Science.gov

Sample records for 1-year interval mri

  1. Bone marrow edema on magnetic resonance imaging (MRI) of the sacroiliac joints is associated with development of fatty lesions on MRI over a 1-year interval in patients with early inflammatory low back pain: a 2-year followup study.

    PubMed

    van Onna, Marloes; van Tubergen, Astrid; van der Heijde, Désirée M; Jurik, Anne Grethe; Landewé, Robert

    2014-06-01

    To assess whether bone marrow edema (BME) detected on magnetic resonance imaging (MRI) of the sacroiliac joints (MRI-SIJ) is associated with development of structural changes on both MRI and pelvic radiographs in patients with early inflammatory back pain (IBP). Patients with IBP ≤ 2 years were followed for 2 years with annual MRI-SIJ. MRI were scored for BME and structural changes (erosions and fatty lesions). Pelvic radiographs were graded according to the modified New York (mNY) criteria. With generalized estimated equation analysis, a time trend in the structural change scores was investigated. Sixty-eight patients [38% male; mean (SD) age 34.9 (10.3) yrs] were included. During the 2-year followup, pelvic radiograph grading remained constant. On MRI, the number of erosions per patient increased significantly (mean score 2.5 at baseline and 3.5 at 2-yr followup; p = 0.05). A trend was found for an increase in the number of fatty lesions per patient (mean score 5.4 at baseline and 8.5 at 2-yr followup; p = 0.06). Overall, BME was associated with the development of fatty lesions (right SIJ: OR 3.13, 95% CI 1.06-9.20; left SIJ: OR 22.13, 95% CI 1.27-384.50), preferentially in quadrants showing resolution of BME. In contrast, BME (or the resolution thereof) was not associated with the development of erosions. BME at baseline, especially when it disappears over time, results in the development of fatty lesions, but an association with erosions could not be demonstrated.

  2. MRI as outcome measure in facioscapulohumeral muscular dystrophy: 1-year follow-up of 45 patients.

    PubMed

    Andersen, Grete; Dahlqvist, Julia R; Vissing, Christoffer R; Heje, Karen; Thomsen, Carsten; Vissing, John

    2017-03-01

    There is no effective treatment available for facioscapulohumeral muscular dystrophy type 1 (FSHD1), but emerging therapies are under way that call for a better understanding of natural history in this condition. In this prospective, longitudinal study, we used quantitative MRI to assess yearly disease progression in patients with FSHD1. Ambulatory patients with confirmed diagnosis of FSHD1 (25/20 men/women, age 20-75 years, FSHD score: 0-12) were tested with 359-560-day interval between tests. Using the MRI Dixon technique, muscle fat replacement was evaluated in paraspinal, thigh, and calf muscles. Changes were compared with those in FSHD score, muscle strength (hand-held dynamometry), 6-minute-walk-distance, 14-step-stair-test, and 5-time-sit-to-stand-test. Composite absolute fat fraction of all assessed muscles increased by 0.036 (CI 0.026-0.046, P < 0.001), with increases in all measured muscle groups. The clinical severity FSHD score worsened (10%, P < 0.05), muscle strength decreased over the hip (8%), neck (8%), and back (17%) (P < 0.05), but other strength measures, 6-minute-walk-distance, 5-times-sit-to-stand-test, and 14-step-stair-test were unchanged. Changes in muscle strength, FSHD score, and fat fraction did not correlate. This first study to systemically monitor quantitative fat replacement longitudinally in FSHD1 shows that MRI provides an objective measure of disease progression, often before changes can be appreciated in strength and functional tests. The study indicates that quantitative MRI can be a helpful end-point in follow-up and therapeutic trials of patients with FSHD1.

  3. Reference Intervals of Hematology and Clinical Chemistry Analytes for 1-Year-Old Korean Children.

    PubMed

    Lee, Hye Ryun; Shin, Sue; Yoon, Jong Hyun; Roh, Eun Youn; Chang, Ju Young

    2016-09-01

    Reference intervals need to be established according to age. We established reference intervals of hematology and chemistry from community-based healthy 1-yr-old children and analyzed their iron status according to the feeding methods during the first six months after birth. A total of 887 children who received a medical check-up between 2010 and 2014 at Boramae Hospital (Seoul, Korea) were enrolled. A total of 534 children (247 boys and 287 girls) were enrolled as reference individuals after the exclusion of data obtained from children with suspected iron deficiency. Hematology and clinical chemistry analytes were measured, and the reference value of each analyte was estimated by using parametric (mean±2 SD) or nonparametric methods (2.5-97.5th percentile). Iron, total iron-binding capacity, and ferritin were measured, and transferrin saturation was calculated. As there were no differences in the mean values between boys and girls, we established the reference intervals for 1-yr-old children regardless of sex. The analysis of serum iron status according to feeding methods during the first six months revealed higher iron, ferritin, and transferrin saturation levels in children exclusively or mainly fed formula than in children exclusively or mainly fed breast milk. We established reference intervals of hematology and clinical chemistry analytes from community-based healthy children at one year of age. These reference intervals will be useful for interpreting results of medical check-ups at one year of age.

  4. Reference Intervals of Hematology and Clinical Chemistry Analytes for 1-Year-Old Korean Children

    PubMed Central

    Lee, Hye Ryun; Roh, Eun Youn; Chang, Ju Young

    2016-01-01

    Background Reference intervals need to be established according to age. We established reference intervals of hematology and chemistry from community-based healthy 1-yr-old children and analyzed their iron status according to the feeding methods during the first six months after birth. Methods A total of 887 children who received a medical check-up between 2010 and 2014 at Boramae Hospital (Seoul, Korea) were enrolled. A total of 534 children (247 boys and 287 girls) were enrolled as reference individuals after the exclusion of data obtained from children with suspected iron deficiency. Hematology and clinical chemistry analytes were measured, and the reference value of each analyte was estimated by using parametric (mean±2 SD) or nonparametric methods (2.5-97.5th percentile). Iron, total iron-binding capacity, and ferritin were measured, and transferrin saturation was calculated. Results As there were no differences in the mean values between boys and girls, we established the reference intervals for 1-yr-old children regardless of sex. The analysis of serum iron status according to feeding methods during the first six months revealed higher iron, ferritin, and transferrin saturation levels in children exclusively or mainly fed formula than in children exclusively or mainly fed breast milk. Conclusions We established reference intervals of hematology and clinical chemistry analytes from community-based healthy children at one year of age. These reference intervals will be useful for interpreting results of medical check-ups at one year of age. PMID:27374715

  5. Prefrontal cortical thickening after mild traumatic brain injury: a 1-year MRI study.

    PubMed

    Dall'Acqua, Patrizia; Johannes, Sönke; Mica, Ladislav; Simmen, Hans-Peter; Glaab, Richard; Fandino, Javier; Schwendinger, Markus; Meier, Christoph; Ulbrich, Erika Jasmin; Müller, Andreas; Jäncke, Lutz; Hänggi, Jürgen

    2017-08-28

    To evaluate group-by-time interactions between gray matter morphology of healthy controls and that of patients with mild traumatic brain injury (mTBI) as they transitioned from acute to chronic stages and to relate these findings to long-term cognitive alterations to identify distinct recovery trajectories between good (GO) and poor outcome (PO). High-resolution T1-weighted MR images were acquired in 49 mTBI patients within 7 days and 1 year post-injury and at equivalent times in 49 healthy controls. Using linear mixed-effects models, we performed mass-univariate analyses and associated the results of the interaction with changes in cognitive performance. Morphological alterations indexed by increased or decreased cortical thickness have been expected mainly in frontal, parietal and temporal brain regions. A significant interaction was found in cortical thickness, spatially restricted to bilateral structures of the prefrontal cortex showing thickening in mTBI and normal developmental thinning in controls. A discrete thickness increase that can interpreted as the absence of cortical thinning typically seen in the healthy population was associated with cognitive recovery in the GO subgroup, but the exaggerated cortical thickening in the PO patients was linked to worsening cognitive performance. Thickness of the prefrontal cortex is subject to structural alterations during the first year after mTBI. Beside beneficial neuroplasticity, a prolonged state of neuroinflammation for symptomatic patients (maladaptive neuroplasticity) cannot be excluded. If the underlying cellular processes responsible for cortical thickening following mTBI have been determined, brain stimulation or even pharmacological intervention targeting the prefrontal cortex might promote endogenous neural restoration.

  6. Automated mapping of hippocampal atrophy in 1-year repeat MRI data from 490 subjects with Alzheimer’s disease, mild cognitive impairment, and elderly controls

    PubMed Central

    Morra, Jonathan H.; Tu, Zhuowen; Apostolova, Liana G.; Green, Amity E.; Avedissian, Christina; Madsen, Sarah K.; Parikshak, Neelroop; Toga, Arthur W.; Jack, Clifford R.; Schuff, Norbert; Weiner, Michael W.; Thompson, Paul M.

    2009-01-01

    As one of the earliest structures to degenerate in Alzheimer’s disease (AD), the hippocampus is the target of many studies of factors that influence rates of brain degeneration in the elderly. In one of the largest brain mapping studies to date, we mapped the 3D profile of hippocampal degeneration over time in 490 subjects scanned twice with brain MRI over a 1-year interval (980 scans). We examined baseline and 1-year follow-up scans of 97 AD subjects (49 males/48 females), 148 healthy control subjects (75 males/73 females), and 245 subjects with mild cognitive impairment (MCI; 160 males/85 females). We used our previously validated automated segmentation method, based on AdaBoost, to create 3D hippocampal surface models in all 980 scans. Hippocampal volume loss rates increased with worsening diagnosis (normal=0.66%/year; MCI=3.12%/year; AD=5.59%/year), and correlated with both baseline and interval changes in Mini-Mental State Examination (MMSE) scores and global and sum-of-boxes Clinical Dementia Rating scale (CDR) scores. Surface-based statistical maps visualized a selective profile of ongoing atrophy in all three diagnostic groups. Healthy controls carrying the ApoE4 gene atrophied faster than non-carriers, while more educated controls atrophied more slowly; converters from MCI to AD showed faster atrophy than non-converters. Hippocampal loss rates can be rapidly mapped, and they track cognitive decline closely enough to be used as surrogate markers of Alzheimer’s disease in drug trials. They also reveal genetically greater atrophy in cognitively intact subjects. PMID:19041724

  7. Do MRI Findings Change Over a Period of Up to 1 Year in Patients With Low Back Pain and/or Sciatica?: A Systematic Review.

    PubMed

    Panagopoulos, John; Hush, Julia; Steffens, Daniel; Hancock, Mark J

    2017-04-01

    Systematic review OBJECTIVE.: The aim of the study was to investigate whether magnetic resonance imaging (MRI) findings change over a relatively short period of time (<1 yr) in people with low back pain (LBP) or sciatica. We also investigated whether there was an association between any change in MRI findings and change in clinical outcomes. MRI offers the potential to identify possible pathoanatomic sources of LBP and/or sciatica; however, the clinical importance of MRI findings remains unclear. Little is known about whether lumbar MRI findings change over the short term and if so whether these changes are associated with changes in clinical outcomes. Medline, EMBASE, and CINAHL databases were searched. Included were cohort studies that performed repeat MRI scans within 12 months in patients with LBP and/or sciatica. Data on study characteristics and change in MRI findings were extracted from included studies. Any data describing associations between change in MRI findings and change in clinical outcomes were also extracted. A total of 12 studies met the inclusion criteria and were included in the review. Pooling was not possible due to heterogeneity of studies and findings. Seven studies reported on changes in disc herniation and reported 15% to 93% of herniations reduced or disappeared in size. Two studies reported on changes in nerve root compression and reported 17% to 91% reduced or disappeared. Only one study reported on the association between change in MRI findings and change in clinical outcomes within 1 year, and found no association. This review found moderate evidence that the natural course of herniations and nerve root compression is favorable over a 1-year period in people with sciatica or LBP. There is a lack of evidence on whether other MRI findings change, and whether changes in MRI findings are associated with changes in clinical outcomes. 1.

  8. Low Compliance in a Health-Conscience Spending Era Likely Helps Obviates the Need for 6 month BI-RADS 3 Breast MRI Follow-up After 1 year.

    PubMed

    Mosier, Andrew; Gupta, Esha; Ataya, Dana; Bhatt, Kavita; Rim, Alice

    2017-03-01

    The goal of our IRB-approved study was to assess if a follow-up MRI every 6 months for 2 years is the most appropriate short-interval follow-up schedule. 203 breast MRI exams were performed from October 2009 to January 2014 as part of a BI-RADS 3 follow-up representing 2.6% of all breast MRIs (7,822) performed. We performed a retrospective longitudinal medical records review of compliance; malignancy rate of BI-RADS 3 exams; and average time and number of breast MRIs necessary prior to definitive disposition. While 77.8% eventually returned, only 45.5% of patients were compliant with follow-up at or near 6 months (4.5-7.5 months). Of those who eventually returned, it took an average of 1.31 follow-up MRIs (95% CI: 1.20-1.43 exams) and 10.3 months (95% CI: 9.0-11.7 months) before definitive disposition. 93.5% of initial findings were dispositioned as benign after two follow-up MRI exams (malignancy rate: 0.98%). Our results lend support to the possibility that the follow-up interval for BI-RADS 3 breast MRIs could be lengthened to 12 months if additional follow-up MRIs are necessary after the first year of 6-month follow-up breast MRIs. Foremost, this appears to be a safe follow-up alternative since benign definitive disposition can usually be made in less than 1 year. Supplemental reasons include persistent low-patient compliance (as redemonstrated in our study) and the higher cost of breast MRI compared to mammogram/ultrasound follow-up. Finally, this paper's findings further support the suggested MRI follow-up interval in the newest BI-RADS atlas.

  9. Magnetic resonance imaging of breast cancer: does the time interval between biopsy and MRI influence MRI-pathology discordance in lesion sizing?

    PubMed

    Mennella, Simone; Paparo, Francesco; Revelli, Matteo; Baccini, Paola; Secondini, Lucia; Barbagallo, Stella; Friedman, Daniele; Garlaschi, Alessandro

    2017-07-01

    Background Breast magnetic resonance imaging (MRI) is more accurate than ultrasound and mammography in estimating local extension of both invasive breast cancer and ductal carcinoma in situ (DCIS) and it is part of a breast cancer patient's preoperative management. Purpose To verify if time interval between breast biopsy and preoperative MRI, lesion margins, and biopsy technique can influence tumor sizing on MRI. Material and Methods By a database search, we retrospectively identified all women with a newly diagnosed, biopsy-proven, primary breast cancer who underwent MRI before surgery. The time interval between biopsy and MRI, the type of biopsy procedure, and various pathological features of tumors were collected. We defined the concordance between MRI and pathology measurements as a difference of <5 mm in lesion sizing. Results One hundred and sixty-six women (mean age, 51.4 ± 10.4 years) were included. The time interval between biopsy and MRI showed only a weak correlation with the absolute MRI-pathology difference (r = 0.236). Stratifying the whole cohort of patients using a cutoff value of 30 days, we found that the MRI-pathology discordance was significantly higher in patients with a biopsy-MRI time interval >30 days ( P < 0.05). By means of multivariate analysis, we found that DCIS subtype and the presence of poorly defined margins on MRI are the only two factors independently and strongly associated with MRI-pathology discordance in lesion sizing. Conclusion Size, histology, and margins of tumors may affect the accuracy of MRI measurements. The type of biopsy procedure and the time interval between biopsy and preoperative MRI are not independently associated to MRI-pathology discordance.

  10. Relationship between heart rate and quiescent interval of the cardiac cycle in children using MRI.

    PubMed

    Zhang, Wei; Bogale, Saivivek; Golriz, Farahnaz; Krishnamurthy, Rajesh

    2017-07-25

    Imaging the heart in children comes with the challenge of constant cardiac motion. A prospective electrocardiography-triggered CT scan allows for scanning during a predetermined phase of the cardiac cycle with least motion. This technique requires knowing the optimal quiescent intervals of cardiac cycles in a pediatric population. To evaluate high-temporal-resolution cine MRI of the heart in children to determine the relationship of heart rate to the optimal quiescent interval within the cardiac cycle. We included a total of 225 consecutive patients ages 0-18 years who had high-temporal-resolution cine steady-state free-precession sequence performed as part of a magnetic resonance imaging (MRI) or magnetic resonance angiography study of the heart. We determined the location and duration of the quiescent interval in systole and diastole for heart rates ranging 40-178 beats per minute (bpm). We performed the Wilcoxon signed rank test to compare the duration of quiescent interval in systole and diastole for each heart rate group. The duration of the quiescent interval at heart rates <80 bpm and >90 bpm was significantly longer in diastole and systole, respectively (P<.0001 for all ranges, except for 90-99 bpm [P=.02]). For heart rates 80-89 bpm, diastolic interval was longer than systolic interval, but the difference was not statistically significant (P=.06). We created a chart depicting optimal quiescent intervals across a range of heart rates that could be applied for prospective electrocardiography-triggered CT imaging of the heart. The optimal quiescent interval at heart rates <80 bpm is in diastole and at heart rates ≥90 bpm is in systole. The period of quiescence at heart rates 80-89 bpm is uniformly short in systole and diastole.

  11. Magnetic resonance imaging characteristics of ischemic stroke in an Afro-Caribbean population: A 1-year prospective MRI study on 534 consecutive patients.

    PubMed

    Mejdoubi, M; Signate, A; Colombani, S; Arrigo, A; Olindo, S

    2017-02-01

    Few population-based MRI studies on stroke, particularly in African-descent populations, are available. Based on a 1-year Afro-Caribbean population-based study MRI, ischemic stroke characteristics were extensively analyzed. All strokes occurring in Martinique (390,371 inhabitants) were prospectively included. Ascertainment was based, whenever possible, on MRI. All patients were categorized as single- (subclassified as cortical, cortical-subcortical, subcortical, lacunar) or multiple-lesion pattern, and vascular (single, multiple or junctional) territory. Brain parenchyma was evaluated, based on visualization of macrobleeds, microbleeds, white-matter hyperintensities or stroke sequelae. Etiology was classified according to TOAST criteria. Among 596 ischemic stroke patients included, 534 (295 men, 239 women; mean age, 71 [range 23-110] years) underwent MRI (median delay 1 day). Four hundred and eighty-eight had single-type lesion (14.8% cortical, 42.4% cortical-subcortical, 14.5% subcortical, 16.6% lacunar), involving anterior cerebral (4%), middle cerebral (63.7%), posterior cerebral artery (10.4%) or basilar trunk (11.7%) territories, with 10.3% simultaneously involving multiple territories and 4.9% junctional infarction. Etiologies were LAA (11.2%), SVD (10.7%), CE (29.6%), rare (4.5%) or undetermined (44.1%). Our prospective, consecutive, ischemic stroke series gives a comprehensive description of ischemic stroke imaging patterns and etiologic distributions in an Afro-Caribbean population with high socio-economic status. Our patients' stroke characteristics are close to those of European-descent populations. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. Optimal MRI interval for detection of asymptomatic recurrence in surgically treated early cervical cancer by use of a mathematical model.

    PubMed

    Laios, A; Gubbala, K; Lampe, R; Tolis, A

    2016-01-01

    Applications of mathematical modeling may provide an insight into the timing of surveillance modalities. We aimed to determine the optimal magnetic resonance imaging (MRI) interval for the detection of surgically treated early cervical cancer asymptomatic recurrence by using a mathematical model for volumetric tumor growth time. We assumed that tumor volume increases by a factor equal to the basis of natural logarithms (e~2.718) at constant time intervals. Using a mathematical formula, the tumor volume (V) was converted to diameter (D), which could be expressed as a function of time (t), given an initial diameter Di (corresponding to initial volume Vi) and a constant DT, where DT is the time required for volumetric tumor growth by a factor (e). Three different DTs were used for demonstration of the model, i.e. 20, 100 and 400 days. Assuming complete surgical clearance, a worst-case scenario for a 20-day DT indicated that a 20 μm cervical tumor would need at least 12 months to reach 10 mm in diameter, which would be detected with an annual surveillance interval MRI. Over a 5-year (60 months) follow-up, nearly five surveillance MRIs would be required if the threshold of 10 mm was desired. For a 100-day DT over a 5-year (60 months) follow-up, a single only MRI would be required, if the threshold of 10 mm was desired. In the case of an indolent tumor (DT is 400 days), the model would not recommend a surveillance MRI to detect asymptomatic recurrence. A positive linear association between optimal MRI intervals and volumetric tumor DTs was demonstrated. In the absence of evidence, we postulate annual MRI scanning is probably the shortest interval, which can be clinically useful for optimization of routine surveillance follow-up protocols in surgically treated early cervical cancer. This mathematical model requires proper verification in prospective clinical studies. Hippokratia 2016, 20(1): 4-8.

  13. fMRI Mapping of Brain Activity Associated with the Vocal Production of Consonant and Dissonant Intervals.

    PubMed

    González-García, Nadia; Rendón, Pablo L

    2017-05-23

    The neural correlates of consonance and dissonance perception have been widely studied, but not the neural correlates of consonance and dissonance production. The most straightforward manner of musical production is singing, but, from an imaging perspective, it still presents more challenges than listening because it involves motor activity. The accurate singing of musical intervals requires integration between auditory feedback processing and vocal motor control in order to correctly produce each note. This protocol presents a method that permits the monitoring of neural activations associated with the vocal production of consonant and dissonant intervals. Four musical intervals, two consonant and two dissonant, are used as stimuli, both for an auditory discrimination test and a task that involves first listening to and then reproducing given intervals. Participants, all female vocal students at the conservatory level, were studied using functional Magnetic Resonance Imaging (fMRI) during the performance of the singing task, with the listening task serving as a control condition. In this manner, the activity of both the motor and auditory systems was observed, and a measure of vocal accuracy during the singing task was also obtained. Thus, the protocol can also be used to track activations associated with singing different types of intervals or with singing the required notes more accurately. The results indicate that singing dissonant intervals requires greater participation of the neural mechanisms responsible for the integration of external feedback from the auditory and sensorimotor systems than does singing consonant intervals.

  14. Are early MRI findings correlated with long-lasting symptoms following whiplash injury? A prospective trial with 1-year follow-up

    PubMed Central

    Sorensen, Joan S.; Andersen, Hans; Keseler, Bjarne; Jensen, Troels S.; Bendix, Tom

    2008-01-01

    Neck pain is the cardinal symptom following whiplash injuries. The trauma mechanism could theoretically lead to both soft tissue and bone injury that could be visualised by means of MRI. From previous quite small trials it seems that MRI does not demonstrate significant tissue damage. Large prospectively followed cohorts are needed to identify possible clinically relevant MRI findings. The objective of this trial was to evaluate (1) the predictive value of cervical MRI after whiplash injuries and (2) the value of repeating MRI examinations after 3 months including sequences with flexion and extension of the cervical spine. Participants were included after rear-end or frontal car collisions. Patients with fractures or dislocations diagnosed by standard procedures at the emergency unit were not included. MRI scans of the cervical spine were performed at baseline and repeated after 3 months. Clinical follow-ups were performed after 3 and 12 months. Outcome parameters were neck pain, headache, neck disability and working ability. A total of 178 participants had a cervical MRI scan on average 13 days after the injury. Traumatic findings were observed in seven participants. Signs of disc degeneration were common and most frequent at the C5–6 and C6–7 levels. Findings were not associated with outcome after 3 or 12 months. The population had no considerable neck trouble prior to the whiplash injury and the non-traumatic findings represent findings to be expected in the background population. Trauma-related MRI findings are rare in a whiplash population screened for serious injuries in the emergency unit and not related to a specific symptomatology. Also, pre-existing degeneration is not associated with prognosis. PMID:18512085

  15. Pulmonary 3 T MRI with ultrashort TEs: influence of ultrashort echo time interval on pulmonary functional and clinical stage assessments of smokers.

    PubMed

    Ohno, Yoshiharu; Nishio, Mizuho; Koyama, Hisanobu; Yoshikawa, Takeshi; Matsumoto, Sumiaki; Seki, Shinichiro; Obara, Makoto; van Cauteren, Marc; Takahashi, Masaya; Sugimura, Kazuro

    2014-04-01

    To assess the influence of ultrashort TE (UTE) intervals on pulmonary magnetic resonance imaging (MRI) with UTEs (UTE-MRI) for pulmonary functional loss assessment and clinical stage classification of smokers. A total 60 consecutive smokers (43 men and 17 women; mean age 70 years) with and without COPD underwent thin-section multidetector row computed tomography (MDCT), UTE-MRI, and pulmonary functional measurements. For each smoker, UTE-MRI was performed with three different UTE intervals (UTE-MRI A: 0.5 msec, UTE-MRI B: 1.0 msec, UTE-MRI C: 1.5 msec). By using the GOLD guidelines, the subjects were classified as: "smokers without COPD," "mild COPD," "moderate COPD," and "severe or very severe COPD." Then the mean T2* value from each UTE-MRI and CT-based functional lung volume (FLV) were correlated with pulmonary function test. Finally, Fisher's PLSD test was used to evaluate differences in each index among the four clinical stages. Each index correlated significantly with pulmonary function test results (P < 0.05). CT-based FLV and mean T2* values obtained from UTE-MRI A and B showed significant differences among all groups except between "smokers without COPD" and "mild COPD" groups (P < 0.05). UTE-MRI has a potential for management of smokers and the UTE interval is suggested as an important parameter in this setting. Copyright © 2013 Wiley Periodicals, Inc.

  16. Postmortem interval alters the water relaxation and diffusion properties of rat nervous tissue--implications for MRI studies of human autopsy samples.

    PubMed

    Shepherd, Timothy M; Flint, Jeremy J; Thelwall, Peter E; Stanisz, Greg J; Mareci, Thomas H; Yachnis, Anthony T; Blackband, Stephen J

    2009-02-01

    High-resolution imaging of human autopsy tissues may improve our understanding of in vivo MRI findings, but interpretation is complicated because samples are obtained by immersion fixation following a postmortem interval (PMI). This study tested the hypotheses that immersion fixation and PMI's from 0-24 h would alter the water relaxation and diffusion properties in rat cortical slice and spinal cord models of human nervous tissue. Diffusion data collected from rat cortical slices at multiple diffusion times (10-60 ms) and b-values (7-15,000 s/mm(2)) were analyzed using a two-compartment model with exchange. Rat spinal cords were characterized with standard diffusion tensor imaging (21 directions, b=1250 s/mm(2)). Switching from perfusion- to immersion-fixation at 0 h PMI altered most MRI properties of rat cortical slices and spinal cords, including a 22% decrease in fractional anisotropy (P<0.001). After 4 h PMI, cortical slice T(1) and T(2) increased 22% and 65% respectively (P<0.001), transmembrane water exchange decreased 23% (P<0.001) and intracellular proton fraction increased 25% (P=0.002). After 6 h PMI, spinal cord white matter fractional anisotropy had decreased 38% (P<0.001). MRI property changes were observed for PMIs up to 24 h. The MRI changes correlated with protease activity and histopathological signs of autolysis. Thus, immersion fixation and/or even short PMIs (4-6 h) altered the MRI properties of rat nervous tissue. This suggests comparisons between in vivo clinical MRI and MRI data from human autopsy tissues should be interpreted with caution.

  17. Language Development: 1 Year Olds

    MedlinePlus

    ... Stages Listen Español Text Size Email Print Share Language Development: 1 Year Olds Page Content Article Body ... assured, it’s not your imagination. He’s developing his language and comprehension skills right on schedule. This giant ...

  18. Heart MRI

    MedlinePlus

    Magnetic resonance imaging - cardiac; Magnetic resonance imaging - heart; Nuclear magnetic resonance - cardiac; NMR - cardiac; MRI of the heart; Cardiomyopathy - MRI; Heart failure - MRI; Congenital heart disease - MRI

  19. Clinically significant weight gain 1 year after occupational back injury.

    PubMed

    Keeney, Benjamin J; Fulton-Kehoe, Deborah; Wickizer, Thomas M; Turner, Judith A; Chan, Kwun Chuen Gary; Franklin, Gary M

    2013-03-01

    To examine the incidence of clinically significant weight gain 1 year after occupational back injury, and risk factors for that gain. A cohort of Washington State workers with wage-replacement benefits for back injuries completed baseline and 1-year follow-up telephone interviews. We obtained additional measures from claims and medical records. Among 1263 workers, 174 (13.8%) reported clinically significant weight gain (≥7%) 1 year after occupational back injury. Women and workers who had more than 180 days on wage replacement at 1 year were twice as likely (adjusted odds ratio = 2.17, 95% confidence interval = 1.54 to 3.07; adjusted odds ratio = 2.40, 95% confidence interval = 1.63 to 3.53, respectively; both P < 0.001) to have clinically significant weight gain. Women and workers on wage replacement for more than 180 days may be susceptible to clinically significant weight gain after occupational back injury.

  20. Head MRI

    MedlinePlus

    ... the head; MRI - cranial; NMR - cranial; Cranial MRI; Brain MRI; MRI - brain; MRI - head ... the test, tell your provider if you have: Brain aneurysm clips An artificial heart valves Heart defibrillator ...

  1. Increased BOLD activation in the left parahippocampal cortex after 1 year of medical school: an association with cumulative verbal memory learning.

    PubMed

    Bernier, Michaël; Gauvreau, Claudie; Theriault, Denis; Madrolle, Stéphanie; Lepage, Jean-François; Whittingstall, Kevin

    2016-01-06

    Although several studies have shown left-right hippocampus asymmetry during learning, it is unclear whether such asymmetry also exists for the parahippocampal cortex, a structure within the limbic system that is also involved in memory and learning. Using a common mental navigation task known to activate the bilateral parahippocampal cortex, this study aimed at determining how BOLD activation in these two areas changes after 1 year of medical school, a program characterized by intensive verbal learning. Fifteen first-year medical students participated in this study and underwent two sessions of functional MRI, at a 1-year interval. In the first session, we observed marginal differences between left and right parahippocampal cortex activity. However, 1 year later, left parahippocampal activation significantly increased (+4.7%), whereas the right remained stable. These results bring new information as to how intensive learning can modify regional metabolism in the human brain and how the left parahippocampal region is particularly important for cumulative verbal memory.

  2. A database of age-appropriate average MRI templates.

    PubMed

    Richards, John E; Sanchez, Carmen; Phillips-Meek, Michelle; Xie, Wanze

    2016-01-01

    This article summarizes a life-span neurodevelopmental MRI database. The study of neurostructural development or neurofunctional development has been hampered by the lack of age-appropriate MRI reference volumes. This causes misspecification of segmented data, irregular registrations, and the absence of appropriate stereotaxic volumes. We have created the "Neurodevelopmental MRI Database" that provides age-specific reference data from 2 weeks through 89 years of age. The data are presented in fine-grained ages (e.g., 3 months intervals through 1 year; 6 months intervals through 19.5 years; 5 year intervals from 20 through 89 years). The base component of the database at each age is an age-specific average MRI template. The average MRI templates are accompanied by segmented partial volume estimates for segmenting priors, and a common stereotaxic atlas for infant, pediatric, and adult participants. The database is available online (http://jerlab.psych.sc.edu/NeurodevelopmentalMRIDatabase/). Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Your Child's Development: 1 Year (12 Months)

    MedlinePlus

    ... Year-Old Your Child’s Development: 1 Year (12 Months) KidsHealth > For Parents > Your Child’s Development: 1 Year (12 Months) A A A Your little one is now ... THIS TOPIC Your Child's Checkup: 1 Year (12 Months) Your Baby's Growth: 12 Months Your Baby's Hearing, ...

