ETV6-NTRK3 fusion. PATIENTS AND METHODS: This alteration was targeted with the pan-Trk inhibitor entrectinib (Ignyta), which possesses potent in vitro activity against cell lines containing various NTRK1/2/3 fusions. RESULTS: A dramatic and durable response was achieved with entrectinib in this patient, followed by acquired resistance that correlated with the appearance of a novel NTRK3 G623R mutation. Structural modeling predicts that this alteration sterically interferes with drug binding, correlating to decreased sensitivity to drug inhibition observed in cell-based assays. CONCLUSIONS: This first report of clinical activity with TrkC inhibition and the development of acquired resistance in an NTRK3-rearranged cancer emphasize the utility of comprehensive molecular profiling and targeted therapy for rare malignancies (NCT02097810).

A radiological survey of the Egrigöz granitoid, Western Anatolia/Turkey.

A radiological survey of the granitoid areas throughout Western Anatolia was conducted during 2007-14. As a part of this radiological survey, this article presents results obtained from Egrigöz pluton, which lies in the northeastern region of Western Anatolia. In the investigated area, the activity measurements of the natural gamma-emitting radionuclides ((226)Ra, (232)Th and (40)K) in the granitic rock samples and soils have been carried out by means of the NaI(Tl) gamma-ray spectrometry system. The activity concentrations of the relevant natural radionuclides in the granite samples appeared in the ranges as follows: (226)Ra, 28-95 Bq kg(-1); (232)Th, 50-122 Bq kg(-1) and (40)K, 782-1365 Bq kg(-1), while the typical ranges of the (226)Ra, (232)Th and (40)K activities in the soil samples were found to be 7-184, 11-174 and 149-1622 Bq kg(-1), respectively. Based on the available data, the radiation hazard parameters associated with the surveyed rocks/soils are calculated. The corresponding absorbed dose rates in air from all those radionuclides were always much lower than 200 nGy h(-1) and did not exceed the typical range of worldwide average values noted in the UNSCEAR (2000) report. Furthermore, the data are also used for the mapping of the surface soil activity of natural radionuclides and the corresponding gamma dose rates of the surveyed area.

Echo-guided pericardiocentesis in patients with clinically significant pericardial effusion. Outcomes over a 10-year period.

BACKGROUND: The purpose of the present study is to evaluate current echocardiographically (echo)-guided pericardiocentesis practice with regard to procedural success, complication rate, etiological causes, and outcomes of patients with clinically significant pericardial effusion. PATIENTS AND METHODS: Patients who underwent echo-guided pericardiocentesis between January 2004 and February 2014 were identified using an institutional code for the procedure. Other complementary data were obtained by interviewing patients or their relatives (directly or by telephone) and by searching the social security death index. RESULTS: A total of 301 patients were identified. The pericardium was approached via the subcostal (85 %) or apical (15 %) route under echo guidance in all procedures. The success rate was 97 %, with an intervention-requiring complication rate of 1.3 %. No patient died from complications. The most common etiology was malignancy (n = 84, 28 %). Patients were followed-up for a median of 35 months. Median survival for patients with malignant effusion was 5.9 months compared with 54 months for those with nonmalignant effusion. CONCLUSIONS: Echo-guided pericardiocentesis has a high success and low complication rate in current practice. Among etiologies, malignancy remains the most common cause of clinically significant pericardial effusion and is associated with a poor prognosis.

Identification of important and potentially avoidable risk factors in a prospective audit study of neonatal deaths in a paediatric hospital in Vietnam.

AIM: Neonatal deaths (≤28 days) account for more than half of child mortality in Vietnam. Presumably most die in hospital, but data are scarce. This study aimed to identify risk factors of death among hospitalised neonates. METHODS: We prospectively studied all neonatal deaths and expected deaths (discharged alive after withdrawal of life-sustaining treatment) in a Vietnamese tertiary paediatric hospital during a 12-month period in 2009-2010. The medical files were audited classifying admission prognosis, discharge outcome, cause of death/expected death according to two classifications, and important and potentially avoidable risk factors during the hospital stay. RESULTS: Among 5763 neonates admitted, 235 deaths and 67 expected deaths were included. According to both classifications, major causes were congenital malformations, prematurity and severe infections. Six risk factors were identified in 85% (60/71) of the neonates with a relatively good prognosis: recognition or response to danger signs, internal transfers, nosocomial infections, sepsis management, access to usual equipment/staff, and family perception. CONCLUSION: Among 302 neonatal deaths/expected deaths, the major causes were congenital malformations, prematurity and severe infections. Six important and potentially avoidable risk factors could be addressed in the subgroup with relatively good admission prognosis, without implementing new technology or major organisational changes.

Reference levels of natural radioactivity and (137)Cs in and around the surface soils of Kestanbol pluton in Ezine region of Çanakkale province, Turkey.

