Search

Multi-tone microwave signals are crucial for advanced quantum computing applications, including frequency-multiplexed qubit control and simultaneous two-qubit gate execution. However, interference among microwave signal components can cause signal amplitudes to surpass the output limits of an arbitrary waveform generator (AWG), hindering the generation of precise signals necessary for accurate qubit manipulation. To address this issue, we introduce a method that adjusts the phase of individual microwave signal components, effectively reducing interference and maintaining signal amplitude within the AWG's operational range. [ABSTRACT FROM AUTHOR]

Objectives: EUS-guided biliary drainage (EUS-BD) is performed after endoscopic transpapillary biliary drainage fails. Although fistula dilation is one of the most difficult steps of EUS-BD, whether an ultratapered ERCP catheter or a dilator is the best choice for fistula dilation is unclear. In this study, we aimed to identify the optimal device for fistula dilation after guidewire placement., Materials and Methods: Patients who underwent EUS-guided transhepatic biliary drainage between March 2019 and July 2024 were enrolled in this study. The successful fistula dilation rates, patient characteristics, and EUS-BD procedures were compared between patients who underwent fistula dilation with an ultratapered ERCP catheter (Catheter group) and patients who underwent fistula dilation with new dilators (ES dilator or Tornus ES) (Dilator group)., Results: A total of 38 fistula dilation sessions were performed. Among these 38 sessions, 12 involved a catheter, and 26 involved a dilator. The ERCP catheter was specifically intended for use with 0.025 guidewires, and the dilators were specifically intended for use with 0.018 or 0.025 guidewires. Successful fistula dilation was more frequently achieved in the dilator group than in the catheter group (100% (26/26) vs. 50% (6/12), p  < 0.01). When the cases were limited to those involving devices specifically intended for use with 0.025 guidewires, the results were similar (dilator group 100% (22/22) vs. catheter group 50% (6/12), p  < 0.01). The other outcomes were not significantly different between the two groups., Conclusions: A dilator is more promising than a tapered ERCP catheter for fistula dilation in EUS-BD.

Purpose: To investigate the anterior segment morphology in cataracts with Retinitis Pigmentosa (RP)., Setting: XXXX (anonymized for review) University Hospital., Design: A retrospective matched case-control study., Methods: The analysis included 28 eyes of 28 patients with cataracts and RP and 28 eyes of 28 patients with cataracts but without RP, matched for age and sex. Lens thickness, anterior lens curvature (Front R), posterior lens curvature, anterior chamber depth (ACD), anterior chamber width, central corneal thickness (CCT), white-to-white distance (WTW), corneal curvature, and axial length (AL) were compared between the groups. Data were obtained from preoperative evaluations conducted before cataract surgery. The same set of comparisons was also conducted for 18 eyes of 18 patients with cataracts and RP and 18 eyes of 18 patients with cataracts but without RP, matched for age, sex, and AL. Cases including missing data, categorized as Emery-Little classification grade 4 or above, or those with a history of acute angle closure were excluded., Results: In the age- and sex-matched analysis, cataracts with RP showed significantly a thicker lens, steeper Front R, shallower ACD, thinner CCT, and shorter AL. In the analysis matched by age, sex, and AL, cataracts with RP had a thicker lens, steeper Front R, and larger WTW., Conclusions: Cataracts with RP demonstrated centripetal swelling of the lens, centrifugal corneal thinning, and AL shortening. A decrease in tension between the lens and eyeball wall due to zonular weakness in the RP may lead to swelling of the lens and horizontal flattening of the eyeball., (Copyright © 2024 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