  4. Interval Training

    MedlinePlus

    ... before trying any type of interval training. Recent studies suggest, however, that interval training can be used safely for short periods even in individuals with heart disease. Also keep the risk of overuse injury in mind. If you rush into a strenuous workout before ...

  5. Traumatic spinal epidural hematoma in a 1-year-old boy.

    PubMed

    Tarbé de Saint Hardouin, A-L; Grévent, D; Sainte-Rose, C; Angoulvant, F; Chéron, G

    2016-07-01

    Traumatic spinal epidural hematoma is uncommon in children, making rapid diagnosis difficult. In this report, we present a case of traumatic cervical epidural hematoma in a 1-year-old boy, diagnosed with computed tomography scanning and magnetic resonance imaging (MRI). Management was conservative and the lesion regressed spontaneously. The presentation in childhood is often nonspecific. MRI is the imaging modality of choice for diagnosing these lesions. Conservative treatment has to be considered in cases with a benign clinical course and provided that the patient is followed up neurologically with repeated MRI. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  6. Stability of physical assessment of older drivers over 1 year.

    PubMed

    Smith, Andrew; Marshall, Shawn; Porter, Michelle; Ha, Linda; Bédard, Michel; Gélinas, Isabelle; Man-Son-Hing, Malcolm; Mazer, Barbara; Rapoport, Mark; Tuokko, Holly; Vrkljan, Brenda

    2013-12-01

    Older adults represent the fastest-growing population of drivers with a valid driver's licence. Also common in this age group are multiple chronic medical conditions that may have an effect on physical function and driving ability. Determining the reliability of physical measures used to assess older drivers' functional ability is important to identifying those who are safe to continue driving. Most previous reliability studies of clinical physical measures of health used test-retest intervals shorter than those between patient visits with a clinician. In the present study we examined a more clinically representative interval of 1 year to determine the stability of commonly used physical measures collected during the Candrive II prospective cohort study of older drivers. Reliability statistics indicate that the sequential finger-thumb opposition, rapid pace walk and the Pelli-Robson contrast sensitivity tests have adequate stability over 1 year. Poor stability was observed for the one-legged stance and Snellen visual acuity test. Several assessments with nominal data (Marottoli method [functional neck range of motion], whispered voice test, range of motion and strength testing) lacked sufficient variability to conduct reliability analyses; however, a lack of variability between test days suggests consistency over a 1-year time frame. Our results provide evidence that specific physical measures are stable in monitoring functional ability over the course of a year.

  7. Your Child's Development: 1 Year (12 Months)

    MedlinePlus

    ... Child Too Busy? Helping Your Child Adjust to Preschool School Lunches Kids and Food: 10 Tips for Parents Healthy Habits for TV, Video Games, and the Internet Your Child’s Development: 1 Year (12 Months) KidsHealth > For Parents > Your ...

  8. Accelerated return to sport after ACL reconstruction and early knee osteoarthritis features at 1 year: an exploratory study.

    PubMed

    Culvenor, Adam G; Patterson, Brooke E; Guermazi, Ali; Morris, Hayden G; Whitehead, Timothy S; Crossley, Kay M

    2017-09-14

    A timely return to competitive sport is a primary goal of anterior cruciate ligament reconstruction (ACLR). It is not known if an accelerated return-to-sport increases the risk of early-onset knee osteoarthritis (KOA). To determine whether an accelerated return-to-sport post-ACLR (i.e., <10 months) is associated with increased odds of early KOA features on MRI 1-year post-surgery, and to evaluate the relationship between an accelerated return-to-sport and early KOA features stratified by type of ACL injury (isolated or concurrent chondral/meniscal injury) and lower-limb function (good or poor). Cross-sectional study SETTING: Private radiology clinic and university laboratory PARTICIPANTS: 111 participants (71 males; mean age 30±8 years) 1-year post-ACLR METHODS: Participants completed a self-report questionnaire regarding postoperative return-to-sport data (specific sport, postoperative month first returned), and isotropic 3T MRI scans were obtained. Early KOA features (bone marrow, cartilage and meniscal lesions, and osteophytes) assessed using the MRI OA Knee Score. Logistic regression analyses evaluated the odds of early KOA features with an accelerated return-to-sport (<10-months post-ACLR vs. ≥10-months or no return-to-sport) in the total cohort, and stratified by type of ACL injury and lower-limb function. Forty-six (41%) participants returned to competitive sport <10-months post-ACLR. An early return-to-sport was associated with significantly increased odds of bone marrow lesions (BMLs) (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.3, 6.0) but not cartilage (OR 1.2, 95%CI 0.5, 2.6) or meniscal lesions (OR 0.8, 95%CI 0.4, 1.8), or osteophytes (OR 0.6, 95%CI 0.3, 1.4). In those with poor lower-limb function, early return-to-sport exacerbated the odds of BMLs (OR 4.6, 95%CI 1.6, 13.5), whereas stratified analyses for type of ACL injury did not reach statistical significance. An accelerated return-to-sport, particularly in the presence of poor lower

  9. Comparison of dynamic contrast enhanced MRI and Doppler ultrasound in the pre-operative assessment of the portal venous system.

    PubMed

    Naik, K S; Ward, J; Irving, H C; Robinson, P J

    1997-01-01

    The purpose of this study was to compare dynamic contrast enhanced MRI (DCEMR) with Doppler ultrasound (US) in the assessment of portal venous anatomy and to analyse the causes of discrepancy. Over a 1 year period, 97 patients undergoing assessment prior to hepatic surgery underwent imaging of the liver and portal venous system using US with colour and spectral Doppler and MRI with axial T2 weighted spin echo (SE) and coronal oblique T1 weighted rapid gradient echo (GRE) imaging before and immediately after bolus injection of Gd-DTPA (0.1 mmol kg-1). When the US and MRI findings were discrepant, the images were reviewed by two observers and compared with surgical findings. US and DCEMR were concordant in 90 patients (portal vein patent in 80, occluded in 10). In three patients with cirrhosis and gross ascites the portal vein was reported as occluded on US and patent on MRI; surgery confirmed the MRI findings. In one patient the portal vein was patient on US but not on MRI, but there was a 3 week interval between the examinations. In three patients the portal vein was patent on US, but MRI detected occlusion of intrahepatic portal vein branches in two, and encasement of an intrahepatic branch in the third case. Spontaneous splenorenal shunts were seen in 15 patients only on MRI; varices were seen in 39 patients on MRI and in 22 patients on US. Both US and DCEMR contribute to the pre-operative assessment of the portal venous system. MRI provides additional information over US in assessing intrahepatic portal branches and detecting varices and splenorenal shunts, and is recommended for all surgical candidates and in patients with abnormal portal venous anatomy and equivocal US findings.

  10. Knee MRI

    MedlinePlus

    ... magnetic field of the MRI unit, metal and electronic items are not allowed in the exam room. ... tell the technologist if you have medical or electronic devices in your body. These objects may interfere ...

  11. Shoulder MRI

    MedlinePlus

    ... magnetic field of the MRI unit, metal and electronic items are not allowed in the exam room. ... tell the technologist if you have medical or electronic devices in your body. These objects may interfere ...

  12. Shoulder MRI

    MedlinePlus

    ... of the shoulder uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of ... scans, MRI does not utilize ionizing radiation. Instead, radio waves redirect alignment of hydrogen atoms that naturally exist ...

  13. Knee MRI

    MedlinePlus

    ... of the knee uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of ... scans, MRI does not utilize ionizing radiation. Instead, radio waves redirect alignment of hydrogen atoms that naturally exist ...

  14. MRI renaissance.

    PubMed

    Hensley, S

    1997-12-01

    A few years ago, magnetic resonance imaging was healthcare's version of a foreign sports car-flashy, expensive and impractical. Now, after years in the doldrums, sales of MRI systems are roaring back. An aging fleet of MRI scanners due for replacement and a hearty increase in doctors' use of the versatile imaging tools are combining to fuel the surge in demand, vendors and customers say.

  15. Cardiac Biomarkers Predict 1-Year Mortality in Elderly Patients Undergoing Hip Fracture Surgery.

    PubMed

    Katsanos, Spyridon; Mavrogenis, Andreas F; Kafkas, Nikolaos; Sardu, Celestino; Kamperidis, Vasileios; Katsanou, Panagiota; Farmakis, Dimitrios; Parissis, John

    2017-05-01

    This prospective study included 152 elderly patients (mean age, 80 years; range, 72-88 years) with a hip fracture treated surgically. Comorbidities were evaluated, and B-type natriuretic peptide was measured at baseline and at postoperative days 4 and 5 in addition to troponin I. Major cardiac events were recorded, and 1-year mortality was assessed. Comorbidity models with the important multivariate predictors of 1-year mortality were analyzed. Overall, 9 patients (6%) experienced major cardiac events postoperatively during their hospitalization. Three patients (2%) died postoperatively, at days 5, 7, and 10, from autopsy-confirmed myocardial infarction. Three patients (2%) experienced a nonfatal myocardial infarction, and 3 patients (2%) experienced acute heart failure. At 1-year follow-up, 37 patients (24%) had died. Age older than 80 years (P=.000), renal failure (P=.016), cardiovascular disease (P=.003), respiratory disease (P=.010), Parkinson disease (P=.024), and dementia (P=.000) were univariate predictors of 1-year mortality. However, in the multivariate model, only age older than 80 years (P=.000) and dementia (P=.024) were important predictors of 1-year mortality. In all comorbidity models, age older than 80 years and dementia were important predictors of 1-year mortality. Postoperative increase in B-type natriuretic peptide was the most important predictor of 1-year mortality. Receiver operating characteristic curve analysis showed a threshold of 90 ng/mL of preoperative B-type natriuretic peptide (area under the curve=0.773, 95% confidence interval, 0.691-0.855, P<.001) had 82% sensitivity and 62% specificity to predict 1-year mortality. Similarly, a threshold of 190 ng/mL of postoperative B-type natriuretic peptide (area under the curve=0.753, 95% confidence interval, 0.662-0.844, P<.001) had 70% sensitivity and 77% specificity to predict the study endpoint. [Orthopedics. 2017; 40(3):e417-e424.]. Copyright 2017, SLACK Incorporated.

  16. Outcomes of Colorado children with acute flaccid myelitis at 1 year.

    PubMed

    Martin, Jan A; Messacar, Kevin; Yang, Michele L; Maloney, John A; Lindwall, Jennifer; Carry, Terri; Kenyon, Patricia; Sillau, Stefan H; Oleszek, Joyce; Tyler, Kenneth L; Dominguez, Samuel R; Schreiner, Teri L

    2017-07-11

    We describe long-term functional, neurodiagnostic, and psychosocial outcomes of a cohort of 12 children from Colorado diagnosed with acute flaccid myelitis (AFM) in 2014. Children were assessed every 3 months for 1 year or until clinical resolution. Assessments included neurologic examination, MRI, EMG/nerve conduction studies (NCS), functional measures (Assisting Hand Assessment, Hammersmith Functional Motor Scale), and Patient-Reported Outcomes Measurement Information System questionnaires. Eight of 12 children completed the study. Six of 8 had persistent motor deficits at 1 year; 2 demonstrated full recovery. Four were not enrolled, 2 of whom reported full recovery. The 6 affected were weakest in proximal muscles, showing minimal to no improvement and significant atrophy at 1 year. All patients improved in distal muscle groups. Cranial nerve dysfunction resolved in 2 of 5 and improved in all. Four of 5 showed progressive functional improvement at 6 and 12 months. Two of 8 reported pain at 1 year. Three of 8 reported depressive symptoms. Repeat MRI was performed in 7 of 8 children a median of 7 months after onset and showed significant improvement or normalization in all but one child. Repeat EMG/NCS was performed on 4 children a median of 8 months after onset and showed ongoing denervation and chronic reinnervation in 3 children with persistent deficits. At 1 year, children with AFM demonstrated functional gains but weakness persisted. EMG changes correlated with persistent deficits better than imaging. Despite improvements, AFM had substantial long-term functional effects on affected children. © 2017 American Academy of Neurology.

  17. Portable MRI

    SciTech Connect

    Espy, Michelle A.

    2012-06-29

    This project proposes to: (1) provide the power of MRI to situations where it presently isn't available; (2) perform the engineering required to move from lab to a functional prototype; and (3) leverage significant existing infrastructure and capability in ultra-low field MRI. The reasons for doing this: (1) MRI is the most powerful tool for imaging soft-tissue (e.g. brain); (2) Billions don't have access due to cost or safety issues; (3) metal will heat/move in high magnetic fields; (4) Millions of cases of traumatic brain injury in US alone; (5) even more of non-traumatic brain injury; (6) (e.g. stroke, infection, chemical exposure); (7) Need for early diagnostic; (8) 'Signature' wound of recent conflicts; (9) 22% of injuries; (10) Implications for post-traumatic stress disorder; and (11) chronic traumatic encephalopathy.

  18. Interval arithmetic in calculations

    NASA Astrophysics Data System (ADS)

    Bairbekova, Gaziza; Mazakov, Talgat; Djomartova, Sholpan; Nugmanova, Salima

    2016-10-01

    Interval arithmetic is the mathematical structure, which for real intervals defines operations analogous to ordinary arithmetic ones. This field of mathematics is also called interval analysis or interval calculations. The given math model is convenient for investigating various applied objects: the quantities, the approximate values of which are known; the quantities obtained during calculations, the values of which are not exact because of rounding errors; random quantities. As a whole, the idea of interval calculations is the use of intervals as basic data objects. In this paper, we considered the definition of interval mathematics, investigated its properties, proved a theorem, and showed the efficiency of the new interval arithmetic. Besides, we briefly reviewed the works devoted to interval analysis and observed basic tendencies of development of integral analysis and interval calculations.

  19. Chest MRI

    MedlinePlus

    ... as the contrast dye is injected. The MRI machine is a large, tunnel-like machine that has a table. You will lie still ... table, and the table will slide into the machine. You will hear loud humming, tapping, and buzzing ...

  20. Cardiac MRI

    MedlinePlus

    ... as the contrast dye is injected. The MRI machine is a large, tunnel-like machine that has a table. You will lie still ... table and the table will slide into the machine. You will hear loud humming, tapping, and buzzing ...

  1. Battlefield MRI

    SciTech Connect

    Espy, Michelle

    2015-06-01

    Magnetic Resonance Imaging is the best method for non-invasive imaging of soft tissue anatomy, saving countless lives each year. It is regarded as the gold standard for diagnosis of mild to moderate traumatic brain injuries. Furthermore, conventional MRI relies on very high, fixed strength magnetic fields (> 1.5 T) with parts-per-million homogeneity, which requires very large and expensive magnets.

  2. Sodium MRI.

    PubMed

    Ouwerkerk, Ronald

    2011-01-01

    Sodium ((23)Na) imaging has a place somewhere between (1)H-MRI and MR spectroscopy (MRS). Like MRS it potentially provides information on metabolic processes, but only one single resonance of ionic (23)Na is observed. Therefore pulse sequences do not need to code for a chemical shift dimension, allowing (23)Na images to be obtained at high resolutions as compared to MRS. In this chapter the biological significance of sodium in the brain will be discussed, as well as methods for observing it with (23)Na-MRI. Many vital cellular processes and interactions in excitable tissues depend on the maintenance of a low intracellular and high extracellular sodium concentration. Healthy cells maintain this concentration gradient at the cost of energy. Leaky cell membranes or an impaired energy metabolism immediately leads to an increase in cytosolic total tissue sodium. This makes sodium a biomarker for ischemia, cancer, excessive tissue activation, or tissue damage as might be caused by ablation therapy. Special techniques allow quantification of tissue sodium for the monitoring of disease or therapy in longitudinal studies or preferential observation of the intracellular component of the tissue sodium. New methods and high-field magnet technology provide new opportunities for (23)Na-MRI in clinical and biomedical research.

  3. Understanding Trends in Kidney Function 1 Year after Kidney Transplant in the United States.

    PubMed

    Huang, Yihung; Tilea, Anca; Gillespie, Brenda; Shahinian, Vahakn; Banerjee, Tanushree; Grubbs, Vanessa; Powe, Neil; Rios-Burrows, Nilka; Pavkov, Meda; Saran, Rajiv

    2017-03-07

    Lower eGFR 1 year after kidney transplant is associated with shorter allograft and patient survival. We examined how practice changes in the past decade correlated with time trends in average eGFR at 1 year after kidney transplant in the United States in a cohort of 189,944 patients who received a kidney transplant between 2001 and 2013. We calculated the average eGFR at 1 year after transplant for the recipient cohort of each year using the appropriate Modification of Diet in Renal Disease equation depending on the prevailing methodology of creatinine measurement, and used linear regression to model the effects of practice changes on the national post-transplant eGFR trend. Between the 2001-2005 period and the 2011-2013 period, average 1-year post-transplant eGFR remained essentially unchanged, with differences of 1.34 (95% confidence interval, 1.03 to 1.65) ml/min per 1.73 m(2) and 0.66 (95% confidence interval, 0.32 to 1.01) ml/min per 1.73 m(2) among deceased and living donor kidney transplant recipients, respectively. Over time, the mean age of recipients increased and more marginal organs were used; adjusting for these trends unmasked a larger temporal improvement in post-transplant eGFR. However, changes in immunosuppression practice had a positive effect on average post-transplant eGFR and balanced out the negative effect of recipient/donor characteristics. In conclusion, average 1-year post-transplant eGFR remained stable, despite increasingly unfavorable attributes in recipients and donors. With an aging ESRD population and continued organ shortage, preservation of average post-transplant eGFR will require sustained improvement in immunosuppression and other aspects of post-transplant care.

  4. Musical intervals in speech

    PubMed Central

    Ross, Deborah; Choi, Jonathan; Purves, Dale

    2007-01-01

    Throughout history and across cultures, humans have created music using pitch intervals that divide octaves into the 12 tones of the chromatic scale. Why these specific intervals in music are preferred, however, is not known. In the present study, we analyzed a database of individually spoken English vowel phones to examine the hypothesis that musical intervals arise from the relationships of the formants in speech spectra that determine the perceptions of distinct vowels. Expressed as ratios, the frequency relationships of the first two formants in vowel phones represent all 12 intervals of the chromatic scale. Were the formants to fall outside the ranges found in the human voice, their relationships would generate either a less complete or a more dilute representation of these specific intervals. These results imply that human preference for the intervals of the chromatic scale arises from experience with the way speech formants modulate laryngeal harmonics to create different phonemes. PMID:17525146

  5. Musical intervals in speech.

    PubMed

    Ross, Deborah; Choi, Jonathan; Purves, Dale

    2007-06-05

    Throughout history and across cultures, humans have created music using pitch intervals that divide octaves into the 12 tones of the chromatic scale. Why these specific intervals in music are preferred, however, is not known. In the present study, we analyzed a database of individually spoken English vowel phones to examine the hypothesis that musical intervals arise from the relationships of the formants in speech spectra that determine the perceptions of distinct vowels. Expressed as ratios, the frequency relationships of the first two formants in vowel phones represent all 12 intervals of the chromatic scale. Were the formants to fall outside the ranges found in the human voice, their relationships would generate either a less complete or a more dilute representation of these specific intervals. These results imply that human preference for the intervals of the chromatic scale arises from experience with the way speech formants modulate laryngeal harmonics to create different phonemes.

  6. Effect of apixaban on brain infarction and microbleeds: AVERROES-MRI assessment study.

    PubMed

    O'Donnell, Martin J; Eikelboom, John W; Yusuf, Salim; Diener, Hans-Christoph; Hart, Robert G; Smith, Eric E; Gladstone, David J; Sharma, Mukul; Dias, Rafael; Flaker, Greg; Avezum, Alvaro; Zhu, Jun; Lewis, Gayle; Connolly, Stuart

    2016-08-01

    Clinical and subclinical (covert) stroke is a cause of cognitive loss and functional impairment. In the AVERROES trial, we performed serial brain magnetic resonance imaging (MRI) scans in a subgroup to explore the effect of apixaban, compared with aspirin, on clinical and covert brain infarction and on microbleeds in patients with atrial fibrillation. We performed brain MRI (T1, T2, fluid-attenuated inversion recovery, and T2* gradient echo sequences) in 1,180 at baseline and in 931 participants at follow-up. Mean interval from baseline to follow-up MRI scans was 1.0 year. The primary outcome was a composite of clinical ischemic stroke and covert embolic pattern infarction (defined as infarction >1.5 cm, cortical-based infarction, or new multiterritory infarction). Secondary outcomes included new MRI-detected brain infarcts and microbleeds and change in white matter hyperintensities. Baseline MRI scans revealed brain infarct(s) in 26.2% and microbleed(s) in 10.5%. The rate of the primary outcomes was 2.0% in the apixaban group and 3.3% in the aspirin group (hazard ratio [HR] 0.55; 0.27-1.14) from baseline to follow-up MRI scan (mean duration of follow-up: 1 year). In those who completed baseline and follow-up MRI scans, the rate of new infarction detected on MRI was 2.5% in the apixaban group and 2.2% in the aspirin group (HR 1.09; 0.47-2.52), but new infarcts were smaller in the apixaban group (P = .03). There was no difference in proportion with new microbleeds on follow-up MRI (HR 0.92; 0.53-1.60) between treatment groups. Apixaban treatment was associated with a nonsignificant trend toward reduction in the composite of clinical ischemic stroke and covert embolic-pattern infarction and did not increase the number of microbleeds in patients with atrial fibrillation compared with aspirin. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Breast MRI scan

    MedlinePlus

    MRI - breast; Magnetic resonance imaging - breast; Breast cancer - MRI; Breast cancer screening - MRI ... the same breast or the other breast after breast cancer has been diagnosed Distinguish between scar tissue and ...

  8. MRI (Magnetic Resonance Imaging)

    MedlinePlus

    ... Procedures Medical Imaging MRI (Magnetic Resonance Imaging) MRI (Magnetic Resonance Imaging) Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Magnetic Resonance Imaging (MRI) is a medical imaging procedure for making ...

  9. Programming with Intervals

    NASA Astrophysics Data System (ADS)

    Matsakis, Nicholas D.; Gross, Thomas R.

    Intervals are a new, higher-level primitive for parallel programming with which programmers directly construct the program schedule. Programs using intervals can be statically analyzed to ensure that they do not deadlock or contain data races. In this paper, we demonstrate the flexibility of intervals by showing how to use them to emulate common parallel control-flow constructs like barriers and signals, as well as higher-level patterns such as bounded-buffer producer-consumer. We have implemented intervals as a publicly available library for Java and Scala.

  10. Interval Graph Limits

    PubMed Central

    Diaconis, Persi; Holmes, Susan; Janson, Svante

    2015-01-01

    We work out a graph limit theory for dense interval graphs. The theory developed departs from the usual description of a graph limit as a symmetric function W (x, y) on the unit square, with x and y uniform on the interval (0, 1). Instead, we fix a W and change the underlying distribution of the coordinates x and y. We find choices such that our limits are continuous. Connections to random interval graphs are given, including some examples. We also show a continuity result for the chromatic number and clique number of interval graphs. Some results on uniqueness of the limit description are given for general graph limits. PMID:26405368

  11. Trends in 1-year survival of people admitted to hospital in Ontario, 1994-2009.

    PubMed

    van Walraven, Carl

    2013-11-05

    Changes in the long-term survival of people admitted to hospital is unknown. This study examined trends in 1-year survival of patients admitted to hospital adjusted for improved survival in the general population. One-year survival after admission to hospital was determined for all adults admitted to hospital in Ontario in 1994, 1999, 2004, or 2009 by linking to vital statistics datasets. Annual survival in the general population was determined from life tables for Ontario. Between 1994 and 2009, hospital use decreased (from 8.8% to 6.3% of the general adult population per year), whereas crude 1-year mortality among people with hospital admissions increased (from 9.2% to 11.6%). During this time, patients in hospital became significantly older (median age increased from 51 to 58 yr) and sicker (the proportion with a Charlson comorbidity index score of 0 decreased from 68.2% to 60.0%), and were more acutely ill on admission (elective admissions decreased from 47.4% to 42.0%; proportion brought to hospital by ambulance increased from 16.1% to 24.8%). Compared with 1994, the adjusted odds ratio (OR) for death at 1 year in 2009 was 0.78 (95% confidence interval [CI] 0.77-0.79). However, 1-year risk of death in the general population decreased by 24% during the same time. After adjusting for improved survival in the general population, risk of death at 1 year for people admitted to hospital remained significantly lower in 2009 than in 1994 (adjusted relative excess risk 0.81, 95% CI 0.80-0.82). After accounting for both the increased burden of patient sickness and improved survival in the general population, 1-year survival for people admitted to hospital increased significantly from 1994 to 2009. The reasons for this improvement cannot be determined from these data.

  12. Steroid hormone levels in pregnancy and 1 year postpartum using isotope dilution tandem mass spectrometry

    PubMed Central

    Soldin, Offie P.; Guo, Tiedong; Weiderpass, Elisabete; Tractenberg, Rochelle E.; Hilakivi-Clarke, Leena; Soldin, Steven J.

    2013-01-01

    Objective To establish normal, trimester-specific reference intervals for serum 17β-estradiol, progesterone (P), 17α-hydroxyprogesterone, cortisol, 11-deoxycortisol, androstenedione, DHEA, and DHEAS, measured simultaneously using isotope dilution tandem mass spectrometry. Design Sequential cohort study. Patient(s) Healthy women undergoing a normal pregnancy (age, 25–38 years; mean, 30 years) attending a prenatal well clinic at gestation weeks 12, 22, and 32 and approximately 1 year postpartum. Main Outcome Measure(s) Trimester-specific reference intervals of endogenous steroid hormones analyzed using an isotope dilution tandem mass spectrometer equipped with an atmospheric pressure photoionization source with deuterium-labeled internal standards. Result(s) Serum estradiol, P, 17α-hydroxyprogesterone, and 11-deoxycortisol increased throughout pregnancy; cortisol increased up to the second trimester and then remained steady, while androstenedione increased by 80 percent by gestation week 12, then remained constant. Serum DHEA-S decreased by 50% by the third trimester. Conclusion(s) Trimester-specific reference intervals are reported for eight serum steroids. The ratios of individual serum hormone concentrations during pregnancy relative to their 1-year postpartum concentrations illustrate the expected normal trends of changes in hormone concentrations during pregnancy. PMID:16169406

  13. Interval estimations in metrology

    NASA Astrophysics Data System (ADS)

    Mana, G.; Palmisano, C.

    2014-06-01

    This paper investigates interval estimation for a measurand that is known to be positive. Both the Neyman and Bayesian procedures are considered and the difference between the two, not always perceived, is discussed in detail. A solution is proposed to a paradox originated by the frequentist assessment of the long-run success rate of Bayesian intervals.

  14. Overconfidence in interval estimates.

    PubMed

    Soll, Jack B; Klayman, Joshua

    2004-03-01

    Judges were asked to make numerical estimates (e.g., "In what year was the first flight of a hot air balloon?"). Judges provided high and low estimates such that they were X% sure that the correct answer lay between them. They exhibited substantial overconfidence: The correct answer fell inside their intervals much less than X% of the time. This contrasts with choices between 2 possible answers to a question, which showed much less overconfidence. The authors show that overconfidence in interval estimates can result from variability in setting interval widths. However, the main cause is that subjective intervals are systematically too narrow given the accuracy of one's information-sometimes only 40% as large as necessary to be well calibrated. The degree of overconfidence varies greatly depending on how intervals are elicited. There are also substantial differences among domains and between male and female judges. The authors discuss the possible psychological mechanisms underlying this pattern of findings.

  15. Direct interval volume visualization.

    PubMed

    Ament, Marco; Weiskopf, Daniel; Carr, Hamish

    2010-01-01

    We extend direct volume rendering with a unified model for generalized isosurfaces, also called interval volumes, allowing a wider spectrum of visual classification. We generalize the concept of scale-invariant opacity—typical for isosurface rendering—to semi-transparent interval volumes. Scale-invariant rendering is independent of physical space dimensions and therefore directly facilitates the analysis of data characteristics. Our model represents sharp isosurfaces as limits of interval volumes and combines them with features of direct volume rendering. Our objective is accurate rendering, guaranteeing that all isosurfaces and interval volumes are visualized in a crack-free way with correct spatial ordering. We achieve simultaneous direct and interval volume rendering by extending preintegration and explicit peak finding with data-driven splitting of ray integration and hybrid computation in physical and data domains. Our algorithm is suitable for efficient parallel processing for interactive applications as demonstrated by our CUDA implementation.

  16. MRI characteristics associated with high-grade myxoid liposarcoma.

    PubMed

    Gimber, L H; Montgomery, E A; Morris, C D; Krupinski, E A; Fayad, L M

    2017-07-01

    To identify magnetic resonance imaging (MRI) features differentiating high-grade (>5% round-cell component) from low-grade myxoid liposarcomas (LPS) (≤5% round-cell component). Informed consent was waived. Patients with myxoid LPS and MRI before biopsy, neoadjuvant therapy, and surgery were included retrospectively. High-grade components were recorded from histological specimens by a pathologist (24 years of experience). Images were evaluated by a senior radiologist (>12 years of experience) for tumour size, location, tissue layer, and MRI features (signal intensity, heterogeneity, margin, and perilesional characteristics). Descriptive statistics, Fisher's exact test to identify associations with a round-cell component, and multivariate logistic regression to identify independent predictors of high-grade tumours were used. Thirty-one patients (16 women [mean 51.1 years; range 19-79 years] and 15 men [mean 45.5 years; range 18-95 years]) with myxoid LPS (23 low-grade, eight high-grade) were included. All high-grade lesions had lipid signal, a peritumoural capsule and peritumoural contrast enhancement, and more commonly exhibited heterogeneous signal; however, the average size of ≥10 cm was the strongest independent indicator of high-grade status (odds ratio [OR], 14.6; 95% confidence interval [CI]: 1.6, 131). Size ≥10 cm is most strongly associated with high-grade myxoid LPS (round-cell component >5%). Other features possibly differentiating high-grade from low-grade status include lesion margin, lipid signal, and perilesional characteristics. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  17. Effect of team training on improving MRI study completion rates and no-show rates.

    PubMed

    Norbash, Alexander; Yucel, Kent; Yuh, William; Doros, Gheorghe; Ajam, Amna; Lang, Elvira; Pauker, Stephen; Mayr, Nina

    2016-10-01

    Magnetic resonance imaging (MRI) is a high-cost imaging modality, and an optimized encounter ideally provides high-quality care, patient satisfaction, and capacity utilization. Our purpose was to assess the effectiveness of team training and its impact on patient show-up and completion rates for their MRI examinations. A total of 97,712 patient visits from three tertiary academic medical centers over 1-year intervals were evaluated, totaling 49,733 visits at baseline and 47,979 after training. Each center's MRI team received team training skill training including advanced communication and team training techniques training. This training included onsite instruction including case simulation with scenarios requiring appropriate behavioral and communicative interventions. Orientation and training also utilized customized online tools and proctoring. The study completion rate and patient show-up rate during consecutive year-long intervals before and after team training were compared to assess its effectiveness. Two-sided chi-square tests for proportions using were applied at a 0.05 significance level. Despite differing no-show rates (5-22.2%) and study incompletion rates (0.7-3.7%) at the three academic centers, the combined patients' data showed significant (P < 0.0001) improvement in the patients' no-show rates (combined decreases from 11.2% to 8.7%) and incompletion rates (combined decreases from 2.3% to 1.4%). Our preliminary results suggest training of the imaging team can improve the no-show and incompletion rates of the MRI service, positively affecting throughput and utilization. Team training can be readily implemented and may help address the needs of the current cost-conscious and consumer-sensitive healthcare environment. J. MAGN. RESON. IMAGING 2016;44:1040-1047. © 2016 International Society for Magnetic Resonance in Medicine.

