R2), and 88.5±5.9 (TB1). Each method satisfied a normal brain V

≤10.0cm

planning goal for targets with diameter ≤2.25cm. The mean V

was 3.1cm

for TB2 vs 5.5cm

, 5.0cm

and4.3cm

, for VR1, VR2, and TB1, respectively. For a 2.5-cm diameter target, only TB2 met the V

planning objective. The MRL clinical brain plans were deemed acceptable for patient treatment. The normal brain V

was ≤6.0cm

for all clinical targets (maximum target volume=3.51cm

). CI and CGI ranged from 1.12-1.65 and 81.2-88.3, respectively. Gamma analysis pass rates (3%/1mm criteria) exceeded 97.6% for six clinical targets planned and delivered on the MRL. The mean measured vs computed absolute dose difference was -0.1%.

The MRL system can produce clinically acceptable brain SRS plans for spherical lesions with diameter ≤2.25cm. Large lesions (>2.25cm) should be treated with a linac capable of delivering noncoplanar beams.

2.25 cm) should be treated with a linac capable of delivering noncoplanar beams.The adult sex ratio (ASR) is important within ecology due to its predicted effects on behaviour, demography and evolution, but research examining the causes and consequences of ASR bias have lagged behind the studies of sex ratios at earlier life stages. Although ungulate ASR is relatively well-studied, exceptions to the usual female-biased ASR challenge our understanding of the underlying drivers of biased ASR and provide an opportunity to better understand its consequences. Some feral ungulate populations, including multiple horse populations, exhibit unusually male-biased ASR. For example, research suggests that the feral horse Equus ferus caballus population on Sable Island, Nova Scotia, Canada may exhibit a male-biased ASR. Such exceptions to the rule provide a valuable opportunity to reveal the contributions of environmental context and trait differences to ASR bias. We aimed to test for bias in Sable Island horse ASR, identify the demographic drivers of bias, and explore its demographic and social cons the strong context dependence of ASR. Furthermore, our work indicates the potential for ASR to substantially alter a population’s social organisation. Such changes in social structure could have knock-on consequences for demography by altering the formation/stability of social relationships, or competition for matings.

In Sweden, cobalt chloride 0.5% has been included in the baseline series since the mid-1980s. A recent study from Stockholm showed that cobalt chloride 1% petrolatum (pet.) was more suitable than 0.5%. Cobalt chloride at 1.0% has been patch tested for decades in many European countries and around the world.

To study the suitability of patch testing to cobalt 1.0% vs 0.5% and to analyze the co-occurrence of allergy to cobalt, chromium, and nickel.

Contact allergy to cobalt was shown in 90 patients (6.6%). Eighty (5.9%) patients tested positive to cobalt 1.0%. Thirty-seven of the 90 patients (41.1%) with cobalt allergy were missed by cobalt 0.5% and 10 (0.7%) were missed by cobalt 1.0% (P < .001). No case of patch test sensitization was reported. Allergy to chromium was seen in 2.6% and allergy to nickel in 13.3%. Solitary allergy to cobalt without nickel allergy was shown in 61.1% of cobalt-positive individuals. Female patients had larger proportions of positive reactions to cobalt (P = .036) and nickel (P < .001) than males.

The results speak in favor of replacing cobalt chloride 0.5% with cobalt chloride 1.0% pet. in the Swedish baseline series, which will be done 2021.

The results speak in favor of replacing cobalt chloride 0.5% with cobalt chloride 1.0% pet. in the Swedish baseline series, which will be done 2021.

COVID-19 first appeared in Iran on 19 February 2020, and then spread rapidly over the country. In this article, we review the action plan of the Iranian Blood Transfusion Organization with respect to this disease.

We collected data on blood donations and RBC inventory for the first 8weeks of the outbreak. We also evaluated the trend of blood donations and RBC inventory and compared them with the data of the past year. We include a summary of actions taken by the National Committee on Management of COVID-19 outbreak.

Blood donations decreased from 33275 to 23465 units during the first 2weeks of the outbreak with a corresponding decrease in the RBC inventory. But after that, donations gradually increased from 23465 to 29665 units. RBC inventory levels improved at the same time. Then, the Iranian New Year’s holiday resulted in another downward trend. After the holiday, blood donations revived, along with the RBC inventory.

Although it appears that this virus cannot be transmitted through transfusion, changes in lifestyle had a significant impact on reducing blood supply. Following implemented measures, we saw an upward trend in blood donations and an adequate supply of RBC units in blood centres, helped by a reduction in demand by hospitals. Blood centres need to be more prepared to manage future viral disasters, especially in case of transfusion-transmissible infections.

Although it appears that this virus cannot be transmitted through transfusion, changes in lifestyle had a significant impact on reducing blood supply. Following implemented measures, we saw an upward trend in blood donations and an adequate supply of RBC units in blood centres, helped by a reduction in demand by hospitals. Blood centres need to be more prepared to manage future viral disasters, especially in case of transfusion-transmissible infections.