Background: Healthcare consumers require diverse resources to assist their navigation of complex healthcare interactions, however, these resources need to be fit for purpose., Aim: In this study, we evaluated the utility, usability and feasibility of children, families and adults requiring long-term intravenous therapy using a recently developed mobile health application (App), intravenous (IV) Passport., Design: Multi-site, parallel, multi-method, prospective cohort study., Methods: A multi-site, multi-method study was carried out in 2020-2021, with 46 participants (20 adults, 26 children/family) reporting on their experiences surrounding the use of the IV Passport for up to 6 months., Results: Overall, utility rates were acceptable, with 78.3% (N = 36) using the IV Passport over the follow-up period, with high rates of planned future use for those still active in the project (N = 21; 73%), especially in the child/family cohort (N = 13; 100%). Acceptability rates were high (9/10; IQR 6.5-10), with the IV Passport primarily used for documenting new devices and complications. Thematic analysis revealed three main themes (and multiple subthemes) in the qualitative data: Advocacy for healthcare needs, Complexity of healthcare and App design and functionality., Conclusion: Several recommendations were made to improve the end-user experience including 'how to' instructions; and scheduling functionality for routine care., Implications for the Profession And/or Patient Care: The IV Passport can be safely and appropriately integrated into healthcare, to support consumers., Impact: Patient-/parent-reported feedback suggests the Intravenous Passport is a useful tool for record-keeping, and positive communication between patients/parents, and clinicians., Reporting Method: Not applicable., Patient Contribution: Consumers reported their experiences surrounding the use of the IV Passport for up to 6 months., (© 2024 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Purpose: Children with chronic and complex health conditions frequently need intravenous devices. The current approach to intravenous device selection, insertion, and monitoring is inconsistent, and healthcare consumers are often negatively affected by siloed health information, and poor future planning. Despite child- and family-centred care being recognised as a pillar of paediatric nursing care, limited implementation for vascular access device planning and management is evident., Design and Methods: To address this, we conducted a multi-phased approach to co-create, then evaluate, a mobile health (mHealth) application: IV Passport. Co-creation involved a prioritisation survey, followed by a Passport advisory panel consensus meeting. Following confirmation of the required content and features of the Passport, the mHealth application was designed and content validation achieved via survey., Results: The prioritisation survey yielded recommendations for seven features (e.g., graphical presentations of current/past devices). Content for nine device types (e.g., totally implanted ports) was suggested, each with 10 related items (e.g., insertion site). Content items for device-associated complications, future vascular access plans, and educational resources were also suggested. Following design, the application was released through Apple and Android platforms; and adapted to a paper version. Content validation was established; 100% strongly agreed the application was easy to use; 80% agreed/strongly agreed that they would recommend the Passport to others., Conclusion: IV Passport embodies effective child- and family-centred care through consumer co-creation to empower patients and families manage vascular access devices., Practice Implications: IV Passport remains active; and can be utilised across many healthcare settings and patient populations., Competing Interests: Declaration of competing interest A.J.U. reports investigator-initiated research grants and speaker fees provided to Griffith University (her previous employer) and the University of Queensland (her current employer) from vascular access product manufacturers (3 M and Becton Dickinson), unrelated to this project. T.M.K. declares investigator-initiated research grants and speaker fees provided to her previous employer Griffith University from vascular access product manufacturers (3 M, BD-Bard, Medical Specialties Australia, Smiths Medical, Vygon), unrelated to this project. NM. reports investigator-initiated research grants and speaker fees provided to Griffith University or University of Queensland on her behalf from vascular access product manufacturers (3 M, BD-Bard;, Eloquest Healthcare) M.C. declares investigator-initiated research grants and provided to Griffith University (her previous employer) by vascular access product manufacturer Becton Dickinson, unrelated to this project. C.M.R. reports investigator-initiated research grants and consultancy fees provided to Griffith University or University of Queensland on her behalf from vascular access product manufacturers (3 M, BD-Bard; Cardinal Health, Eloquest Healthcare, ITL Biomedical), unrelated to this project. E.N.L reports investigator-initiated research grants and educational scholarships provided to Griffith University (employer) and University of Queensland (affiliate) from vascular access product manufacturers (Angiodynamics, Cardinal Health, and Eloquest), unrelated to this project. The remaining authors have no relevant conflicts of interest to disclose., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