  18. Fathers' depression related to positive and negative parenting behaviors with 1-year-old children.

    PubMed

    Davis, R Neal; Davis, Matthew M; Freed, Gary L; Clark, Sarah J

    2011-04-01

    To examine the associations between depression in fathers of 1-year-old children and specific positive and negative parenting behaviors discussed by pediatric providers at well-child visits. We performed a cross-sectional secondary analysis by using interview data from 1746 fathers of 1-year-old children in the Fragile Families and Child Wellbeing Study. Positive parenting behaviors included fathers' reports of playing games, singing songs, and reading stories to their children ≥ 3 days in a typical week. Negative parenting behavior included fathers' reports of spanking their 1-year-old children in the previous month. Depression was assessed by using the World Health Organization Composite International Diagnostic Interview Short Form. Weighted bivariate and multivariate analyses of parenting behaviors were performed while controlling for demographics and paternal substance abuse. Overall, 7% of fathers had depression. In bivariate analyses, depressed fathers were more likely than nondepressed fathers to report spanking their 1-year-old children in the previous month (41% compared with 13%; P < .01). In multivariate analyses, depressed fathers were less likely to report reading to their children ≥ 3 days in a typical week (adjusted odds ratio: 0.38 [95% confidence interval: 0.15-0.98]) and much more likely to report spanking (adjusted odds ratio: 3.92 [95% confidence interval: 1.23-12.5]). Seventy-seven percent of depressed fathers reported talking to their children's doctor in the previous year. Paternal depression is associated with parenting behaviors relevant to well-child visits. Pediatric providers should consider screening fathers for depression, discussing specific parenting behaviors (eg, reading to children and appropriate discipline), and referring for treatment if appropriate.

  19. The Safe Dates program: 1-year follow-up results.

    PubMed Central

    Foshee, V A; Bauman, K E; Greene, W F; Koch, G G; Linder, G F; MacDougall, J E

    2000-01-01

    OBJECTIVES: An earlier report described desirable 1-month follow-up effects of the Safe Dates program on psychological, physical, and sexual dating violence. Mediators of the program-behavior relationship also were identified. The present report describes the 1-year follow-up effects of the Safe Dates program. METHODS: Fourteen schools were in the randomized experiment. Data were gathered by questionnaires in schools before program activities and 1 year after the program ended. RESULTS: The short-term behavioral effects had disappeared at 1 year, but effects on mediating variables such as dating violence norms, conflict management skills, and awareness of community services for dating violence were maintained. CONCLUSIONS: The findings are considered in the context of why program effects might have decayed and the possible role of boosters for effect maintenance. PMID:11029999

  20. Assessment of the association between Apgar scores and seizures in infants less than 1 year old.

    PubMed

    Eun, Seonghoon; Lee, Jeong Min; Yi, Dae Yong; Lee, Na Mi; Kim, Hyery; Yun, Sin Weon; Lim, InSeok; Choi, Eung Sang; Chae, Soo Ahn

    2016-04-01

    The study aimed to assess the association between Apgar scores at 1 and 5 min after birth and seizures in infants less than 1 year old. We conducted a retrospective, observational, hospital-based study by utilising medical records from the Chung-Ang University Hospital admissions from January 2006 to May 2015 in order to identify infants less than 1 year old who had a history of seizures. Using electronic medical records, infants who were diagnosed with infantile seizures at the Chung-Ang University Hospital from January 2006 to May 2015 were included in the seizure group (n=93), and a control group consisting of 296 age-matched cases without a history of seizures was selected from a group of infants born at Chung-Ang University Hospital during the same study period. We found that Apgar scores were significant risk factors for infantile seizures. Apgar scores differed depending on gestational age and birth weight. We found strong associations between Apgar scores and infantile seizures in the full-term and the normal-birth weight groups (bodyweight ≥2.5 kg), regardless of delivery mode. The Apgar scores were inversely correlated with the EEG class, and only the 1-min Apgar scores were correlated with MRI findings. Low Apgar scores are significant perinatal risk factors for infantile seizures, especially in full-term and normal-birth weight infants, and have a strong negative linear relationship with EEG and brain MRI results in the seizure group. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  1. Anxiety Sensitivity and Panic Attacks: A 1-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Li, Wen; Zinbarg, Richard E.

    2007-01-01

    The hypothesis that anxiety sensitivity (AS) is a risk factor for panic genesis has obtained compelling support, but the clinical/practical importance of AS in panic genesis has been questioned. In addition, the association between panic experience and AS increase has not been clearly demonstrated. Through this 1-year longitudinal study among…

  2. Anxiety Sensitivity and Panic Attacks: A 1-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Li, Wen; Zinbarg, Richard E.

    2007-01-01

    The hypothesis that anxiety sensitivity (AS) is a risk factor for panic genesis has obtained compelling support, but the clinical/practical importance of AS in panic genesis has been questioned. In addition, the association between panic experience and AS increase has not been clearly demonstrated. Through this 1-year longitudinal study among…

  3. Otitis Media and Language Development at 1 Year of Age.

    ERIC Educational Resources Information Center

    Wallace, Ina F.; And Others

    1988-01-01

    Fifteen 1-year-olds without otitis media were compared to 12 babies who were otitis positive. No significant differences were detected on the Bayley Scales of Infant Development or the Sequenced Inventory of Communication Development (SICD) Receptive scale. However, the otitis-positive group exhibited lower SICD Expressive scores than the…

  4. Otitis Media and Language Development at 1 Year of Age.

    ERIC Educational Resources Information Center

    Wallace, Ina F.; And Others

    1988-01-01

    Fifteen 1-year-olds without otitis media were compared to 12 babies who were otitis positive. No significant differences were detected on the Bayley Scales of Infant Development or the Sequenced Inventory of Communication Development (SICD) Receptive scale. However, the otitis-positive group exhibited lower SICD Expressive scores than the…

  5. Prognostic value of glomerular filtration rate 1 year after heart transplantation.

    PubMed

    Navarro-Manchón, Josep; Martínez-Dolz, Luis; Almenar, Luis; Moro, José A; Zorio, Esther; Raso, Rafael; Buendía, Francisco; Sánchez-Lázaro, Ignacio; Agüero, Jaime; Salvador, Antonio

    2010-05-01

    The development of renal failure is one of the most important problems after heart transplantation (HT), but the wide range of definitions means that estimates of its prevalence vary considerably. Furthermore, its impact on mortality has not been adequately studied. The objective was to investigate the relationship between the glomerular filtration rate (GFR) 1 year after transplantation and mortality during follow-up. The GFR was determined in 316 patients still living 1 year after transplantation using the abbreviated Modification of Diet in Renal Disease Study formula. Patients were divided into three groups according to GFR (i.e. <30, 30-59 and > or =60 mL/min per 1.73 m2) and pretransplant variables and rejection and infection rates within the first year were analyzed. The association between GFR at 1 year and mortality during follow-up was evaluated and reasons for the association were examined. There was no difference in the number of rejections or infections in the first year between the three groups. During a mean follow-up period of 6.3 years, 74% of patients with a GFR <30 mL/min per 1.73 m2 died, compared with 24% and 30% of those with a GFR > or =60 and 30-59 mL/min per 1.73 m2, respectively. Survival analysis (i.e. Cox regression analysis) demonstrated a significant difference between patients with a GFR <30 mL/min per 1.73 m2 and other patients (P< .001). A very low GFR at 1 year was the only independent predictor that remained statistically significant on multivariate analysis (hazard ratio =2.87; 95% confidence interval, 1.52-5.41). Severe renal dysfunction at 1 year was an independent predictor of long-term all-cause mortality in heart transplant patients.

  6. Predictors of 1-year outcomes in the Taiwan Acute Coronary Syndrome Full Spectrum Registry.

    PubMed

    Chiang, Fu-Tien; Shyu, Kou-Gi; Wu, Chiung-Jen; Mar, Guang-Yuan; Hou, Charles Jia-Yin; Li, Ai-Hsien; Wen, Ming-Shien; Lai, Wen-Ter; Lin, Shing-Jong; Kuo, Chi-Tai; Kuo, Chieh; Li, Yi-Heng; Hwang, Juey-Jen

    2014-11-01

    Evidence-based guidelines have been formulated for optimal management of acute coronary syndrome (ACS). The Taiwan ACS Full Spectrum Registry aimed to evaluate the ACS management and identify the predictors of clinical outcomes of death/myocardial infarction/stroke 1 year post hospital discharge. Three thousand and eighty confirmed ACS patients enrolled in this registry were followed up for 1 year at 3-month intervals. Patient data on medical interventions as well as clinical events were recorded and analyzed by descriptive statistics. One-year mortality among patients with ST-segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI) and unstable angina was 6.1%, 10.1%, and 6.2%, respectively. Use of secondary preventive therapies was suboptimal throughout the follow-up phase, especially dual antiplatelet therapy, which fell from 74.8% patients at discharge to 24.9% patients at 1-year follow-up. The odds of an adverse incidence of death/myocardial infarction/stroke 1 year after discharge was significantly reduced in patients receiving aspirin and clopidogrel for ≥9 months and was consequently higher in patients in whom dual antiplatelet therapy was discontinued or prescribed for <9 months. Chronic renal failure, in-hospital bleeding, a diagnosis of NSTEMI, and antiplatelet therapy discontinuation had a negative association with 1-year outcomes, whereas the use of drug-eluting stents and antiplatelet agents, clopidogrel and aspirin, were predictors of positive outcomes. There is a significant deviation from evidence-based guidelines in ACS management in Taiwan as reported in other countries. Policy adherence, especially with regard to dual antiplatelet therapy may hold the key to long-term favorable outcomes and improved survival rates in ACS patients in Taiwan. Copyright © 2013. Published by Elsevier B.V.

  7. Gait Asymmetries Persist 1 Year After Anterior Cruciate Ligament Reconstruction

    PubMed Central

    White, Kathleen; Logerstedt, David; Snyder-Mackler, Lynn

    2013-01-01

    Background: After anterior cruciate ligament reconstruction (ACLR), motivation to return to previous levels of activity is high. Very few studies have used return-to-activity criteria to determine when to permit athletic play. Return-to-activity measures objectively evaluate functional limb symmetry; however, previous biomechanical studies have found gait deviations in these individuals that persist up to 2 years after surgery. Purpose: To evaluate gait biomechanics in a specific cohort of ACL patients 1 year after surgery and retrospectively compare individuals who pass return-to-activity criteria 6 months after surgery with those who fail. Study Design: Prospective analysis. Methods: A total of 40 athletes who participated regularly (>50 h/y) in cutting, jumping, and pivoting activities and who sustained an isolated, unilateral ACL rupture were included in this study. All participants underwent reconstruction by the same surgeon and received individualized postoperative rehabilitation. Performance-based and self-report data were measured 6 months after surgery to assess readiness to return to activity (90% outcome required to pass); 20 subjects passed return-to-activity criteria and 20 subjects did not. Motion analysis was performed 1 year after surgery, and knee flexion angles, moments, and excursions were measured during gait and evaluated for all subjects. Results: There was no limb × group interaction or effect of group for all measures. Decreased knee measures were seen on the involved limb compared with the uninvolved limb for all subjects, and failed subjects demonstrated larger differences between limbs. Conclusion: Patients continued to demonstrate biomechanical limb asymmetries 1 year after ACLR, regardless of performance-based measures at 6 months. Early return to activity did not ensure limb symmetry at 1 year. Clinical Relevance: Gait asymmetries were seen in all subjects 1 year after surgery regardless of status at 6 months. Potentially prolonging

  8. Interval neural networks

    SciTech Connect

    Patil, R.B.

    1995-05-01

    Traditional neural networks like multi-layered perceptrons (MLP) use example patterns, i.e., pairs of real-valued observation vectors, ({rvec x},{rvec y}), to approximate function {cflx f}({rvec x}) = {rvec y}. To determine the parameters of the approximation, a special version of the gradient descent method called back-propagation is widely used. In many situations, observations of the input and output variables are not precise; instead, we usually have intervals of possible values. The imprecision could be due to the limited accuracy of the measuring instrument or could reflect genuine uncertainty in the observed variables. In such situation input and output data consist of mixed data types; intervals and precise numbers. Function approximation in interval domains is considered in this paper. We discuss a modification of the classical backpropagation learning algorithm to interval domains. Results are presented with simple examples demonstrating few properties of nonlinear interval mapping as noise resistance and finding set of solutions to the function approximation problem.

  9. Breast Cancer in the Elderly: Is MRI Helpful?

    PubMed

    Pilewskie, Melissa; Hirsch, Allison; Eaton, Anne; Stempel, Michelle; Gemignani, Mary L

    2015-01-01

    Appropriate use of magnetic resonance imaging (MRI) in elderly breast cancer (BC) patients remains unclear; we sought to identify the indications and implications of MRI use in our elderly BC population. Women 70 years of age or older at first BC diagnosis with an MRI performed at our institution either perioperatively or in follow-up were included from a prospectively maintained database from 2000 to 2010. Univariate logistic regression was used to test associations with disease identified by MRI only (additional ipsilateral, contralateral, or new cancer) following perioperative MRI. 305 BCs were imaged in 286 patients. 133 were imaged with MRI in the perioperative setting alone, 88 had only follow-up MRIs after BC treatment, and 65 had both. Indications for perioperative MRI include: extent of disease evaluation (181; 91%); occult primary (10; 5%); high-risk screening (5; 3%); and abnormal physical exam with negative conventional imaging (2; 1%). Disease identified by MRI only for occult primary cases was 4/10 (40%; 95% confidence interval: 12.2-73.8%) and 14/181 (7.7%; 95% confidence interval: 4.3-12.6%) for perioperative MRIs performed for extent of disease evaluation. Analysis of imaging and tumor characteristics failed to find significant predictors of disease identified by MRI only. A total of 369 post-treatment follow-up MRIs were performed in 148 patients with a median of 2 MRIs per patient (range 1-8), with seven cases of disease identified by MRI only (1.9%; 95% confidence interval: 0.8-3.9%). MRI had the greatest benefit in women presenting with an occult primary cancer and minimal additional benefit in elderly patients with BC undergoing MRI imaging for extent of disease evaluation or in post-treatment surveillance.

  10. Post-bronchiolitis Use of Asthma Medication: A Prospective 1-year Follow-up Study.

    PubMed

    Bergroth, Eija; Aakula, Matilda; Korppi, Matti; Remes, Sami; Kivistö, Juho E; Piedra, Pedro A; Camargo, Carlos A; Jartti, Tuomas

    2016-04-01

    Our aim was to evaluate the association between viral findings during bronchiolitis and the use of asthma controller medication (primary outcome) and systemic corticosteroids (secondary outcome) during the first post-bronchiolitis year. We enrolled 408 children hospitalized for bronchiolitis at <24 months of age in a prospective, 3-center, 1-year follow-up study in Finland. Viruses were detected with polymerase chain reaction in nasopharyngeal aspirates. The parents underwent a structured interview during hospitalization. Twelve months later, the use of asthma medication was asked in a structured questionnaire. Multivariable logistic regression was used for statistical analysis. In total, 365 (89%) children completed the 1-year follow-up. The use of long-term asthma controller medication was highest in the rhinovirus-positive group (61% vs. 15% in respiratory syncytial virus-positive group; adjusted odd ratios, 7.5; 95% confidence interval: 3.7-15.3), followed by children negative for both respiratory syncytial virus and rhinovirus (36%; adjusted odd ratios, 2.6; 95% confidence interval: 1.3-5.3). Likewise, rhinovirus etiology was associated with more courses of systemic corticosteroids during the follow-up. The main findings were similar in a subset of infants aged <12 months with first wheezing. Children hospitalized for rhinovirus-positive bronchiolitis used long-term asthma controller medication more often than those hospitalized for rhinovirus-negative bronchiolitis during first year after hospitalization.

  11. Pulmonary toxicity of cyclophosphamide: a 1-year study

    SciTech Connect

    Morse, C.C.; Sigler, C.; Lock, S.; Hakkinen, P.J.; Haschek, W.M.; Witschi, H.P.

    1985-01-01

    The development of cyclophosphamide-induced pulmonary lesions over a 1-year period was studied in mice. Male BALB/c mice received a single intraperitoneal injection of 100 mg/kg of cyclophosphamide. Within 3 weeks there were scattered foci of intraalveolar foamy macrophages. With time, these foci increased in size and, 1 year later, occupied large areas in all lung lobes. There was also diffuse interstitial fibrosis. Chemical determination done 3, 12, 24, and 52 weeks after cyclophosphamide showed that lungs of animals treated with cyclophosphamide had significantly more hydroxyproline per lung than controls. One year after cyclophosphamide pressure - volume curves measured in vivo were shifted down and to the right and total lung volumes were decreased. A single injection of cyclophosphamide produced an irreversible and progressive pulmonary lesion. 16 references, 5 figures, 3 tables.

  12. Secondary preventive medication persistence and adherence 1 year after stroke

    PubMed Central

    Olson, D.M.; Zhao, X.; Pan, W.; Zimmer, L.O.; Goldstein, L.B.; Alberts, M.J.; Fagan, S.C.; Fonarow, G.C.; Johnston, S.C.; Kidwell, C.; LaBresh, K.A.; Ovbiagele, B.; Schwamm, L.; Peterson, E.D.

    2011-01-01

    Objective: Data on long-term use of secondary prevention medications following stroke are limited. The Adherence eValuation After Ischemic stroke–Longitudinal (AVAIL) Registry assessed patient, provider, and system-level factors influencing continuation of prevention medications for 1 year following stroke hospitalization discharge. Methods: Patients with ischemic stroke or TIA discharged from 106 hospitals participating in the American Heart Association Get With The Guidelines–Stroke program were surveyed to determine their use of warfarin, antiplatelet, antihypertensive, lipid-lowering, and diabetes medications from discharge to 12 months. Reasons for stopping medications were ascertained. Persistence was defined as continuation of all secondary preventive medications prescribed at hospital discharge, and adherence as continuation of prescribed medications except those stopped according to health care provider instructions. Results: Of the 2,880 patients enrolled in AVAIL, 88.4% (2,457 patients) completed 1-year interviews. Of these, 65.9% were regimen persistent and 86.6% were regimen adherent. Independent predictors of 1-year medication persistence included fewer medications prescribed at discharge, having an adequate income, having an appointment with a primary care provider, and greater understanding of why medications were prescribed and their side effects. Independent predictors of adherence were similar to those for persistence. Conclusions: Although up to one-third of stroke patients discontinued one or more secondary prevention medications within 1 year of hospital discharge, self-discontinuation of these medications is uncommon. Several potentially modifiable patient, provider, and system-level factors associated with persistence and adherence may be targets for future interventions. PMID:21900638

  13. Associations between care pathways and outcome 1 year after severe traumatic brain injury.

    PubMed

    Godbolt, Alison K; Stenberg, Maud; Lindgren, Marie; Ulfarsson, Trandur; Lannsjö, Marianne; Stålnacke, Britt-Marie; Borg, Jörgen; DeBoussard, Catharina Nygren

    2015-01-01

    To assess associations between real-world care pathways for working-age patients in the first year after severe traumatic brain injury and outcomes at 1 year. Prospective, observational study with recruitment from 6 neurosurgical centers in Sweden and Iceland. Follow-up to 1 year, independently of care pathways, by rehabilitation physicians and paramedical professionals. Patients with severe traumatic brain injury, lowest (nonsedated) Glasgow Coma Scale score 3 to 8 during the first 24 hours and requiring neurosurgical intensive care, age 18 to 65 years, and alive 3 weeks after injury. Length of stay in intensive care, time between intensive care discharge and rehabilitation admission, outcome at 1 year (Glasgow Outcome Scale Extended score), acute markers of injury severity, preexisting medical conditions, and post-acute complications. Logistic regression analyses were performed. A multivariate model found variables significantly associated with outcome (odds ratio for good outcome [confidence interval], P value) to be as follows: length of stay in intensive care (0.92 [0.87-0.98], 0.014), time between intensive care discharge and admission to inpatient rehabilitation (0.97 [0.94-0.99], 0.017), and post-acute complications (0.058 [0.006-0.60], 0.017). Delays in rehabilitation admission were negatively associated with outcome. Measures to ensure timely rehabilitation admission may improve outcome. Further research is needed to evaluate possible causation.

  14. Prediction of MRI erosive progression: a comparison of modern imaging modalities in early rheumatoid arthritis patients.

    PubMed

    Bøyesen, Pernille; Haavardsholm, Espen A; van der Heijde, Désirée; Østergaard, Mikkel; Hammer, Hilde Berner; Sesseng, Sølve; Kvien, Tore K

    2011-01-01

    To examine the associations between modern imaging modalities and joint damage measured as 1-year MRI erosive progression, in early rheumatoid arthritis (RA) patients. 84 RA patients with disease duration of less than 1 year were included in this inception cohort. Patients were evaluated at baseline, 3, 6 and 12 months by core measures of disease activity, MRI and ultrasound grey-scale (USGS) of inflammation, conventional radiography and digital x-ray radiogrammetry (DXR) bone mineral density (BMD) of cortical hand bone. 53 of the 79 patients (67%) who completed the follow-up had MRI erosive progression (dependent variable). USGS and MRI bone marrow oedema (BME) were in multivariate analyses independent predictors of 1-year MRI erosive progression. There was a trend towards higher MRI synovitis score and 3-month DXR BMD loss in patients developing MRI erosions. On an individual level, USGS inflammation, MRI synovitis and MRI BME also somewhat better predicted outcome than rheumatoid factor, anticitrullinated protein antibodies and disease activity score 28. USGS inflammation and MRI BME were independent predictors of MRI erosive progression in early RA patients on a group level. The exact prognosis of the individual patients could not be determined by imaging alone.

  15. Overconfidence in Interval Estimates

    ERIC Educational Resources Information Center

    Soll, Jack B.; Klayman, Joshua

    2004-01-01

    Judges were asked to make numerical estimates (e.g., "In what year was the first flight of a hot air balloon?"). Judges provided high and low estimates such that they were X% sure that the correct answer lay between them. They exhibited substantial overconfidence: The correct answer fell inside their intervals much less than X% of the time. This…

  16. Acquired childhood aphasia. Outcome 1 year after onset.

    PubMed

    Loonen, M C; van Dongen, H R

    1990-12-01

    The effects of the variables age at onset, cause, severity and bilaterality of lesion, and type of aphasia on course and outcome were investigated in a group of 28 aphasic children. Analysis of spontaneous speech and tests of auditory verbal comprehension were used to determine the presence of aphasia. The severity of the cerebral lesion was assessed using a rating scale for computed tomographic scans. Most of the children had not recovered completely 1 year after onset. Recovery was significantly different according to etiological categories. Complete recovery was seen in the majority of traumatic cases.

  17. MRI Safety during Pregnancy

    MedlinePlus

    ... 20 to 40 minutes. top of page Contrast material For some MRI exams, a contrast material called gadolinium will need to be injected into a vein in the arm. While contrast material sometimes improves the MRI images, during pregnancy the ...

  18. Sinus MRI scan

    MedlinePlus

    ... sinuses. The test is noninvasive. MRI uses powerful magnets and radio waves instead of radiation. Signals from ... in the eyes. Because the MRI contains a magnet, metal-containing objects such as pens, pocketknives, and ...

  19. Arm MRI scan

    MedlinePlus

    ... arm MRI (magnetic resonance imaging) scan uses strong magnets to create pictures of the upper and lower ... in your eyes) Because the MRI contains strong magnets, metal objects are not allowed into the room ...

  20. Magnetic Resonance Imaging (MRI)

    MedlinePlus

    ... an image. Repeated exposure can be harmful.An MRI scan takes longer to perform (30 to 60 minutes, ... a treatment plan.Depending on your symptoms, an MRI will scan a specific portion of your body to diagnose: ...

  1. MRI Safety during Pregnancy

    MedlinePlus

    ... 20 to 40 minutes. top of page Contrast material For some MRI exams, a contrast material called gadolinium will need to be injected into a vein in the arm. While contrast material sometimes improves the MRI images, during pregnancy the ...

  2. Varieties of Confidence Intervals.

    PubMed

    Cousineau, Denis

    2017-01-01

    Error bars are useful to understand data and their interrelations. Here, it is shown that confidence intervals of the mean (CI M s) can be adjusted based on whether the objective is to highlight differences between measures or not and based on the experimental design (within- or between-group designs). Confidence intervals (CIs) can also be adjusted to take into account the sampling mechanisms and the population size (if not infinite). Names are proposed to distinguish the various types of CIs and the assumptions underlying them, and how to assess their validity is explained. The various CIs presented here are easily obtained from a succession of multiplicative adjustments to the basic (unadjusted) CI width. All summary results should present a measure of precision, such as CIs, as this information is complementary to effect sizes.

  3. Interpregnancy interval and risk of autistic disorder.

    PubMed

    Gunnes, Nina; Surén, Pål; Bresnahan, Michaeline; Hornig, Mady; Lie, Kari Kveim; Lipkin, W Ian; Magnus, Per; Nilsen, Roy Miodini; Reichborn-Kjennerud, Ted; Schjølberg, Synnve; Susser, Ezra Saul; Øyen, Anne-Siri; Stoltenberg, Camilla

    2013-11-01

    A recent California study reported increased risk of autistic disorder in children conceived within a year after the birth of a sibling. We assessed the association between interpregnancy interval and risk of autistic disorder using nationwide registry data on pairs of singleton full siblings born in Norway. We defined interpregnancy interval as the time from birth of the first-born child to conception of the second-born child in a sibship. The outcome of interest was autistic disorder in the second-born child. Analyses were restricted to sibships in which the second-born child was born in 1990-2004. Odds ratios (ORs) were estimated by fitting ordinary logistic models and logistic generalized additive models. The study sample included 223,476 singleton full-sibling pairs. In sibships with interpregnancy intervals <9 months, 0.25% of the second-born children had autistic disorder, compared with 0.13% in the reference category (≥ 36 months). For interpregnancy intervals shorter than 9 months, the adjusted OR of autistic disorder in the second-born child was 2.18 (95% confidence interval 1.42-3.26). The risk of autistic disorder in the second-born child was also increased for interpregnancy intervals of 9-11 months in the adjusted analysis (OR = 1.71 [95% CI = 1.07-2.64]). Consistent with a previous report from California, interpregnancy intervals shorter than 1 year were associated with increased risk of autistic disorder in the second-born child. A possible explanation is depletion of micronutrients in mothers with closely spaced pregnancies.

  4. Breast findings incidentally detected on body MRI.

    PubMed

    Bignotti, Bianca; Succio, Giulia; Nosenzo, Francesca; Perinetti, Michela; Gristina, Licia; Barbagallo, Stella; Secondini, Lucia; Calabrese, Massimo; Tagliafico, Alberto

    2016-01-01

    To evaluate breast findings incidentally detected on body MRI. A retrospective review of the institutional database identified 1752 body MRI performed between January 2015 and September 2015. MRI of women with breast tissue visible in the field-of-view were reviewed for breast findings. Breast findings were classified with the breast imaging reporting and data system (BI-RADS) lexicon. The standard statistic, costs of additional work-up, and the clinical relevance were used to describe breast findings, and we calculated 95 % exact confidence intervals (CIs). 440 body MRI of 440 women (mean age: 57 ± 20 years) included breast tissue in the field-of-view. A total of 41 breast findings were identified in 41 patients. Breast findings were classified BI-RADS 2 N = 25, BI-RADS 3 N = 13, BI-RADS 4 N = 3. A total of 3.6 % [95 % CI 1.6 %, 5.6 %] women with breast tissue visible on MRI had a recommendation for further imaging work-up for a breast finding. The 18.7 % (3 of 16) of these patients had a clinically important finding (breast cancer). Further imaging evaluation increased costs of €108.3 per patient with a breast finding. Clinically important breast findings could be detected on body MRI in up to 0.7 % (3 of 440) of women.

  5. Patient-based and clinical outcomes of implant telescopic attachment-retained mandibular overdentures: a 1-year longitudinal prospective study.

    PubMed

    Yunus, Norsiah; Saub, Roslan; Taiyeb Ali, Tara Bai; Salleh, Nosizana Mohd; Baig, Mirza Rustum

    2014-01-01

    The purpose of this study was to evaluate and compare Oral Health-Related Quality of Life (OHRQoL), denture satisfaction, and masticatory performance in edentulous patients provided with mandibular implant-supported overdentures (ISODs) retained with telescopic attachments and those of conventional complete dentures (CCDs). Peri-implant soft tissue changes were also evaluated at various intervals during a 1-year observation period. Participating patients received new CCDs and later received two mandibular interforaminal implants and had their mandibular CCDs converted into ISODs with telescopic attachments. Questionnaires were used to assess OHRQoL (Shortened Oral Health Impact Profile-14, Malaysian version) and denture satisfaction at different stages of treatment with CCDs and ISODs. Objective masticatory performance with the CCDs and ISODs was recorded with a mixing ability test. Evaluations were carried out at 3 months with the new CCDs, 3 months after mandibular ISOD provision, and 1 year after receiving the ISOD. Peri-implant parameters were additionally assessed at specific intervals during the treatment period. The data obtained were statistically analyzed and compared. In the 17 patients who completed the protocol, significant improvements were observed in OHRQoL and patient satisfaction when CCDs were modified to ISODs, after 3 months, and at 1 year. Significantly better mixing ability with the ISOD was noted, with the highest values observed at 1 year. Statistically insignificant differences were observed for all the peri-implant parameters, except for gingival recession, for which significant changes were observed 6 months after ISOD delivery (values had stabilized by 1 year). Telescopic crown attachment-retained mandibular ISODs improved OHRQoL, dental prosthesis satisfaction, and masticatory performance compared to CCDs. Peri-implant soft tissue response and implant stability were found to be favorable after 1 year.