The aim of the study was to conduct a systematic investigation on the natural gamma emitting radionuclides ((226)Ra, (232)Th and (40)K) as well as (137)Cs in the surface soils from Kestanbol/Ezine plutonic area in Çanakkale province as part of the environmental monitoring program on radiologic impact of the granitoid areas in Western Anatolia. The activity measurements of the gamma emitters in the surface soil samples collected from 52 sites distributed all over the region has been carried out, by means of HPGe gamma-ray spectrometry system. The activity concentrations of the relevant radionuclides in the soil samples appeared in the ranges as follows: (226)Ra was 20-521 Bq kg(-1); (232)Th, 11-499 Bq kg(-1)and; (40)K, 126-3181 Bq kg(-1), yet the (137)Cs was much lower than 20 Bq kg(-1)at most. Furthermore, based on the available data, the radiation hazard parameters associated with the surveyed soils were calculated. The present data also allowed evaluation of some correlations that may exist in the investigated natural radionuclides of the soil samples from the plutonic area in Çanakkale province. It is concluded from the above that the concerned region did not lead to any significant radiological exposure to the environment.

A survey of natural radiation levels in soils and rocks from Aliaga-Foca region in Izmir, Turkey.

The gamma spectroscopic analysis of (226)Ra, (232)Th and (40)K has been carried out in surface soil samples collected from Aliaga-Foça industrial region. The rock samples as parent materials of the soils are also collected and analysed for relevant radionuclides in order to evaluate the natural radiation levels. In the present study, the mean activity concentrations and ranges of the related radionuclides in the soil samples from 60 sites distributed all over the region are as follows: (226)Ra is 38 (14-123) Bq kg(-1); (232)Th, 63 (27-132) Bq kg(-1) and (40)K, 633 (141-1666) Bq kg(-1). Meanwhile, the ranges of natural radionuclide activities in the rock samples characterising the region are 41-95 Bq kg(-1) for (226)Ra, 10-122 Bq kg(-1) for (232)Th and 264-1470 Bq kg(-1) for (40)K, respectively. Based on the available data, the radiation hazard parameters associated with the surveyed soils/rocks are calculated and the results do not exceed the permissible recommended values except for soils originated from Foça rhyolites and tuffs. Furthermore, the collected data allowed for the mapping of the measured activities and corresponding gamma dose rates.

Prematurity, asphyxia and congenital malformations underrepresented among neonates in a tertiary pediatric hospital in Vietnam.

BACKGROUND: Estimated 17,000 neonates (≤ 28 days of age) die in Vietnam annually, corresponding to more than half of the child mortality burden. However, current knowledge about these neonates is limited. Prematurity, asphyxia and congenital malformations are major causes of death in neonates worldwide. To improve survival and long term development, these vulnerable neonates need access to the specialized neonatal care existing, although limited, in lower middle-income countries like Vietnam. The aim of this study was to describe these conditions in a specialized Vietnamese hospital, compared to a Danish hospital. METHODS: We performed a comparative observational study of all neonates admitted to a tertiary pediatric hospital in South Vietnam in 2009-2010. The data were prospectively extracted from the central hospital registry and included basic patient characteristics and diagnoses (International Classification of Diseases, 10th revision). Prematurity, asphyxia and designated congenital malformations (oesophageal atresia, gastroschisis, omphalocoele, diaphragmatic hernia and heart disease) were investigated. In a subgroup, the prematurity diagnosis was validated using a questionnaire. The hospitalization ratio of each diagnosis was compared to those obtained from a Danish tertiary hospital. The Danish data were retrieved from the neonatal department database for a ten-year period. RESULTS: The study included 5763 neonates (missing<1%). The catchment population was 726,578 live births. The diagnosis was prematurity in 7%, asphyxia in 2% and one of the designated congenital malformations in 6%. The diagnosis of prematurity was correctly assigned to 85% of the neonates, who were very premature or had very low birth weight according to the questionnaire, completed by 2196 neonates. Compared to the Danish Hospital, the hospitalization ratios of neonates diagnosed with prematurity (p<0.01), asphyxia (p<0.01) and designated congenital malformations (p<0.01- 0.04) were significantly lower. CONCLUSION: Our findings suggest the investigated diagnoses were underrepresented in the Vietnamese study hospital. In contrast, relatively mild diagnoses were frequent. These results indicate the use of specialized care may not be optimal. Pre-hospital selection mechanisms were not investigated and additional studies are needed to optimise utilisation of specialized care and improve neonatal survival.

The natural radioactivity contents in feed coals from the lignite-fired power plants in Western Anatolia, Turkey.

