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Background: There are many post‐procedural treatments touted to improve comfort and decrease downtime, but very few prospective randomized studies. Aims: To analyze the safety and efficacy of a post‐procedural biotech cellulose mask. Patients/Method: Fifteen patients undergoing either a microneedling with radiofrequency (n = 5), non‐ablative fractional (n = 5), or full erbium:YAG resurfacing (n = 5) treatment were randomized to receive a biotech cellulose mask on one side of the face for 30 min after the procedure and for 2 h a day until healed. Standardized photos and thermal images were taken 30 min after the procedure and daily until healed. The investigator and blind evaluators reviewed the photos, and subjects answered daily questionnaires. Results: An analysis of the thermal images showed a significant reduction in facial temperature on the biotech cellulose mask side as compared to the control side in all groups with an average of 2.2 (range 0.2–6.5) degree Celsius reduction across all 15 subjects. All subjects reported less pain and heat immediately upon application of the mask. Thirty minutes after application, 13/15 continued to report less pain and heat, and 11/15 reported less erythema and swelling on the mask side while blind evaluators were able to choose which side had the mask 80% of the time. On average, subjects also reported significantly less swelling on Day 1 and Day 2. Conclusion: The biotech cellulose mask decreased patient's facial temperature, feelings of heat and pain, as well as downtime without any side effects for the subjects in this study undergoing a variety of treatments. [ABSTRACT FROM AUTHOR]

BACKGROUND: The long-term efficacy and safety of hyaluronic acid fillers injected into the neck have yet to be analyzed in a prospective trial in the United States. OBJECTIVE: Analyze the long-term efficacy and safety of a hyaluronic acid filler for static horizontal neck rhytids. MATERIALS AND METHODS: Twenty-six subjects were enrolled in the study. Six subjects were randomized to receive saline and 20 subjects were randomized to receive HARR. All subjects were randomized to use a cannula on 1 side and needle on the other with optional retreatment on day 30 and optional crossover treatment with different assignment on day 60. The subjects were graded using the Transverse Neck Line Scale, Canfield photography, and the Global Aesthetic Improvement Scale on day 360. RESULTS: A significant improvement from baseline on day 360 was achieved on the Transverse Neck Line Scale according to the blind evaluator, subjects, and investigator without any delayed-onset or prolonged side effects. There was no significant difference in the average improvement from the short-term analysis on day 60 to the long-term analysis on day 360. CONCLUSION: HARR achieved significant long-term improvement in static horizontal neck rhytids without any long-term side effects. [ABSTRACT FROM AUTHOR]

Simple Summary: Mosquitoes are able to transmit a wide variety of devastating pathogens when they bite and obtain blood from their vertebrate hosts. Therefore, identifying the physiological processes required for biting by vector mosquitoes can contribute to developing strategies to suppress biting behavior and prevent disease transmission. In this study, we investigate the differential expression of small regulatory RNAs (microRNAs) between different strains of the Northern house mosquito, Culex pipiens, which is a major vector of West Nile virus and filarial nematodes. We measured differential microRNA expression specifically in the context of a behavioral biting assay, using populations with previously documented differences in biting propensity and the ability to produce eggs without a blood meal. We identified eight differentially expressed microRNAs; six of these are implicated in regulating physiological processes related to energy utilization, reproduction, and immunity. Our results are strikingly similar to previous studies demonstrating increased expression of messenger RNA-encoding proteins involved in energy utilization in association with biting. Furthermore, while previous studies have identified changes in microRNA expression occurring after consuming a blood meal, ours is the first study to demonstrate anticipatory changes in microRNA expression before blood is consumed. Understanding the molecular and physiological processes underlying biting behavior in vector mosquitoes has important implications for developing novel strategies to suppress disease transmission. Here, we conduct small-RNA sequencing and qRT-PCR to identify differentially expressed microRNAs (miRNAs) in the head tissues of two subspecies of Culex pipiens that differ in biting behavior and the ability to produce eggs without blood feeding. We identified eight differentially expressed miRNAs between biting C. pipiens pipiens (Pipiens) and non-biting C. pipiens molestus (Molestus); six of these miRNAs have validated functions or predicted targets related to energy utilization (miR8-5-p, miR-283, miR-2952-3p, miR-1891), reproduction (miR-1891), and immunity (miR-2934-3p, miR-92a, miR8-5-p). Although miRNAs regulating physiological processes associated with blood feeding have previously been shown to be differentially expressed in response to a blood meal, our results are the first to demonstrate differential miRNA expression in anticipation of a blood meal before blood is actually imbibed. We compare our current miRNA results to three previous studies of differential messenger RNA expression in the head tissues of mosquitoes. Taken together, the combined results consistently show that biting mosquitoes commit to specific physiological processes in anticipation of a blood meal, while non-biting mosquitoes mitigate these anticipatory costs. [ABSTRACT FROM AUTHOR]

HARES is a supportive (high G') HA filler with a low degree of water affinity (gel swelling) and modification (<1% BDDE) that has a well-established safety and efficacy profile in the literature, especially for infraorbital hollow (IOH) rejuvenation. To further support the safety of this product, a long-term review of delayed-onset adverse events of interest (DAEIs) related to HARES was conducted using reports from a global post-marketing safety surveillance database over the past 23 years. This review demonstrated low reporting frequencies of delayed-onset nodules and inflammatory events, establishing a long-term safety profile for HARES that supports its continued use in clinical practice, especially for IOH rejuvenation. [ABSTRACT FROM AUTHOR]

Background: Culex mosquitoes are the primary vectors of West Nile virus (WNV) across the USA. Understanding when these vectors are active indicates times when WNV transmission can occur. This study determined the proportion of female Culex mosquitoes that were in diapause during the fall and winter and when they terminated diapause and began blood feeding in the spring. Methods: Mosquitoes were collected from parks using various traps and/or aspirated from culverts in Franklin County, Ohio, from October to mid-May from 2019 to 2022. Culex mosquitoes were morphologically identified to species, and the ovaries of females were dissected to determine their diapause and parity statuses. Results: By early October 2021, roughly 95% of Culex pipiens collected in culverts were in diapause and 98% of Cx. erraticus were in diapause. Furthermore, gravid and blood-fed Culex salinarius, Cx. pipiens, and Cx. restuans were collected in late November in 2019 and 2021 in standard mosquito traps. In the winter of 2021, the proportions of non-diapausing Culex decreased within culverts. The last non-diapausing Cx. erraticus was collected in late December 2021 while the final non-diapausing Cx. pipiens was collected in mid-January 2022, both in culverts. Roughly 50% of Cx. pipiens terminated diapause by mid-March 2022, further supported by our collections of gravid females in late March in all 3 years of mosquito collection. In fact, male mosquitoes of Cx. pipiens, Cx. restuans, and Cx. territans were collected by the 1st week of May in 2022, indicating that multiple species of Culex produced a second generation that reached adulthood by this time. Conclusions: We collected blood-fed and gravid Culex females into late November in 2 of the 3 years of our collections, indicating that it might be possible for WNV transmission to occur in late fall in temperate climates like Ohio. The persistence of non-diapausing Cx. pipiens and Cx. erraticus throughout December has important implications for the winter survival of WNV vectors and our overall understanding of diapause. Finally, determining when Culex terminate diapause in the spring may allow us to optimize mosquito management programs and reduce the spread of WNV before it is transmitted to humans. [ABSTRACT FROM AUTHOR]