  6. Dietary quality 1 year after diagnosis of coronary heart disease.

    PubMed

    Ma, Yunsheng; Li, Wenjun; Olendzki, Barbara C; Pagoto, Sherry L; Merriam, Philip A; Chiriboga, David E; Griffith, Jennifer A; Bodenlos, Jamie; Wang, Yanli; Ockene, Ira S

    2008-02-01

    The purpose of this ancillary study is to determine the quality of diets in patients with documented coronary heart disease (CHD). Dietary data were originally collected using a 24-hour dietary recall in 555 patients with CHD, 1 year after a diagnostic coronary angiography. Data used for this investigation were collected between March 2001 and November 2003. Patients were participants in a clinical trial to improve adherence to lipid-lowering medications. The Alternate Healthy Eating Index, an instrument designed to evaluate the degree to which a diet has the potential to prevent cardiovascular disease, measured dietary quality. Linear regression models were used to assess the association of dietary quality with patients' sociodemographic and clinical characteristics. Mean age of participants was 61 years, with an average body mass index of 30 (calculated as kg/m(2)). Sixty percent were men. Average daily caloric intake was 1,775 kcal, with 50% of calories derived from carbohydrates, 18% from protein, and 32% from total fat. Average Alternate Healthy Eating Index score was 30.8 out of a possible maximum score of 80. Only 12.4% of subjects met the recommended consumption of vegetables, 7.8% for fruit, 8% for cereal fiber, and 5.2% for trans-fat intake. Lower dietary quality was associated with lower total caloric intake, as well as with smoking, obesity, and lower educational level. A high proportion of patients reported poor dietary quality 1 year after experiencing a coronary event. Our data support continued efforts to enhance healthful dietary changes over time for secondary prevention of CHD. Dietary change should be emphasized with CHD patients who are less educated, smokers, or obese.

  7. [Otitis media with effusion in children younger than 1 year].

    PubMed

    Di Francesco, Renata Cantisani; Barros, Vivian Boschesi; Ramos, Rafael

    2016-06-01

    To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position), type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2,500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score <7 and day care attendance. The multivariate analysis showed that artificial feeding is the factor most often associated to otitis media with effusion. Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  8. Multichannel interval timer (MINT)

    SciTech Connect

    Kimball, K.B.

    1982-06-01

    A prototype Multichannel INterval Timer (MINT) has been built for measuring signal Time of Arrival (TOA) from sensors placed in blast environments. The MINT is intended to reduce the space, equipment costs, and data reduction efforts associated with traditional analog TOA recording methods, making it more practical to field the large arrays of TOA sensors required to characterize blast environments. This document describes the MINT design features, provides the information required for installing and operating the system, and presents proposed improvements for the next generation system.

  9. Shock-wave therapy for tennis and golfer's elbow--1 year follow-up.

    PubMed

    Krischek, O; Hopf, C; Nafe, B; Rompe, J D

    1999-01-01

    Thirty patients with chronic medial epicondylitis were treated with low-energy shock waves. They received 500 impulses of 0.08 mJ/mm2 three times at weekly intervals. At 1 year follow-up examinations were performed. According to the Verhaar criteria, only seven patients reached excellent or good results. In eight cases a fair outcome was recorded, and in 14 patients the outcome was poor. Only six patients were satisfied with the treatment. The average relief of pain was 32%. These data were significantly worse than for identically treated patients with chronic tennis elbow. Thus, the question arises as to whether extracorporal shock-wave therapy is indicated in medial epicondylitis.

  10. Laparoscopic reconstruction of ureteral strictures involving solitary renal units-1 year and 5 year outcomes.

    PubMed

    Abraham, George P; Das, Krishanu; Siddiaiah, Avinash T; Ramaswami, Krishnamohan; George, P Datson; Abraham, Jisha J

    2015-01-01

    Long-term outcome following a laparoscopic reconstruction of ureteral strictures (US) involving solitary renal units (SRU) are scarcely reported. The aim was to report short-term (1 year) and long-term (5 years) outcomes following a laparoscopic reconstruction of US in a solitary kidney. Retrospective. Records of patients operated for similar scenarios between January 2004 and January 2014 were evaluated. Clinical, biochemical and radiological profile were noted. Operative and post-operative profile were recorded. Follow-ups were scheduled at regular intervals (3 months post-procedure, 6 monthly for 2 years and yearly thereafter. Imaging was repeated at yearly intervals). Outcome was assessed by comparing pre-operative and post-operative clinical, biochemical, and radiological parameters. SAS software 9.2 version. A P < 0.05 was inferred as statistically significant. Seven patients underwent a laparoscopic reconstruction. Stricture location was upper ureter (n = 1), mid ureter (n = 2), lower ureter (n = 4). Surgeries performed were ureteroureterostomy, Boari flap ureteroneocystostomy and ureteroneocystostomy with psoas hitch. Four patients reported prior contralateral nephrectomy. Three patients underwent prior endoscopic correction. Four patients presented with elevated serum creatinine (>1.4 mg/dl). Till last follow-up, improvement in symptomatology and improvement or stabilisation of serum creatinine was perceived in all. Ureteral patency with resolution of hydronephrosis was observed in five patients at 1 year follow-up. Two patients revealed ureteral patency with persistence of hydronephrosis. Clinical, biochemical and radiological outcomes were maintained till long-term follow-up. Laparoscopic reconstruction of US in SRU offers impressive short- and long-term outcome.

  11. Interval probabilistic neural network.

    PubMed

    Kowalski, Piotr A; Kulczycki, Piotr

    2017-01-01

    Automated classification systems have allowed for the rapid development of exploratory data analysis. Such systems increase the independence of human intervention in obtaining the analysis results, especially when inaccurate information is under consideration. The aim of this paper is to present a novel approach, a neural networking, for use in classifying interval information. As presented, neural methodology is a generalization of probabilistic neural network for interval data processing. The simple structure of this neural classification algorithm makes it applicable for research purposes. The procedure is based on the Bayes approach, ensuring minimal potential losses with regard to that which comes about through classification errors. In this article, the topological structure of the network and the learning process are described in detail. Of note, the correctness of the procedure proposed here has been verified by way of numerical tests. These tests include examples of both synthetic data, as well as benchmark instances. The results of numerical verification, carried out for different shapes of data sets, as well as a comparative analysis with other methods of similar conditioning, have validated both the concept presented here and its positive features.

  12. Accelerated Gastric Emptying but No Carbohydrate Malabsorption 1 Year After Gastric Bypass Surgery (GBP)

    PubMed Central

    Wang, Gary; Agenor, Keesandra; Pizot, Justine; Kotler, Donald P.; Harel, Yaniv; Van Der Schueren, Bart J.; Quercia, Iliana; McGinty, James

    2013-01-01

    Background Following gastric bypass surgery (GBP), there is a post-prandial rise of incretin and satiety gut peptides. The mechanisms of enhanced incretin release in response to nutrients after GBP is not elucidated and may be in relation to altered nutrient transit time and/or malabsorption. Methods Seven morbidly obese subjects (BMI=44.5±2.8 kg/m2) were studied before and 1 year after GBP with a d-xylose test. After ingestion of 25 g of d-xylose in 200 mL of non-carbonated water, blood samples were collected at frequent time intervals to determine gastric emptying (time to appearance of d-xylose) and carbohydrate absorption using standard criteria. Results One year after GBP, subjects lost 45.0±9.7 kg and had a BMI of 27.1±4.7 kg/m2. Gastric emptying was more rapid after GBP. The mean time to appearance of d-xylose in serum decreased from 18.6±6.9 min prior to GBP to 7.9±2.7 min after GBP (p=0.006). There was no significant difference in absorption before (serum d-xylose concentrations=35.6±12.6 mg/dL at 60 min and 33.9±9.1 mg/dL at 180 min) or 1 year after GBP (serum d-xylose=31.5± 18.1 mg/dL at 60 min and 27.2±11.9 mg/dL at 180 min). Conclusions These data confirm the acceleration of gastric emptying for liquid and the absence of carbohydrate malabsorption 1 year after GBP. Rapid gastric emptying may play a role in incretin response after GBP and the resulting improved glucose homeostasis. PMID:22527599

  13. Alternative diagnoses at paediatric appendicitis MRI.

    PubMed

    Moore, M M; Kulaylat, A N; Brian, J M; Khaku, A; Hulse, M A; Engbrecht, B W; Methratta, S T; Boal, D K B

    2015-08-01

    As the utilization of MRI in the assessment for paediatric appendicitis increases in clinical practice, it is important to recognize alternative diagnoses as the cause of abdominal pain. The purpose of this review is to share our institution's experience using MRI in the evaluation of 510 paediatric patients presenting with suspected appendicitis over a 30 month interval (July 2011 to December 2013). An alternative diagnosis was documented in 98/510 (19.2%) patients; adnexal pathology (6.3%, n = 32), enteritis-colitis (6.3%, n = 32), and mesenteric adenitis (2.2%, n = 11) comprised the majority of cases. These common entities and other less frequent illustrative cases obtained during our overall institutional experience with MRI for suspected appendicitis are reviewed.

  14. Varicella paediatric hospitalisations in Belgium: a 1-year national survey

    PubMed Central

    Blumental, Sophie; Sabbe, Martine; Lepage, Philippe

    2016-01-01

    Background Varicella universal vaccination (UV) has been implemented in many countries for several years. Nevertheless, varicella UV remains debated in Europe and few data are available on the real burden of infection. We assessed the burden of varicella in Belgium through analysis of hospitalised cases during a 1-year period. Methods Data on children admitted to hospital with varicella were collected through a national network from November 2011 to October 2012. Inclusion criteria were either acute varicella or related complications up to 3 weeks after the rash. Results Participation of 101 hospitals was obtained, covering 97.7% of the total paediatric beds in Belgium. 552 children were included with a median age of 2.1 years. Incidence of paediatric varicella hospitalisations reached 29.5/105 person-years, with the highest impact among those 0–4 years old (global incidence and odds of hospitalisation: 79/105 person-years and 1.6/100 varicella cases, respectively). Only 14% (79/552) of the cohort had an underlying chronic condition. 65% (357/552) of children had ≥1 complication justifying their admission, 49% were bacterial superinfections and 10% neurological disorders. Only a quarter of children (141/552) received acyclovir. Incidence of complicated hospitalised cases was 19/105 person-years. Paediatric intensive care unit admission and surgery were required in 4% and 3% of hospitalised cases, respectively. Mortality among Belgian paediatric population was 0.5/106 and fatality ratio 0.2% among our cohort. Conclusions Varicella demonstrated a substantial burden of disease in Belgian children, especially among the youngest. Our thorough nationwide study, run in a country without varicella UV, offers data to support varicella UV in Belgium. PMID:26130380

  15. Varicella paediatric hospitalisations in Belgium: a 1-year national survey.

    PubMed

    Blumental, Sophie; Sabbe, Martine; Lepage, Philippe

    2016-01-01

    Varicella universal vaccination (UV) has been implemented in many countries for several years. Nevertheless, varicella UV remains debated in Europe and few data are available on the real burden of infection. We assessed the burden of varicella in Belgium through analysis of hospitalised cases during a 1-year period. Data on children admitted to hospital with varicella were collected through a national network from November 2011 to October 2012. Inclusion criteria were either acute varicella or related complications up to 3 weeks after the rash. Participation of 101 hospitals was obtained, covering 97.7% of the total paediatric beds in Belgium. 552 children were included with a median age of 2.1 years. Incidence of paediatric varicella hospitalisations reached 29.5/10(5) person-years, with the highest impact among those 0-4 years old (global incidence and odds of hospitalisation: 79/10(5) person-years and 1.6/100 varicella cases, respectively). Only 14% (79/552) of the cohort had an underlying chronic condition. 65% (357/552) of children had ≥1 complication justifying their admission, 49% were bacterial superinfections and 10% neurological disorders. Only a quarter of children (141/552) received acyclovir. Incidence of complicated hospitalised cases was 19/10(5) person-years. Paediatric intensive care unit admission and surgery were required in 4% and 3% of hospitalised cases, respectively. Mortality among Belgian paediatric population was 0.5/10(6) and fatality ratio 0.2% among our cohort. Varicella demonstrated a substantial burden of disease in Belgian children, especially among the youngest. Our thorough nationwide study, run in a country without varicella UV, offers data to support varicella UV in Belgium. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. [Temporomandibular joint: MRI diagnostics].

    PubMed

    Kress, B; Schmitter, M

    2005-09-01

    MRI of the temporomandibular joint (TMJ) requires 1.5 T. The radiologist must be familiar with the anatomy and pathology of the TMJ. This review gives a description of MRI protocols for the TMJ, and MRI anatomy and pathology of the TMJ (open and closed mouth) by means of MR images and drawings. Diagnosing of the TMJ related diseases depends on standardized clinical and MR examinations. Therefore close interdisciplinary cooperation between dentist and radiologist is necessary.

  17. MRI brain imaging.

    PubMed

    Skinner, Sarah

    2013-11-01

    General practitioners (GPs) are expected to be allowed to request MRI scans for adults for selected clinically appropriate indications from November 2013 as part of the expansion of Medicare-funded MRI services announced by the Federal Government in 2011. This article aims to give a brief overview of MRI brain imaging relevant to GPs, which will facilitate explanation of scan findings and management planning with their patients. Basic imaging techniques, common findings and terminology are presented using some illustrative case examples.

  18. Factors associated with death 1 year after lower extremity bypass in Northern New England.

    PubMed

    Goodney, Philip P; Nolan, Brian W; Schanzer, Andres; Eldrup-Jorgensen, Jens; Stanley, Andrew C; Stone, David H; Likosky, Donald S; Cronenwett, Jack L

    2010-01-01

    Using 30-day operative mortality reported with lower extremity bypass (LEB) in preoperative decision making may underestimate the actual death rate encountered before patients have truly recovered from surgery, especially in elderly, debilitated patients with significant tissue loss. Therefore, we examined preoperative, patient-level risk factors that predict survival within the first year following LEB. Using our regional quality improvement initiative in 11 hospitals in Northern New England, we studied 2306 LEB procedures performed in 2031 patients between January 2003 and December 2007. Sixty surgeons contributed to our database, and over 100 demographic and clinical variables were abstracted by trained researchers. Cox proportional hazards models were used to generate hazard ratios (HR) and surrounding 95% confidence intervals (CI) for our combined outcome measure of death occurring within the first year postoperatively. We found that within our cohort of 2306 bypass procedures, 11% of patients died within 1 year of surgery (2% prior to discharge, 9% prior to 1-year follow-up). We identified six preoperative patient characteristics associated with higher risk of death in multivariate analysis: congestive heart failure (HR 1.3, 95% CI 1.0-1.8), diabetes (HR 1.5, 95% CI 1.1-2.1), critical limb ischemia (CLI) (HR 1.7, 95% CI 1.3-2.4), lack of single-segment saphenous vein (HR 1.9, 95% CI 1.5-2/5), age over 80 (HR 2.0, 95% CI 1.5-2.7), dialysis dependence (HR 2.7, 95% CI 1.9-3.6), and emergent nature of the procedure (HR 3.4, 95% CI 1.7-6.8). While patients with no risk factors had 1-year death rates that were less than 5%: patients with three or more risk factors had a 28% chance of dying before 1 year postoperatively. When we compared risk-adjusted survival across centers, we found that one center in our region performed significantly better than expected (observed-to-expected outcome ratio 0.7, 95% CI 0.6-0.9, P = .04). Preoperative risk factors allow surgeons

  19. Serial magnetic resonance imaging of global and regional left ventricular remodeling during 1 year after acute myocardial infarction.

    PubMed

    Schroeder, A P; Houlind, K; Pedersen, E M; Nielsen, T T; Egeblad, H

    2001-01-01

    Biplane long-axis cine MRI was performed in 51 patients 1, 13, 26, and 52 weeks after their first AMI. LV mass index (LVMI) was significantly increased 1 week after AMI (84.3 +/- 16.9 vs. 68.1 +/- 11.4 g/m(2) controls, n = 48, p < 0.001), presumably owing to edema of the infarcted myocardium. Six months after AMI, LVMI decreased to 76.5 +/- 16.4 g/m(2), but had again augmented after 1 year (81.8 +/- 17.3 g/m(2), p < 0.05), suggesting late, compensatory left ventricular hypertrophy. In patients treated with primary percutaneous transluminal coronary angioplasty, LVMI decreased 5% over 1 year, while LVMI increased 10% in patients receiving thrombolysis (p < 0.05). In the entire population, the global increase in LVMI 1 year after AMI seemed to reflect global cavity dilatation with unchanged thickness of the vital myocardium. In conclusion, in patients receiving contemporary treatment, LV remodeling only partially complied with the classical patho-anatomical concept.

  20. Interval hypoxic training.

    PubMed

    Bernardi, L

    2001-01-01

    Interval hypoxic training (IHT) is a technique developed in the former Soviet Union, that consists of repeated exposures to 5-7 minutes of steady or progressive hypoxia, interrupted by equal periods of recovery. It has been proposed for training in sports, to acclimatize to high altitude, and to treat a variety of clinical conditions, spanning from coronary heart disease to Cesarean delivery. Some of these results may originate by the different effects of continuous vs. intermittent hypoxia (IH), which can be obtained by manipulating the repetition rate, the duration and the intensity of the hypoxic stimulus. The present article will attempt to examine some of the effects of IH, and, whenever possible, compare them to those of typical IHT. IH can modify oxygen transport and energy utilization, alter respiratory and blood pressure control mechanisms, induce permanent modifications in the cardiovascular system. IHT increases the hypoxic ventilatory response, increase red blood cell count and increase aerobic capacity. Some of these effects might be potentially beneficial in specific physiologic or pathologic conditions. At this stage, this technique appears interesting for its possible applications, but still largely to be explored for its mechanisms, potentials and limitations.

  1. Weight changes in children in foster care for 1 year

    PubMed Central

    Schneiderman, Janet U.; Smith, Caitlin; Arnold, Janet S.; Fuentes, Jorge; Duan, Lei

    2013-01-01

    Objective The aims of this study of predominately racial/ethnic minority children in foster care (N = 360, birth to 19 years old) in Los Angeles, CA were to examine the (1) prevalence of obesity (≥ 95 percentile) and overweight/obese(≥ 85 percentile) upon entrance to foster care (T1) and after 1 year in foster care (T2); (2) comparison of high weight categories to national statistics; (3) relationship of changes in weight status to age, reason for entry into foster care, and placement. Methods Chi-square test and McNemar test comparing paired proportions were used to determine whether there were significant changes in the proportion of high weight categories between T1 and T2. Chi-square test or Fisher’s exact test were used to evaluated the association between age, placement, and reason for foster care with the change in weight category. Changes in weight were categorized as (1) decreased in weight, (2) remained at overweight or obese, (3) increased in weight, or (4) remained normal. Results The proportion of obese and obese/overweight children between age 2 and 5 were significantly lower at T2 than T1. There were no significant changes in the prevalence of obesity for the total population at T2. Children age 6 or older had a higher prevalence of obesity and overweight/obesity compared to national statistics. Of children at all ages, 64.7% of children of all ages entered foster care with a normal weight and stayed in the normal range during their first year in foster care, 12.2% decreased their weight, 15.4% remained overweight or obese, and 7.7% increased their weight. Age and parental substance use was related to change in weight category from T1 to T2. Conclusions Children did not become more overweight or obese in foster care; however 28% of the children were obese or overweight upon entry into foster care. Children who are 6 years or older and obese upon entering foster care should be targeted for weight reduction. The pediatric community and child

  2. Weight changes in children in foster care for 1 year.

    PubMed

    Schneiderman, Janet U; Smith, Caitlin; Arnold-Clark, Janet S; Fuentes, Jorge; Duan, Lei

    2013-10-01

    The aims of this study of predominately racial/ethnic minority children in foster care (N=360, birth to 19 years old) in Los Angeles, CA were to examine the (1) prevalence of obesity (≥ 95 percentile) and overweight/obese (≥ 85 percentile) upon entrance to foster care (T1) and after 1 year in foster care (T2); (2) comparison of high weight categories to national statistics; (3) relationship of changes in weight status to age, reason for entry into foster care, and placement. Chi-square test and McNemar test comparing paired proportions were used to determine whether there were significant changes in the proportion of high weight categories between T1 and T2. Chi-square test or Fisher's exact test were used to evaluate the association between age, placement, and reason for foster care with the change in weight category. Changes in weight were categorized as (1) decreased in weight, (2) remained at overweight or obese, (3) increased in weight, or (4) remained normal. The proportion of obese and obese/overweight children between ages 2 and 5 were significantly lower at T2 than T1. There were no significant changes in the prevalence of obesity for the total population at T2. Children age 6 or older had a higher prevalence of obesity and overweight/obesity compared to national statistics. Of children at all ages, 64.7% of children of all ages entered foster care with a normal weight and stayed in the normal range during their first year in foster care, 12.2% decreased their weight, 15.4% remained overweight or obese, and 7.7% increased their weight. Age and parental substance use was related to change in weight category from T1 to T2. Children did not become more overweight or obese in foster care; however 28% of the children were obese or overweight upon entry into foster care. Children who are 6 years or older and obese upon entering foster care should be targeted for weight reduction. The pediatric community and child welfare system need to work together by

  3. A 1-Year Prospective Analysis of Ice Climbing Injuries.

    PubMed

    Runer, Armin; Lampl, Kathrin; Neunhäuserer, Daniel; Runer, Florian; Frick, Nora; Seitlinger, Gerd; Resch, Herbert; Moroder, Philipp

    2017-03-01

    To describe rates, patterns, and causes of acute injuries in an increasingly popular outdoor sport. Prospective cohort study. One winter season ranging from November 2011 to March 2011. Seventy ice climbers from 13 different countries and various performance levels. Participants were asked to complete a monthly Internet-based survey regarding their completed hours of training and competitions and eventual sustained injuries. During 4275 hours of ice climbing, 42 injuries occurred, of which 81.0% were defined as mild, 16.6% as moderate, and 2.4% as severe. The calculated injury rate was 9.8 injuries per 1000 hours of sports exposure. Intermediate ice climbers had a significantly higher injury risk compared with advanced ice climbers (odds ratio, 2.55; 95% confidence intervals, 1.17-5.54; P = 0.018). About 73.8% of all injuries occurred on a frozen waterfall, icicles, or icefalls, whereas 4.8% occurred on artificial ice walls. The head was the most injured body part (47.6%), followed by the knee (14.3%) and the shoulder (11.9%). The most common types of injuries were abrasions (38.1%), contusions (35.7%), and joint sprains (7.1%). Falling ice was the main circumstance leading to injury (59.5%). All athletes with a head injury wore a helmet; however, only 35.0% mentioned they used protective goggles. Ice climbing is a sport with moderate risk for injury with most of the reported injuries being of minor severity. However, severe and fatal injuries, although less common, also occur. Advanced ice climbers with greater experience and skill level have a lower overall injury risk.

  4. MRI of the Musculoskeletal System

    MedlinePlus

    ... does not completely surround you. Some newer MRI machines have a larger diameter bore which can be ... size patients or patients with claustrophobia. Other MRI machines are open on the sides (open MRI). Open ...

  5. Magnetic Resonance Imaging (MRI) - Spine

    MedlinePlus

    ... does not completely surround you. Some newer MRI machines have a larger diameter bore which can be ... size patients or patients with claustrophobia. Other MRI machines are open on the sides (open MRI). Open ...

  6. Prognosis of stroke in the south of Greece: 1 year mortality, functional outcome and its determinants: the Arcadia Stroke Registry

    PubMed Central

    Vemmos, K; Bots, M; Tsibouris, P; Zis, V; Takis, C; Grobbee, D; Stamatelopoulos, S

    2000-01-01

    OBJECTIVES—For Greece, data on incidence of stroke, type of stroke, and prognosis of stroke is limited. Recently, results on incidence of stroke were published. Here 1 year mortality, functional outcome after a first ever stroke, and determinants of the prognosis are described.
METHODS—A population based registry was established in the Arcadia area, located in eastern central Peloponessos in southern Greece. Between 1 November 1993 and 31 October 1995, 555 patients with a first ever stroke were identified using information from death certificates, hospital records, public health centres and general practitioners. Extensive information on cardiovascular risk factors and stroke characteristics was obtained. After 1 year a modified Rankin score was determined in all surviving patients.
RESULTS—After 1 year of follow up, 204 (36.8%) patients died. The probability of survival 1 year after stroke was higher for cerebral infarction than for intracerebral haemorrhage; 67.8% (95% confidence interval (95% CI) 64-72) and 46.4% (35-57), respectively. Of the survivors, 68.9% had either no symptoms or symptoms that would not interfere with their capacity to look after themselves (Rankin score 0 to 2). Increasing age and low Glasgow coma scale score were the most powerful predictors of death within 1 year (p<0.01), whereas increasing age, atrial fibrillation, and low Glasgow coma scale score were the most important predictors of functional outcome 1 year after a stroke (p<0.01).
CONCLUSIONS—One year mortality from stroke in Greece is similar to that of other industrialised countries. The most important factors that affect the prognosis of a patient with a first ever stroke are increasing age, stroke severity, and atrial fibrillation.

 PMID:11032610

  7. MRI Scans - Multiple Languages

    MedlinePlus

    ... español) Ukrainian (українська ) Arabic (العربية) Expand Section MRI (Magnetic Resonance Imaging) - العربية (Arabic) Bilingual PDF Health Information Translations Chinese, Simplified (Mandarin dialect) (简体中文) Expand Section MRI ( ...

  8. Risk stratification for 1-year mortality in acute heart failure: classification and regression tree analysis.

    PubMed

    Arenja, Nisha; Breidthardt, Tobias; Socrates, Thenral; Schindler, Christian; Heinisch, Corinna; Tschung, Christopher; Potocki, Mihael; Gualandro, Danielle; Mueller, Christian

    2011-10-09

    Simple tools for risk stratification of patients with acute heart failure (AHF) are an unmet clinical need, particularly regarding long-term mortality. We prospectively enrolled 610 consecutive patients presenting to the emergency department with AHF. The diagnosis of AHF was adjudicated by two independent cardiologists. The classification and regression tree (CART) analysis was used to develop a simple risk algorithm. This was internally validated by cross-validation. One-year follow-up was complete in all patients (100%). A total of 201 patients (33%) died within 360 days. The CART analysis identified blood urea nitrogen (BUN) and age as the best single predictors of 1-year mortality and patients were categorised to three risk groups: high risk group (BUN >27.5 mg/dl and age >86 years), intermediate risk group (BUN >27.5 mg/dl and age ≤ 86 years) and low risk group (BUN ≤ 27.5 mg/dl). The Kaplan-Meier curves showed a significant increase in mortality in the high risk group compared with the lower risk groups (log-rank test p <0.001). The hazard ratio regarding 1-year mortality between patients identified as low and high risk was 2.0 (95% confidence interval, 1.7-2.4), with statistically significant differences between all risk groups (p <0.001). The likelihood-based 95%-confidence set for the age- and the urea-threshold is contained in the rectangular set defined by 25 mg/dl ≤ urea threshold ≤30.6 mg/dl and 76 years ≤ age threshold ≤96 years. These results suggest that AHF patients at low, intermediate and high risk for death within 360 days can be easily identified using patient's demographics and laboratory data obtained at presentation. Application of this simple risk stratification algorithm may help to improve the management of these patients.

  9. Prospect of future housing and risk of psychological distress at 1 year after an earthquake disaster.

    PubMed

    Nakaya, Naoki; Nakamura, Tomohiro; Tsuchiya, Naho; Narita, Akira; Tsuji, Ichiro; Hozawa, Atsushi; Tomita, Hiroaki

    2016-04-01

    Since the Great East Japan Earthquake in 2011, many of the affected have been forced to live in temporary housing or at a relative's house. Special attention needs to be paid to the negative health impacts resulting from such changes in living conditions. This study examined the association between future housing prospects and the risk of psychological distress 1 year after the earthquake. In 2012, a questionnaire was completed by a cross-sectional study of people aged 20 years or older living in Shichigahama Town, Miyagi, northeastern Japan, an area that had been severely inundated by the tsunami. Future housing prospects post-earthquake were classified into four categories: already settled in permanent housing, moving to new housing, under consideration, or unable to make any plans. Psychological distress was evaluated using the Kessler 6 scale, defined as ≥5 points out of 24. We performed multiple logistic regression analyses adjusted for potential confounding factors. Of the 3614 individuals studied, subjects whose future housing was under consideration (odds ratio [OR] = 2.1, 95% confidence interval [CI] = 1.6-2.7, P < 0.01) and those who were unable to make any future housing plans (OR = 1.9, 95%CI = 1.4-2.5, P < 0.01) exhibited a significantly higher risk of psychological distress compared with subjects who had already settled in permanent housing. In this study, subjects whose future housing prospects were under consideration and those who were unable to make any future housing plans were at a higher risk of psychological distress 1 year after the earthquake disaster. © 2015 The Authors. Psychiatry and Clinical Neurosciences © 2015 Japanese Society of Psychiatry and Neurology.

  10. Prediction of failure to retain work 1 year after interdisciplinary functional restoration in occupational injuries.

    PubMed

    Brede, Emily; Mayer, Tom G; Gatchel, Robert J

    2012-02-01

    To identify risk factors for work retention (a patients' ability to both obtain and retain employment) at 1 year after treatment for a chronic disabling occupational musculoskeletal disorder (CDOMD). Prospective cohort study. Consecutive patients undergoing interdisciplinary functional restoration treatment in a regional rehabilitation referral center. A sample of 1850 consecutive CDOMD patients, who were admitted to and completed a functional restoration program, were subsequently classified as work retention or nonwork retention at a 1-year posttreatment evaluation. Not applicable. Measures, including medical evaluations, demographic and occupational data, psychosocial diagnostic evaluation, and validated measures of pain, disability, and depressive symptoms, were obtained at admission to, and discharge from, the program. Using a multivariate logistic regression analysis, the following variables were found to be significant predictors of failure to retain work: older age (odds ratio [OR]=1.84; 95% confidence interval [CI], 1.33-2.54), female sex (OR=1.46; 95% CI, 1.09-1.94), nonworking status at discharge (OR=1.65; 95% CI, 1.11-2.45), extreme disability at admission (OR=1.46; 95% CI, 1.06-2.00), antisocial personality disorder (OR=2.11; 95% CI, 1.09-4.08), receipt of government disability benefits at admission (OR=2.28; 95% CI, 1.06-4.89), and dependence on opiate pain medications (OR=1.43; 95% CI, 1.02-2.00). The final model improved prediction by 75% over assigning all patients to the larger (work retention) group. This study identified demographic, psychosocial, and occupational factors that were predictive of failure to retain work. These risk factors may be used to individualize treatment plans for CDOMD patients in order to provide optimal functional restoration. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  11. Perceived Unmet Rehabilitation Needs 1 Year After Stroke: An Observational Study From the Swedish Stroke Register.

    PubMed

    Ullberg, Teresa; Zia, Elisabet; Petersson, Jesper; Norrving, Bo

    2016-02-01

    Met care demands are key aspects in poststroke quality of care. This study aimed to identify baseline predictors and 12-month factors that were associated with perceived unmet rehabilitation needs 1 year poststroke. Data on patients who were independent in activities of daily living, hospitalized for acute stroke during 2008 to 2010, and followed up 1 year poststroke through a postal questionnaire were obtained from the Swedish stroke register. Patients reporting fulfilled rehabilitation needs were compared with those with unmet needs (Chi square test). The study included 37 383 patients, 46% female. At 12 months, 8019 (21.5%) patients reported unmet rehabilitation needs. Compared with those with met rehabilitation needs, patients reporting unmet rehabilitation needs were older (75.4 versus 72.4 years; P<0.0001); a higher proportion was activities of daily living-dependent (59% versus 31.9%; P<0.0001) and institutionalized (24.3% versus 11.5%; P<0.0001) at 12 months. Poststroke depression (32.3% versus 24.9%; P<0.0001) and insufficient pain medication were more common in patients with unmet needs (54.5% versus 32.3%; P<0.0001). Baseline predictors of unmet rehabilitation needs at 12 months in an age-adjusted model were severe stroke (odds ratio [OR]=3.04; confidence interval [CI]: 2.39-3.87), prior stroke (OR=1.63; CI: 1.53-1.75), female sex (OR=1.14; CI: 1.07-1.20), diabetes mellitus (OR=1.24; CI: 1.15-1.32), stroke other than ischemic (OR=1.26; CI: 1.20-1.32), and atrial fibrillation (OR=1.19; CI: 1.12-1.27). Unfulfilled rehabilitation needs 1 year poststroke are common and associated with high age, dependency, pain, and depression. Long-term follow-up systems should, therefore, be comprehensive and address multiple domains of poststroke problems, rather than having a single-domain focus. © 2016 American Heart Association, Inc.