A 72-year-old woman was admitted to our department in March 2020 for an evaluation of nausea, vomiting, diarrhea, liver dysfunction, and hypokalemia, which had persisted intermittently since 2013. Thickening of the descending duodenal wall and a sac-like appearance the intestinal tract in the vicinity of the duodenal papilla were observed in abdominal computed tomography. No duodenojejunal curvature, with two intestinal loops identified in the descending region, was detected in contrast-enhanced upper gastrointestinal imaging. Based on these imaging findings, the patient was diagnosed with intestinal malrotation (incomplete rotation and fixation) accompanied by a right paraduodenal hernia based on the Nishijima classification. Thus, surgery was performed at our hospital. Gastrointestinal symptoms did not recur, and liver dysfunction and hypokalemia improved postoperatively.

Purpose: Alport syndrome comprises a heterogeneous group of inherited kidney diseases that are associated with ocular complications. In this study, we aimed to detail the clinical characteristics of a patient with X-linked Alport syndrome., Methods: We performed next-generation sequencing (NGS) with hybridization capture to identify the disease-causing variant of Alport syndrome and a comprehensive ophthalmic examination, including full-field electroretinography (FF-ERG)., Results: Genetic testing using NGS with hybridization capture revealed a novel hemizygous variant [c.51&#95;52delGA (p.Trp20GlyfsTer19)] in exon 1 of COL4A5. The patient underwent cataract surgery in both eyes because of decreased visual acuity and photophobia. The best-corrected visual acuity improved from 0.9 and 0.7 in the right and left eyes, respectively, to 1.5 in both eyes. Anterior-segment optical coherence tomography (OCT) revealed anterior and posterior lenticonus. Fundus photographs showed central and peripheral fleck retinopathy. Wide-field fundus autofluorescence (AF) imaging showed mottled hyper- and hypo-AF in the peripheral retina, which was consistent with peripheral fleck retinopathy. Furthermore, OCT revealed thinning of the inner retinal layers, especially at the temporal macular, but the outer retinal layers were preserved. Ganglion cell analysis showed no progression for 5 years. FF-ERG was performed at 41 (phakia) and 46 (pseudophakia) years of age. The amplitudes of dark-adapted (DA) and light-adapted (LA) responses showed selective b-wave abnormalities. The b/a-wave ratios of DA 3.0 were 1.22 and 1.16 in the right and left eyes, respectively. The amplitudes of DA 3.0 oscillatory potentials (OP) were reduced. Five years later, the amplitudes of DA and LA responses revealed no remarkable changes, except for an OP wave of DA 3.0, which was substantially reduced., Conclusions: Our findings revealed electroretinographic abnormalities in a patient with Alport syndrome, which predominantly indicated impairment of the inner retina. Notably, little short-term progression was observed., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The purpose of our study was to differentiate between thymoma and thymic carcinoma using a radiomics analysis based on the computed tomography (CT) image features., Methods: The CT images of 61 patients with thymic epithelial tumors (TETs) who underwent contrast-enhanced CT with slice thickness <1 mm were analyzed. Pathological examination of the surgical specimens revealed thymoma in 45 and thymic carcinoma in 16. Tumor volume and the ratio of major axis to minor axis were calculated using a computer-aided diagnostic software. Sixty-one different radiomics features in the segmented CT images were extracted, then filtered and minimized by least absolute shrinkage and selection operator (LASSO) regression to select the optimal radiomics features for predicting thymic carcinoma. The association between the quantitative values and a diagnosis of thymic carcinoma were analyzed with logistic regression models. Parameters identified as significant in univariate analysis were included in multiple analyses. Receiver-operating characteristic (ROC) curves were assessed to evaluate the diagnostic performance., Results: Thymic carcinoma was significantly predominant in men (P=0.001). Optimal radiomics features for predicting thymic carcinoma were as follows: gray-level co-occurrence matrix (GLCM)-homogeneity, GLCM-energy, compactness, large zone high gray-level emphasis (LZHGE), solidity, size of minor axis, and kurtosis. Multiple logistic regression analysis of these features revealed solidity and GLCM-energy as independent indicators associated with thymic carcinoma [odds ratio, 14.7 and 14.3; 95% confidence interval (CI): 1.6-139.0 and 3.0-68.7; and P=0.045 and 0.002, respectively]. Area under the curve (AUC) for diagnosing thymic carcinoma was 0.882 (sensitivity, 81.2%; specificity, 91.1%). Multivariate analysis adjusted for sex similarly revealed two features (solidity and GLCM-energy) as independent indicators associated with thymic carcinoma (odds ratio, 14.6 and 23.9; 95% CI: 2.4-89.2 and 1.9-302.8; P=0.004 and 0.014, respectively). Adjusted AUC for diagnosing thymic carcinoma was 0.921 (95% CI: 0.82-0.97): sensitivity, 62.5% and specificity, 100%., Conclusions: Two texture features (GLCM-energy and solidity) were significant predictors of thymic carcinoma., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-21-1948/coif). The authors have no conflicts of interest to declare., (2022 Journal of Thoracic Disease. All rights reserved.)