Background: Hyaluronic acid fillers have been studied extensively for facial wrinkles; however, their efficacy for atrophic facial scars has yet to be analyzed in a prospective placebo‐controlled study. Objective: To analyze the efficacy and safety of a hyaluronic acid filler for atrophic facial scars. Methods & Materials: Fifteen subjects were randomized to receive up to 1 ml of VYC‐17.5 L on one cheek and up to 1 ml of saline on the other side, with an optional touch‐up treatment. Subjects were graded by a live blind evaluator using the Quantitative Global Scarring Grading System (QGSGS) (J Cosmet Dermatol. 2006;5:48), the Global Aesthetic Improvement Scale (GAIS), and Canfield photo‐analysis. Results: According to the blind evaluator, there was a significant reduction 90 days after the last treatment on the QGSGS for VYC‐17.5L compared with saline (−6.6 VYC‐17.5L vs −1.7 saline [t(28) = −4.3196, p = 0.008]). There was a smaller, but still significant reduction on the QGSGS for saline alone (10.4 to 8.6 [t(14) = −3.453, p = 0.004]). In addition, 93% (13/14) of subjects chose VYC‐17.5L over saline treatment and reported an improvement on the GAIS. There were no serious side effects and all minor side effects resolved by Day 30. Conclusion: VYC‐17.5L achieved significant improvements in rolling atrophic scars as compared to saline, though saline also had modest improvements. [ABSTRACT FROM AUTHOR]

Mosquitoes transmit a wide variety of devastating pathogens when they bite vertebrate hosts and feed on their blood. However, three entire mosquito genera and many individual species in other genera have evolved a nonbiting life history in which blood is not required to produce eggs. Our long‐term goal is to develop novel interventions that reduce or eliminate the biting behavior in vector mosquitoes. A previous study used biting and nonbiting populations of a nonvector mosquito, Wyeomyia smithii, as a model to uncover the transcriptional basis of the evolutionary transition from a biting to a nonbiting life history. Herein, we ask whether the molecular pathways that were differentially expressed due to differences in biting behavior in W. smithii are also differentially expressed between subspecies of Culex pipiens that are obligate biting (Culex pipiens pipiens) and facultatively nonbiting (Culex pipiens molestus). Results from RNAseq of adult heads show dramatic upregulation of transcripts in the ribosomal protein pathway in biting C. pipiens, recapitulating the results in W. smithii, and implicating the ancient and highly conserved ribosome as the intersection to understanding the evolutionary and physiological basis of blood feeding in mosquitoes. Biting Culex also strongly upregulate energy production pathways, including oxidative phosphorylation and the citric acid (TCA) cycle relative to nonbiters, a distinction that was not observed in W. smithii. Amino acid metabolism pathways were enriched for differentially expressed genes in biting versus nonbiting Culex. Relative to biters, nonbiting Culex upregulated sugar metabolism and transcripts contributing to reproductive allocation (vitellogenin and cathepsins). These results provide a foundation for developing strategies to determine the natural evolutionary transition between a biting and nonbiting life history in vector mosquitoes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Hyaluronic acid (HA) fillers have been studied extensively on the face; however, their safety and efficacy on the neck has not yet been evaluated in a prospective trial in the United States. OBJECTIVE: Analyze the efficacy and safety of a HA filler for static horizontal neck rhytides using either a cannula or needle. MATERIALS AND METHODS : Twenty-six subjects were randomized to receive up to 1 mL of the HA filler Restylane Refyne (HARR, n = 20) or saline (n = 6) using a cannula on one side and a needle on the other with optional repeat treatment. Subjects were graded using the Transverse Neck Line Scale, Canfield photography, and the Global Aesthetic Improvement Scale. RESULTS : A significant improvement 30 days after the last treatment was achieved on the Transverse Neck Line Scale when comparing HARR with saline according to the blind evaluator, subjects, and investigator without any significant side effects. In addition, the blind evaluator, subjects, and investigator rated the side of the neck injected with a needle as having significantly greater improvement than the cannula. CONCLUSION : The hyaluronic acid filler, Restylane Refyne, achieved significant improvement in static horizontal neck rhytides using either a cannula or needle without any serious side effects, although the needle was more effective. [ABSTRACT FROM AUTHOR]

Objective: This retrospective review assesses the efficacy and safety of low-dose triamcinolone (1mg/cc) added to hyaluronic acid fillers to decrease swelling after infraorbital injection.Methods: This retrospective analysis includes 447 patients who underwent 706 infraorbital hyaluronic acid filler treatments from April 2013 to March 2020 by a single injector. Short-term post-procedural swelling (≤2 weeks) was assessed through follow-up phone calls, which were documented in patient charts. The effect of triamcinolone, filler type, volume, and patient characteristics on the rate of post-procedure swelling were analyzed.Results: Swelling after infraorbital hyaluronic acid filler occurred in over half of the patients (51%, 103/202), but significantly decreased (23%, 29/124) when 1mg/cc of triamcinolone was mixed with the filler (x2[1, N=326]=24.296, p<0.00001). The incidence of swelling was directly correlated with the amount of hyaluronic acid filler injected (37% ≤ 0.55cc, 51% 0.56-1cc, and 60% >1cc) [x2[1, N=95]=3.9231, p=.048]. There was no significant difference in patient age, sex, Fitzpatrick skin type, or history of allergies on incidence of post-procedure swelling. Adverse events were limited to expected injection-site reactions, and there were no reports of hypopigmentation or atrophy from the addition of triamcinolone.Limitations: This is a retrospective study that used patient reporting for short-term post procedure swelling.Conclusion: This is the first retrospective study showing the safety and efficacy of a novel technique adding low-dose triamcinolone (1mg/cc) to hyaluronic acid filler to reduce post-procedure swelling within the first few weeks following infraorbital injection. Additionally, using lower volumes is also effective at reducing post-procedure swelling. Larger, randomized, controlled trials are needed to support our findings. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This retrospective review assesses the efficacy and safety of low-dose triamcinolone (1mg/cc) added to hyaluronic acid fillers to decrease swelling after infraorbital injection. METHODS: This retrospective analysis includes 447 patients who underwent 706 infraorbital hyaluronic acid filler treatments from April 2013 to March 2020 by a single injector. Short-term post-procedural swelling (<2 weeks) was assessed through follow-up phone calls, which were documented in patient charts. The effect of triamcinolone, filler type, volume, and patient characteristics on the rate of post-procedure swelling were analyzed. RESULTS: Swelling after infraorbital hyaluronic acid filler occurred in over half of the patients (51%, 103/202), but significantly decreased (23%, 29/124) when 1mg/cc of triamcinolone was mixed with the filler (x2[1, N=326]=24.296, p<0.00001). The incidence of swelling was directly correlated with the amount of hyaluronic acid filler injected (37% < 0.55cc, 51% 0.56-1cc, and 60% >1cc) [x2[1, N=95]=3.9231, p=.048]. There was no significant difference in patient age, sex, Fitzpatrick skin type, or history of allergies on incidence of post-procedure swelling. Adverse events were limited to expected injection-site reactions, and there were no reports of hypopigmentation or atrophy from the addition of triamcinolone. LIMITATIONS: This is a retrospective study that used patient reporting for short-term post procedure swelling. CONCLUSION: This is the first retrospective study showing the safety and efficacy of a novel technique adding low-dose triamcinolone (1mg/cc) to hyaluronic acid filler to reduce post-procedure swelling within the first few weeks following infraorbital injection. Additionally, using lower volumes is also effective at reducing post-procedure swelling. Larger, randomized, controlled trials are needed to support our findings. [ABSTRACT FROM AUTHOR]