  12. Maintenance of Increased Childhood Influenza Vaccination Rates 1 Year After an Intervention in Primary Care Practices.

    PubMed

    Nowalk, Mary Patricia; Zimmerman, Richard K; Lin, Chyongchiou Jeng; Reis, Evelyn Cohen; Huang, Hsin-Hui; Moehling, Krissy K; Hannibal, Kristin M; Matambanadzo, Annamore; Shenouda, Emeil M; Allred, Norma J

    2016-01-01

    Influenza vaccination rates among some groups of children remain below the Healthy People 2020 goal of 70%. Multistrategy interventions to increase childhood influenza vaccination have not been evaluated recently. Twenty pediatric and family medicine practices were randomly assigned to receive the intervention in either year 1 or year 2. This study focuses on influenza vaccine uptake in the 10 year 1 intervention sites during intervention and the following maintenance year. The intervention included the 4 Pillars Immunization Toolkit-a practice improvement toolkit, early delivery of donated vaccine for disadvantaged children, staff education, and feedback on progress. During the maintenance year, practices were not assisted or contacted, except to complete follow-up surveys. Student's t tests assessed vaccine uptake of children aged 6 months to 18 years, and multilevel regression modeling in repeated measures determined variables related to the likelihood of vaccination. Influenza vaccine uptake increased 12.4 percentage points (PP; P < .01) during active intervention and uptake was sustained (+0.4 PP; P > .05) during maintenance, for an average change of 12.7 PP over all sites, increasing from 42.2% at baseline to 54.9% (P < .001) during maintenance. In regression modeling that controlled for age, race, and insurance, likelihood of vaccination was greater during intervention than baseline (odds ratio 1.47; 95% confidence interval 1.44-1.50; P < .001) and greater during maintenance than baseline (odds ratio 1.50; 95% confidence interval 1.47-1.54; P < .001). In primary care practices, a multistrategy intervention that included the 4 Pillars Immunization Toolkit, early delivery of vaccine, and feedback was associated with significant improvements in childhood influenza vaccination rates that were maintained 1 year after active intervention. Copyright © 2016 Academic Pediatric Association. All rights reserved.

  13. Race and Sex Differences in Post-Myocardial Infarction Angina Frequency and Risk of 1-Year Unplanned Rehospitalization.

    PubMed

    Hess, Connie N; Kaltenbach, Lisa A; Doll, Jacob A; Cohen, David J; Peterson, Eric D; Wang, Tracy Y

    2017-02-07

    Race and sex disparities in in-hospital treatment and outcomes of patients with acute myocardial infarction (MI) have been described, but little is known about race and sex differences in post-MI angina and long-term risk of unplanned rehospitalization. We examined race and sex differences in post-MI angina frequency and 1-year unplanned rehospitalization to identify factors associated with unplanned rehospitalization, testing for whether race and sex modify these relationships. Using TRANSLATE-ACS (Treatment With Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events after Acute Coronary Syndrome) data, we examined 6-week and 1-year angina frequency and 1-year unplanned rehospitalization stratified by race and sex among MI patients treated with percutaneous coronary intervention. We used multivariable logistic regression to assess factors associated with unplanned rehospitalization and tested for interactions among angina frequency, race, and sex. A total of 11 595 MI patients survived to 1 year postdischarge; there were 66.6% white male patients, 24.3% white female patients, 5.3% black male patients, and 3.8% black female patients. Overall, 29.7% had angina at 6 weeks, and 20.6% had angina at 1 year postdischarge. Relative to white patients, black patients were more likely to have angina at 6 weeks (female: 44.2% versus 31.8%; male: 33.5% versus 27.1%; both P<0.0001) and 1 year (female: 49.4% versus 38.9%; male: 46.3% versus 31.1%; both P<0.0001). Rates of 1-year unplanned rehospitalization were highest among black female patients (44.1%), followed by white female patients (38.4%), black male patients (36.4%), and white male patients (30.2%, P<0.0001). In the multivariable model, 6-week angina was most strongly associated with unplanned rehospitalization (hazard ratio, 1.49; 95% confidence interval, 1.36-1.62; P<0.0001); this relationship was not modified by race or sex (adjusted 3-way Pinteraction=0.41). One

  14. Minimax confidence intervals in geomagnetism

    NASA Technical Reports Server (NTRS)

    Stark, Philip B.

    1992-01-01

    The present paper uses theory of Donoho (1989) to find lower bounds on the lengths of optimally short fixed-length confidence intervals (minimax confidence intervals) for Gauss coefficients of the field of degree 1-12 using the heat flow constraint. The bounds on optimal minimax intervals are about 40 percent shorter than Backus' intervals: no procedure for producing fixed-length confidence intervals, linear or nonlinear, can give intervals shorter than about 60 percent the length of Backus' in this problem. While both methods rigorously account for the fact that core field models are infinite-dimensional, the application of the techniques to the geomagnetic problem involves approximations and counterfactual assumptions about the data errors, and so these results are likely to be extremely optimistic estimates of the actual uncertainty in Gauss coefficients.

  15. Minimax confidence intervals in geomagnetism

    NASA Technical Reports Server (NTRS)

    Stark, Philip B.

    1992-01-01

    The present paper uses theory of Donoho (1989) to find lower bounds on the lengths of optimally short fixed-length confidence intervals (minimax confidence intervals) for Gauss coefficients of the field of degree 1-12 using the heat flow constraint. The bounds on optimal minimax intervals are about 40 percent shorter than Backus' intervals: no procedure for producing fixed-length confidence intervals, linear or nonlinear, can give intervals shorter than about 60 percent the length of Backus' in this problem. While both methods rigorously account for the fact that core field models are infinite-dimensional, the application of the techniques to the geomagnetic problem involves approximations and counterfactual assumptions about the data errors, and so these results are likely to be extremely optimistic estimates of the actual uncertainty in Gauss coefficients.

  16. Effect Sizes, Confidence Intervals, and Confidence Intervals for Effect Sizes

    ERIC Educational Resources Information Center

    Thompson, Bruce

    2007-01-01

    The present article provides a primer on (a) effect sizes, (b) confidence intervals, and (c) confidence intervals for effect sizes. Additionally, various admonitions for reformed statistical practice are presented. For example, a very important implication of the realization that there are dozens of effect size statistics is that "authors must…

  17. Temporal binding of interval markers

    PubMed Central

    Derichs, Christina; Zimmermann, Eckart

    2016-01-01

    How we estimate the passage of time is an unsolved mystery in neuroscience. Illusions of subjective time provide an experimental access to this question. Here we show that time compression and expansion of visually marked intervals result from a binding of temporal interval markers. Interval markers whose onset signals were artificially weakened by briefly flashing a whole-field mask were bound in time towards markers with a strong onset signal. We explain temporal compression as the consequence of summing response distributions of weak and strong onset signals. Crucially, temporal binding occurred irrespective of the temporal order of weak and strong onset markers, thus ruling out processing latencies as an explanation for changes in interval duration judgments. If both interval markers were presented together with a mask or the mask was shown in the temporal interval center, no compression occurred. In a sequence of two intervals, masking the middle marker led to time compression for the first and time expansion for the second interval. All these results are consistent with a model view of temporal binding that serves a functional role by reducing uncertainty in the final estimate of interval duration. PMID:27958311

  18. Reference Intervals in Neonatal Hematology.

    PubMed

    Henry, Erick; Christensen, Robert D

    2015-09-01

    The various blood cell counts of neonates must be interpreted in accordance with high-quality reference intervals based on gestational and postnatal age. Using very large sample sizes, we generated neonatal reference intervals for each element of the complete blood count (CBC). Knowledge of whether a patient has CBC values that are too high (above the upper reference interval) or too low (below the lower reference interval) provides important insights into the specific disorder involved and in many instances suggests a treatment plan. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Relapse to Smoking After 1 Year of Abstinence: A Meta-analysis

    PubMed Central

    Hughes, John R.; Peters, Erica N.; Naud, Shelly

    2008-01-01

    Most clinical trials use 6 mo or 1 yr follow-ups as proxies for life-time smoking cessation. Retrospective studies have estimated 2–15% of smokers relapse each year after the first 1 year of abstinence, but these have methodological problems such as memory bias. We searched for prospective studies of adult quitters that reported the number of participants abstinent at 1 yr follow-up and who remained abstinent at ≥ 2 year follow-ups. We included studies that reported the percent who remained lapse-free, did not continue treatment after 1 yr, and had ≤ 10% lost to follow-up. We did not locate any population-based studies but did locate eight randomized, controlled trials, all testing nicotine medications. After deleting one trial with outlier results, a meta-analysis estimated the annual incidence of relapse after 1 yr to be 10%; however, the small sample sizes resulted in a wide 95% confidence interval (5–17%) suggesting this estimate is not very accurate. We conclude a non-significant amount of relapse occurs after 1 yr. Better quantification of this relapse rate is important to improve estimates of lifelong abstinence and reductions in morbidity and mortality from smoking cessation. PMID:18706769

  20. Stress Underestimation and Mental Health Outcomes in Male Japanese Workers: a 1-Year Prospective Study.

    PubMed

    Izawa, Shuhei; Nakamura-Taira, Nanako; Yamada, Kosuke Chris

    2016-12-01

    Being appropriately aware of the extent of stress experienced in daily life is essential in motivating stress management behaviours. Excessive stress underestimation obstructs this process, which is expected to exert adverse effects on health. We prospectively examined associations between stress underestimation and mental health outcomes in Japanese workers. Web-based surveys were conducted twice with an interval of 1 year on 2359 Japanese male workers. Participants were asked to complete survey items concerning stress underestimation, depressive symptoms, sickness absence, and antidepressant use. Multiple logistic regression analysis revealed that high baseline levels of 'overgeneralization of stress' and 'insensitivity to stress' were significantly associated with new-onset depressive symptoms (OR = 2.66 [95 % CI, 1.54-4.59], p < .01) and antidepressant use (OR = 4.91 [95 % CI, 1.22-19.74], p < .05), respectively, during the 1-year follow-up period. This study clearly demonstrated that stress underestimation, including stress insensitivity and the overgeneralization of stress, could exert adverse effects on mental health.

  1. Barriers to Care and 1-Year Mortality Among Newly Diagnosed HIV-Infected People in Durban, South Africa

    PubMed Central

    Coleman, Sharon M.; Giddy, Janet; Bogart, Laura M.; Chaisson, Christine E.; Ross, Douglas; Flash, Moses J. E.; Govender, Tessa; Walensky, Rochelle P.; Freedberg, Kenneth A.; Losina, Elena

    2017-01-01

    Background: Prompt entry into HIV care is often hindered by personal and structural barriers. Our objective was to evaluate the impact of self-perceived barriers to health care on 1-year mortality among newly diagnosed HIV-infected individuals in Durban, South Africa. Methods: Before HIV testing at 4 outpatient sites, adults (≥18 years) were surveyed regarding perceived barriers to care including (1) service delivery, (2) financial, (3) personal health perception, (4) logistical, and (5) structural. We assessed deaths via phone calls and the South African National Population Register. We used multivariable Cox proportional hazards models to determine the association between number of perceived barriers and death within 1 year. Results: One thousand eight hundred ninety-nine HIV-infected participants enrolled. Median age was 33 years (interquartile range: 27–41 years), 49% were females, and median CD4 count was 192/μL (interquartile range: 72–346/μL). One thousand fifty-seven participants (56%) reported no, 370 (20%) reported 1–3, and 460 (24%) reported >3 barriers to care. By 1 year, 250 [13%, 95% confidence interval (CI): 12% to 15%] participants died. Adjusting for age, sex, education, baseline CD4 count, distance to clinic, and tuberculosis status, participants with 1–3 barriers (adjusted hazard ratio: 1.49, 95% CI: 1.06 to 2.08) and >3 barriers (adjusted hazard ratio: 1.81, 95% CI: 1.35 to 2.43) had higher 1-year mortality risk compared with those without barriers. Conclusions: HIV-infected individuals in South Africa who reported perceived barriers to medical care at diagnosis were more likely to die within 1 year. Targeted structural interventions, such as extended clinic hours, travel vouchers, and streamlined clinic operations, may improve linkage to care and antiretroviral therapy initiation for these people. PMID:28060226

  2. MRI of the Breast

    MedlinePlus

    ... magnetic field of the MRI unit, metal and electronic items are not allowed in the exam room. ... tell the technologist if you have medical or electronic devices in your body. These objects may interfere ...

  3. MRI of the Prostate

    MedlinePlus

    ... magnetic field of the MRI unit, metal and electronic items are not allowed in the exam room. ... tell the technologist if you have medical or electronic devices in your body. These objects may interfere ...

  4. Lumbar MRI scan

    MedlinePlus

    ... may need a lumbar MRI if you have: Low back pain that does not get better after treatment Leg ... spine Injury or trauma to the lower spine Low back pain and a history or signs of cancer Multiple ...

  5. Cervical MRI scan

    MedlinePlus

    ... magnetic resonance imaging) scan uses energy from strong magnets to create pictures of the part of the ... in your eyes) Because the MRI contains strong magnets, metal objects are not allowed into the room ...

  6. Leg MRI scan

    MedlinePlus

    ... resonance imaging) scan of the leg uses strong magnets to create pictures of the leg. This may ... in your eyes) Because the MRI contains strong magnets, metal objects are not allowed into the room ...

  7. Shoulder MRI scan

    MedlinePlus

    ... an imaging test that uses energy from powerful magnets and to create pictures of the shoulder area. ... in your eyes) Because the MRI contains strong magnets, metal objects are not allowed in the room ...

  8. MRI of the Breast

    MedlinePlus

    ... of the breast uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of ... scans, MRI does not utilize ionizing radiation. Instead, radio waves redirect alignment of hydrogen atoms that naturally exist ...

  9. Teaching Confidence Intervals Using Simulation

    ERIC Educational Resources Information Center

    Hagtvedt, Reidar; Jones, Gregory Todd; Jones, Kari

    2008-01-01

    Confidence intervals are difficult to teach, in part because most students appear to believe they understand how to interpret them intuitively. They rarely do. To help them abandon their misconception and achieve understanding, we have developed a simulation tool that encourages experimentation with multiple confidence intervals derived from the…

  10. Explorations in Statistics: Confidence Intervals

    ERIC Educational Resources Information Center

    Curran-Everett, Douglas

    2009-01-01

    Learning about statistics is a lot like learning about science: the learning is more meaningful if you can actively explore. This third installment of "Explorations in Statistics" investigates confidence intervals. A confidence interval is a range that we expect, with some level of confidence, to include the true value of a population parameter…

  11. Interval Recognition in Minimal Context.

    ERIC Educational Resources Information Center

    Shatzkin, Merton

    1984-01-01

    Music majors were asked to identify interval when it was either preceded or followed by a tone moving in the same direction. Difficulties in interval recognition in context appear to be an effect not just of placement within the context or of tonality, but of particular combinations of these aspects. (RM)

  12. Children's Discrimination of Melodic Intervals.

    ERIC Educational Resources Information Center

    Schellenberg, E. Glenn; Trehub, Sandra E.

    1996-01-01

    Adults and children listened to tone sequences and were required to detect changes either from intervals with simple frequency ratios to intervals with complex ratios or vice versa. Adults performed better on changes from simple to complex ratios than on the reverse changes. Similar performance was observed for 6-year olds who had never taken…

  13. Explorations in Statistics: Confidence Intervals

    ERIC Educational Resources Information Center

    Curran-Everett, Douglas

    2009-01-01

    Learning about statistics is a lot like learning about science: the learning is more meaningful if you can actively explore. This third installment of "Explorations in Statistics" investigates confidence intervals. A confidence interval is a range that we expect, with some level of confidence, to include the true value of a population parameter…

  14. Automatic Error Analysis Using Intervals

    ERIC Educational Resources Information Center

    Rothwell, E. J.; Cloud, M. J.

    2012-01-01

    A technique for automatic error analysis using interval mathematics is introduced. A comparison to standard error propagation methods shows that in cases involving complicated formulas, the interval approach gives comparable error estimates with much less effort. Several examples are considered, and numerical errors are computed using the INTLAB…

  15. Automatic Error Analysis Using Intervals

    ERIC Educational Resources Information Center

    Rothwell, E. J.; Cloud, M. J.

    2012-01-01

    A technique for automatic error analysis using interval mathematics is introduced. A comparison to standard error propagation methods shows that in cases involving complicated formulas, the interval approach gives comparable error estimates with much less effort. Several examples are considered, and numerical errors are computed using the INTLAB…

  16. Molecular fMRI

    PubMed Central

    Bartelle, Benjamin B.; Barandov, Ali

    2016-01-01

    Comprehensive analysis of brain function depends on understanding the dynamics of diverse neural signaling processes over large tissue volumes in intact animals and humans. Most existing approaches to measuring brain signaling suffer from limited tissue penetration, poor resolution, or lack of specificity for well-defined neural events. Here we discuss a new brain activity mapping method that overcomes some of these problems by combining MRI with contrast agents sensitive to neural signaling. The goal of this “molecular fMRI” approach is to permit noninvasive whole-brain neuroimaging with specificity and resolution approaching current optical neuroimaging methods. In this article, we describe the context and need for molecular fMRI as well as the state of the technology today. We explain how major types of MRI probes work and how they can be sensitized to neurobiological processes, such as neurotransmitter release, calcium signaling, and gene expression changes. We comment both on past work in the field and on challenges and promising avenues for future development. SIGNIFICANCE STATEMENT Brain researchers currently have a choice between measuring neural activity using cellular-level recording techniques, such as electrophysiology and optical imaging, or whole-brain imaging methods, such as fMRI. Cellular level methods are precise but only address a small portion of mammalian brains; on the other hand, whole-brain neuroimaging techniques provide very little specificity for neural pathways or signaling components of interest. The molecular fMRI techniques we discuss have particular potential to combine the specificity of cellular-level measurements with the noninvasive whole-brain coverage of fMRI. On the other hand, molecular fMRI is only just getting off the ground. This article aims to offer a snapshot of the status and future prospects for development of molecular fMRI techniques. PMID:27076413

  17. Binary Interval Search: a scalable algorithm for counting interval intersections

    PubMed Central

    Layer, Ryan M.; Skadron, Kevin; Robins, Gabriel; Hall, Ira M.; Quinlan, Aaron R.

    2013-01-01

    Motivation: The comparison of diverse genomic datasets is fundamental to understand genome biology. Researchers must explore many large datasets of genome intervals (e.g. genes, sequence alignments) to place their experimental results in a broader context and to make new discoveries. Relationships between genomic datasets are typically measured by identifying intervals that intersect, that is, they overlap and thus share a common genome interval. Given the continued advances in DNA sequencing technologies, efficient methods for measuring statistically significant relationships between many sets of genomic features are crucial for future discovery. Results: We introduce the Binary Interval Search (BITS) algorithm, a novel and scalable approach to interval set intersection. We demonstrate that BITS outperforms existing methods at counting interval intersections. Moreover, we show that BITS is intrinsically suited to parallel computing architectures, such as graphics processing units by illustrating its utility for efficient Monte Carlo simulations measuring the significance of relationships between sets of genomic intervals. Availability: https://github.com/arq5x/bits. Contact: arq5x@virginia.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:23129298

  18. MRI findings in aphasic status epilepticus.

    PubMed

    Toledo, Manuel; Munuera, Josep; Sueiras, Maria; Rovira, Rosa; Alvarez-Sabín, José; Rovira, Alex

    2008-08-01

    Ictal-MRI studies including diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI), and MR-angiography (MRA) in patients with aphasic status epilepticus (ASE) are lacking. In this report, we aim to describe the consequences of the ASE on DWIs and its impact on cerebral circulation. We retrospectively studied eight patients with ASE confirmed by ictal-EEG, who underwent ictal-MRI shortly after well-documented onset (mean time delay 3 h). ASE consisted in fluctuating aphasia, mostly associated with other subtle contralateral neurological signs such as hemiparesia, hemianopia, or slight clonic jerks. In MRI, six patients showed cortical temporoparietal hyperintensity in DWI and four of them had also ipsilateral pulvinar lesions. Five patients showed close spatial hyperperfusion areas matching the DWI lesions and an enhanced blow flow in the middle cerebral artery. Parenchymal lesions and hemodynamic abnormalities were not associated with seizure duration or severity in any case. The resolution of DWI lesions at follow-up MRI depended on the length of the MRIs interval. In patients with ASE, lesions on DWI in the temporo-parietal cortex and pulvinar nucleus combined with local hyperperfusion can be observed, even when they appear distant from the epileptic focus or the language areas.

  19. VARIABLE TIME-INTERVAL GENERATOR

    DOEpatents

    Gross, J.E.

    1959-10-31

    This patent relates to a pulse generator and more particularly to a time interval generator wherein the time interval between pulses is precisely determined. The variable time generator comprises two oscillators with one having a variable frequency output and the other a fixed frequency output. A frequency divider is connected to the variable oscillator for dividing its frequency by a selected factor and a counter is used for counting the periods of the fixed oscillator occurring during a cycle of the divided frequency of the variable oscillator. This defines the period of the variable oscillator in terms of that of the fixed oscillator. A circuit is provided for selecting as a time interval a predetermined number of periods of the variable oscillator. The output of the generator consists of a first pulse produced by a trigger circuit at the start of the time interval and a second pulse marking the end of the time interval produced by the same trigger circuit.

  20. MRI-guided brachytherapy

    PubMed Central

    Tanderup, Kari; Viswanathan, Akila; Kirisits, Christian; Frank, Steven J.

    2014-01-01

    The application of MRI-guided brachytherapy has demonstrated significant growth during the last two decades. Clinical improvements in cervix cancer outcomes have been linked to the application of repeated MRI for identification of residual tumor volumes during radiotherapy. This has changed clinical practice in the direction of individualized dose administration, and mounting evidence of improved clinical outcome with regard to local control, overall survival as well as morbidity. MRI-guided prostate HDR and LDR brachytherapy has improved the accuracy of target and organs-at-risk (OAR) delineation, and the potential exists for improved dose prescription and reporting for the prostate gland and organs at risk. Furthermore, MRI-guided prostate brachytherapy has significant potential to identify prostate subvolumes and dominant lesions to allow for dose administration reflecting the differential risk of recurrence. MRI-guided brachytherapy involves advanced imaging, target concepts, and dose planning. The key issue for safe dissemination and implementation of high quality MRI-guided brachytherapy is establishment of qualified multidisciplinary teams and strategies for training and education. PMID:24931089

  1. Optogenetic Functional MRI

    PubMed Central

    Lin, Peter; Fang, Zhongnan; Liu, Jia; Lee, Jin Hyung

    2016-01-01

    The investigation of the functional connectivity of precise neural circuits across the entire intact brain can be achieved through optogenetic functional magnetic resonance imaging (ofMRI), which is a novel technique that combines the relatively high spatial resolution of high-field fMRI with the precision of optogenetic stimulation. Fiber optics that enable delivery of specific wavelengths of light deep into the brain in vivo are implanted into regions of interest in order to specifically stimulate targeted cell types that have been genetically induced to express light-sensitive trans-membrane conductance channels, called opsins. fMRI is used to provide a non-invasive method of determining the brain's global dynamic response to optogenetic stimulation of specific neural circuits through measurement of the blood-oxygen-level-dependent (BOLD) signal, which provides an indirect measurement of neuronal activity. This protocol describes the construction of fiber optic implants, the implantation surgeries, the imaging with photostimulation and the data analysis required to successfully perform ofMRI. In summary, the precise stimulation and whole-brain monitoring ability of ofMRI are crucial factors in making ofMRI a powerful tool for the study of the connectomics of the brain in both healthy and diseased states. PMID:27167840

  2. Association of breastfeeding with maternal control of infant feeding at age 1 year.

    PubMed

    Taveras, Elsie M; Scanlon, Kelley S; Birch, Leann; Rifas-Shiman, Sheryl L; Rich-Edwards, Janet W; Gillman, Matthew W

    2004-11-01

    restriction question. The mean (SD) score on the pressure to eat scale was 5.3 (3.7), and the range was 0 to 20. After adjusting for mothers' preexisting concerns about their children's future eating and weight status, as well as sociodemographic, economic, and anthropometric predictors of breastfeeding duration, we found that the longer the mothers breastfed, the less likely they were to restrict their children's food intake at age 1 year. The adjusted odds ratio was 0.89 (95% confidence interval [CI]: 0.84-0.95) for each 1-month increment in breastfeeding duration. In addition, we found that compared with mothers who were exclusively formula feeding, mothers who were exclusively breastfeeding at 6 months of age had much lower odds of restricting their children's food intake at 1 year (odds ratio: 0.27; 95% CI: 0.10-0.72). Preponderance of breastfeeding in the first 6 months of life and breastfeeding duration (beta = -0.01 points on the 0-20 scale for each additional 1 month of breastfeeding [95% CI: -0.07 to 0.05]) were not related to mothers' pressuring their children to eat more. Mothers who fed their infants breast milk in early infancy and who breastfed for longer periods reported less restrictive behavior regarding child feeding at 1 year. Additional longitudinal studies should examine the extent to which any protective effect of breastfeeding on overweight is explained by decreased maternal feeding restriction.

  3. Nocturnal heart rate variability in 1-year-old infants analyzed by using the Least Square Cosine Spectrum Method.

    PubMed

    Kochiya, Yuko; Hirabayashi, Akari; Ichimaru, Yuhei

    2017-09-16

    To evaluate the dynamic nature of nocturnal heart rate variability, RR intervals recorded with a wearable heart rate sensor were analyzed using the Least Square Cosine Spectrum Method. Six 1-year-old infants participated in the study. A wearable heart rate sensor was placed on their chest to measure RR intervals and 3-axis acceleration. Heartbeat time series were analyzed for every 30 s using the Least Square Cosine Spectrum Method, and an original parameter to quantify the regularity of respiratory-related heart rate rhythm was extracted and referred to as "RA (RA-COSPEC: Respiratory Area obtained by COSPEC)." The RA value is higher when a cosine curve is fitted to the original data series. The time sequential changes of RA showed cyclic changes with significant rhythm during the night. The mean cycle length of RA was 70 ± 15 min, which is shorter than young adult's cycle in our previous study. At the threshold level of RA greater than 3, the HR was significantly decreased compared with the RA value less than 3. The regularity of heart rate rhythm showed dynamic changes during the night in 1-year-old infants. Significant decrease of HR at the time of higher RA suggests the increase of parasympathetic activity. We suspect that the higher RA reflects the regular respiratory pattern during the night. This analysis system may be useful for quantitative assessment of regularity and dynamic changes of nocturnal heart rate variability in infants.

  4. Strategies for Preventing Endoscopic Recurrence of Crohn's Disease 1 Year after Surgery: A Network Meta-Analysis

    PubMed Central

    2017-01-01

    Objective To assess the benefits of different treatments that aim to prevent the endoscopic recurrence of Crohn's disease (CD) after ileal resection. Methods Randomized controlled trials (RCTs) were searched from MEDLINE, Embase, and the Cochrane Central Database. All the included RCTs with an endoscopic recurrence outcome which was defined as Rutgeerts' score ≥ i2 have a duration of more than 1 year. The quality of the included RCTs was assessed by the Cochrane Risk of Bias Tool. Pairwise treatment effects were estimated through a Bayesian random effects network meta-analysis by using the OpenBUGS 1.4 software and reported as odds ratios (ORs) with a 95% credible interval (CI). Results Fourteen RCTs (877 participants) were included. Two strategies were superior to placebo for preventing endoscopic recurrence of CD at 1 year after surgery: infliximab (d, −5.475; 95% CI, −10.47 to –1.632) and adalimumab (d, −7.273; 95% CI, −13.84 to −2.585). Nine strategies were not effective: budesnoid, mesalazine (in both high and low dose), azathioprine, Tripterygium wilfordii, mesalazine + infliximab, ornidazole, untreated intervention, and Lactobacillus GG. Conclusions Except for infliximab and adalimumab, other strategies included in our analysis were not effective for preventing endoscopic recurrence of CD at 1 year after ileal resection. PMID:28630623

  5. Bystander Efforts and 1-Year Outcomes in Out-of-Hospital Cardiac Arrest.

    PubMed

    Kragholm, Kristian; Wissenberg, Mads; Mortensen, Rikke N; Hansen, Steen M; Malta Hansen, Carolina; Thorsteinsson, Kristinn; Rajan, Shahzleen; Lippert, Freddy; Folke, Fredrik; Gislason, Gunnar; Køber, Lars; Fonager, Kirsten; Jensen, Svend E; Gerds, Thomas A; Torp-Pedersen, Christian; Rasmussen, Bodil S

    2017-05-04

    The effect of bystander interventions on long-term functional outcomes among survivors of out-of-hospital cardiac arrest has not been extensively studied. We linked nationwide data on out-of-hospital cardiac arrests in Denmark to functional outcome data and reported the 1-year risks of anoxic brain damage or nursing home admission and of death from any cause among patients who survived to day 30 after an out-of-hospital cardiac arrest. We analyzed risks according to whether bystander cardiopulmonary resuscitation (CPR) or defibrillation was performed and evaluated temporal changes in bystander interventions and outcomes. Among the 2855 patients who were 30-day survivors of an out-of-hospital cardiac arrest during the period from 2001 through 2012, a total of 10.5% had brain damage or were admitted to a nursing home and 9.7% died during the 1-year follow-up period. During the study period, among the 2084 patients who had cardiac arrests that were not witnessed by emergency medical services (EMS) personnel, the rate of bystander CPR increased from 66.7% to 80.6% (P<0.001), the rate of bystander defibrillation increased from 2.1% to 16.8% (P<0.001), the rate of brain damage or nursing home admission decreased from 10.0% to 7.6% (P<0.001), and all-cause mortality decreased from 18.0% to 7.9% (P=0.002). In adjusted analyses, bystander CPR was associated with a risk of brain damage or nursing home admission that was significantly lower than that associated with no bystander resuscitation (hazard ratio, 0.62; 95% confidence interval [CI], 0.47 to 0.82), as well as a lower risk of death from any cause (hazard ratio, 0.70; 95% CI, 0.50 to 0.99) and a lower risk of the composite end point of brain damage, nursing home admission, or death (hazard ratio, 0.67; 95% CI, 0.53 to 0.84). The risks of these outcomes were even lower among patients who received bystander defibrillation as compared with no bystander resuscitation. In our study, we found that bystander CPR and

  6. Biparametric versus multiparametric MRI in the diagnosis of prostate cancer

    PubMed Central

    Logager, Vibeke; Baslev, Ingerd; Møller, Jakob M; Hansen, Rasmus Hvass; Thomsen, Henrik S

    2016-01-01

    Background Since multiparametric magnetic resonance imaging (mp-MRI) of the prostate exceeds 30 min, minimizing the evaluation time of significant (Gleason scores > 6) prostate cancer (PCa) would be beneficial. A reduced protocol might be sufficient for the diagnosis. Purpose To study whether a short unenhanced biparametric MRI (bp-MRI) matches mp-MRI in detecting significant PCa. Material and Methods A total of 204 men (median age, 65 years; mean ± SD, 64.1; range 45–75 years; median serum PSA level, 14 ng/mL; range, 2.2–120 ng/mL; median prostate volume, 60 mL; range, 23–263 mL) fulfilled the criteria for being enrolled. They underwent mp-MRI and prostate biopsy from January through June 2014. Of the included patients, 9.3% underwent prostatectomy, 90.7% had TRUS-bx, and 10.8 had MRI-targeted TRUS-bx. Two radiologists separately assessed the mp-MRI examination (T2-weighted [T2W] imaging, diffusion-weighted imaging [DWI], apparent diffusion coefficient map [ADC-map] and dynamic contrast-enhanced imaging [DCE]). Two months later, the bp-MRI version (T2W imaging, DWI, and ADC-map) was evaluated. Results Reader 1: Assessing mp-MRI: 0 false negatives, sensitivity of 1, and specificity 0.04. Assessing bp-MRI: four false negatives, sensitivity of 0.94, and specificity 0.15. Reader 2: Assessing mp-MRI: five false negatives, sensitivity of 0.93, and specificity 0.16. Assessing bp-MRI: three false negatives, sensitivity of 0.96, and specificity 0.15. Intra-reader agreement Cohen’s Kappa (κ) was 0.87 for reader 1 (95% confidence interval [CI], 0.83–0.92) and 0.84 for reader 2 (95% CI 0.78–0.89). Conclusion Bp-MRI is as good as mp-MRI at detecting PCa. A large prospective study seems to be strongly warranted. PMID:27583170

  7. TIME-INTERVAL MEASURING DEVICE

    DOEpatents

    Gross, J.E.