Objective: To evaluate the feasibility, efficacy and safety of transcatheter arterial chemoembolization (TACE) with HepaSphere for patients with pulmonary or mediastinal metastases from hepatocellular carcinoma (HCC)., Methods: Between June 2009 and January 2018, 14 patients with pulmonary or mediastinal metastases from HCC were treated with TACE with a combination of 1-3 chemotherapeutic drugs followed by HepaSphere embolization. As first end point, local tumor response and adverse events were evaluated after the first session of TACE, with Response Evaluation Criteria In Solid Tumors v. 1.1 and Common Terminology Criteria for Adverse Events v. 4 criteria, respectively. Overall survival was evaluated as secondary end point. TACE was repeated on-demand., Results: TACE with HepaSphere was well tolerated with acceptable safety profile and no 30 day mortality. 1 month objective response and disease control rate were calculated to be 7.1 and 100%, respectively. Mean tumor size reduction rate was 15.6±9.5% at the first month. Two Grade 3 cytopenia events were seen (14.3 %), however none of the Grade 2 or more post-embolization syndrome was observed. The median overall survival time was 15.0 months and the 1 year, 3 year and 5 year survival rate were, 57.1%, 28.6%, 19.1%, respectively., Conclusion: Early experience showed that the transarterial treatment with HepaSphere is safe and effective treatment for patients with pulmonary or mediastinal metastases from HCC., Advances in Knowledge: Currently, the effects of molecular targeted drugs on HCC metastases are limited and side-effects are relatively frequent. In the present study, transarterial treatment might be a promising treatment for HCC metastasis.

Here, we report a case of cholangiocellular carcinoma that was successfully treated with chemotherapy using a selective intra-arterial infusion technique. A 65-year-old man presented to our hospital to obtain a second opinion regarding his disease. The patient was diagnosed with cholangiocellular carcinoma. The giant tumor was located in the porta hepatis. Some small nodules that were considered to be metastatic lesions were also observed in the surroundingarea. The tumor was judged by the primary physician to be too large for surgical treatment. Consequently, it was decided to treat the patient with trans-arterial chemoembolization(TACE)by selectingintra -arterial infusion of 5-FU, epirubicin(EPI), and mitomycin C prior to EPI-loaded HepaSphere(super-absorbent polymer microsphere)embolization, combined with concurrent systemic gemcitabine chemotherapy. After 5 sessions of the above treatment, the primary lesion reduced dramatically in size. In addition, the levels of CEA and CA19-9 decreased from 34.2 to 2.6 ng/mL and 1,540 to 149 U/mL, respectively. Although the patient's initial life expectancy was only 3 to 6 months, his life expectancy was extended to as longas 26 months followingthe initiation of TACE. This case suggests that treatment with TACE together with systemic chemotherapy can be a powerful therapeutic option for patients with inoperable cholangiocellular carcinoma.

