In a cohort of patients with CHC, ARFI imaging was more accurate than TE for the non-invasive staging of both significant and severe classes of liver fibrosis.

We evaluated the efficacy and safety of a single injection technique with a small volume of anesthetic for ocular peribulbar anesthesia. We included 857 patients undergoing various ophthalmic procedures. Anesthesia consisted of a medial percutaneous injection of 5-6.5 mL of 2% lidocaine. At 2 min 85.6% of the patients had a motor block of at least 50% and at 5 min 78.6% had a motor block >80%. After 5 min 100% of the patients had adequate surgical anesthesia. There were no serious block-related complications. The described technique is a simple and satisfactory alternative to the classical techniques.

Agent-based models (ABMs) are increasingly used in the management sciences. Though useful, ABMs are often critiqued: it is hard to discern why they produce the results they do and whether other assumptions would yield similar results. To help researchers address such critiques, we propose a systematic approach to conducting sensitivity analyses of ABMs. Our approach deals with a feature that can complicate sensitivity analyses: most ABMs include important non-parametric elements, while most sensitivity analysis methods are designed for parametric elements only. The approach moves from charting out the elements of an ABM through identifying the goal of the sensitivity analysis to specifying a method for the analysis. We focus on four common goals of sensitivity analysis: determining whether results are robust, which elements have the greatest impact on outcomes, how elements interact to shape outcomes, and which direction outcomes move when elements change. For the first three goals, we suggest a combination of randomized finite change indices calculation through a factorial design. For direction of change, we propose a modification of individual conditional expectation (ICE) plots to account for the stochastic nature of the ABM response. We illustrate our approach using the Garbage Can Model, a classic ABM that examines how organizations make decisions.

In our study, we evaluated the feasibility of a new sampling method for splenic stiffness (SS) measurement by Quantitative Acoustic Radiation Force Impulse Elastography (Virtual Touch Tissue Quantification (VTTQ)).We measured SS in 54 patients with HCV-related cirrhosis of whom 28 with esophageal varices (EV), 27 with Chronic Hepatitis C (CHC) F1–F3, and 63 healthy controls. VTTQ-SS was significantly higher among cirrhotic patients with EV (3.37 m/s) in comparison with controls (2.19 m/s, P < 0.001), CHC patients (2.37 m/s, P < 0.001), and cirrhotic patients without EV (2.7 m/s, P < 0.001). Moreover, VTTQ-SS was significantly higher among cirrhotic patients without EV in comparison with both controls (P < 0.001) and CHC patients (P < 0.01). The optimal VTTQ-SS cut-off value for predicting EV was 3.1 m/s (AUROC = 0.96, sensitivity 96.4%, specificity 88.5%, positive predictive value 90%, negative predictive value 96%, positive likelihood ratio 8.36, and negative likelihood ratio 0.04). In conclusion, VTTQ-SS is a promising noninvasive and reliable diagnostic tool to screen cirrhotic patients for EV and reduce the need for upper gastrointestinal endoscopy. By using our cut-off value of 3.1 m/s, we would avoid endoscopy in around 45% of cirrhotic subjects, with significant time and cost savings.

A case of ectopic cervical thymus in a child is reported. Clinical and diagnostic aspects of this condition are discussed.