    1958-04-15

    An electronic device for measuring the time interval between two control pulses is presented. The device incorporates part of a previous approach for time measurement, in that pulses from a constant-frequency oscillator are counted during the interval between the control pulses. To reduce the possible error in counting caused by the operation of the counter gating circuit at various points in the pulse cycle, the described device provides means for successively delaying the pulses for a fraction of the pulse period so that a final delay of one period is obtained and means for counting the pulses before and after each stage of delay during the time interval whereby a plurality of totals is obtained which may be averaged and multplied by the pulse period to obtain an accurate time- Interval measurement.

  8. Simple Interval Timers for Microcomputers.

    ERIC Educational Resources Information Center

    McInerney, M.; Burgess, G.

    1985-01-01

    Discusses simple interval timers for microcomputers, including (1) the Jiffy clock; (2) CPU count timers; (3) screen count timers; (4) light pen timers; and (5) chip timers. Also examines some of the general characteristics of all types of timers. (JN)

  9. Predictors of ICU Admission and Outcomes 1 Year Post-Admission in Persons with IBD: A Population-based Study

    PubMed Central

    Garland, Allan; Peschken, Christine A.; Hitchon, Carol A.; Chen, Hui; Fransoo, Randy; Marrie, Ruth Ann

    2015-01-01

    Background: To determine predictors of intensive care unit (ICU) admission and to assess health care utilization (HCU) post-ICU admission among persons with inflammatory bowel disease (IBD). Methods: We matched a population-based database of Manitobans with IBD to a general population cohort on age, sex, and region of residence and linked these cohorts to a population-based ICU database. We compared the incidence rates of ICU admission among prevalent IBD cases according to HCU in the year before admission using generalized linear models adjusting for age, sex, socioeconomic status, region, and comorbidity. Among incident cases of IBD who survived their first ICU admission, we compared HCU with matched controls who survived ICU admission. Results: Risk factors for ICU admission from the year before admission included cumulative corticosteroid use (incidence rate ratio, 1.006 per 100 mg of prednisone; 95% confidence interval, 1.004–1.008) and IBD-related surgery (incidence rate ratio, 2.79; 95% confidence interval, 1.99–3.92). Use of immunomodulatory therapies within 1 year, or surgery for IBD beyond 1 year prior, were not associated with ICU admission. In those who used corticosteroids and immunomodulatory medications in the year before ICU admission, the use of immunomodulatory medications conferred a 30% risk reduction in ICU admission (incidence rate ratio, 0.70; 95% confidence interval, 0.50–0.97). Persons with IBD who survived ICU admission had higher HCU in the year following ICU discharge than controls. Conclusions: Corticosteroid use and surgery within the year are associated with ICU admission in IBD while immunomodulatory therapy is not. Surviving ICU admission is associated with high HCU in the year post-ICU discharge. PMID:25989339

  10. Multidimensional diffusion MRI

    NASA Astrophysics Data System (ADS)

    Topgaard, Daniel

    2017-02-01

    Principles from multidimensional NMR spectroscopy, and in particular solid-state NMR, have recently been transferred to the field of diffusion MRI, offering non-invasive characterization of heterogeneous anisotropic materials, such as the human brain, at an unprecedented level of detail. Here we revisit the basic physics of solid-state NMR and diffusion MRI to pinpoint the origin of the somewhat unexpected analogy between the two fields, and provide an overview of current diffusion MRI acquisition protocols and data analysis methods to quantify the composition of heterogeneous materials in terms of diffusion tensor distributions with size, shape, and orientation dimensions. While the most advanced methods allow estimation of the complete multidimensional distributions, simpler methods focus on various projections onto lower-dimensional spaces as well as determination of means and variances rather than actual distributions. Even the less advanced methods provide simple and intuitive scalar parameters that are directly related to microstructural features that can be observed in optical microscopy images, e.g. average cell eccentricity, variance of cell density, and orientational order - properties that are inextricably entangled in conventional diffusion MRI. Key to disentangling all these microstructural features is MRI signal acquisition combining isotropic and directional dimensions, just as in the field of multidimensional solid-state NMR from which most of the ideas for the new methods are derived.

  11. Music Therapy Using Singing Training Improves Psychomotor Speed in Patients with Alzheimer's Disease: A Neuropsychological and fMRI Study

    PubMed Central

    Satoh, Masayuki; Yuba, Toru; Tabei, Ken-ichi; Okubo, Yukari; Kida, Hirotaka; Sakuma, Hajime; Tomimoto, Hidekazu

    2015-01-01

    Background/Aims To investigate the effect of singing training on the cognitive function in Alzheimer's disease (AD) patients. Methods Ten AD patients (mean age 78.1 years) participated in music therapy using singing training once a week for 6 months (music therapy group). Each session was performed with professional musicians using karaoke and a unique voice training method (the YUBA Method). Before and after the intervention period, each patient was assessed by neuropsychological batteries, and functional magnetic resonance imaging (fMRI) was performed while the patients sang familiar songs with a karaoke device. As the control group, another 10 AD patients were recruited (mean age 77.0 years), and neuropsychological assessments were performed twice with an interval of 6 months. Results In the music therapy group, the time for completion of the Japanese Raven's Colored Progressive Matrices was significantly reduced (p = 0.026), and the results obtained from interviewing the patients' caregivers revealed a significant decrease in the Neuropsychiatric Inventory score (p = 0.042) and a prolongation of the patients' sleep time (p = 0.039). The fMRI study revealed increased activity in the right angular gyrus and the left lingual gyrus in the before-minus-after subtraction analysis of the music therapy intervention. Conclusion Music therapy intervention using singing training may be useful for dementia patients by improving the neural efficacy of cognitive processing. PMID:26483829

  12. Causes and risk factors for mortality within 1 year after obesity surgery in a population-based cohort study.

    PubMed

    Tao, Wenjing; Plecka-Östlund, Magdalena; Lu, Yunxia; Mattsson, Fredrik; Lagergren, Jesper

    2015-01-01

    The use of obesity surgery has increased during the past decade. There is a need for population-based assessments of causes and risk factors for postoperative mortality. The objective of this study was to assess causes and risk factors for 1-year mortality after obesity surgery. This nationwide retrospective population-based cohort study included essentially all obesity surgery patients in Sweden from 1980-2010. Data were collected from Swedish national registries and medical records. Patient characteristics, co-morbidities, and surgical procedures were assessed in relation to 1-year mortality through multivariable Cox proportional hazards regression, providing hazard ratios (HR), and 95% confidence intervals (CI) adjusted for age, sex, surgical procedure, surgical access, and co-morbidity. Among 22,487 obesity surgery patients the 1-year cumulative mortality was .38% (n = 85). Follow-up of cohort was complete. Median time of postoperative death was 45 days. Main causes of death included cardiopulmonary complications (myocardial infarction [n = 14; 16%], pulmonary embolism [n = 12; 14%], sudden cardiac arrest [n = 11; 13%]), and anastomotic leak (n = 12; 14%). Male sex (HR = 2.31; 95% CI 1.48-3.60), diabetes (HR = 2.47; 95% CI 1.44-4.23), and congestive heart failure (HR = 4.82; 95% CI 2.25-10.35) were independently associated with increased 1-year mortality, while age, hypertension, cerebrovascular disease, coronary heart disease, chronic obstructive pulmonary disease, asthma, and surgical procedure were not. Open surgery entailed an increased mortality compared to laparoscopic surgery from 2000-2010 (HR = 2.72; 95% CI 1.53-4.83), but not from 1990-1999 (HR = .39; 95% CI .11-1.32). Although the absolute risk of mortality is low, the increased relative risk of mortality associated with male sex, diabetes, congestive heart failure, and open surgical access could influence clinical decision making. Copyright © 2015 American Society for Bariatric Surgery. Published

  13. Antipsychotic adjunctive therapy to mood stabilizers and 1-year rehospitalization rates in bipolar disorder: A cohort study.

    PubMed

    Hochman, Eldar; Krivoy, Amir; Schaffer, Ayal; Weizman, Abraham; Valevski, Avi

    2016-12-01

    Antipsychotic adjunctive therapy to mood stabilizers (MSs) may improve relapse prevention; however, only a few naturalistic studies, reflecting more generalizable bipolar disorder (BD) samples, support this notion. We compared the 1-year rehospitalization rates of manic patients with bipolar I disorder (BD-I) who were discharged with MS (lithium or valproate) monotherapy or with adjunctive atypical or typical antipsychotic therapy. A total of 201 patients with BD-I who were hospitalized with manic episodes between 2005 and 2013 were retrospectively followed for 1-year rehospitalization rates according to treatment at discharge: MS monotherapy, MS with atypical antipsychotics, and MS with typical antipsychotics. Additionally, time to rehospitalization during the 1-year period after discharge was compared between treatment groups. Multivariable survival analyses adjusted for covariates known to influence rehospitalization were conducted. Rehospitalization rates within 1 year were significantly lower in the MS with atypical antipsychotics group (6.3%) compared to the MS monotherapy group (24.3%, P=.008) and to the MS with typical antipsychotics group (20.6%, P=.02). Time to rehospitalization was significantly longer for the MS with atypical antipsychotics group (345.5 days) compared to the MS monotherapy group (315.1 days, P=.006) and to the MS with typical antipsychotics group (334.1 days, P=.02). The MS with atypical antipsychotics group had a significantly reduced adjusted risk of rehospitalization (hazard ratio=0.17, 95% confidence interval: 0.05-0.61, P=.007) compared to the MS monotherapy group. Atypical antipsychotic adjunctive therapy to MSs may be more effective than MS monotherapy in preventing rehospitalization during the 1-year period after a BD manic episode. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Ultra-low field MRI: bringing MRI to new arenas

    DOE PAGES

    Magnelind, Per Erik; Matlashov, Andrei Nikolaevich; Newman, Shaun Garrett; ...

    2016-11-01

    Conventional magnetic resonance imaging (MRI) is moving toward the use of stronger and stronger magnetic fields with 3T, and even 7 T systems being increasingly used in routine clinical applications. However there is another branch of MRI, namely Ultra Low Field MRI (ULF-MRI) where the magnetic fields during readout are several orders of magnitude smaller, namely 1–100 μT. While conventional high-field MRI remains the gold standard there are several situations such as in military emergencies or in developing countries where for cost and logistical reasons, conventional MRI is not practical. In such scenarios, ULF-MRI could provide a solution. Lastly, thismore » article describes the basic principles and the potential of ULF-MRI.« less

  15. Ultra-low field MRI: bringing MRI to new arenas

    SciTech Connect

    Magnelind, Per Erik; Matlashov, Andrei Nikolaevich; Newman, Shaun Garrett; Sandin, Henrik; Urbaitis, Algis V.; Volegov, Petr Lvovich; Espy, Michelle A.

    2016-11-01

    Conventional magnetic resonance imaging (MRI) is moving toward the use of stronger and stronger magnetic fields with 3T, and even 7 T systems being increasingly used in routine clinical applications. However there is another branch of MRI, namely Ultra Low Field MRI (ULF-MRI) where the magnetic fields during readout are several orders of magnitude smaller, namely 1–100 μT. While conventional high-field MRI remains the gold standard there are several situations such as in military emergencies or in developing countries where for cost and logistical reasons, conventional MRI is not practical. In such scenarios, ULF-MRI could provide a solution. Lastly, this article describes the basic principles and the potential of ULF-MRI.

  16. Diagnostic accuracy and patient acceptance of MRI in children with suspected appendicitis.

    PubMed

    Thieme, Mai E; Leeuwenburgh, Marjolein M N; Valdehueza, Zaldy D; Bouman, Donald E; de Bruin, Ivar G J M; Schreurs, W Hermien; Houdijk, Alexander P J; Stoker, Jaap; Wiarda, Bart M

    2014-03-01

    To compare magnetic resonance imaging (MRI) and ultrasound in children with suspected appendicitis. In a single-centre diagnostic accuracy study, children with suspected appendicitis were prospectively identified at the emergency department. All underwent abdominal ultrasound and MRI within 2 h, with the reader blinded to other imaging findings. An expert panel established the final diagnosis after 3 months. We evaluated the diagnostic accuracy of three imaging strategies: ultrasound only, conditional MRI after negative or inconclusive ultrasound, and MRI only. Significance between sensitivity and specificity was calculated using McNemar's test statistic. Between April and December 2009 we included 104 consecutive children (47 male, mean age 12). According to the expert panel, 58 patients had appendicitis. The sensitivity of MRI only and conditional MRI was 100% (95% confidence interval 92-100), that of ultrasound was significantly lower (76%; 63-85, P < 0.001). Specificity was comparable among the three investigated strategies; ultrasound only 89% (77-95), conditional MRI 80% (67-89), MRI only 89% (77-95) (P values 0.13, 0.13 and 1.00). In children with suspected appendicitis, strategies with MRI (MRI only, conditional MRI) had a higher sensitivity for appendicitis compared with a strategy with ultrasound only, while specificity was comparable. • In children, MRI has a higher sensitivity for appendicitis than ultrasound. • Ultrasound followed by MRI in negative or inconclusive findings is accurate. • The tolerance for ultrasound and MRI in children is comparable. • MRI can be performed in children in an emergency setting.

  17. Impact of magnetic resonance imaging on ventricular tachyarrhythmia sensing: Results of the Evera MRI Study.

    PubMed

    Gold, Michael R; Sommer, Torsten; Schwitter, Juerg; Kanal, Emanuel; Bernabei, Matthew A; Love, Charles J; Surber, Ralf; Ramza, Brian; Cerkvenik, Jeffrey; Merkely, Béla

    2016-08-01

    Studies have shown that magnetic resonance imaging (MRI) conditional pacemakers experience no significant effect from MRI on device function, sensing, or pacing. More recently, similar safety outcomes were demonstrated with MRI conditional defibrillators (implantable cardioverter-defibrillator [ICD]), but the impact on ventricular arrhythmias has not been assessed. The purpose of this study was to assess the effect of MRI on ICD sensing and treatment of ventricular tachyarrhythmias. The Evera MRI Study was a worldwide trial of 156 patients implanted with an ICD designed to be MRI conditional. Device-detected spontaneous and induced ventricular tachycardia/ventricular fibrillation (VT/VF) episodes occurring before and after whole body MRI were evaluated by a blinded episode review committee. Detection delay was computed as the sum of RR intervals of undersensed beats. A ≥5-second delay in detection due to undersensing was prospectively defined as clinically significant. Post-MRI, there were 22 polymorphic VT/VF episodes in 21 patients, with 16 of these patients having 17 VT/VF episodes pre-MRI. Therapy was successful for all episodes, with no failures to treat or terminate arrhythmias. The mean detection delay due to undersensing pre- and post-MRI was 0.60 ± 0.59 and 0.33 ± 0.63 seconds, respectively (P = .17). The maximum detection delay was 2.19 seconds pre-MRI and 2.87 seconds post-MRI. Of the 17 pre-MRI episodes, 14 (82%) had some detection delay as compared with 11 of 22 (50%) post-MRI episodes (P = .03); no detection delay was clinically significant. Detection and treatment of VT/VF was excellent, with no detection delays or significant impact of MRI observed. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  18. Decrease in 1-year Kidney Graft Size Predicts Inferior Outcomes After Deceased Donor Kidney Transplantation.

    PubMed

    Černe, Senka; Arnol, Miha; Kandus, Aljoša; Buturović-Ponikvar, Jadranka

    2016-08-01

    Longest bipolar length of the kidney graft is routinely measured for ultrasonographic assessment of graft size (GS), although the value of the graft length remains unclear. In a single-center, observational study involving 319 deceased-donor kidney transplant recipients, we assessed variations in absolute and adjusted GS (corrected for body surface area) between 1 and 12 months after transplantation ([INCREMENT]GS1m→12m). We tested whether variations in GS during the first year were predictive of the composite outcome of a reduction of 50% or more in the estimated glomerular filtration rate or end-stage graft failure. At 1 year after transplantation, 121 patients (38%) had a decrease in GS ([INCREMENT]GS1m→12m <0), and 198 patients (62%) had an increase in GS ([INCREMENT]GS1m→12m ≥0). After a median follow-up of 53 months, 41 patients with a decrease in GS reached the composite outcome as compared with 12 patients with an increase in GS (34% and 6%, respectively; P < 0.001). Areas under the receiver operating characteristics curves of absolute and adjusted [INCREMENT]GS1m→12m for composite outcome were 0.81 (95% confidence interval [95% CI], 0.74-0.88) and 0.78 (95% CI, 0.70-0.86), respectively. In multivariate analysis, the risk of the composite outcome was significantly higher among patients with a decrease in GS during the first year after transplantation (hazard ratio, 4.55; 95% CI, 2.35-8.81; P < 0.001). A decrease in kidney GS during the first year after transplantation, as compared with an increase in GS, is a powerful predictor of subsequent graft dysfunction or end-stage graft failure.

  19. Speed fluctuations near 60 AU on scales from 1 day to 1 year: Observations and model

    NASA Astrophysics Data System (ADS)

    Burlaga, L. F.; Richardson, J. D.; Wang, C.

    2002-10-01

    This paper describes the multiscale, statistical state of the speed observed near 60 AU from mid-1999 to mid-2000 by Voyager 2 (V2), and it shows that a multifluid MHD model can explain the basic features of these observations. The probability distribution functions (PDFs) of the running speed differences (dVn) on scales from 1 day to 256 days provide a relatively complete description of some important properties of the large-scale speed fluctuations. On a scale of 1 or 2 days the PDFs of the positive and negative speed differences observed by V2 are approximately exponential, which is related to jump-ramp structures but might include a contribution from intermittent turbulence. On scales greater than 26 days (the solar rotation period) the PDFs of the speed differences are approximately Gaussian, i.e., quadratic on a semilog scale. On a scale of the order of several days, on which one sees jump-ramp structures in the speed profile, the PDF of the speed differences is cubic on a semilog scale. The standard deviation of dVn increases with increasing scale. The skewness and kurtosis of dVn are relatively large at small scales and decrease to Gaussian values at scales ≥16 days. The PDFs of speed differences and their lower moments versus scale near 60 AU were also derived from a speed profile predicted by the deterministic, spherically symmetric, multifluid, MHD model of Chi Wang, using ACE observations at 1 AU as the inner boundary conditions. Although the projected speed profile is not the same as the observed speed profile because ACE and Voyager are not radially aligned throughout the 1-year interval, the statistical properties of the observed profiles are essentially the same as the projected speed profiles. Significant evolution of the multiscale statistical properties of the solar wind speed fluctuations occurs between 1 and 60 AU; this evolution can be explained by a deterministic model.

  20. Radiotherapy Planning using MRI

    PubMed Central

    Schmidt, Maria A; Payne, Geoffrey S

    2016-01-01

    The use of Magnetic Resonance Imaging (MRI) in Radiotherapy (RT) planning is rapidly expanding. We review the wide range of image contrast mechanisms available to MRI and the way they are exploited for RT planning. However a number of challenges are also considered: the requirements that MR images are acquired in the RT treatment position, that they are geometrically accurate, that effects of patient motion during the scan are minimised, that tissue markers are clearly demonstrated, that an estimate of electron density can be obtained. These issues are discussed in detail, prior to the consideration of a number of specific clinical applications. This is followed by a brief discussion on the development of real-time MRI-guided RT. PMID:26509844

  1. The Role of Preoperative Magnetic Resonance Imaging in the Assessment and Surgical Treatment of Interval and Screen-Detected Breast Cancer in Older Women.

    PubMed

    Goodrich, Martha E; Weiss, Julie; Onega, Tracy; Balch, Steve L; Buist, Diana S M; Kerlikowske, Karla; Henderson, Louise M; Hubbard, Rebecca A

    2016-11-01

    We describe the relationship between preoperative magnetic resonance imaging (MRI) and the utilization of additional imaging, biopsy, and primary surgical treatment for subgroups of women with interval versus screen-detected breast cancer. We determined the proportion of women receiving additional breast imaging or biopsy and type of primary surgical treatment, stratified by use of preoperative MRI, separately for both groups. Using Breast Cancer Surveillance Consortium (BCSC) data, we identified a cohort of women age 66 and older with an interval or screen-detected breast cancer diagnosis between 2005 and 2010. Using logistic regression, we explored associations between primary surgical treatment type and preoperative MRI use for interval and screen-detected cancers. There were 204 women with an interval cancer and 1,254 with a screen-detected cancer. The interval cancer group was more likely to receive preoperative MRI (21% versus 13%). In both groups, women receiving MRI were more likely to receive additional imaging and/or biopsy. Receipt of MRI was not associated with increased odds of mastectomy (OR = 0.99, 95% CI: 0.67-1.50), while interval cancer diagnosis was associated with significantly higher odds of mastectomy (OR = 1.64, 95% CI: 1.11-2.42). Older women with interval cancer were more likely than women with a screen-detected cancer to have preoperative MRI, however, those with an interval cancer had 64% higher odds of mastectomy regardless of receipt of MRI. Given women with interval cancer are reported to have a worse prognosis, more research is needed to understand effectiveness of imaging modalities and treatment consequences within this group. © 2016 Wiley Periodicals, Inc.

  2. Magnetic Resonance Imaging (MRI) Safety

    MedlinePlus

    ... Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) Safety What is MRI and how does ... the area being scanned include: Metallic spinal rod Plates, pins, screws, or metal mesh used to repair ...

  3. MRI and low back pain

    MedlinePlus

    ... cause of the pain cannot be found. An MRI scan is an imaging test that creates detailed pictures ... neck pain often gets better on its own. MRI scans create detailed pictures of your spine. It can ...

  4. Interval From Imaging to Treatment Delivery in the Radiation Surgery Age: How Long Is Too Long?

    SciTech Connect

    Seymour, Zachary A.; Fogh, Shannon E.; Westcott, Sarah K.; Braunstein, Steve; Larson, David A.; Barani, Igor J.; Nakamura, Jean; Sneed, Penny K.

    2015-09-01

    Purpose: The purpose of this study was to evaluate workflow and patient outcomes related to frameless stereotactic radiation surgery (SRS) for brain metastases. Methods and Materials: We reviewed all treatment demographics, clinical outcomes, and workflow timing, including time from magnetic resonance imaging (MRI), computed tomography (CT) simulation, insurance authorization, and consultation to the start of SRS for brain metastases. Results: A total of 82 patients with 151 brain metastases treated with SRS were evaluated. The median times from consultation, insurance authorization, CT simulation, and MRI for treatment planning were 15, 7, 6, and 11 days to SRS. Local freedom from progression (LFFP) was lower in metastases with MRI ≥14 days before treatment (P=.0003, log rank). The 6- and 12-month LFFP rate were 95% and 75% for metastasis with interval of <14 days from MRI to treatment compared to 56% and 34% for metastases with MRI ≥14 days before treatment. On multivariate analysis, LFFP remained significantly lower for lesions with MRI ≥14 days at SRS (P=.002, Cox proportional hazards; hazard ratio: 3.4, 95% confidence interval: 1.6-7.3). Conclusions: Delay from MRI to SRS treatment delivery for brain metastases appears to reduce local control. Future studies should monitor the timing from imaging acquisition to treatment delivery. Our experience suggests that the time from MRI to treatment should be <14 days.

  5. Radio-frequency ablation of small renal tumors: minimum follow up of 1 year

    NASA Astrophysics Data System (ADS)

    Patel, Vipul; Thaly, Rahul; Shah, Ketul

    2007-02-01

    OBJECTIVE: With the increased utility of complex imaging modalities small renal tumors are being diagnosed with rising frequency. We performed radiofrequency ablation to treat tumors less than 4cm in size using a combination of temperature, impedance, ultrasound and laparoscopic guidance. In this article we reviewed the outcome of radiofrequency ablation of renal tumors at one year at our institution. MATERIALS AND METHODS: Over a three-year period 75 patients with a total of 93 renal tumors underwent radiofrequency ablation. Average patient age was 64.5 years with ASA of 2.9. Indications for nephron sparing were imperative in 33 (solitary kidney 21, renal insufficiency 12). Seventeen patients had significant co-morbidities with ASA score of 3 or more and were thought to be poor candidates for nephrectomy or partial nephrectomy. Five were Jehovah's Witness patients. Average tumor size was 3.2 cm (1.5-4.0). 60% of the tumors were exophytic and 40% deep. Radiofrequency ablation was performed via a transperitoneal approach using the single pronged 3cm Cool tip electrode (Radionics Inc). Tumor was isolated laparoscopically. Prior to ablation the lesions were biopsied. Ablation was performed using both laparoscopic and real-time ultrasound imaging of the boarders of the tumor. During ablation impedance and temperature monitoring was performed. For each tumor two separate ablations were performed at perpendicular angles, the first ablation was for 6 minutes and the second for 3 minutes. The center and periphery of the tumor was monitored to insure that the temperature rose above 70 degrees Celsius. Patients were followed at three-month intervals with triple phase CT scan or MRI to evaluate efficacy of the ablation. Our criteria for recurrent tumor were growth or enhancement of the lesion. RESULTS: Average operative time was 109 minutes with and average EBL of <25cc. Mean hospital stay was 1.4 days. At average follow up of 19.2 months (range 2-24), one lesion showed

  6. High resolution time interval meter

    DOEpatents

    Martin, A.D.

    1986-05-09

    Method and apparatus are provided for measuring the time interval between two events to a higher resolution than reliability available from conventional circuits and component. An internal clock pulse is provided at a frequency compatible with conventional component operating frequencies for reliable operation. Lumped constant delay circuits are provided for generating outputs at delay intervals corresponding to the desired high resolution. An initiation START pulse is input to generate first high resolution data. A termination STOP pulse is input to generate second high resolution data. Internal counters count at the low frequency internal clock pulse rate between the START and STOP pulses. The first and second high resolution data are logically combined to directly provide high resolution data to one counter and correct the count in the low resolution counter to obtain a high resolution time interval measurement.

  7. Finding Nested Common Intervals Efficiently

    NASA Astrophysics Data System (ADS)

    Blin, Guillaume; Stoye, Jens

    In this paper, we study the problem of efficiently finding gene clusters formalized by nested common intervals between two genomes represented either as permutations or as sequences. Considering permutations, we give several algorithms whose running time depends on the size of the actual output rather than the output in the worst case. Indeed, we first provide a straightforward O(n 3) time algorithm for finding all nested common intervals. We reduce this complexity by providing an O(n 2) time algorithm computing an irredundant output. Finally, we show, by providing a third algorithm, that finding only the maximal nested common intervals can be done in linear time. Considering sequences, we provide solutions (modifications of previously defined algorithms and a new algorithm) for different variants of the problem, depending on the treatment one wants to apply to duplicated genes.

  8. MRI of intact plants.

    PubMed

    Van As, Henk; Scheenen, Tom; Vergeldt, Frank J

    2009-01-01

    Nuclear magnetic resonance imaging (MRI) is a non-destructive and non-invasive technique that can be used to acquire two- or even three-dimensional images of intact plants. The information within the images can be manipulated and used to study the dynamics of plant water relations and water transport in the stem, e.g., as a function of environmental (stress) conditions. Non-spatially resolved portable NMR is becoming available to study leaf water content and distribution of water in different (sub-cellular) compartments. These parameters directly relate to stomatal water conductance, CO(2) uptake, and photosynthesis. MRI applied on plants is not a straight forward extension of the methods discussed for (bio)medical MRI. This educational review explains the basic physical principles of plant MRI, with a focus on the spatial resolution, factors that determine the spatial resolution, and its unique information for applications in plant water relations that directly relate to plant photosynthetic activity. © Springer Science+Business Media B.V. 2009

  9. Contrast agents for MRI.

    PubMed

    Shokrollahi, H

    2013-12-01

    Contrast agents are divided into two categories. The first one is paramagnetic compounds, including lanthanides like gadolinium, which mainly reduce the longitudinal (T1) relaxation property and result in a brighter signal. The second class consists of super-paramagnetic magnetic nanoparticles (SPMNPs) such as iron oxides, which have a strong effect on the transversal (T2) relaxation properties. SPMNPs have the potential to be utilized as excellent probes for magnetic resonance imaging (MRI). For instance, clinically benign iron oxide and engineered ferrite nanoparticles provide a good MRI probing capability for clinical applications. Furthermore, the limited magnetic property and inability to escape from the reticuloendothelial system (RES) of the used nanoparticles impede their further advancement. Therefore, it is necessary to develop the engineered magnetic nanoparticle probes for the next-generation molecular MRI. Considering the importance of MRI in diagnosing diseases, this paper presents an overview of recent scientific achievements in the development of new synthetic SPMNP probes whereby the sensitive and target-specific observation of biological events at the molecular and cellular levels is feasible.

  10. Biomimetic phantom for cardiac diffusion MRI

    PubMed Central

    Teh, Irvin; Zhou, Feng‐Lei; Hubbard Cristinacce, Penny L.; Parker, Geoffrey J.M.