Serious illness is often characterised by physical/psychological problems, family support needs, and high healthcare resource use. Hospital-based specialist palliative care (HSPC) has developed to assist in better meeting the needs of patients and their families and potentially reducing hospital care expenditure. There is a need for clarity on the effectiveness and optimal models of HSPC, given that most people still die in hospital and also to allocate scarce resources judiciously.

To assess the effectiveness and cost-effectiveness of HSPC compared to usual care for adults with advanced illness (hereafter patients) and their unpaid caregivers/families.

We searched CENTRAL, CDSR, DARE and HTA database via the Cochrane Library; MEDLINE; Embase; CINAHL; PsycINFO; CareSearch; National Health Service Economic Evaluation Database (NHS EED) and two trial registers to August 2019, together with checking of reference lists and relevant systematic reviews, citation searching and contact with experts to identify l conducted studies are needed to study populations with non-malignant diseases and mixed diagnoses, ward-based models of HSPC, 24 hours access (out-of-hours care) as part of HSPC, pain, achieving patient preferred place of care, patient satisfaction with care, caregiver outcomes (satisfaction with care, burden, depression, anxiety, grief, quality of life), and cost-effectiveness of HSPC. In addition, research is needed to provide validated person-centred outcomes to be used across studies and populations.On 27 February 2010, Chile experienced one of the strongest earthquakes in recorded history. The study aimed to evaluate post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) in children and adolescents 12 months (T1) and 24 months (T2) after the earthquake and tsunamis in Chile in 2010. Three hundred twenty-five children and adolescents (47.4% girls; 52.6% boys) between the ages of 10 and 16 years participated in the study. The instruments included the Revised Post-traumatic Growth Inventory for Children by Kilmer et al., the Childhood PTSD Scale by Foa et al. and the Rumination Scale for Children by Cryder et al., as well as a scale to assess the severity of the event and a sociodemographic questionnaire. The PTSS and PTG scores decreased at T2. In addition, the main predictors of PTSS and PTG were disruptive experiences, losses after the event and intrusive and deliberate rumination during the previous year. These results enhance understanding of factors related to PTG, improve the ability to predict PTSS and PTG in children and adolescents following natural disasters, and inform the design of intervention strategies to promote better mental health in those affected.

Previous studies have suggested that finite element analysis (FEA) can estimate the rupture risk of an abdominal aortic aneurysm (AAA); however, the value of biomechanical estimates over measurement of AAA diameter alone remains unclear. This study aimed to compare peak wall stress (PWS) and peak wall rupture index (PWRI) in participants with ruptured and asymptomatic intact AAAs.

The reproducibility of semiautomated methods for estimating aortic PWS and PWRI from CT images was assessed. PWS and PWRI were estimated in people with ruptured AAAs and those with asymptomatic intact AAAs matched by orthogonal diameter on a 1  2 basis. Spearman’s correlation coefficient was used to assess the association between PWS or PWRI and AAA diameter. Independent associations between PWS or PWRI and AAA rupture were identified by means of logistic regression analyses.

Twenty individuals were included in the analysis of reproducibility. The main analysis included 50 patients with an intact AAA and 25 with a ruptured AAA. Median orthogonal diameter was similar in ruptured and intact AAAs (82·3 (i.q.r. 73·5-92·0) versus 81·0 (73·2-92·4) mm respectively; P =0·906). Median PWS values were 286·8 (220·2-329·6) and 245·8 (215·2-302·3) kPa respectively (P =0·192). There was no significant difference in PWRI between the two groups (P =0·982). PWS and PWRI correlated positively with orthogonal diameter (both P < 0·001). Participants with high PWS, but not PWRI, were more likely to have a ruptured AAA after adjusting for potential confounders (odds ratio 5·84, 95 per cent c.i. 1·22 to 27·95; P =0·027). This association was not maintained in all sensitivity analyses.

High aortic PWS had an inconsistent association with greater odds of aneurysm rupture in patients with a large AAA.

High aortic PWS had an inconsistent association with greater odds of aneurysm rupture in patients with a large AAA.

There is no treatment for cancer-related cognitive impairment, an important adverse effect that negatively impacts quality of life (QOL). We conducted a 3-arm randomized controlled trial to evaluate the impact of computer-assisted cognitive rehabilitation (CR) on cognition, QOL, anxiety, and depression among cancer patients treated with chemotherapy.

Patients who reported cognitive complaints during or after completing chemotherapy were randomly assigned to 1 of 3 12-week CR programs computer-assisted CR with a neuropsychologist (experimental group A), home cognitive self-exercises (active control group B), or phone follow-up (active control group C). Subjective cognition was assessed by the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog), objective cognition was assessed by neuropsychological tests, QOL was assessed by the FACT-General, and depression and anxiety were assessed by psychological tests. The primary endpoint was the proportion of patients with a 7-point improvement in the FACT-Cog perceived cognitive impairment (PCI) score.