This study examined the effectiveness of the Young Athletes program to promote motor development in preschool-aged children with disabilities. In the study, 233 children were randomly assigned to a control group or the Young Athletes (YA) intervention group which consisted of 24 motor skill lessons delivered 3 times per week for 8 weeks. Hierarchical Linear Modeling (HLM) showed that children who participated in the YA intervention exhibited mean gains of 7-9 months on the Peabody Developmental Motor Subscales (PDMS) compared with mean gains of 3-5 months for the control group. Children in the YA intervention also exhibited significant gains on the gross motor subscale of the Vineland Teacher Rating Form (VTRF). Teachers and parents reported benefits for children not only in specific motor skills, but also kindergarten readiness skills and social/play skills. The necessity for direct and intentional instruction of motor skills, as well as the challenges of involving families in the YA program, are discussed. [ABSTRACT FROM AUTHOR]

Poly(ethylene oxide)- b -poly(butylmethacrylate) (PEO- b -PBMA) copolymers have recently been identified as excellent building blocks for the synthesis of hierarchical nanoporous materials. Nevertheless, while experiments have unveiled their potential to form bicontinuous phases and vesicles, a general picture of their phase and aggregation behavior is still missing. By performing Molecular Dynamics simulations, we here apply our recent coarse-grained model of PEO- b -PBMA to investigate its self-assembly in water and tetrahydrofuran (THF) and unveil the occurrence of a wide spectrum of mesophases. In particular, we find that the morphological phase diagram of this ternary system incorporates bicontinuous and lamellar phases at high copolymer concentrations, and finite-size aggregates, such as dispersed sheets or disk-like aggregates, spherical vesicles and rod-like vesicles, at low copolymer concentrations. The morphology of these mesophases can be controlled by tuning the THF/water relative content, which has a striking effect on the kinetics of self-assembly as well as on the resulting equilibrium structures. Our results disclose the fascinating potential of PEO- b -PBMA copolymers for the templated synthesis of nanostructured materials and offer a guideline to fine-tune their properties by accurately selecting the THF/water ratio. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the sport experience for athletes with intellectual disabilities (ID) who participate in Special Olympics (SO). This study included a nationally representative sample of 1,307 families and 579 athletes in the U.S., focusing on sport involvement over the lifespan and motives for participating and for leaving SO. Athletes with ID are similar to athletes without disabilities in that sport is a significant life experience. They participate in sport for fun (54%) and social interaction (21%). Like athletes without disabilities, SO athletes leave sport because of changes in interest (38%) but also because of program availability (33%). These findings suggest that we continue to document the involvement of people with ID in sports and work to expand the sport opportunities available. [ABSTRACT FROM AUTHOR]

Leisure involves people engaging in structured and unstructured activities in community settings. Despite the myriad benefits of leisure participation, some people do not have opportunities to use their free time in a satisfying manner. Although most professionals consider inclusion to be an important goal of leisure services, many agencies do not welcome or offer unwelcoming or inaccessible services to people who are marginalized and/or oppressed as a result of various characteristics (e.g., ability, economic resources, age, gender, religion, ethnicity, race, sexuality). There is a need for research that highlights facilitators to inclusive leisure services. This study is part of a larger initiative to identify best practices in structured inclusive leisure programs and to develop an accreditation process with standards that reflect evidence-based practices. To this end, a focus group allowed a team of professionals to share its knowledge and experiences with inclusive leisure services. Focus group participants were eight members of the accreditation development team. The following lead request drove the discussion: Please describe services you consider best practices for inclusive leisure services. The focus group, lasting approximately three hours, was audio-recorded and transcribed. Following the constant comparative analytic framework, researchers identified patterns in data and relationships between concepts. Member check sessions providing opportunities for participants to provide input on codes, categories, and themes. Seven themes emerged: (a) participation, (b) social connections, (c) enjoyment, (d) choice, (e) competence, (f) social responsibility, and (g) learning. The themes of participation and social connections are primary themes because of the extensiveness of examples and emphasis discussants placed on them. Although several participants have expertise associated with inclusion of people with disabilities, their expertise and comments during the focus group encompassed other characteristics that often result in challenges to leisure (e.g., economic resources, age, gender, religion, ethnicity, race, sexuality). Results encourage practitioners to deliver inclusive leisure services by making accommodations to ensure all participants regardless of characteristics experience leisure, and by intentionally fostering social connections to help participants develop meaningful relationships. Focus group members emphasized the importance of leisure service providers creating enjoyable experiences, encouraging all participants to make choices, instilling a sense of competence in participants, modeling and rewarding social responsibility, and teaching a variety of skills. By following these best practices, practitioners can actively promote social inclusion across various leisure experiences for all community members. [ABSTRACT FROM AUTHOR]

Metal Organic Frameworks (MOFs) have the potential to be used as adsorbents in industrial separations. Different ligand lengths can generate MOFs with similar topology but differing pore sizes. Molecular simulations were used in this work to assess the adsorption isotherms, heats of adsorption and selectivity of H 2 S and CH 4 in MOF UiO-66, UiO-67, and UiO-68. Detailed analysis of the distribution of molecules in the cages and the radial distribution functions suggest that the effect of the linker on the macroscopic properties is negligible at low pressures, but it becomes evident at high pressures, where adsorption far from the linker is observed in large pore materials. Based on the adsorption selection parameter, UiO-67 shows better performance in a wider range of conditions than the other materials. [ABSTRACT FROM AUTHOR]

