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Inductive Effects on Chemical Shift: Overview01:27

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The protons in unsubstituted alkanes are strongly shielded with chemical shifts below 1.8 ppm. Methine, methylene, and methyl protons appear at approximately 1.7, 1.2 and 0.7 ppm, while the proton signal from methane appears at 0.23 ppm. An electronegative substituent, such as chlorine, withdraws the electron density from the protons, increasing their chemical shift. Progressive substitution of the hydrogens in methane by chlorine shifts the proton signals increasingly downfield, to 3.05 ppm in...
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Gene therapy is a technique where a gene is inserted into a person’s cells to prevent or treat a serious disease. The added gene may be a healthy version of the gene that is mutated in the patient, or it could be a different gene that inactivates or compensates for the patient’s disease-causing gene. For example, in patients with severe combined immunodeficiency (SCID) due to a mutation in the gene for the enzyme adenosine deaminase, a functioning version of the gene can be...
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Induction01:16

Induction

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An emf is induced when the magnetic field in a coil is changed by pushing a bar magnet into or out of the coil. emfs of opposite signs are produced by motion in opposite directions, and the directions of emfs are also reversed by reversing poles. The same results are produced if the coil is moved rather than the magnet—it is the relative motion that is important. The faster the motion, the greater the emf. Additionally, there is no emf when the magnet is stationary relative to the coil.
A...
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Organic molecules primarily contain carbon and hydrogen atoms. While all the hydrogen isotopes are NMR-active, protium or hydrogen-1 is the most abundant. It has a significant energy separation between its nuclear spin states due to its large gyromagnetic ratio. As per Boltzmann's distribution, an increase in the energy separation implies a greater excess population of nuclei available for excitation, resulting in a strong NMR absorption signal.
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Group Therapy01:26

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Thoracoscopic lobectomy after induction therapy-a paradigm shift?

Sameer A Hirji1, Asishana Osho2, Stafford S Balderson3

  • 1Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Journal of Visualized Surgery
|February 6, 2018
PubMed
Summary

Video-assisted thoracoscopic surgery (VATS) is increasingly used for locally advanced non-small cell lung cancer (NSCLC). This review examines controversies in mediastinal staging, induction therapy, and VATS lobectomy for stage IIIA (N2) NSCLC.

Keywords:
Thoracoscopy/video-assisted thoracoscopic surgery (VATS)induction therapylobectomy

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Pulmonology

Background:

  • Video-assisted thoracoscopic surgery (VATS) is gaining prominence in managing locally advanced non-small cell lung cancer (NSCLC).
  • Advancements in technology and surgical experience have expanded VATS applications, particularly for stage IIIA (N2) NSCLC.
  • Significant debates persist regarding mediastinal staging, induction therapy efficacy, and the role of VATS post-induction.

Purpose of the Study:

  • To critically evaluate current controversies in the management of stage IIIA (N2) NSCLC using VATS.
  • To analyze the utility of induction chemotherapy versus chemoradiation for N2 disease.
  • To review the role of VATS lobectomy after neoadjuvant therapy.

Main Methods:

  • Review of existing clinical guidelines.
  • Analysis of contemporary research studies on VATS for NSCLC.
  • Discussion of controversial aspects of mediastinal staging and restaging.

Main Results:

  • VATS is effective for locally advanced NSCLC, with improved outcomes due to technological advancements.
  • Controversies remain regarding optimal mediastinal staging and restaging protocols post-induction therapy.
  • The comparative efficacy of induction chemotherapy versus chemoradiation for N2 disease requires further investigation.

Conclusions:

  • VATS is a viable option for stage IIIA (N2) NSCLC, but optimal neoadjuvant strategies and staging require clarification.
  • Further research is needed to standardize mediastinal staging and define the precise role of VATS lobectomy after induction therapy.
  • Evidence-based guidelines are crucial for guiding the application of VATS in complex NSCLC cases.