For patients with ischemic stroke treated within 48 hours of the onset of symptoms, low-molecular-weight heparin was effective in improving outcomes at six months.

Purpose: To report on rectal dosimetric and toxicity outcomes of intermediate and high-risk prostate cancer patients undergoing combined high-dose-rate (HDR) brachytherapy and external beam radiotherapy (EBRT) with or without hydrogel spacer (HS) insertion. Material and methods: A total of 97 patients were analyzed in this study, with 32 patients (33%) who had HS insertion compared with a preceding group of 65 patients (67%) without HS. HS safety, the dosimetric effects on organs at risk (rectal, urethral, penile bulb, and bladder) as well as gastrointestinal (GI) and genitourinary toxicity were evaluated and compared between the two groups. Results: The median prostate-rectal separation achieved with HS was 10 mm (range, 5-14 mm). There were no post-operative complications following HS insertion. Patients with HS had significantly lower radiation dose to the rectum across all rectal dose volumes from rV 30 to rV 80 , whether in absolute volume (cc) or as percentage of contoured OAR (p < 0.001). There was also significantly less acute > grade 1 GI toxicity (12.5% vs. 30.8%, p = 0.05) and a trend towards less late grade 1 GI toxicity (0% vs. 7.7%; p = 0.11) in the HS group compared to the non-HS group. Conclusions: Insertion of HS in prostate cancer patients receiving combined HDR and EBRT is safe and has resulted in a significant radiation dose reduction to the rectum, resulting in significantly less acute GI toxicity and a trend towards less late GI toxicity.

Objective. The aim of this study was to validate and compare the performance of serum paraquat level, severity index of paraquat poisoning (SIPP), Acute Physiology And Chronic Health Evaluation II (APACHE II), modifi ed Simplifi ed Acute Physiology Score II (MSAPS II), and modifi ed Expanded Simplifi ed Acute Physiology Score II (MSAPS IIe) calculated immediately after arrival on emergency department (ED) for assessing the mortality of acute paraquat poisoning. Methods . A retrospective study design was employed with the main outcome measure being mortality from year 2001 to 2010. MSAPS II and MSAPS IIe were employed in that assessment of the 24-hour urine output were not included. The performance of APACHE II, MSAPS II, MSAPS IIe, serum paraquat level and SIPP for prediction of mortality in acute paraquat poisoning were compared. Results. A total of 102 patients were enrolled in the study. The area under the ROC curve for APACHE II (0.800) was statistically lower than those for MSAPS II, MSAPS IIe, SIPP and serum paraquat (0.879, 0.893, 0.924,and 0.951, respectively). The Hosmer-Lemeshow goodness-of-fi t test C statistic revealed that APACHE II, MSAPS II, MSAPS IIe and serum paraquat level showed good calibrations (chi-square 8.477 and p ϭ 0.388, chi-square 4.614 and p ϭ 0.798, chi-squared 5.301 and p ϭ 0.725, chisquared 1.009 and p ϭ 0.985 respectively), but poor calibration for SIPP (chi-square 21.293 and p ϭ 0.006). Conclusion. Serum paraquat level is still the most reliable prognosis factor in acute paraquat poisoning. But MSAPS II or MSAPS IIe calculated immediately after arrival on ED may be helpful to predict mortality in acute paraquat poisoning especially when hospital has no facility to measure serum paraquat level.

The Vietnamese diasporic population, largely constituted within international and regional political turbulences in the 1970s and early 1980s, has been swiftly recycled over the last decade. Many first-and second-generation overseas Vietnamese have been returning to Vietnam to live and work. This article examines the interactive dynamics between the homeland society and the returning migrants, and the impact of return migration on Vietnamese nationhood. Unlike most transnational studies that centre on the identity issues of transmigrants, this paper examines changes occurring both to the migrants and to the state and society of origin. It challenges the common perception that migrants are fluid and flexible, whereas the homeland state and society are fixed. While the homeland has been drawing up rhetorical strategies and policy to accommodate these once-discordant overseas subjects, the returning migrants continue their negotiations on history, identity and nationhood. The interactions between the Vietnamese state and the returning diaspora have created a dynamic transnational social field for the reconstruction of the Vietnamese past and present, which in turn poses new questions of boundary-making within the Vietnamese nation as a whole.

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