Background and Aims: The use of the word retard ("the r-word") among adolescents sheds light on societal views about individuals with intellectual disability and the need to address the colloquial use of this word and its underlying stigma. Schools provide an important platform for intervening to promote social change among youth. The present study examined the impact of a schoolwide social inclusion program on students' bystander behavior against the use of the r-word.Methods and Procedures: 1233 students from 5 high schools were surveyed about the prevalence of the r-word in their school, the contexts in which it is used, and their bystander behavior in response to the word. Approximately 40% of surveyed students participated in an R-word Campaign, Unified Sports team, and/or Unified Club as part of the Special Olympics Unified Champion Schools (UCS) program.Outcomes and Results: Students' prosocialness, the context in which the r-word was used, and participation in UCS activities significantly predicted active bystander behavior in response to the r-word.Conclusions and Implications: By empowering students to be active bystanders against the use of the r-word in school, school-based interventions provide a promising avenue for addressing both the use of the r-word and its underlying stigma. [ABSTRACT FROM AUTHOR]

This study examines the impact of the Special Olympics Unified Champion Schools program in high schools across the country. Data were analyzed from 2,774 students from 11 high schools implementing the program concerning their perceptions and attitudes toward including students with intellectual disability (ID). Students participating in 1 or more program activities reported increased visibility of and social interactions with students with ID in school. This, in turn, promoted more positive perceptions and attitudes regarding school and classroom inclusion. Participation in different activities had unique effects on students' perceptions of their school's inclusive environment and on their attitudes toward classroom inclusion. These findings support an ecological approach to social inclusion and for structured, schoolwide interventions embedded within normative school contexts. [ABSTRACT FROM AUTHOR]

Background: The diagnosis of primary hyperparathyroidism (1°HP) has become more complex, as fewer patients present with classic phenotype of concomitant elevation of calcium and parathyroid hormone (PTH). In addition, the distinction between normal versus abnormal patients is challenging, with an increasing number of patients with 1°HP, who have calcium and/or PTH values within the 'reference' range. Patients with 'inappropriately' elevated PTH values relative to their serum calcium are considered to have 1°HP. Methods: The study population consisted of 1753 patients with pathologically proven 1°HP and 74 healthy control patients. Nomograms were created by plotting PTH versus calcium of the two groups. The 95 % confidence zone of calcium and PTH for normal individuals was plotted and compared to patients with 1°HP. Results: The comparison of control and disease groups showed a clear demarcation zone on the plots of calcium versus PTH. In the group of 1°HP, 70 % had classic 1°HP presentation with the concomitant elevation of both calcium (≥10.5 mg/dL) and PTH (≥65 pg/dL). 21 % had 'normocalcemic' HP with calcium ≤10.5 mg/dL and PTH ≥65 pg/dL. 6 % had 'normohormonal' HP with calcium ≥10.5 mg/dL and PTH ≤65 pg/dL. 3 % had both calcium and PTH within the reference range. 68.5 % of patients had single adenoma, 16 % double adenoma, and 15.5 % hyperplasia. Conclusion: This nomogram serves as a diagnostic tool to distinguish normal patients from those with 1°HP, particularly those with atypical presentations. This recognition would permit previously observed patients to benefit from curative surgery. [ABSTRACT FROM AUTHOR]

This work presents a study on the transferability of simulation parameters and the effect of local composition in a model metal-organic framework (MOF). (FP)YEu MOF was selected as a case study of a model MOF for modeling adsorption of polar gases, such as H2S and H2O, and nonpolar gases, such as CH4, and C2H6, as it is a class of MOF that is relevant for sensor applications but that has not been widely researched. (FP)YEu has two different rare-earth metals, whose distribution is unknown. Results showed that taking interaction parameters from the literature and calculating charges using the Qeq method, the adsorption of nonpolar gases is overestimated, but the adsorption of polar gases is underestimated. Although this could suggest that some pores in the material studied experimentally are inaccessible, care must be taken when using molecular simulations as a predictive tool for different MOF families. [ABSTRACT FROM AUTHOR]

Background: Radiofrequency thermal ablation (RFA) is gaining increased acceptance for the treatment of unresectable primary and metastatic liver tumors. Understanding the morbidity and laboratory changes after RFA is important for operative indications and perioperative management.Methods: The authors prospectively analyzed the 30-day morbidity and mortality rates of patients undergoing laparoscopic RFA for liver tumors in a 10-year period. Laboratory studies included a complete blood count, electrolytes, liver function tests, prothrombin time/international normalized ratio (INR), and tumor markers obtained preoperatively, on postoperative days (PODs) 1 and 7, then at 3 months.Results: A total of 521 RFA procedures were performed for 428 patients (286 men and 142 women) with a mean age of 61 years (range, 25-89 years). A total of 346 patients underwent a single operation, and 82 patients had two or more operations. The pathology was metastatic colon cancer for 244 patients (47%), hepatocellular cancer for 109 patients (21%), metastatic neuroendocrine cancer for 74 patients (14%), and other noncolorectal, nonneuroendocrine liver metastasis for 94 patients (18%). A total of 1,636 lesions (mean, 3.1 per patient; range, 1-16) were ablated. The mean tumor size was 2.7 +/- 1.6 cm (range, 0.3-11.5 cm). All cases were managed laparoscopically. The 30-day mortality rate was 0.4% (n = 2), and the morbidity rate was 3.8 % (n = 20). The average length of hospital stay was 1 day for RFA-only cases and 2.1 days when another surgical procedure was combined with RFA. Serum aspartate aminotransferase (AST) increased 14-fold, alanine aminotransferase (ALT) increased 10-fold, and bilirubin levels increased 2-fold on POD 1, with return to baseline in 3 months. Serum alkaline phosphatase and gamma-glutamyltransferase (GGT) levels showed a 25% increase on POD 7, with return to baseline in 3 months. There were no significant changes in platelet counts or prothrombin times postoperatively.Conclusions: This large series provides valuable insight into the perioperative period and allows the expected morbidity of the procedure to be understood. Despite significant patient comorbidities, this procedure was tolerated with low morbidity and mortality rates. Postoperative coagulopathy was not observed. A postoperative rise in liver function tests is expected, reflecting the liver injury response to RFA. This information can be used to expand the patient population that may benefit from laparoscopic RFA. [ABSTRACT FROM AUTHOR]

