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In clinical practice, the diagnosis of breast lesions is achieved by the triple approach of the specialized surgeon, radiologist and pathologist. The recommended approach to breast lesions should always include a detailed history, along with a thorough clinical examination, mammography and/or ultrasound, as well as preoperative cytodiagnosis. In this context, fine needle aspiration cytology and core needle biopsy are the methods of choice for histological diagnosis. Herein, we aim to explain why these procedures seem to be superior compared to open biopsy and we propose a cytodiagnostic algorithm for breast lesions. [ABSTRACT FROM AUTHOR]

Heart Failure (HF) affects more than 650,000 Canadians (3.6% of Canadian adults above age 40). Even with recent advances in the diagnosis and treatment of this disease, HF remains among the five most common causes for hospitalization in Canada, with a readmission rate above 30% at the 1-year mark. Despite the significant economic and clinical burden of this disease, there is limited awareness among healthcare providers, healthcare system managers, and governments regarding the current HF epidemic and available therapies. This article reviews the definition of HF and the approach to evaluating a patient with suspected HF, focusing on the different presentations of HF, the clinical significance of ejection fraction, and the usefulness of BNP as a marker of cardiac function.

Background: The "Minimalistic Hybrid Approach" (MHA) has been proposed to reduce the invasiveness of chronic total occlusion (CTO) percutaneous coronary intervention (PCI)., Aims: This study aims to assess whether MHA may also reduce the utilization of PCI resources (devices, radiations, and contrast) by comparing it with other conventional algorithms., Methods: We aimed to assess the impact of MHA on device, radiation, and contrast usage during CTO-PCI analyzing data from the Belgian Working Group on CTO (BWG-CTO) registry. Patients were divided, depending on the algorithm used, into two groups: Conventional versus Minimalistic. Primary objectives were procedure performance measures such as device usage (microcatheters and guidewires), radiological parameters, and contrast use. At 1-year follow-up, patients were evaluated for target vessel failure (TVF), defined as a composite of cardiac death, new myocardial infarction, and target vessel revascularization., Results: Overall, we analyzed 821 CTO-PCIs (Conventional n = 650, Minimalistic n = 171). The Minimalistic group demonstrated higher complexity of CTO lesions. After adjusting for propensity score, the Minimalistic group had a significantly lower number of microcatheters used (1.49 ± 0.85 vs. 1.24 ± 0.64, p = 0.026), while the number of guidewires was comparable (4.80 ± 3.29 vs. 4.35 ± 2.94, p = 0.30). Both groups had similar rates of success and procedural complications, as well as comparable procedural and fluoroscopic times and contrast volume used. At the 1-year follow-up, both groups showed comparable rates of TVF (hazard ratio: 0.57; 95% confidence interval: 0.24-1.34, p = 0.195)., Conclusion: The MHA may slightly reduce the number of dedicated devices used during CTO-PCI, without adversely affecting the procedural success or long-term outcome., (© 2024 Wiley Periodicals LLC.)

Background: Blockchain and distributed ledger technology is a disruptive force in healthcare. Methods: This article provides a globally relevant, interdisciplinary perspective intended to aid disparate group of actors, participants, and users that represent the diverse stakeholders of an increasingly complex and technologically reliant healthcare system. Domain expertise reinforced by literature published via industry, technical, and academic venues was used to inform these perspectives. Results: Key characteristics of blockchain and distributed ledger technology are highlighted and framed for a readership ranging from healthcare executive to policy makers to researchers. Antecedent application of blockchain in the financial sector is explored followed by the technical, security, and interoperability considerations specific to healthcare. Conclusion: Blockchain remains an emerging technology both fraught with unanticipated challenges and the promise of unrealized potential in healthcare. Keywords: Blockchain, Healthcare, Innovation, Adoption, Global, Interoperability

Complex geographical atlases represent geosystems of different hierarchical rank, complexity and diversity, scale and connection. They represent a set of large number of different pieces of information about geospace. Also, they contain systematized, correlative and in the apparent form represented pieces of information about space. The degree of information revealed in the atlas is precisely explained by its content structure and the form of presentation. The quality of atlas depends on the method of visualization of data and the quality of geodata. Cartographic visualization represents cognitive process. The analysis converts geospatial data into knowledge. A complex geographical atlas represents information complex of spatial - temporal coordinated database on geosystems of different complexity and territorial scope. Each geographical atlas defines a concrete geosystem. Systemic organization (structural and contextual) determines its complexity and concreteness. In complex atlases, the attributes of geosystems are modeled and pieces of information are given in systematized, graphically unique form. The atlas can be considered as a database. In composing a database, semantic analysis of data is important. The result of semantic modeling is expressed in structuring of data information, in emphasizing logic connections between phenomena and processes and in defining their classes according to the degree of similarity. Accordingly, the efficiency of research of needed pieces of information in the process of the database use is enabled. An atlas map has a special power to integrate sets of geodata and present information contents in user - friendly and understandable visual and tactile way using its visual ability. Composing an atlas by systemic cartography requires the pieces of information on concrete - defined geosystems of different hierarchical level, the application of scientific methods and making of adequate number of analytical, synthetic and complex maps. The essence of each database is its model. The selection of model - the organization of database is very important.

Technological pneumatic conveying systems are intended to convey materials from one place to another by various phases of the production process. For example: loading/unloading materials (grain) using railway and sea transport, pneumatic dispatch tube installations or air tunnel container transport, supplying combustion plants with smut coal, etc. The system is energy saving, offering a series of advantages, such as: it is facile to fit various technological processes, it protects the conveyed material from contamination, without affecting the outer environment, it is easy to handle and it has automation possibilities and also it allows the conveying of flammable and explosive materials, in which case noble gases closed systems should be used. [ABSTRACT FROM AUTHOR]

Introduction: The main objective of all the sagittal compensating mechanisms is to allow a subject to stand and keep an erect position. Materials and methods: The cascade of compensating mechanisms appears progressively with the increasing amount of imbalance of the spine until compensation is no longer possible. The loss of lumbar lordosis can be considered as the initiating event of sagittal imbalance. This loss of the normal lordosis pushes the C7 plumb line forward. Results: The assessment of sagittal balance has to include to be complete: a parameter measuring the global balance of the trunk, either C7 plumb line and sacral plateau, the position of the pelvis rotation by the pelvic tilt, and a description of the position of the lower limbs. Those three parameters have been taken into account by the newly described method called full balance integrated (FBI). This evaluation is easily done on a sagittal full spine standing X-ray from C2 to the pelvis, including the first 10 cm of the femur. Conclusion: Three questions to answer: What is the value of the pelvis incidence? Is the patient balanced? Are there compensatory mechanisms? [ABSTRACT FROM AUTHOR]