<p>Supporting Video S6. Horizontal PET(red)/CT(blue) projection showing dynamic, systemic (tail-vein) delivery of [18F]-1. PET is overexposed in attempts to capture drug presence in the brain volume. (Video of Fig.4Aiv and v)</p>
This case report presents a 63-year-old male patient with chronic left foot drop. The etiology for his condition most likely involved lateral lumbar stenosis and/or sacroiliac joint dysfunction resulting in radiculopathy and subsequent symptoms. The patient was previously recommended a surgical approach for his condition. After an extensive osteopathic examination and application of a high-amplitude low-velocity technique, the patient reported a significant improvement in his pain and resolution of his foot drop. To the best of the author's knowledge, this is the first reported case of the use of osteopathic medicine in the successful treatment and management of left foot drop most likely secondary lumbar stenosis and/or sacroiliac joint dysfunction. The aim of this case report is to discuss the possible mechanisms by which the condition may have been resolved and the role that osteopathic treatment played in it.
This research examines how the bi-directional relationship between housing precariousness and wellbeing varies across population subgroups and over time; sheds light on the dimensions of housing precariousness that affect wellbeing, and vice versa; and considers how policy interventions to effectively minimise negative impacts of precarious housing on wellbeing.
With the number of people driving a car increasing every day, there has been a proliferation in the number of cars insurance claims being registered. The life cycle of registering, processing and making a decision for each claim involves the manual examination by the service engineer who creates the damage report followed by the physical inspection by a surveyor from the insurance company which makes it a long drawn out process. We propose an end to end system to automate this process, which would be beneficial for both the company and the customer. This system takes images of the damaged car as input and gives relevant information like the damaged parts and provides an estimate of the extent of damage (no damage, mild or severe) to each part. This serves as a cue to then estimate the cost of repair which would be used in deciding insurance claim amount. We have experimented with popular instance segmentation models like the Mask R-CNN, PANet and an ensemble of these two along with a transfer learning [1] based VGG16 network to perform different tasks of localizing and detecting various classes of parts and damages found in the car. Additionally, the proposed system achieves good mAP scores for parts localization and damage localization (0.38 and 0.40 respectively).
The number of cataract surgeries performed globally will continue to rise to meet the needs of an aging population. This increased demand will require healthcare systems and providers to find new surgical efficiencies while maintaining excellent surgical outcomes. Immediately sequential bilateral cataract surgery (ISBCS) has been proposed as a solution and is increasingly being performed worldwide. The purpose of this review is to discuss the advantages and disadvantages of ISBCS.When appropriate patient selection occurs and guidelines are followed, ISBCS is comparable with delayed sequential bilateral cataract surgery in long-term patient satisfaction, visual acuity and complication rates. In addition, the risk of bilateral postoperative endophthalmitis and concerns of poorer refractive outcomes have not been supported by the literature. ISBCS is cost-effective for the patient, healthcare payors and society, but current reimbursement models in many countries create significant financial barriers for facilities and surgeons.As demand for cataract surgery rises worldwide, ISBCS will become increasingly important as an alternative to delayed sequential bilateral cataract surgery. Advantages include potentially decreased wait times for surgery, patient convenience and cost savings for healthcare payors. Although they are comparable in visual acuity and complication rates, hurdles that prevent wide adoption include liability concerns as ISBCS is not an established standard of care, economic constraints for facilities and surgeons and inability to fine-tune intraocular lens selection in the second eye. Given these considerations, an open discussion regarding the advantages and disadvantages of ISBCS is important for appropriate patient selection.
Abstract BACKGROUND Recurrence rates for atypical and anaplastic meningiomas range between 9% and 50% after gross total resection and between 36% and 83% after subtotal resection. Optimal treatment of recurrent meningiomas exhibiting atypical/anaplastic histology is complicated because they are often refractory to both surgery and radiation. OBJECTIVE To evaluate clinical determinants of recurrence and treatment-specific outcomes in patients with recurrent meningiomas exhibiting atypical/anaplastic histology at our institution. METHODS A cohort study was conducted using clinical data of all patients treated for meningiomas with atypical/anaplastic histology at first recurrence between January 1985 and July 2014 at a tertiary cancer center. Predictors of second recurrence were analyzed using competing risks regression models. RESULTS Nine hundred eighteen patients with meningioma were screened, of whom 60 (55% female) had recurrent disease with atypical/anaplastic histology at a median age of 58.1 yr at diagnosis. The median follow-up from the time of first recurrence was 36.7 mo, with 32 (53%) patients alive at last follow-up. There was no effect of extent of resection at first recurrence on time to a subsequent recurrence. Inclusion of radiation as primary or adjuvant therapy at first recurrence reduced the risk of progression or subsequent recurrence compared to surgery alone ( P = .07). CONCLUSION Treatment of recurrent meningiomas with atypical/anaplastic histology remains challenging. Our data, from one of the largest cohorts, suggest better tumor control with the addition of radiation and challenges the importance of extent of resection at first recurrence. A multicenter effort is needed to confirm these findings and propose treatment guidelines.
<p>Supporting Video S6. Horizontal PET(red)/CT(blue) projection showing dynamic, systemic (tail-vein) delivery of [18F]-1. PET is overexposed in attempts to capture drug presence in the brain volume. (Video of Fig.4Aiv and v)</p>
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