As tactile feedback and degree of freedom for instrument movement are restricted in laparoscopic surgery, the video image plays the most crucial role in giving the surgeon information about the performance of the operation. The development of small, reliable, high-resolution imaging systems is essential for the surgeon's acquisition detailed information about the tissues being manipulated. Image quality depends on each component of the laparoscopic imaging unit. In this context, it is crucial for the surgeon to have an understanding of how the video signal is formed, transmitted, and displayed. Moreover, the surgeon also needs to have an idea about the basic principles and specifications of the surgical video systems (i.e. charge-coupled device (CCD) camera, monitors, and digitizers). This knowledge is essential for choosing pieces of equipment and knowing how to assemble them into a functional operating suite. The aim of this review is to provide the surgeon with the basics of video signaling, and to familiarize him or her with the technical principles of the surgical video systems. An insight into the future of laparoscopic video systems also is made, and practical tips for improving image quality and troubleshooting are given throughout the article. [ABSTRACT FROM AUTHOR]

BACKGROUND: The federal government has invested billions of dollars to promote employment for adults with intellectual disabilities. Despite this investment, the employment rate within this population has remained stable during the recent decades. OBJECTIVE: The objective of this study is to identify characteristics of adults with intellectual disabilities who are employed, and to understand the paths towards employment for these individuals. METHODS: Respondents included a nationally representative sample of 1,055 parents/guardians of adult children (21 years of age or older) with an intellectual disability surveyed by Gallup. These parents/guardians were selected from approximately 341,000 households screened by Gallup. This methodology allowed for the inclusion of a sample of adults with ID who had never been in the labor force or even sought employment. RESULTS: Several characteristics are associated with greater likelihood of employment, including younger age, early work experience, higher levels of adaptive behavior, and absence of emotional and behavioral problems. These characteristics are especially predictive of employment in a competitive setting, and relatively less predictive of sheltered employment. There is very little movement between the two types of employment settings: very few people currently in competitive employment ever worked in a sheltered setting. CONCLUSIONS: The results from this study have clear implications for policies and programs. Young adults with intellectual disabilities need early opportunities to work in community settings. These community-based experiences must provide them with the opportunity to develop necessary adaptive, behavioral, and emotional skills. Finally, policy makers must recognize that sheltered employment is not a stepping-stone to employment in a competitive setting. [ABSTRACT FROM AUTHOR]

Organic molecules of intrinsic microporosity (OMIMs) are a new class of highly concave molecules, designed to pack inefficiently and create microporous materials. In this work, OMIM-1 was described with full atomistic models using Dreiding, optimised potentials for liquid simulations (OPLS) and Universal force fields to recognise the features enhanced by each force field and assess their ability in representing the structural properties of this new class of materials. In addition, argon adsorption isotherms were modelled to determine the features observed in the isotherm generated by each force field, for future comparison with experimental data. [ABSTRACT FROM AUTHOR]

We determined the pore-size distributions (PSDs) of 12 activated carbons (ACs) using a combination of density functional theory method from Kierlik and Rosinberg applied to slit-like pores and a regularization method. This combination of methods was applied to nitrogen adsorption isotherms at 77.35 K on the selected ACs, prepared by heat treatment of lignin impregnated with orthophosphoric acid. The effect of three variables, namely, activation temperature, orthophosphoric acid/lignin weight ratio and time of impregnation, was discussed with respect to the resultant PSDs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Employment has been recognized as an important goal for improving the quality of life of adults with intellectual disabilities (ID). Governments at both the federal and state level have invested billions of dollars to encourage better outcomes for adults with ID as they transition out of high school and into the labor force. OBJECTIVE: Given these important efforts, this study documented the employment situation of working-aged adults with intellectual disabilities across the country. METHODS: Respondents included a nationally representative random sample of 1,017 parents/guardians of adult children (21 years of age or older) with an intellectual disability surveyed by Gallup. These parents/guardians were selected from approximately 341,000 households screened by Gallup. This methodology allowed for the inclusion of a sample of adults with ID who had never been in the labor force or even sought employment. RESULTS: The results indicate a troublingly low employment rate for adults with ID and a puzzlingly low number who are even in the labor force. CONCLUSIONS: The employment outlook for adults with ID will continue to be bleak until new ways are found to meaningfully incorporate this population into the labor force. [ABSTRACT FROM AUTHOR]

Highlights: [•] Virtual models of OMIMs were constructed using molecular simulation tools. [•] OMIM termini’s structure determines the adsorbent density but not its gas capacity. [•] Adsorbent properties are closely related to the packing ability of OMIMs. [•] Similar adsorption regimes are found in OMIMs and MOFs. [Copyright &y& Elsevier]

The presented work shows that a qualitative assessment of the trends in surface area in a given microporous polymer family can be obtained by analyzing the properties of a single polymer chain. We analyzed the properties of polymers of intrinsic microporosity (PIMs) that contain imide groups (known as PIM-PIs) and obtained the surface area of available PIM-PIs and proposed some hypothetical structures that can result in higher surface areas and potentially more favourable properties for adsorption. The advantage of the proposed method is that it allows for a rapid screening of potential monomers avoiding the need to perform computationally expensive calculations. [ABSTRACT FROM AUTHOR]

Surfactants self-associate in aqueous solutions to form micelles. Less well-known is that they form a wide range of liquid crystals - through self-association. These liquid crystals often occur in consumer products where they play an essential role in product stability and function. Some products are marketed in a liquid crystalline state although they are not recognized by the consumer (or, on occasion, by the manufacturer). This review describes the formation of micelles and the various liquid crystalline phases. These include lamellar, hexagonal, cubic and gel phases which have different long range structures but are based on micelles. The key factors linking surfactant molecular structure to liquid crystal architecture have been elucidated. These are the sizes of the surfactant hydrophobic tail(s) and head groups, together with the head group charge and the presence of any additives. Examples of liquid crystals in emulsion stabilization, household cleaners, conditioners, detergent liquid and some food are described. [ABSTRACT FROM AUTHOR]

Investigations of why students with emotional disturbance (ED) are underidentified in special education have often focused on economic factors and problems with the definition of ED. The present study focuses on variation in underidentification across states and its relationship to political ideology. State-level political, economic, and demographic data were obtained from multiple sources, including the National Election Pool exit polls (2008), the U.S. Census Bureau (2010), the National Center for Educational Statistics (2010), the U.S. Department of Education/ Office of Special Education Programs (2009), and the National Center for Children in Poverty (2009). The authors conducted a series of regression analyses in which per pupil expenditure, per capita income, percentage child poverty, ethnicity, and conservatism were used to explain state rates of ED identification and state rates of intellectual disability (ID) identification. The resulting model for the identification of ED explained more than 50% of the variance, with conservatism being the strongest predictor (ß = -.72, p < .001), whereas per pupil expenditure was nonsignificant. States with higher levels of conservatism had distinctly lower ED identification rates. Conservatism was not a significant factor in state identification of ID. The influence of state political leaning on ED identification and special education for children and youth with ED is discussed. [ABSTRACT FROM AUTHOR]