    2015-01-01

    Purpose Diffusion magnetic resonance imaging (MRI) is increasingly used to characterize cardiac tissue microstructure, necessitating the use of physiologically relevant phantoms for methods development. Existing phantoms are generally simplistic and mostly simulate diffusion in the brain. Thus, there is a need for phantoms mimicking diffusion in cardiac tissue. Materials and Methods A biomimetic phantom composed of hollow microfibers generated using co‐electrospinning was developed to mimic myocardial diffusion properties and fiber and sheet orientations. Diffusion tensor imaging was carried out at monthly intervals over 4 months at 9.4T. 3D fiber tracking was performed using the phantom and compared with fiber tracking in an ex vivo rat heart. Results The mean apparent diffusion coefficient and fractional anisotropy of the phantom remained stable over the 4‐month period, with mean values of 7.53 ± 0.16 × 10‐4 mm2/s and 0.388 ± 0.007, respectively. Fiber tracking of the 1st and 3rd eigenvectors generated analogous results to the fiber and sheet‐normal direction respectively, found in the left ventricular myocardium. Conclusion A biomimetic phantom simulating diffusion in the heart was designed and built. This could aid development and validation of novel diffusion MRI methods for investigating cardiac microstructure, decrease the number of animals and patients needed for methods development, and improve quality control in longitudinal and multicenter cardiac diffusion MRI studies. J. MAGN. RESON. IMAGING 2016;43:594–600. PMID:26213152

  11. MRI-Based Assessment of Safe Margins in Tumor Surgery

    PubMed Central

    Bellanova, Laura; Schubert, Thomas; Cartiaux, Olivier; Lecouvet, Frédéric; Galant, Christine; Banse, Xavier; Docquier, Pierre-Louis

    2014-01-01

    Introduction. In surgical oncology, histological analysis of excised tumor specimen is the conventional method to assess the safety of the resection margins. We tested the feasibility of using MRI to assess the resection margins of freshly explanted tumor specimens in rats. Materials and Methods. Fourteen specimen of sarcoma were resected in rats and analysed both with MRI and histologically. Slicing of the specimen was identical for the two methods and corresponding slices were paired. 498 margins were measured in length and classified using the UICC classification (R0, R1, and R2). Results. The mean difference between the 498 margins measured both with histology and MRI was 0.3 mm (SD 1.0 mm). The agreement interval of the two measurement methods was [−1.7 mm; 2.2 mm]. In terms of the UICC classification, a strict correlation was observed between MRI- and histology-based classifications (κ = 0.84, P < 0.05). Discussion. This experimental study showed the feasibility to use MRI images of excised tumor specimen to assess the resection margins with the same degree of accuracy as the conventional histopathological analysis. When completed, MRI acquisition of resected tumors may alert the surgeon in case of inadequate margin and help advantageously the histopathological analysis. PMID:24701131

  12. High resolution time interval counter

    NASA Technical Reports Server (NTRS)

    Zhang, Victor S.; Davis, Dick D.; Lombardi, Michael A.

    1995-01-01

    In recent years, we have developed two types of high resolution, multi-channel time interval counters. In the NIST two-way time transfer MODEM application, the counter is designed for operating primarily in the interrupt-driven mode, with 3 start channels and 3 stop channels. The intended start and stop signals are 1 PPS, although other frequencies can also be applied to start and stop the count. The time interval counters used in the NIST Frequency Measurement and Analysis System are implemented with 7 start channels and 7 stop channels. Four of the 7 start channels are devoted to the frequencies of 1 MHz, 5 MHz or 10 MHz, while triggering signals to all other start and stop channels can range from 1 PPS to 100 kHz. Time interval interpolation plays a key role in achieving the high resolution time interval measurements for both counters. With a 10 MHz time base, both counters demonstrate a single-shot resolution of better than 40 ps, and a stability of better than 5 x 10(exp -12) (sigma(sub chi)(tau)) after self test of 1000 seconds). The maximum rate of time interval measurements (with no dead time) is 1.0 kHz for the counter used in the MODEM application and is 2.0 kHz for the counter used in the Frequency Measurement and Analysis System. The counters are implemented as plug-in units for an AT-compatible personal computer. This configuration provides an efficient way of using a computer not only to control and operate the counters, but also to store and process measured data.

  13. Immunization dropout rates in ihe, awgu local government area, enugu state, South East Nigeria: a 1 year review.

    PubMed

    Chinawa, Jm

    2014-07-01

    Immunization against childhood diseases is one of the most important ways of preventing childhood morbidity and mortality. The objective of this study is to review the dropout rates of immunization of children in a health center using a single dose of diphtheria-pertussis-tetanus (DPT1) and three doses of diphtheria-pertussis-tetanus (DPT3) vaccine. This is a cross sectional study where immunization dropout rate of children less than 1 year in a health center was ascertained. Data was analyzed by Statistical Package for the Social Sciences version 17 (Chicago, IL, USA). Data presentation was in the form of tables and charts. The P values and confidence intervals were calculated using Chi-square. The mean and ranges of all the variables were calculated. The level of significance was set at P ≤ 0.05. Out of 972 children who are within 1 year, 63% (613/972) were immunized for DPT3 while 63.7% (619/972) were immunized for DPT1 with an overall dropout rates and percentage of 6 and 1% (6/613) respectively. Immunization coverage for 2012 was also stratified into intervals of 4 months: From January to April 2012, 168 children received DPT1 while 166 received DPT3. Between May and August 2012, 222 children received DPT1 while 226 received DPT3. The last 3(rd) of the year showed that 223 children received DPT1 while 227 received DPT3. Though the total immunization coverage for DPT in this rural health center is poor, they have a very low dropout rate.

  14. Management and 1-year outcomes of patients with atrial fibrillation in the Middle East: Gulf survey of atrial fibrillation events.

    PubMed

    Zubaid, Mohammad; Rashed, Wafa A; Alsheikh-Ali, Alawi A; Al-Zakwani, Ibrahim; AlMahmeed, Wael; Shehab, Abdullah; Sulaiman, Kadhim; Qudaimi, Ahmed Al; Asaad, Nidal; Amin, Haitham

    2015-05-01

    We describe management and outcomes of patients with nonvalvular atrial fibrillation (AF) in the Middle East. Consecutive patients with AF presenting to emergency departments (EDs) were prospectively enrolled. Among 1721 patients with nonvalvular AF, mean age was 59 ± 16 years and 44% were women. Comorbidities were common such as hypertension (59%), diabetes (33%), and coronary artery disease (33%). Warfarin was not prescribed to 40% of patients with Congestive heart failure, Hypertension, Age, Diabetes mellitus, Stroke/TIA2 score of ≥2. One-year rates of stroke/transient ischemic attack (TIA) and all-cause mortality were 4.2% and 15.3%, respectively. Warfarin use at hospital-ED discharge was independently associated with lower 1-year rate of stroke/TIA (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.17-0.85; P = .015) and all-cause mortality (OR, 0.51; 95% CI, 0.32-0.83; P = .006). Prior history of heart failure and peripheral vascular disease was independent mortality predictors. Our patients are relatively young with significant cardiovascular risk. Their anticoagulation treatment is suboptimal, and 1-year all-cause mortality and stroke/TIA event rates are relatively high. © The Author(s) 2014.

  15. Swallowing Function and Nutritional Status in Japanese Elderly People Receiving Home-care Services: A 1-year Longitudinal Study.

    PubMed

    Okabe, Y; Furuta, M; Akifusa, S; Takeuchi, K; Adachi, M; Kinoshita, T; Kikutani, T; Nakamura, S; Yamashita, Y

    2016-01-01

    Malnutrition is a serious health concern for frail elderly people. Poor oral function leading to insufficient food intake can contribute to the development of malnutrition. In the present study, we explored the longitudinal association of malnutrition with oral function, including oral health status and swallowing function, in elderly people receiving home nursing care. Prospective observational cohort study with 1-year follow-up. Two mid-sized cities in Fukuoka, Japan from November 2010 to March 2012. One hundred and ninety-seven individuals, aged ≥ 60 years, living at home and receiving home-care services because of physical disabilities, without malnutrition. Oral health status, swallowing function, taking modified-texture diets such as minced or pureed foods, nutritional status, cognitive function, and activities of daily living were assessed at baseline. The associations between malnutrition at 1-year follow-up and these related factors were analyzed using a logistic regression model. Swallowing disorders [risk ratio (RR): 5.21, 95% confidence interval (95% CI): 1.65-16.43] were associated with malnutrition. On the other hand, oral health status did not have a direct association with malnutrition. Swallowing disorders may be associated with the incidence of malnutrition in elderly people receiving home-care. The findings indicate that maintaining swallowing function may contribute to the prevention of malnutrition in frail elderly people.

  16. Prevalence and predictors of anal incontinence during pregnancy and 1 year after delivery: a prospective cohort study.

    PubMed

    Johannessen, H H; Wibe, A; Stordahl, A; Sandvik, L; Backe, B; Mørkved, S

    2014-02-01

    To evaluate the prevalence and predictors of anal incontinence (AI) in late pregnancy and 1 year after delivery. Prospective population-based cohort study. Two maternity units in Norway 2009-2010. Primiparae aged 18 years or over. Primiparae answered questions on the St. Mark's score about AI during the last 4 weeks of pregnancy. One year later, the same questionnaires were distributed by postal mail. Socio-economic and delivery-related data were obtained from hospital records. Self-reported AI. Answers on AI in late pregnancy were obtained from 1571 women, and 1030 responded 1 year later. Twenty-four per cent experienced one and 4.7% experienced three or more AI symptoms in late pregnancy. One year later, this was reduced to 19% and 2.2%, respectively. Multivariate logistic regression analyses were applied. Formed and loose stool incontinence were strongly associated at both time points. The main predictor of AI 1 year after delivery was AI in late pregnancy. Obstetric anal sphincter injury increased the risk of incontinence of stool and flatus (odds ratio [OR], 4.1; 95% confidence interval [CI], 1.7-9.6) after delivery. Urgency was associated with greater age (OR, 1.8; 95% CI, 1.0-3.3) and operative delivery (OR, 2.0; 95% CI, 1.3-2.9). One in four primiparae experienced AI in late pregnancy. One year later, still one in five suffered from incontinence. Sphincter injury predicted incontinence of stool and flatus, whereas greater age and operative delivery predicted urgency. The identification and adequate follow-up of pregnant women with AI may reduce AI after delivery. © 2013 Royal College of Obstetricians and Gynaecologists.

  17. Risk model for estimating the 1-year risk of deferred lesion intervention following deferred revascularization after fractional flow reserve assessment.

    PubMed

    Depta, Jeremiah P; Patel, Jayendrakumar S; Novak, Eric; Gage, Brian F; Masrani, Shriti K; Raymer, David; Facey, Gabrielle; Patel, Yogesh; Zajarias, Alan; Lasala, John M; Amin, Amit P; Kurz, Howard I; Singh, Jasvindar; Bach, Richard G

    2015-02-21

    Although lesions deferred revascularization following fractional flow reserve (FFR) assessment have a low risk of adverse cardiac events, variability in risk for deferred lesion intervention (DLI) has not been previously evaluated. The aim of this study was to develop a prediction model to estimate 1-year risk of DLI for coronary lesions where revascularization was not performed following FFR assessment. A prediction model for DLI was developed from a cohort of 721 patients with 882 coronary lesions where revascularization was deferred based on FFR between 10/2002 and 7/2010. Deferred lesion intervention was defined as any revascularization of a lesion previously deferred following FFR. The final DLI model was developed using stepwise Cox regression and validated using bootstrapping techniques. An algorithm was constructed to predict the 1-year risk of DLI. During a mean (±SD) follow-up period of 4.0 ± 2.3 years, 18% of lesions deferred after FFR underwent DLI; the 1-year incidence of DLI was 5.3%, while the predicted risk of DLI varied from 1 to 40%. The final Cox model included the FFR value, age, current or former smoking, history of coronary artery disease (CAD) or prior percutaneous coronary intervention, multi-vessel CAD, and serum creatinine. The c statistic for the DLI prediction model was 0.66 (95% confidence interval, CI: 0.61-0.70). Patients deferred revascularization based on FFR have variation in their risk for DLI. A clinical prediction model consisting of five clinical variables and the FFR value can help predict the risk of DLI in the first year following FFR assessment. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  18. Association of fewer hours of sleep at 6 months postpartum with substantial weight retention at 1 year postpartum.

    PubMed

    Gunderson, Erica P; Rifas-Shiman, Sheryl L; Oken, Emily; Rich-Edwards, Janet W; Kleinman, Ken P; Taveras, Elsie M; Gillman, Matthew W

    2008-01-15

    Shorter sleep duration is linked to obesity, coronary artery disease, and diabetes. Whether sleep deprivation during the postpartum period affects maternal postpartum weight retention remains unknown. This study examined the association of sleep at 6 months postpartum with substantial postpartum weight retention (SPPWR), defined as 5 kg or more above pregravid weight at 1 year postpartum. The authors selected 940 participants in Project Viva who enrolled during early pregnancy from 1999 to 2002. Logistic regression models estimated odds ratios of SPPWR for sleep categories, controlling for sociodemographic, prenatal, and behavioral attributes. Of the 940 women, 124 (13%) developed SPPWR. Sleep distributions were as follows: 114 (12%) women slept < or =5 hours/day, 280 (30%) slept 6 hours/day, 321 (34%) slept 7 hours/day, and 225 (24%) slept > or =8 hours/day. Adjusted odds ratios of SPPWR were 3.13 (95% confidence interval (CI): 1.42, 6.94) for < or =5 hours/day, 0.99 (95% CI: 0.50, 1.97) for 6 hours/day, and 0.94 (95% CI: 0.50, 1.78) for > or =8 hours/day versus 7 hours/day (p = 0.012). The adjusted odds ratio for SPPWR of 2.05 (95% CI: 1.11, 3.78) was twofold greater (p = 0.02) for a decrease in versus no change in sleep at 1 year postpartum. Sleeping < or =5 hours/day at 6 months postpartum was strongly associated with retaining > or =5 kg at 1 year postpartum. Interventions to prevent postpartum obesity should consider strategies to attain optimal maternal sleep duration.

  19. Baseline characteristics and 1-year follow-up of Chinese atrial fibrillation patients according to age: a registry study.

    PubMed

    Chen, Tao; Yang, Yan-Min; Tan, Hui-Qiong; Liang, Yan; Zhu, Jun

    2014-10-01

    The prevalence of atrial fibrillation (AF) increases with age, and may lead to complications and reduced quality of life. The aim of this study was to determine the characteristics, management, and prognosis of Chinese AF patients and whether there were differences according to age. This registry-based study enrolled ambulatory, outpatient clinic, or hospitalized patients with AF in four sites in China. Based on the Birmingham 2009 schema, patients without and with valve lesion were stratified into three groups according to age. Between September 2008 and April 2011, 2,016 patients were enrolled, including 1,606 patients without valve lesion and 410 patients with valve lesion. Compared with the other two groups, patients >74 years of age were more likely to have morbidity and a CHADS2 score >1, and less likely to receive oral anticoagulants and rhythm-control drugs. At the 1-year follow-up, patients >74 years of age were more likely to have died or suffered a cerebrovascular event or systemic embolism. Age as a continuous variable (subdivided hazard ratio [SHR] 0.98, 95% confidence interval [CI] 0.96-1.01, P = 0.29) was not associated with risk of a cerebrovascular event or systemic embolism at 1-year but age ≥75 years (SHR 1.73, 95% CI 1.05-2.87, P = 0.03) was an independent risk factor for the outcome at 1-year when all AF patients were included. Elderly AF patients are inadequately studied and treated compared with younger patients. Education on evidence-based management and the design of randomized controlled trials, specifically targeting the elderly, especially the Chinese elderly, should improve the management and prognosis of this frail segment of the AF population. ©2014 Wiley Periodicals, Inc.

  20. Cost effective mass standard calibration intervals

    SciTech Connect

    Shull, A.H.; Clark, J.P.

    1995-11-01

    National Institute of Standards and Technology (NIST) traceable standard weights serve as the foundation of mass measurement control programs. These standards are normally recalibrated annually at a cost of approximately $100 per weight. The Savannah River Site (SRS) has more than 4,000 standard weights. Most have recalibration intervals of 1 year. The cost effectiveness of the current practice was questioned. Are these mass standards being calibrated too often, and are all of these standards needed for calibration and QC activities? Statistical analyses of data from the calibration histories were performed on a random sample of eight weight sets. The analyses indicated no time effects or significant trends in the weight masses for periods of from 5 to 8 years. In other words, calibration checks were being performed too frequently. In addition, current electronic balance technology does not require a traditional set of standard weights that cover the entire weighing range of a balance. At the most, only 2 or 3 standards are needed for most weighing systems. Hence, by increasing weight set recalibration frequencies from 1 to 3 years, and by reducing the number standards calibrated by 80%, annual cost savings of over $400,000 are attainable at SRS. Details of the data analysis, technological advances, and cost savings are included in the paper.

  1. Sleep Quality and 1-Year Incident Cognitive Impairment in Community-Dwelling Older Adults

    PubMed Central

    Potvin, Olivier; Lorrain, Dominique; Forget, Hélène; Dubé, Micheline; Grenier, Sébastien; Préville, Michel; Hudon, Carol

    2012-01-01

    Study Objectives: To examine in cognitively intact older men and women the associations between subjective sleep quality and 1-yr incident cognitive impairment. Design: Prospective cohort study. Setting: General community. Participants: 1,664 cognitively intact individuals age 65 to 96 years. Measurements and Results: Sleep quality at baseline was measured using the Pittsburgh Sleep Quality Index (PSQI). Cognitive functioning was assessed at baseline and 12 months later using the Mini-Mental State Examination (MMSE). Incident general cognitive impairment was defined according to a follow-up MMSE score below the 15th percentile according to normative data and of at least 2 points below baseline. General cognitive impairments were also separated into amnestic and nonamnestic subtypes according to MMSE delayed recall performance. Associations between sleep quality indicators at baseline and incident cognitive impairment were assessed by odds ratio (OR) adjusted for age, education, baseline MMSE score, psychotropic drug use, anxiety, depressive episodes, cardiovascular conditions, and chronic diseases. Results revealed that global PSQI score was significantly linked with incident cognitive impairment (OR 1.17, 95% confidence interval (CI) 1.05-1.30) in men, but not in women. In women, sleep disturbance score (OR 2.62, 95% CI 1.41-4.86) and long sleep duration (≥ 9 hr; OR 3.70, 95% CI 1.49-9.17) were associated with nonamnestic and amnestic incident cognitive impairment, respectively. In men, short sleep duration (≤ 5 hr; OR 4.95, 95% CI 1.72-14.27) and habitual sleep efficiency score (OR 1.94, 95% CI 1.42-2.66) were associated with amnestic and general incident cognitive impairment, respectively. Conclusions: Sleep quality in older adults should receive particular attention by clinicians because poor sleep quality can be an early sign of cognitive decline. Citation: Potvin O; Lorrain D; Forget H; Dubé M; Grenier S; Préville M; Hudon C. Sleep quality and 1-year

  2. MRI of the penis

    PubMed Central

    Kirkham, A

    2012-01-01

    MRI of the penis is an expensive test that is not always superior to clinical examination or ultrasound. However, it shows many of the important structures, and in particular the combination of tumescence from intracavernosal alprostadil, and high-resolution T2 sequences show the glans, corpora and the tunica albuginea well. In this paper we summarise the radiological anatomy and discuss the indications for MRI. For penile cancer, it may be useful in cases where the local stage is not apparent clinically. In priapism, it is an emerging technique for assessing corporal viability, and in fracture it can in most cases make the diagnosis and locate the injury. In some cases of penile fibrosis and Peyronie's disease, it may aid surgical planning, and in complex pelvic fracture may replace or augment conventional urethrography. It is an excellent investigation for the malfunctioning penile prosthesis. PMID:23118102

  3. MRI of the penis.

    PubMed

    Kirkham, A

    2012-11-01

    MRI of the penis is an expensive test that is not always superior to clinical examination or ultrasound. However, it shows many of the important structures, and in particular the combination of tumescence from intracavernosal alprostadil, and high-resolution T(2) sequences show the glans, corpora and the tunica albuginea well. In this paper we summarise the radiological anatomy and discuss the indications for MRI. For penile cancer, it may be useful in cases where the local stage is not apparent clinically. In priapism, it is an emerging technique for assessing corporal viability, and in fracture it can in most cases make the diagnosis and locate the injury. In some cases of penile fibrosis and Peyronie's disease, it may aid surgical planning, and in complex pelvic fracture may replace or augment conventional urethrography. It is an excellent investigation for the malfunctioning penile prosthesis.

  4. MRI of the knee.

    PubMed

    Skinner, Sarah

    2012-11-01

    Magnetic resonance imaging (MRI) is the gold standard in noninvasive investigation of knee pain. It has a very high negative predictive value and may assist in avoiding unnecessary knee arthroscopy; its accuracy in the diagnosis of meniscal and anterior cruciate ligament (ACL) tears is greater than 89%; it has a greater than 90% sensitivity for the detection of medial meniscal tears; and it is probably better at assessing the posterior horn than arthroscopy.

  5. Quiet Technology of MRI.

    PubMed

    Yamashita, Yuichi

    A number of clinical applications for MRI have been developed in accordance with the advancement in imaging technology. Recently, medical checkup of brain or heart are becoming popular. In this situation, there is a growing need for performance improvement of MRI and thus acoustic noise during examinations tends to become louder with the use of higher static magnetic field and higher gradient performance. Noise reduction measures for MRI are classified into two categories, pulse sequence optimization and hardware renovation. For pulse sequence, noise is reduced by decreasing the changes of the current applied for gradient coil. Since there exist solid-borne sound and airborne sound, for hardware measure, not only making gradient coil itself vibration suppressed structure but also controlling vibration to prevent propagation of sounds to the other structure is required. Pianissimo(TM) mechanism employs both solid-borne sound suppression and airborne sound suppression by vacuum-encapsulating the gradient coil, and realizes 33 dB noise reduction. Pianissimo(TM) mechanism, in contrast to the noise reduction by pulse sequence modification, reduces the acoustic noise produced by scans of all kinds and can be readily adapted to the newly developed applications regardless of imaging technique.

  6. MRI of human hair.

    PubMed

    Mattle, Eveline; Weiger, Markus; Schmidig, Daniel; Boesiger, Peter; Fey, Michael

    2009-06-01

    Hair care for humans is a major world industry with specialised tools, chemicals and techniques. Studying the effect of hair care products has become a considerable field of research, and besides mechanical and optical testing numerous advanced analytical techniques have been employed in this area. In the present work, another means of studying the properties of hair is added by demonstrating the feasibility of magnetic resonance imaging (MRI) of the human hair. Established dedicated nuclear magnetic resonance microscopy hardware (solenoidal radiofrequency microcoils and planar field gradients) and methods (constant time imaging) were adapted to the specific needs of hair MRI. Images were produced at a spatial resolution high enough to resolve the inner structure of the hair, showing contrast between cortex and medulla. Quantitative evaluation of a scan series with different echo times provided a T*(2) value of 2.6 ms for the cortex and a water content of about 90% for hairs saturated with water. The demonstration of the feasibility of hair MRI potentially adds a new tool to the large variety of analytical methods used nowadays in the development of hair care products.

  7. Validation of CT-MRI fusion for intraoperative assessment of stereotactic accuracy in DBS surgery.

    PubMed

    Mirzadeh, Zaman; Chapple, Kristina; Lambert, Meg; Dhall, Rohit; Ponce, Francisco A

    2014-12-01

    Deep brain stimulation is typically performed with intraoperative microelectrode recording and test stimulation for target confirmation. Recent studies have shown accurate, clinically efficacious results after lead placement without microelectrode recording or test stimulation, using interventional magnetic resonance imaging (MRI) or intraoperative computed tomography (CT; iCT) for verification of accuracy. The latter relies on CT-MRI fusion. To validate CT-MRI fusion in this setting, we compared stereotactic coordinates determined intraoperatively using CT-MRI fusion with those obtained on postoperative MRI. Deep brain stimulation electrodes were implanted with patients under general anesthesia. Direct targeting was performed on preoperative MRI, which was merged with preimplantation iCT images for stereotactic registration and postimplantation iCT images for accuracy confirmation. Magnetic resonance imaging was obtained 6 weeks postoperatively for comparison. Postoperative MRI was obtained for 48 patients, with 94 leads placed over a 1-year period. Vector error of the targeted contact relative to the initial plan was 1.1 ± 0.7 mm on iCT and 1.6 ± 0.7 mm on postoperative MRI. Variance comparisons (F-tests) showed that the discrepancy between iCT- and postoperative MRI-determined errors was attributable to measurement error on postoperative MRI, as detected in inter-rater reliability testing. In multivariate analysis, improved lead placement accuracy was associated with frame-based stereotaxy with the head of the bed at 0° compared with frameless stereotaxy with the head of the bed at 30° (P = 0.037). Intraoperative CT can be used to determine lead placement accuracy in deep brain stimulation surgery. The discrepancy between coordinates determined intraoperatively by CT-MRI fusion and postoperatively by MRI can be accounted for by inherent measurement error. © 2014 International Parkinson and Movement Disorder Society.

  8. High Spatiotemporal Resolution Prostate MRI

    DTIC Science & Technology

    2016-09-01

    8 reconstruction of scans made of phantoms or of human subjects originating from multiple MRI scanners across Mayo. We are pleased with the...red lines are for the unenhanced test scans of the 32-Channel Prostate DCE- MRI June 1, 2016 Page 10 volunteer. The green shaded region shows...1 AD AWARD NUMBER: W81XWH-15-1-0341 TITLE: High Spatiotemporal Resolution Prostate MRI PRINCIPAL INVESTIGATOR: Stephen J. Riederer CONTRACTING

  9. [MRI-based radiotherapy planning].

    PubMed

    Largent, A; Nunes, J-C; Lafond, C; Périchon, N; Castelli, J; Rolland, Y; Acosta, O; de Crevoisier, R

    2017-07-06

    MRI-based radiotherapy planning is a topical subject due to the introduction of a new generation of treatment machines combining a linear accelerator and a MRI. One of the issues for introducing MRI in this task is the lack of information to provide tissue density information required for dose calculation. To cope with this issue, two strategies may be distinguished from the literature. Either a synthetic CT scan is generated from the MRI to plan the dose, or a dose is generated from the MRI based on physical underpinnings. Within the first group, three approaches appear: bulk density mapping assign a homogeneous density to different volumes of interest manually defined on a patient MRI; machine learning-based approaches model local relationship between CT and MRI image intensities from multiple data, then applying the model to a new MRI; atlas-based approaches use a co-registered training data set (CT-MRI) which are registered to a new MRI to create a pseudo CT from spatial correspondences in a final fusion step. Within the second group, physics-based approaches aim at computing the dose directly from the hydrogen contained within the tissues, quantified by MRI. Excepting the physics approach, all these methods generate a synthetic CT called "pseudo CT", on which radiotherapy planning will be finally realized. This literature review shows that atlas- and machine learning-based approaches appear more accurate dosimetrically. Bulk density approaches are not appropriate for bone localization. The fastest methods are machine learning and the slowest are atlas-based approaches. The less automatized are bulk density assignation methods. The physical approaches appear very promising methods. Finally, the validation of these methods is crucial for a clinical practice, in particular in the perspective of adaptive radiotherapy delivered by a linear accelerator combined with an MRI scanner. Copyright © 2017. Published by Elsevier SAS.

  10. Disclusion time measurement studies: stability of disclusion time--a 1-year follow-up.

    PubMed

    Kerstein, R

    1994-08-01

    Six of seven women were recalled after 1 year to remeasure their right- and left-side working disclusion times. Before the occlusal adjustment technique known as immediate complete anterior guidance development (ICAGD), these patients presented lengthy mean disclusion times (> 1.0 second) and multiple chronic myofascial pain dysfunction syndrome (MPDS) symptoms. After ICAGD, these patients presented with short mean disclusion times (< 0.7 second) and no chronic MPDS symptoms were observed. At 1-year follow-up, there was no statistical difference between present measurements of disclusion time and those of 1 year earlier. In addition, all six posttreatment patients demonstrated no observed chronic MPDS symptoms. However, the symptom of nocturnal bruxism appeared to recur with some chronic regularity. These results suggest that, for this population, disclusion time was stable over the 1-year period of observation, and the short disclusion time appears to allow normal daily muscle function with significantly lessened appearance of chronic myofacial pain dysfunction symptoms.

  11. Sodium MRI: Methods and applications

    PubMed Central

    Madelin, Guillaume; Lee, Jae-Seung; Regatte, Ravinder R.; Jerschow, Alexej

    2014-01-01

    Sodium NMR spectroscopy and MRI have become popular in recent years through the increased availability of high-field MRI scanners, advanced scanner hardware and improved methodology. Sodium MRI is being evaluated for stroke and tumor detection, for breast cancer studies, and for the assessment of osteoarthritis and muscle and kidney functions, to name just a few. In this article, we aim to present an up-to-date review of the theoretical background, the methodology, the challenges and limitations, and current and potential new applications of sodium MRI. PMID:24815363

  12. MRI of the Fetal Brain.

    PubMed

    Weisstanner, C; Kasprian, G; Gruber, G M; Brugger, P C; Prayer, D

    2015-10-01

    The purpose of this article is to provide an overview of the possibilities for fetal magnetic resonance imaging (MRI) in the evaluation of the fetal brain. For brain pathologies, fetal MRI is usually performed when an abnormality is detected by previous prenatal ultrasound, and is, therefore, an important adjunct to ultrasound. The most commonly suspected brain pathologies referred to fetal MRI for further evaluation are ventriculomegaly, missing corpus callosum, and abnormalities of the posterior fossa. We will briefly discuss the most common indications for fetal brain MRI, as well as recent advances.

  13. An Event Restriction Interval Theory of Tense

    ERIC Educational Resources Information Center

    Beamer, Brandon Robert

    2012-01-01

    This dissertation presents a novel theory of tense and tense-like constructions. It is named after a key theoretical component of the theory, the event restriction interval. In Event Restriction Interval (ERI) Theory, sentences are semantically evaluated relative to an index which contains two key intervals, the evaluation interval and the event…

  14. Using a reference when defining an abnormal MRI reduces false-positive MRI results-a longitudinal study in two cohorts at risk for rheumatoid arthritis.

    PubMed

    Boer, Aleid C; Burgers, Leonie E; Mangnus, Lukas; Ten Brinck, Robin M; Nieuwenhuis, Wouter P; van Steenbergen, Hanna W; Reijnierse, Monique; Huizinga, Tom W J; van der Helm van Mil, Annette H M

    2017-10-01

    The use of hand and foot MRI in the diagnostic process of RA has been advocated. Recent studies showed that MRI is helpful in predicting progression from clinically suspect arthralgia (CSA) to clinical arthritis, and from undifferentiated arthritis (UA) to RA. Symptom-free persons can also show inflammation on MRI. This study aimed to evaluate if MRI findings in symptom-free volunteers are relevant when defining a positive MRI. Two hundred and twenty-five CSA patients and two hundred and one UA patients underwent MRI of MCP, wrist and MTP joints at baseline and were followed for 1 year on progression to arthritis and RA, respectively, as reported previously. MRI was considered positive if ⩾ 1 joint showed inflammation (called uncorrected definition), or if ⩾ 1 joint had inflammation that was present in < 5% of persons of the same age category at the same location (called 5% corrected definition). Test characteristics were compared for both definitions. By using MRI data of symptom-free volunteers as reference, specificity of MRI-detected inflammation increased from 22 to 56% in CSA patients, and from 10 to 36% in UA patients. The sensitivity was not affected; it was 88 and 85% in CSA patients and 93 and 93% in UA patients. The accuracy also increased, from 32 to 60% in CSA patients and 22 to 44% in UA patients. The use of a reference population resulted in a substantial reduction of false-positive results, without influencing the sensitivity. Although common for other tests in medicine, this phenomenon is novel for MRI in the early detection of RA.