Melanoma is a potentially aggressive disease, and patients with metastatic melanoma have a poor prognosis, with a median survival of only 6-9 months. There is no effective standard treatment for liver metastasis of malignant melanoma. Primary ovarian malignant melanoma is extremely rare and is usually associated with teratoma. We report a case of malignant melanoma arising in a mature ovarian cystic teratoma that had metastasized to the liver. Six courses of systemic chemotherapy were administered. However, as the liver metastases became enlarged, we performed transarterial chemoembolization(TACE). Following repeated TACE using drug-eluting microspheres for the liver metastasis, the patient survived 80 months from the initial diagnosis.

The case of a 78-year-old man with hormone-independent locally advanced prostatic cancer with liver metastases is reported. Standard systemic chemotherapy was not administered due to his poor general condition. At the initial consultation, rapidly growing liver metastases, multiple lymph node metastases, and extensive locally advanced prostatic lesions were found. Transcatheter arterial chemoembolization, low dose systemic chemotherapy, and thermotherapy were administered. After introduction of this combination therapy, marked regression of all of the lesions, including the liver metastases, lymph node metastases, and pelvic extension was observed. The patient's condition and prognosis were markedly improved without serious complications.

A 60-year-old male patient underwent curative surgical resection for gastric cancer. After the surgery, the patient was diagnosed with T4b, N3b, ly3, v2, CY0, fStageⅢc gastric cancer, and adjuvant systemic chemotherapy using S-1 and CDDP was administered. However, follow-up computed tomography (CT) scan examination taken 2 months after surgery revealed a pancreatic fistula and retroperitoneal abscess, and percutaneous drainage was performed. After 1 month, the enhanced CT scan detected liver metastasis measuring 25 mm in diameter at segment 7. The CT-guided percutaneous radiofrequency ablation (RFA) combined with transcatheter arterial chemoembolization (TACE) procedure was performed on the liver metastasis using degradable starch microspheres (DSM). Two months after the RFA, a follow-up CT scan revealed local recurrence of the lesion in the medial side of the ablated area in segment 7. A second CT-guided RFA, which was combined with DSM-TACE, was performed on the recurrent lesion. The patient has since survived more than 2 years after the second treatment without any further recurrences. This case report suggests that RFA treatment combined with DSM-TACE might be a safe and feasible treatment for liver metastasis from gastric cancer.

Purpose: To evaluate the safety and effectiveness of superselective coil embolization with coaxial microballoon occlusion (B-coiling) for vascular disorders., Materials and Methods: Clinical data were retrospectively evaluated for 16 consecutive patients (6 men, 10 women; mean age, 70 y; age range, 57-80 y) with vascular disorders who underwent B-coiling with 0.010-0.014-inch detachable microcoils delivered through a guide-wire lumen of a microballoon catheter. Routine angiographic catheters (4-5 F) were introduced in all cases, including splenic (n = 4) and renal (n = 3) artery aneurysms, pulmonary and renal arteriovenous malformations (AVMs; n = 3 and n = 1, respectively), gastroesophageal varices (GEVs; n = 3), gastroduodenal artery stump pseudoaneurysm (n = 1), and superficial temporal artery aneurysm (n = 1)., Results: Complete primary occlusion was achieved in 87.5% of cases (n = 14) without complications. Additional percutaneous transhepatic sclerotherapy by N-butyl cyanoacrylate (NBCA)/iodized oil mixtures without balloon occlusion resulted in successful occlusion of one GEV. Additional balloon-occluded NBCA injection was successfully performed in one renal AVM., Conclusions: Superselective coaxial microballoon embolization with detachable microcoils is a safe and useful treatment. Selective B-coiling induces tight packing under flow control in the treatment of vascular disorders., (Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.)