Lack of progress of children with emotional disturbance (ED) has begun to be documented in longitudinal school-based studies. Variability in these studies may be due to several factors, including widespread differences in academic, behavioral, and social functioning of these children, their special education status, and school contextual factors. In this study, 86 children were followed over a two-year period: children were drawn from three subgroups-children with ED receiving special education in low-income schools, children with ED receiving special education services in high-income schools, and children not receiving special education services but who were considered high risk for ED. Outcome measures included reading and math achievement along with ratings of behavioral progress. Despite initial differences in overall functioning, there was, almost without exception, no significant progress in any of the three subgroups over the course of a full academic year. This lack of progress was not related to the type of special education and related services that students received in self-contained or full inclusion programs. Results and implications are discussed regarding lack of response of children with or at risk for ED to intervention in both general and special education. [ABSTRACT FROM AUTHOR]

In recent years, there has been a global effort to support the inclusion of students with intellectual disabilities (ID) in schools and classrooms. China in particular has recently enacted laws that provide for inclusive educational opportunities for students with ID. There are many barriers, however, to successfully including students with ID in regular education schools and classrooms, one of which is negative attitudes. Over the past decade, much research has focused on documenting the attitudes of the adult public; however, adults only represent one segment of society as it is youth who play a critical role in the successful inclusion and acceptance of students with ID in schools and classrooms. The aim of this study was to replicate a previous study of middle school-aged youths' attitudes towards the inclusion of peers with ID conducted with youth in the USA with similar aged youth in China. A survey was conducted with a random sample of 4059 middle school-aged youth in China on their attitudes towards students with ID. Students' attitudes were measured in terms of their perceptions of the capabilities of students with ID, their beliefs about and expectations regarding the inclusion of students with ID and their willingness to interact with students with ID both in and out of school. The findings indicated that youth in China (1) perceive students with ID as moderately, rather than mildly, impaired; (2) believe that students with ID can not participate in their academic classes; (3) view inclusion as having both positive and negative effects on them personally; and (4) do not want to interact with a peer with ID in school, particularly on academic tasks. Structural equation modelling showed that youths' perceptions of the competence of students with ID significantly influenced their willingness to interact with these students and their support of inclusion. The findings replicated previous research conducted with middle school-aged youth in the USA and are discussed from a cultural perspective and in terms of the current special education policies and practices in China. [ABSTRACT FROM AUTHOR]

Variability in the social and behavioral characteristics of students with emotional disturbance (ED) in the public schools may impact special education effectiveness; yet very little evidence exists on how such variability may express itself from school to school. One place to begin such investigation involves school context as expressed by income level and academic performance. In this study, we selected 140 children (grades kindergarten through 6) receiving special education services for ED in schools in a large east-coast urban area. We gathered school-wide test results from state achievement testing and school poverty levels from eligibility for free or reduced lunch on each school. For each child, we collected teacher ratings of problem behavior and social skills. Findings from regression analyses revealed significant relationships between school context and children’s externalizing and internalizing behavior. We discuss the implications of these findings for the concept of ED as a unitary disability category in special education research and practice. [ABSTRACT FROM AUTHOR]

The present study explored the prevalence of the derogatory invective "retard" (i.e., "r-word") in everyday speech among American youth. A total of 1,169 youth between the ages of 8 and 18 years old participated in the present study. Results showed high prevalence of the r-word, as 92% of youth had heard someone use the word as a slang invective. Results also indicated that youth responded differently depending on who the word was directed toward (i.e., person with or without an intellectual disability), who said the word (i.e., friend vs. nonfriend), and who heard the word (i.e., females vs. males; younger vs. older youth). Implications for eliminating the r-word from everyday use are discussed. [ABSTRACT FROM AUTHOR]

Background A key aspect of social perception is the interpretation of others' intentions. Children with intellectual disabilities (IDs) have difficulty interpreting benign intentions when a negative event occurs. From a cognitive processing perspective, interpreting benign intentions can be challenging because it requires integration of conflicting information, as the social cues accompanying the negative event convey non-hostile intentions. The present study examined how children with ID process conflicting social information in a more diverse set of situational circumstances than was investigated previously, including situations involving hostile intentions. We hypothesised that when conflicting information in a social situation consists of mixed social cues that convey insincere benign intentions (a type of hostile intentions), children with ID would have difficulty arriving at an accurate interpretation, just as they do when a negative event is accompanied by cues that convey benign intentions. We also hypothesised that when a negative event is accompanied by cues that convey benign intentions, the presence of a highly salient negative event would pose added interpretation difficulty for these children. Methods Participants (58 children with ID and 189 children without ID in grades 2–6) viewed 13 videotaped vignettes. In each vignette, social cues that accompanied a negative event provided information about the intentions of the character that caused the event. After presenting each vignette, we asked the child questions designed to assess aspects of social perception, including his/her interpretation of intentions. Vignettes represented three types of situations that pose conflicting information: (1) a conflict between a negative event and social cues, which conveyed benign intentions (five items); (2) the presence of conflicting social cues that conveyed insincere benign intentions (four items); and (3) additional items designed to examine the effect of the salience of negative event and cues on accurate interpretation of benign intentions (four items). Teachers completed rating scales of social behaviour, enabling us to examine whether the ability to interpret intentions when conflicting information is present is related to children's social behaviour. Results Children with ID had lower interpretation accuracy than children without ID for all three social situations that presented conflicting information. Children with ID appeared to have particular difficulty interpreting benign intentions when a negative event (but not the social cue) was made salient. For children with ID, interpretation accuracy and teacher-rated social behaviour were related. Conclusions Results demonstrated that the presence of conflicting information poses cognitive processing challenges in a variety of social situations, making it difficult for children with ID to arrive at accurate interpretations. Children with ID were less likely than children without ID to interpret intentions accurately, not just when the social cues conveyed benign intentions, but also when mixed social cues conveyed hostile intentions. In addition, when social cues accompanying a negative event convey benign intentions, the relative salience of the negative event and the cues can affect interpretation accuracy for children with ID. Discussion focuses on implications for understanding the cognitive component of the social domain of adaptive behaviour, for explaining gullibility in children with ID and for instructional practices. [ABSTRACT FROM AUTHOR]

The social acceptance of children with and without intellectual disabilities was examined in an inclusive, summer recreational program. Participants were 67 children entering Grades 3 through 6, of which 29 were identified as having a mild intellectual disability. Children were recruited from economically and racially diverse urban school districts. Results showed that children with and without intellectual disabilities were equally accepted by their peers. Specifically, 95% of children without intellectual disabilities indicated that they liked to "hang out with" at least 1 child with an intellectual disability. Results also indicated that the majority of children without intellectual disabilities made at least 1 new friend with another child with an intellectual disability. The features of recreational programming that promote social inclusion are discussed. [ABSTRACT FROM AUTHOR]

The article discusses the dimensions of inclusion and social integration, by Gary N. Siperstein and Robin C. Parker.