Lignite burning is one of the sources of technologically enhanced exposure to humans from natural radionuclides. In the preliminary study, part of the survey, the activity concentrations of (226)Ra, (232)Th and (40)K in 112 samples of feed lignites from seven lignite-fired power plants in Western Anatolia (Seyitömer, Tunçbilek, Orhaneli, Soma, Yatagan, Yeniköy and Kemerköy) were, therefore, determined by scintillation gamma spectrometry. The ranges of the relevant radionuclides in the lignite samples are as follows: (226)Ra, 23-291 Bq kg(-1); (232)Th, 12-68 Bq kg(-1); and (40)K, 67-284 Bq kg(-1). Taking the coefficient of variation (CV) as a measure of the variability, the CV is also calculated for the natural radionuclides in the feed lignites. Furthermore, the dose rates in the coal-handling areas due to external gamma radiation are found to be within the range specified by UNSCEAR (2000) report.

Natural radioactivity (226Ra, 232Th and 40K) and assessment of radiological hazards in the Kestanbol granitoid, Turkey.

The surveys of natural gamma-emitting radionuclides in rocks and soils from the Ezine plutonic area were conducted during 2007. Direct dose measurement using a survey meter was carried out simultaneously. The present study, which is part of the survey, analysed the activity concentrations of (238)U, (232)Th and (40)K in granitoid samples from all over the region by HPGe gamma spectrometry. The activity concentrations of (226)Ra ranged from 94 to 637 Bq kg(-1), those of (232)Th ranged from 120 to 601 Bq kg(-1)and those of (40)K ranged from 1074 to 1527 Bq kg(-1) in the analysed rock samples from different parts of the pluton. To evaluate the radiological hazard of the natural radioactivity in the samples, the absorbed dose rate (D), the annual effective dose rate, the radium equivalent activity (Ra(eq)) and the external (H(ex)) hazard index were calculated according to the UNSCEAR 2000 report. The thorium-to-uranium concentration ratios were also estimated.

An iatrogenic enchondroma? An unusual X-ray finding.

In this unusual case, accumulation of silver nitrate used to treat over-granulation in a finger injury led to a near-misdiagnosis of a bony tumour on X-ray. This underlines the need to support X-ray results with a full clinical assessment.

Rib impingement in first class cricketers: case reports of two patients who underwent rib resection.

Two first class cricket bowlers presented with costoiliac pain secondary to rib impingement. In both patients, conservative management of the injury had failed to improve symptoms. Surgical resection of the affected rib was undertaken. At follow up, both patients had made a good recovery and had returned to competitive cricket.

Effects of levosimendan on left ventricular functional remodelling and exercise intolerance: a tissue Doppler study.

Levosimendan is a calcium sensitizer that demonstrates enhanced myocardial contractility. There is little information concerning the effect of levosimendan on left ventricular tissue parameters and exercise capacity. We evaluated the effects of a 24-h course of levosimendan therapy on cardiac tissue parameters in 30 patients, aged 48 - 70 years, admitted to our hospital for the management of decompensated heart failure. All patients underwent echocardiographic examination using tissue Doppler imaging (TDI) and a 6-min walk test. Systolic myocardial velocity of the mitral annulus (Sm) was significantly increased in levosimendan-treated patients compared with placebo-treated patients. There was a positive correlation between Sm and exercise capacity. Levosimendan might be expected to increase cardiac contractile force, especially Sm velocity, in parallel with exercise tolerance. The study has also shown that the progress of ventricular function after levosimendan treatment in patients with exercise intolerance could be monitored effectively by Sm velocity measurements using TDI.

Safety and immunogenicity of a novel recombinant subunit respiratory syncytial virus vaccine (BBG2Na) in healthy young adults.

A novel recombinant respiratory syncytial virus (RSV) subunit vaccine, designated BBG2Na, was administered to 108 healthy adults randomly assigned to receive 10, 100, or 300 microg of BBG2Na in aluminum phosphate or saline placebo. Each subject received 1, 2, or 3 intramuscular injections of the assigned dose at monthly intervals. Local and systemic reactions were mild, and no evidence of harmful properties of BBG2Na was reported. The highest ELISA and virus-neutralizing (VN) antibody responses were evident in the 100- and 300-microg groups; second or third injections provided no significant boosts against RSV-derived antigens. BBG2Na induced > or 2-fold and > or =4-fold increases in G2Na-specific ELISA units in up to 100% and 57% of subjects, respectively; corresponding RSV-A-specific responses were 89% and 67%. Furthermore, up to 71% of subjects had > or =2-fold VN titer increases. Antibody responses to 2 murine lung protective epitopes were also highly boosted after vaccination. Therefore, BBG2Na is safe, well tolerated, and highly immunogenic in RSV-seropositive adults.

Laser angioplasty in a right coronary artery stent restenosis with the guidance of left internal mammary artery contrast injection: case report.

A 43-years-old male who underwent right coronary artery stent implantation 6 months ago presented with total occlusion of right coronary artery at proximal part of the stent without antegrade flow. We successfully used the left internal mammary artery contrast injections for guidance in all stages of the right coronary laser angioplasty intervention.