We report on theoretical and experimental investigations of optical wave propagations in two-dimensional photonic lattice structures formed in a holographic polymer-dispersed liquid crystal (HPDLC) film. In the theoretical analysis we employed the 2×2 matrix formulation and the statistical thermodynamics model to analyze the formation of anisotropic photonic lattice structures by holographic polymerization. The influence of multiple reflections inside an HPDLC film on the formed refractive index distribution was taken into account in the analysis. In the experiment we fabricated two-dimensional photonic lattice structures in an HPDLC film under three-beam interference holographic polymerization and performed optical measurements of spectral transmittances and wavelength dispersion. We also demonstrated the electrical control capability of the fabricated photonic lattice structure and its dependence on incident wave polarization. These measured results were compared with the calculated ones by means of photonic band and beam propagation calculations.

The plasminogen activator system consists of two proteins: tissue plasminogen activator (tPA) and urokinase plasminogen activator (uPA), which act upon their specific receptors to generate plasmin from plasminogen located on the cell surface. Plasmin then acts directly and indirectly to degrade the components of the extracellular matrix (ECM). This process is likely to be important in the normal turnover of the ECM of fetal membranes and in its premature weakening in preterm premature rupture of the fetal membranes. Quantitative Northern analysis and in situ hybridization have shown that the decidua expresses mRNA for tPA. However, the immunolocalized tPA protein was most strongly associated with the amnion and chorion, as was its receptor annexin II, suggesting that the amnion and chorion are the targets for decidual tPA. At term, decidual tPA expression was unaffected by labor, and the tPA receptor was elevated both before and after labor. At preterm, the converse was found: decidual tPA expression was significantly (p < 0. 05) up-regulated by labor, but the tPA receptor was not. The results suggest that the generation of plasmin at term would be controlled by an increased concentration of the tPA receptor in the amnion and chorion, whereas at preterm a pathological increase in plasmin would be generated by an overexpression of tPA, initiated by labor.

Interstitial collagen types I and III are the predominant collagens in the amniotic and chorionic connective tissues. However, this matrix also contains proteoglycans, fibronectin, laminin, and elastin, which together with the collagens may undergo partial degradation prior to fetal membrane rupture at term. In this study, stromelysin (MMP-3) and tissue inhibitor of metalloproteinases-1 (TIMP-1) were immunolocalized in fetal membranes obtained at term prior to labor. MMP-3 stained the cells of the amniotic epithelium, fibroblasts and macrophages of the amniotic and chorionic matrix, and those of the chorionic cytotrophoblast; there was no staining in the maternal decidua. TIMP-1 showed a similar staining pattern, except that the staining was darker in some amniotic epithelial cells and was present in the maternal decidua. The maternal decidua produces the two human relaxins H1 and H2; the latter, when incubated with explants of human fetal membranes, caused a dose-dependent and significant increase in expression of the MMP-3 gene and its secreted protein into the media. A significant effect of relaxin H2 on 92-kDa gelatinase (MMP-9) gene expression was also shown--an effect requiring poly(A)+ RNA rather than total RNA. Both relaxin H1 and H2 caused a significant increase in secretion of MMP-9 protein and its enzyme activity in the media. The magnitude of the effects of the two relaxins was similar, in contrast to findings from other biological studies in which relaxin H2 was shown to be more active. Neither of the relaxins had any effect on 72-kDa gelatinase (MMP-2) activity or on the TIMP-1 protein or its activity. This study suggests that local relaxins may be involved in the degradation of the complex fetal membrane extracellular matrix and may cause activation of an enzyme cascade resulting in fully activated MMP-9. Such effects could be important in the degradative pathways occurring in the amnion and chorion in the peripartal period.