The authors examined the academic characteristics of 140 elementary-aged students served under the category of emotional disturbance (ED) from schools that differed in income level, performance on state testing, and suspension rates, School income accounted for a large amount of the variance in the reading and math achievement of students with ED as measured by the Woodcock-Johnson III. However, relative academic performance (as measured by performance on state testing compared with same-school peers and teacher ratings or academic competence) was similar across school income levels. Implications for intervention research and eligibility, practices for students with ED are discussed. [ABSTRACT FROM AUTHOR]

The authors surveyed a national random sample of 5,837 middle school students on their attitudes toward the inclusion of peers with intellectual disabilities (ID). The national sample provided results that were accurate, with a margin of error of ± 1.4%. Findings indicated that youth (a) have limited contact with students with ID in their classrooms and school; (b) perceive students with ID as moderately impaired rather than mildly impaired; (c) believe that students with ID can participate in nonacademic classes, but not in academic classes; (d) view inclusion as having both positive and negative effects; and (e) do not want to interact socially with a peer with ID, particularly outside school. Structural equation modeling showed that youths' perceptions of the competence of students with ID significantly influence their willingness to interact with these students and their support of inclusion. [ABSTRACT FROM AUTHOR]

Employers' negative attitudes and fears have long been a barrier to the employment of individuals with disabilities. Accordingly, attitude literature on the employment of people with disabilities has focused almost exclusively on employers. However, due to their influence over business practices, the successful employment of people with disabilities is also contingent on the views of the consumer. This study extends previous studies that focused on the attitudes of employers, and went directly to the consumer. Consumer attitudes toward companies that hire individuals with disabilities were assessed through a national public survey (N=803). Most of the participants (75%) had direct experience with people with disabilities in a work environment. Moreover, these experiences were positive. All participants responded positively towards companies that are socially responsible, including 92% of consumers who felt more favorable toward those that hire individuals with disabilities. The participants also had strong positive beliefs about the value and benefits of hiring people with disabilities, with 87% specifically agreeing that they would prefer to give their business to companies that hire individuals with disabilities. Implications of consumer support on company hiring practices are discussed. [ABSTRACT FROM AUTHOR]

Employers' negative attitudes and fears have long been a barrier to the employment of individuals with disabilities. Accordingly, attitude literature on the employment of people with disabilities has focused almost exclusively on employers. However, due to their influence over business practices, the successful employment of people with disabilities is also contingent on the views of the consumer. This study extends previous studies that focused on the attitudes of employers, and went directly to the consumer. Consumer attitudes toward companies that hire individuals with disabilities were assessed through a national public survey (N=803). Most of the participants (75%) had direct experience with people with disabilities in a work environment. Moreover, these experiences were positive. All participants responded positively towards companies that are socially responsible, including 92% of consumers who felt more favorable toward those that hire individuals with disabilities. The participants also had strong positive beliefs about the value and benefits of hiring people with disabilities, with 87% specifically agreeing that they would prefer to give their business to companies that hire individuals with disabilities. Implications of consumer support on company hiring practices are discussed. [ABSTRACT FROM AUTHOR]

Abstract: The phase behavior of a binary mixture containing a model surfactant and solvent was determined from lattice Monte Carlo simulations in the grand canonical ensemble using parallel tempering techniques. First and second derivatives of the free energy with respect to the chemical potential (in particular, the density and the isothermal compressibility) were calculated from the combined simulation results through histogram reweighting. Maximums in the isothermal compressibility and heat capacity are observed and it is possible to determine the order–disorder transition temperature; however, they cannot be used to indicate the formation of a hexagonal liquid crystal phase as surfactant concentration increases at constant temperature. [Copyright &y& Elsevier]

Monovariate and multivariate analyses including logistic regression were performed to determine associations among predicting variables [age, gender, immunofluorescence pattern, and anti-nuclear antibody (ANA) titer] and anti-extractable nuclear antigen (ENA) and -dsDNA antibodies (Abs) in 1089 patients with positive fluorescent ANA (FANA) test results. Samples with high titer ANAs had an increased frequency of anti-ENA and -dsDNA Abs. The receiver operating (ROC) curves of the ANA titer for anti-ENA Abs had a larger under the curve area compared to the ROC curve for anti-dsDNA Abs, indicating that ANA titer is better for predicting anti-ENA Abs than anti-dsDNA Abs. There was no relation noticed between immunofluorescence patterns and anti-ENA and -dsDNA Abs except an increased frequency of anti-dsDNA Abs found in samples with a homogeneous pattern. Probability calculations on the basis of the ANA pattern and the titer showed that samples with low titer ANAs (1:160 or less) had low probabilities for anti-ENA Abs (0.002-0.009) regardless of immunofluorescence patterns. However, samples with a homogeneous pattern at any titers including low titers had high probabilities for anti-dsDNA Abs. A decreased frequency of anti-dsDNA Abs as measured byCrithidiaassay was noticed in samples from patients aged 50 or older. In contrast, no association was noticed between age and anti-ENA Abs. There was no female preponderance found in the presence of anti-ENA and -dsDNA Abs. In conclusion, our study shows that the ANA titer but not the immunofluorescence pattern is useful in predicting anti-ENA Abs. In contrast, both the ANA titer and the immunofluorescence pattern help in predicting anti-dsDNA Abs. Samples with low titer ANAs (1:160 or less) may not need a further test for anti-ENA Abs unless an ANA-associated disease is highly suspected. However, a test for anti-dsDNA Abs should be considered in samples with a homogeneous pattern at any titer including low titers. [ABSTRACT FROM AUTHOR]

Information on age and nature of the onset of autism and other developmental disorders was obtained through review of parent completed developmental history; in addition information on the child's early development, diagnostic information, and information on parent characteristics was also obtained. In this relatively large series of cases the parents of children with autism were more likely than parents of children with other developmental disorders to report possible loss of developmental skills. However, the question of actual skill loss was complicated since in some cases parents also had reported even earlier developmental delays or a pattern more of developmental stagnation than clear loss of abilities. Only a few children exhibited a clear and unequivocal loss of developmental skills. [ABSTRACT FROM AUTHOR]

Long range corrections are routinely applied to simulations of bulk fluids by assuming that the radial distribution function is unity beyond a certain cutoff radius for pairwise interactions. Similar long range corrections for gas-solid interactions in adsorption frequently are ignored because of the anisotropic structure of the solid. However, the error associated with assuming isotropy beyond the cutoff radius is small compared with the magnitude of the long range correction. The long range correction to the Henry constant for a cutoff radius of 13Å is 14% for CH[sub 4] and 70% for SF[sub 6] for adsorption in silicalite at 298K. The large errors incurred by neglecting long range corrections can be concealed by increasing the well depth of the gas- solid interaction, but this approximation reduces the accuracy and portability of the potential parameters. Consistency in the cutoff radius is more important than the inclusion or neglect of long range corrections to the energy. [ABSTRACT FROM AUTHOR]

Background and Purpose: Laparoscopic adrenalectomy has emerged as the treatment of choice for most adrenal surgical disorders. We describe our experience with 176 laparoscopic operations. Patients and Methods: The patients were treated for hyperaldosteronism (N = 62), pheochromocytoma (N = 43), "incidentaloma" (N = 21), Cushing's syndrome (N = 20), suspected adrenal metastasis (N = 16), Cushing's disease (N = 8), adrenal hemorrhage (N = 3), or virilizing tumor (N = 1). In 154 of the 176 laparoscopic operations, a lateral transabdominal approach (15 bilateral, 76 left, and 63 right) was used. In the remaining 22, a posterior laparoscopic approach (3 bilateral, 10 left, and 9 right) was used. Results: The average total operating time for unilateral laparoscopic adrenalectomy was 2.8 hours, and for bilateral adrenalectomy, it was 5.2 hours. The mean tumor size was 4.6 cm (range 1-15 cm). There was no significant difference in operating time according to the tumor size. The average length of hospitalization was 1.7 days (range 1-9 days). The perioperative complication rate was 5.1%. There were no conversions to an open procedure. The operating time, length of hospitalization, and perioperative complication rate were stable over the period. Although we used the posterior laparoscopic approach only for smaller tumors (<6 cm), we found no differences in patient outcome between the lateral and posterior laparoscopic approaches. Conclusion: For almost all adrenal surgical disorders, an initial laparoscopic approach is optimal. It is safe and is associated with the best patient outcome. [ABSTRACT FROM AUTHOR]

Examines two social-cognitive processes, social perception (encoding and interpretation of social cues) and generation of social strategies in children with and without mental retardation. Responses to vignettes of social conflicts; Difficulties experienced by children with MR in focusing simultaneously on multiple cues.

Background: Radiofrequency thermal ablation is a new technology for the local destruction of liver tumors. Since we first described laparoscopic radiofrequency ablation (LRFA) for the treatment of liver tumors, much has been learned about patient selection, laparoscopic ultrasound (LU) guided placement of the ablation catheter, monitoring of the ablation process, and patient follow-up.Methods: Since January 1996 we have performed LRFA of 250 tumors in 67 patients including 85 adenocarcinomas, 107 neuroendocrine tumors, 34 sarcomas, 1 melanoma, and 11 hepatomas. We used LU to guide placement of the ablation catheter and to monitor the ablation process. Most of the patients had two trocars (camera and laparoscopic ultrasound) with the 15-gauge ablation catheter (RITA Medical Systems, Mountain View, CA, USA) placed percutaneously.Results: The LRFA procedure was completed successfully in all patients, with 1 to 14 lesions per patient, ranging in size from 0.5 to 10 cm in diameter. The entire liver could be examined by LU via right subcostal ports. Criteria for successful ablation were 5-min ablation times at 100 degrees C with 1-min cool-down temperatures of 60 degrees to 70 degrees C. Outgassing of dissolved nitrogen, monitored by ultrasound, was useful in confirming the zone of ablation. Intralesional color-flow Doppler, seen before ablation, was eliminated after ablation. Placement of the grounding pad closer to the lesion on the back rather than the thigh resulted in more efficient energy delivery to the tumor. Lesions larger than 3 cm in diameter required overlapping ablations to achieve a 1-cm margin of normal liver. Most patients required overnight hospitalization, with no coagulopathy or electrolyte disturbances noted.Conclusions: The LRFA procedure is a novel, minimally invasive technique for treatment of liver tumors that have failed conventional therapy. This study documents the technical aspects of targeting lesions and performing reproducible zones of ablation. Familiarity with these techniques should lead to more widespread application. [ABSTRACT FROM AUTHOR]

Background: Radiofrequency thermal ablation is a new technology for the local destruction of liver tumors. Since we first described laparoscopic radiofrequency ablation (LRFA) for the treatment of liver tumors, much has been learned about patient selection, laparoscopic ultrasound (LU) guided placement of the ablation catheter, monitoring of the ablation process, and patient follow-up. Methods: Since January 1996 we have performed LRFA of 250 tumors in 67 patients including 85 adenocarcinomas, 107 neuroendocrine tumors, 34 sarcomas, 1 melanoma, and 11 hepatomas. We used LU to guide placement of the ablation catheter and to monitor the ablation process. Most of the patients had two trocars (camera and laparoscopic ultrasound) with the 15-gauge ablation catheter (RITA Medical Systems, Mountain View, CA, USA) placed percutaneously. Results: The LRFA procedure was completed successfully in all patients, with 1 to 14 lesions per patient, ranging in size from 0.5 to 10 cm in diameter. The entire liver could be examined by LU via right subcostal ports. Criteria for successful ablation were 5-min ablation times at 100°C with 1-min cool-down temperatures of 60° to 70°C. Outgassing of dissolved nitrogen, monitored by ultrasound, was useful in confirming the zone of ablation. Intralesional color-flow Doppler, seen before ablation, was eliminated after ablation. Placement of the grounding pad closer to the lesion on the back rather than the thigh resulted in more efficient energy delivery to the tumor. Lesions larger than 3 cm in diameter required overlapping ablations to achieve a 1-cm margin of normal liver. Most patients required overnight hospitalization, with no coagulopathy or electrolyte disturbances noted. Conclusions: The LRFA procedure is a novel, minimally invasive technique for treatment of liver tumors that have failed conventional therapy. This study documents the technical aspects of targeting lesions and performing reproducible zones of ablation. Familiarity with these techniques should lead to more widespread application. [ABSTRACT FROM AUTHOR]

Background: This study compares laparoscopic ultrasonography to fluorocholangiography in detecting common bile duct (CBD) stones and delineating biliary anatomy.Methods: A prospective nonrandomized study of 300 consecutive patients undergoing laparoscopic cholecystectomy in a university hospital was performed. After port placement but before dissection, laparoscopic ultrasonography of the extrahepatic CBD was performed in both transverse and longitudinal planes. Cystic duct fluorocholangiography was attempted in all patients.Results: Of 300 patients, CBD stones were detected in 26 (9%) with 25 of these (96%) detected on laparoscopic ultrasonography. Sonography identified the location and size of the CBD as well as anomalous anatomy prior to dissection. No CBD injuries were encountered. End-fire transducers were easier to use than rigid or flexible side-fire transducers; all gave excellent image quality.Conclusions: In this large study, laparoscopic ultrasonography and fluorocholangiography were equally sensitive in detecting CBD stones. Sonography delineates the biliary anatomy noninvasively and does not require dissection or opening of the biliary system. Laparoscopic ultrasonography may improve the safety of laparoscopic cholecystectomy, especially in cases of acute inflammation or distorted anatomy. [ABSTRACT FROM AUTHOR]