  15. High resolution time interval counter

    DOEpatents

    Condreva, K.J.

    1994-07-26

    A high resolution counter circuit measures the time interval between the occurrence of an initial and a subsequent electrical pulse to two nanoseconds resolution using an eight megahertz clock. The circuit includes a main counter for receiving electrical pulses and generating a binary word--a measure of the number of eight megahertz clock pulses occurring between the signals. A pair of first and second pulse stretchers receive the signal and generate a pair of output signals whose widths are approximately sixty-four times the time between the receipt of the signals by the respective pulse stretchers and the receipt by the respective pulse stretchers of a second subsequent clock pulse. Output signals are thereafter supplied to a pair of start and stop counters operable to generate a pair of binary output words representative of the measure of the width of the pulses to a resolution of two nanoseconds. Errors associated with the pulse stretchers are corrected by providing calibration data to both stretcher circuits, and recording start and stop counter values. Stretched initial and subsequent signals are combined with autocalibration data and supplied to an arithmetic logic unit to determine the time interval in nanoseconds between the pair of electrical pulses being measured. 3 figs.

  16. High resolution time interval counter

    DOEpatents

    Condreva, Kenneth J.

    1994-01-01

    A high resolution counter circuit measures the time interval between the occurrence of an initial and a subsequent electrical pulse to two nanoseconds resolution using an eight megahertz clock. The circuit includes a main counter for receiving electrical pulses and generating a binary word--a measure of the number of eight megahertz clock pulses occurring between the signals. A pair of first and second pulse stretchers receive the signal and generate a pair of output signals whose widths are approximately sixty-four times the time between the receipt of the signals by the respective pulse stretchers and the receipt by the respective pulse stretchers of a second subsequent clock pulse. Output signals are thereafter supplied to a pair of start and stop counters operable to generate a pair of binary output words representative of the measure of the width of the pulses to a resolution of two nanoseconds. Errors associated with the pulse stretchers are corrected by providing calibration data to both stretcher circuits, and recording start and stop counter values. Stretched initial and subsequent signals are combined with autocalibration data and supplied to an arithmetic logic unit to determine the time interval in nanoseconds between the pair of electrical pulses being measured.

  17. Obturator hernia - MRI image.

    PubMed

    Vitone, Louis; Joel, Abraham; Masters, Andrew; Lea, Simon

    2013-08-01

    Obturator hernia although considered a rare entity is the most frequently encountered pelvic floor hernia. Since the first published report in the 18th century, their unusual and unfamiliar clinical presentation still represents a diagnostic dilemma for the modern day clinician. A detailed history and clinical examination in our thin, elderly female patient who presented with intermittent small bowel obstruction and symptoms of right obturator nerve compression with a positive Howship-Romberg sign was crucial in establishing a diagnosis. Sophisticated radiologic modalities such as MRI as shown below in the case of our patient can reliably confirm the diagnosis of obturator hernia.

  18. Occupational exposure in MRI

    PubMed Central

    Mcrobbie, D W

    2012-01-01

    This article reviews occupational exposure in clinical MRI; it specifically considers units of exposure, basic physical interactions, health effects, guideline limits, dosimetry, results of exposure surveys, calculation of induced fields and the status of the European Physical Agents Directive. Electromagnetic field exposure in MRI from the static field B0, imaging gradients and radiofrequency transmission fields induces electric fields and currents in tissue, which are responsible for various acute sensory effects. The underlying theory and its application to the formulation of incident and induced field limits are presented. The recent International Commission on Non-Ionizing Radiation Protection (ICNIRP) Bundesministerium für Arbeit und Soziales and Institute of Electrical and Electronics Engineers limits for incident field exposure are interpreted in a manner applicable to MRI. Field measurements show that exposure from movement within the B0 fringe field can exceed ICNIRP reference levels within 0.5 m of the bore entrance. Rate of change of field dB/dt from the imaging gradients is unlikely to exceed the new limits, although incident field limits can be exceeded for radiofrequency (RF) exposure within 0.2–0.5 m of the bore entrance. Dosimetric surveys of routine clinical practice show that staff are exposed to peak values of 42±24% of B0, with time-averaged exposures of 5.2±2.8 mT for magnets in the range 0.6–4 T. Exposure to time-varying fields arising from movement within the B0 fringe resulted in peak dB/dt of approximately 2 T s−1. Modelling of induced electric fields from the imaging gradients shows that ICNIRP-induced field limits are unlikely to be exceeded in most situations; however, movement through the static field may still present a problem. The likely application of the limits is discussed with respect to the reformulation of the European Union (EU) directive and its possible implications for MRI. PMID:22457400

  19. Acetabular anteversion is associated with gluteal tendinopathy at MRI.

    PubMed

    Moulton, Kyle M; Aly, Abdel-Rahman; Rajasekaran, Sathish; Shepel, Michael; Obaid, Haron

    2015-01-01

    Gluteal tendinopathy and greater trochanteric pain syndrome (GTPS) remain incompletely understood despite their pervasiveness in clinical practice. To date, no study has analyzed the morphometric characteristics of the hip on magnetic resonance imaging (MRI) that may predispose to gluteal tendinopathy. This study aimed to evaluate whether acetabular anteversion (AA), femoral neck anteversion (FNA), and femoral neck-shaft angle (FNSA) are associated with MRI features of gluteal tendinopathy. A total of 203 MRI examinations of the hip met our inclusion and exclusion criteria. A single blinded investigator measured AA, FNA, and FNSA according to validated MRI techniques. Two blinded subspecialty-trained musculoskeletal radiologists then independently evaluated the presence of gluteal tendinosis, trochanteric bursitis, and subgluteal bursitis. Statistical analysis was performed using a one-way analysis of variance (ANOVA; post-hoc Tukey's range test). At MRI, 57 patients had gluteal tendinosis with or without bursitis, 26 had isolated trochanteric bursitis, and 11 had isolated subgluteal bursitis. AA was significantly (p = 0.01) increased in patients with MRI evidence of gluteal tendinosis with or without bursitis [mean: 18.4°, 95 % confidence interval (CI): 17.2°-19.6°] compared with normal controls (mean: 15.7°, 95 % CI: 14.7°-16.8°). Similarly, AA was significantly (p = 0.04) increased in patients with isolated trochanteric bursitis (mean: 18.8°, 95 % CI: 16.2°-21.6°). No association was found between FNA or FNSA and the presence of gluteal tendinopathy. Interobserver agreement for the presence and categorization of gluteal tendinopathy was very good (kappa = 0.859, 95 % CI: 0.815-0.903). Our MRI study suggests that there is an association between increased AA and gluteal tendinopathy, which supports a growing body of evidence implicating abnormal biomechanics in the development of this condition.

  20. Correlates of 1-year incidence of urinary incontinence in older Latino adults enrolled in a community-based physical activity trial.

    PubMed

    Morrisroe, Shelby N; Rodriguez, Larissa V; Wang, Pin-Chieh; Smith, Ariana L; Trejo, Laura; Sarkisian, Catherine A

    2014-04-01

    The prevalence of urinary incontinence (UI) among older urban Latinos is high. Insight into etiologies of and contributing factors to the development of this condition is needed. This longitudinal cohort study identified correlates of 1-year incidence of UI in older community-dwelling Latino adults participating in a senior center-based physical activity trial in Los Angeles, California. Three hundred twenty-eight Latinos aged 60 to 93 participating in Caminemos, a randomized trial to increase walking, were studied. Participants completed an in-person survey and physical performance measures at baseline and 1 year. UI was measured using the International Consultation on Incontinence item: "How often do you leak urine?" Potential correlates of 1-year incidence of UI included sociodemographic, behavioral, medical, physical, and psychosocial characteristics. The overall incidence of UI at 1 year was 17.4%. Incident UI was associated with age, baseline activity of daily living impairment, health-related quality of life (HRQoL), mean steps per day, and depressive symptoms. Multivariate logistic regression models revealed that improvement in physical performance score (odds ratio (OR) = 0.69, 95% confidence interval (CI) = 0.50-0.95) and high baseline physical (OR = 0.60, 95% CI = 0.40-0.89) and mental (OR = 0.62, 95% CI = 0.43-0.91) HRQoL were independently associated with lower rates of 1-year incident UI. An increase in depressive symptoms at 1 year (OR = 4.48, 95% CI = 1.02-19.68) was independently associated with a higher rate of incident UI. One-year UI incidence in this population of older urban Latino adults participating in a walking trial was high but was lower in those who improved their physical performance. Interventions aimed at improving physical performance may help prevent UI in older Latino adults.

  1. Mortality in primary angioplasty patients starting antiplatelet therapy with prehospital prasugrel or clopidogrel: a 1-year follow-up from the European MULTIPRAC Registry

    PubMed Central

    Goldstein, Patrick; Grieco, Niccolò; Ince, Hüseyin; Danchin, Nicolas; Ramos, Yvonne; Goedicke, Jochen; Clemmensen, Peter

    2016-01-01

    Aim MULTIPRAC was designed to provide insights into the use and outcomes associated with prehospital initiation of antiplatelet therapy with either prasugrel or clopidogrel in the context of primary percutaneous coronary intervention. After a previous report on efficacy and safety outcomes during hospitalization, we report here the 1-year follow-up data, including cardiovascular (CV) mortality. Methods and results MULTIPRAC is a multinational, prospective registry of patients with ST-elevation myocardial infarction (STEMI) from 25 hospitals in nine countries, all of which had an established practice of prehospital start of dual antiplatelet therapy in place. The key outcome was CV death at 1 year. Among 2,036 patients followed-up through 1 year, 49 died (2.4%), 10 during the initial hospitalization and 39 within 1 year after hospital discharge. The primary analysis was based on the P2Y12-inhibitor, used from prehospital loading dose through hospital discharge. Prasugrel (n=824) was more commonly used than clopidogrel (n=425). The observed 1-year rates for CV death were 0.5% with prasugrel and 2.6% with clopidogrel. After adjustment for differences in baseline characteristics, treatment with prasugrel was associated with a significantly lower risk of CV death than treatment with clopidogrel (odds ratio 0.248; 95% confidence interval 0.06–0.89). Conclusion In STEMI patients from routine practice undergoing primary angioplasty, who were able to start oral antiplatelet therapy prehospital, treatment with prasugrel as compared to clopidogrel was associated with a lower risk of CV death at 1-year follow-up. PMID:27143908

  2. Nonalcoholic fatty liver disease and increased risk of 1-year all-cause and cardiac hospital readmissions in elderly patients admitted for acute heart failure

    PubMed Central

    Valbusa, Filippo; Bonapace, Stefano; Agnoletti, Davide; Scala, Luca; Grillo, Cristina; Arduini, Pietro; Turcato, Emanuela; Mantovani, Alessandro; Zoppini, Giacomo; Arcaro, Guido; Byrne, Christopher; Targher, Giovanni

    2017-01-01

    Nonalcoholic fatty liver disease (NAFLD) is an emerging risk factor for heart failure (HF). Although some progress has been made in improving survival among patients admitted for HF, the rates of hospital readmissions and the related costs continue to rise dramatically. We sought to examine whether NAFLD and its severity (diagnosed at hospital admission) was independently associated with a higher risk of 1-year all-cause and cardiac re-hospitalization in patients admitted for acute HF. We studied 212 elderly patients who were consecutively admitted with acute HF to the Hospital of Negrar (Verona) over a 1-year period. Diagnosis of NAFLD was based on ultrasonography, whereas the severity of advanced NAFLD fibrosis was based on the fibrosis (FIB)-4 score and other non-invasive fibrosis scores. Patients with acute myocardial infarction, severe valvular heart diseases, end-stage renal disease, cancer, known liver diseases or decompensated cirrhosis were excluded. Cox regression was used to estimate hazard ratios (HR) for the associations between NAFLD and the outcome(s) of interest. The cumulative rate of 1-year all-cause re-hospitalizations was 46.7% (n = 99, mainly due to cardiac causes). Patients with NAFLD (n = 109; 51.4%) had remarkably higher 1-year all-cause and cardiac re-hospitalization rates compared with their counterparts without NAFLD. Both event rates were particularly increased in those with advanced NAFLD fibrosis. NAFLD was associated with a 5-fold increased risk of 1-year all-cause re-hospitalization (adjusted-hazard ratio 5.05, 95% confidence intervals 2.78–9.10, p<0.0001) after adjustment for established risk factors and potential confounders. Similar results were found for 1-year cardiac re-hospitalization (adjusted-hazard ratio 8.05, 95% confidence intervals 3.77–15.8, p<0.0001). In conclusion, NAFLD and its severity were strongly and independently associated with an increased risk of 1-year all-cause and cardiac re-hospitalization in elderly

  3. Cardiac function and cardiac events 1-year postpartum in women with congenital heart disease.

    PubMed

    Kampman, Marlies A M; Balci, Ali; Groen, Henk; van Dijk, Arie P J; Roos-Hesselink, Jolien W; van Melle, Joost P; Sollie-Szarynska, Krystyna M; Wajon, Elly M C J; Mulder, Barbara J M; van Veldhuisen, Dirk J; Pieper, Petronella G

    2015-02-01

    Pregnancy is increasingly common in women with congenital heart disease (CHD), but little is known about long-term cardiovascular outcome after pregnancy in these patients. We studied the incidence of cardiovascular events 1-year postpartum and compared cardiac function prepregnancy and 1-year postpartum in women with CHD. From our national, prospective multicenter cohort study, 172 women were studied. Follow-up with clinical evaluation and echocardiography and NT-proBNP measurement were performed during pregnancy and 12 months postpartum. Cardiovascular events were defined as need for an urgent invasive cardiovascular procedure, heart failure, arrhythmia, thromboembolic events, myocardial infarction, cardiac arrest, cardiac death, endocarditis, and aortic dissection. Cardiovascular events were observed after 11 pregnancies (6.4%). Women with cardiovascular events postpartum had significant higher NT-proBNP values at 20-week gestation (191 [137-288] vs 102.5 [57-167]; P = .049) and 1-year postpartum compared with women without cardiovascular events postpartum (306 [129-592] vs 105 [54-187] pg/mL; P = .014). Women with cardiovascular events during pregnancy were at higher risk for late cardiovascular events (HR 7.1; 95% CI 2.0-25.3; P = .003). In women with cardiovascular events during pregnancy, subpulmonary end-diastolic diameter had significantly increased 1-year postpartum (39.0 [36.0-48.0] to 44.0 [40.0-50.0]; P = .028). No other significant differences were found in cardiac function or size 1-year postpartum compared with preconception values. Cardiovascular events are relatively rare 1 year after pregnancy in women with CHD. Women with cardiovascular events during pregnancy are prone to develop cardiovascular events 1-year postpartum and have increased subpulmonary ventricular diameter compared with preconception values. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. [Nissen fundoplication in children under 1 year of age: is age important?

    PubMed

    Romo, M I; López-Fernández, S; Núñez, V; Amesty, M V; Triana, P; Domínguez, E; De La Torre, C A; Barrena, S; López-Santamaría, M; Martínez, L

    2016-10-10

    Nissen fundoplication (NF) is a procedure with technical difficulties and variable functional prognosis the lower the patient's age is. Our objective is to analyze the peculiarities of this procedure when performed in children under 1 year. Retrospective study of the NF in our center from 1999 to 2014. We review the differences between children under 1 year of age and the leftover of the series: history, indications, surgical approach and postoperative outcomes. A total of 233 patients (57.1% male) were operated at a median age of 2.3years (1 month-17.31years), of which 82 (35.2%) were younger than 1 year. It Open surgery was performed in 118 patients (86.6% of children under 1 year and 31.1% over 1 year, p <0.05) and laparoscopic in 115. The median follow-up was 3.92 ± 3.24 years. Patients under 1 year had a higher number of comorbidities (91.5% vs 81.5%), respiratory symptoms (76.8% vs 49.7%) and postoperative complications (20.7% vs 9.9% OR = 2.4), with statistically significant differences (p <0.05). There were not differences in the Nissen's failure rate (15.9% vs 8.6%) or the need of reoperation (15.9% vs 7.9%). Patients under 1 year operated by NF form a group with particular indications and comorbidities. Although the outcomes among these patients are favourable, surgical complications are more frequent than in older children.

  5. Cyclic generalized projection MRI.

    PubMed

    Sarty, Gordon E

    2015-04-01

    Progress in the development of portable MRI hinges on the ability to use lightweight magnets that have non-uniform magnetic fields. An image encoding method and mathematical procedure for recovering the image from the NMR signal from non-uniform magnets with closed isomagnetic contours is given. Individual frequencies in an NMR signal from an object in a non-uniform magnetic field give rise to integrals of the object along contours of constant magnetic field: generalized projections. With closed isomagnetic field contours a simple, cyclic, direct reconstruction of the image from the generalized projections is possible when the magnet and RF transmit coil are held fixed relative to the imaged object while the RF receive coil moves. Numerical simulations, using the Shepp and Logan mathematical phantom, were completed to show that the mathematical method works and to illustrate numerical limitations. The method is numerically verified and exact reconstruction demonstrated for discrete mathematical image phantoms. Correct knowledge of the RF receive field is necessary or severe image distortions will result. The cyclic mathematical reconstruction method presented here will be useful for portable MRI schemes that use non-uniform magnets with closed isomagnetic contours along with mechanically or electronically moving the RF receive coils.

  6. MRI atlas of ectopic endometriosis.

    PubMed

    Dallaudière, B; Salut, C; Hummel, V; Pouquet, M; Piver, P; Rouanet, J-P; Maubon, A

    2013-03-01

    Ectopic endometriosis is a common condition which is often underdiagnosed, where MRI can help make a diagnosis simply, non-invasively and without irradiation. However, imagery signs of it are enormously polymorphic with a wide range of possible locations. In this paper, we have tried to illustrate comprehensively all its MRI appearances depending on the different locations where it occurs.

  7. A 1-year randomized controlled trial of deferasirox vs deferoxamine for myocardial iron removal in β-thalassemia major (CORDELIA)

    PubMed Central

    Porter, John B.; Piga, Antonio; Lai, Yongrong; El-Beshlawy, Amal; Belhoul, Khawla M.; Elalfy, Mohsen; Yesilipek, Akif; Kilinç, Yurdanur; Lawniczek, Tomasz; Habr, Dany; Weisskopf, Marianne; Zhang, Yiyun; Aydinok, Yesim

    2014-01-01

    Randomized comparison data on the efficacy and safety of deferasirox for myocardial iron removal in transfusion dependent patients are lacking. CORDELIA was a prospective, randomized comparison of deferasirox (target dose 40 mg/kg per day) vs subcutaneous deferoxamine (50-60 mg/kg per day for 5-7 days/week) for myocardial iron removal in 197 β-thalassemia major patients with myocardial siderosis (T2* 6-20 milliseconds) and no signs of cardiac dysfunction (mean age, 19.8 years). Primary objective was to demonstrate noninferiority of deferasirox for myocardial iron removal, assessed by changes in myocardial T2* after 1 year using a per-protocol analysis. Geometric mean (Gmean) myocardial T2* improved with deferasirox from 11.2 milliseconds at baseline to 12.6 milliseconds at 1 year (Gmeans ratio, 1.12) and with deferoxamine (11.6 milliseconds to 12.3 milliseconds; Gmeans ratio, 1.07). The between-arm Gmeans ratio was 1.056 (95% confidence interval [CI], 0.998, 1.133). The lower 95% CI boundary was greater than the prespecified margin of 0.9, establishing noninferiority of deferasirox vs deferoxamine (P = .057 for superiority of deferasirox). Left ventricular ejection fraction remained stable in both arms. Frequency of drug-related adverse events was comparable between deferasirox (35.4%) and deferoxamine (30.8%). CORDELIA demonstrated the noninferiority of deferasirox compared with deferoxamine for myocardial iron removal. This trial is registered at www.clinicaltrials.gov as #NCT00600938. PMID:24385534

  8. Sarcopenia as a Risk Factor for Cognitive Deterioration in Community-Dwelling Older Adults: A 1-Year Prospective Study.

    PubMed

    Nishiguchi, Shu; Yamada, Minoru; Shirooka, Hidehiko; Nozaki, Yuma; Fukutani, Naoto; Tashiro, Yuto; Hirata, Hinako; Yamaguchi, Moe; Tasaka, Seishiro; Matsushita, Tomofumi; Matsubara, Keisuke; Tsuboyama, Tadao; Aoyama, Tomoki

    2016-04-01

    The purpose of this 1-year prospective study was to determine whether sarcopenia is an independent risk factor of cognitive deterioration in community-dwelling older adults. One-year prospective study. Japanese community. A total of 131 community-dwelling older adults aged 65 years and older participated in this study. We defined sarcopenia using the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia, and the participants were classified into the sarcopenia and normal groups according to this definition. The participants' cognitive functions were assessed using the Mini-Mental State Examination (MMSE) during pre- and postdata collection (after 1 year). The rate of change in pre- and post-MMSE scores during the follow-up term was significantly different between the 2 groups (normal group, -0.32 ± 8.39%; sarcopenia group, -5.86 ± 5.16%; P = .002). The analysis of covariance, adjusted for demographic data and the pre-MMSE scores, showed a significant change in the MMSE scores between the normal and sarcopenia group (F = 9.30, P = .003). Furthermore, in the multivariate logistic regression analysis, the cognitive function was significantly more likely to deteriorate (defined as a loss of at least 2 points of MMSE) in the sarcopenia group during the follow-up term (odds ratio: 7.86, 95% confidence interval: 1.53-40.5). Sarcopenia was identified as an independent risk factor of cognitive deterioration in community-dwelling older adults during the 1-year study period. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  9. Monitoring Shore A hardness of silicone facial elastomers: the effect of natural aging and silicone type after 1 year.

    PubMed

    Polyzois, Gregory; Lyons, Karl

    2014-07-01

    The purpose of this study was to investigate the effect of natural aging after storage in the dark for 1 year and material type on Shore A hardness of 2 silicone prosthetic elastomers. The silicone elastomers tested were low- and high-temperature vulcanizing materials, namely, Premium and Silasto 30, respectively. Ten samples, 25 × 25 × 10 mm3, from each silicone were made and stored in sealed glass containers in the dark. Shore A hardness was measured according to the American Society for Testing Materials specification D2240. Three recordings were made on each sample at baseline and then weekly for 12 months (quadruplicate per mo). Data were analyzed by general linear modeling for repeated measures and Student-Newman-Keuls test for post hoc comparisons at α = 0.05. General linear modeling analysis indicated a significant influence of either silicone type (F = 229.5, P = 0.0001) or natural aging (F = 105.9, P = 0.0001) or their interaction (F = 27.6, P = 0.0001) on Shore A hardness values. For Premium and Silasto 30, Shore A hardness ranged from 16.9 to 26.0 and 32.0 to 36.3, respectively. The elastomers showed a trend to increase hardness over natural aging, which was significant (Premium) or not (Silasto 30), depending on the material and time intervals. Premium silicone showed a significant hardness increase after 1 year of natural aging in the dark, reaching a convergent value approximately 6 months from the onset, whereas Silasto 30 hardness remained stable during this period. Both elastomers showed Shore A hardness values within clinical acceptable limits after aging.

  10. Comparison of clinical outcomes of endodontic microsurgery: 1 year versus long-term follow-up.

    PubMed

    Song, Minju; Nam, Taekjin; Shin, Su-Jung; Kim, Euiseong

    2014-04-01

    The purpose of this study was to examine and compare the clinical outcome of endodontic microsurgery after 1 year of follow-up and over a period of 4 years. The database of the Department of Conservative Dentistry, Yonsei University, Seoul, South Korea, was searched for patients who had undergone endodontic microsurgery and had been evaluated 1 year after surgery and over a period of 4 years. Two examiners independently evaluated the postoperative radiographs taken 1 year after surgery and over a period of 4 years using Rud's criteria. To analyze and compare the success rate based on the observation period, the McNemar test was performed with a significance level of 0.05. The study included 115 cases. Using Rud's criteria, the overall success rate of cases with 4 or more years of follow-up was 87.8% compared with 91.3% at 1 year of follow-up. There was no significant difference between the follow-up periods (P = .344). There was no significant difference in the clinical outcome after endodontic microsurgery when comparing 1-year follow-up periods with longer follow-up periods. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  11. The interaction between constituent year and within-1-year effects in elite German youth basketball.

    PubMed

    Steingröver, C; Wattie, N; Baker, J; Helsen, W F; Schorer, J

    2016-03-19

    The current state of research on relative age effects in basketball shows an uneven picture. These mixed results might be caused by the interaction of constituent year and within-year effects. Our aim was to examine constituent and within-1-year effects in elite German youth basketball. The sample (n = 4400) included players competing in the JBBL (Under-16 first division) and the NBBL (Under-19 first division) from 2011/2012 until 2013/2014. A multi-way frequency analysis revealed an interaction of constituent year effects and within-1-year effects for the JBBL, χ(2) (6, 2590) = 12.76, P < 0.05. NBBL data showed significant constituent year effects, χ(2) (2, n = 1810) = 25.32, P < 0.01, and within-1-year effects for all three age bands but no interaction. The interaction between constituent year and within-1-year effects in the JBBL showed reduced within-1-year effects with increasing age. Once players enter the system in the JBBL, relatively younger players seem less likely to drop out of the system. Results offer new insight regarding how the regulations of this talent development system may influence athletes' opportunities to enter the system and their likelihood of staying at the highest levels of competition.

  12. A Technique for Generating Volumetric Cine MRI (VC-MRI)

    PubMed Central

    Harris, Wendy; Ren, Lei; Cai, Jing; Zhang, You; Chang, Zheng; Yin, Fang-Fang

    2016-01-01

    Purpose To develop a technique to generate on-board volumetric-cine MRI (VC-MRI) using patient prior images, motion modeling and on-board 2D-cine MRI. Methods One phase of a 4D-MRI acquired during patient simulation is used as patient prior images. 3 major respiratory deformation patterns of the patient are extracted from 4D-MRI based on principal-component-analysis. The on-board VC-MRI at any instant is considered as a deformation of the prior MRI. The deformation field is represented as a linear combination of the 3 major deformation patterns. The coefficients of the deformation patterns are solved by the data fidelity constraint using the acquired on-board single 2D-cine MRI. The method was evaluated using both XCAT simulation of lung cancer patients and MRI data from four real liver cancer patients. The accuracy of the estimated VC-MRI was quantitatively evaluated using Volume-Percent-Difference(VPD), Center-of-Mass-Shift(COMS), and target tracking errors. Effects of acquisition orientation, region-of-interest(ROI) selection, patient breathing pattern change and noise on the estimation accuracy were also evaluated. Results Image subtraction of ground-truth with estimated on-board VC-MRI shows fewer differences than image subtraction of ground-truth with prior image. Agreement between profiles in the estimated and ground-truth VC-MRI was achieved with less than 6% error for both XCAT and patient data. Among all XCAT scenarios, the VPD between ground-truth and estimated lesion volumes was on average 8.43±1.52% and the COMS was on average 0.93±0.58mm across all time-steps for estimation based on the ROI region in the sagittal cine images. Matching to ROI in the sagittal view achieved better accuracy when there was substantial breathing pattern change. The technique was robust against noise levels up to SNR=20. For patient data, average tracking errors were less than 2 mm in all directions for all patients. Conclusions Preliminary studies demonstrated the

  13. Decision-to-delivery interval for instrumental vaginal deliveries: vacuum extraction versus forceps.

    PubMed

    Lurie, Samuel; Glezerman, Marek; Baider, Carolina; Sadan, Oscar

    2006-04-01

    The aim of this study was to assess the decision-to-delivery interval for forceps delivery and vacuum extraction. A retrospective analysis of all instrumental deliveries over a 1-year period in a delivery ward of a university tertiary health care facility was performed. The decision-to-delivery interval was compared between forceps delivery and vacuum extraction. The decision-to-delivery interval was 8.6+/-5.4 and 13.8+/-6.2 min for forceps and vacuum deliveries, respectively (P=0.0001). It appears that it is quicker to accomplish forceps delivery than vacuum extraction.

  14. Functional MRI of disease progression in Parkinson disease and atypical parkinsonian syndromes

    PubMed Central

    Burciu, Roxana G.; Chung, Jae Woo; Shukla, Priyank; Ofori, Edward; Li, Hong; McFarland, Nikolaus R.; Okun, Michael S.

    2016-01-01

    Objective: To explore longitudinal changes in brain activity in patients with Parkinson disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP) using task-based functional MRI (fMRI). Methods: A total of 112 individuals were scanned 1 year apart while performing a unimanual grip force task: 46 PD, 13 MSA, 19 PSP, and 34 healthy controls. The outcome measure was percent signal change in prespecified regions of interest: putamen, primary motor cortex (M1), supplementary motor area (SMA), and superior motor regions of the cerebellum (lobules V–VI). Results: Patients with PD showed a decline in functional activity over the course of 1 year in the putamen and M1 compared to controls. Changes after 1 year in MSA were exclusively extrastriatal, and included a reduction in functional activity in M1, SMA, and superior cerebellum. In PSP, all regions of interest were less active at 1 year compared to baseline. The functional activity of these regions did not change in the control group. Conclusions: We provide evidence using task-based fMRI for cortical and striatal functional deterioration in PD over a 1-year period of time. Results also describe more widespread and unique patterns of functional changes in MSA and PSP compared to PD, suggesting distinct rates of disease progression in parkinsonian disorders that may assist in future clinical studies testing the potential efficacy of disease-modifying therapies. PMID:27421545

  15. MRI findings in Hirayama disease.

    PubMed

    Raval, Monali; Kumari, Rima; Dung, Aldrin Anthony Dung; Guglani, Bhuvnesh; Gupta, Nitij; Gupta, Rohit

    2010-11-01

    The objective of the study was to study the magnetic resonance imaging (MRI) features of Hirayama disease on a 3 Tesla MRI scanner. Nine patients with clinically suspected Hirayama disease were evaluated with neutral position, flexion, contrast-enhanced MRI and fast imaging employing steady-state acquisition (FIESTA) sequences. The spectrum of MRI features was evaluated and correlated with the clinical and electromyography findings. MRI findings of localized lower cervical cord atrophy (C5-C7), abnormal curvature, asymmetric cord flattening, loss of attachment of the dorsal dural sac and subjacent laminae in the neutral position, anterior displacement of the dorsal dura on flexion and a prominent epidural space were revealed in all patients on conventional MRI as well as with the dynamic 3D-FIESTA sequence. Intramedullary hyperintensity was seen in four patients on conventional MRI and on the 3D-FIESTA sequence. Flow voids were seen in four patients on conventional MRI sequences and in all patients with the 3D-FIESTA sequence. Contrast enhancement of the epidural component was noted in all the five patients with thoracic extensions. The time taken for conventional and contrast-enhanced MRI was about 30-40 min, while that for the 3D-FIESTA sequence was 6 min. Neutral and flexion position MRI and the 3D-FIESTA sequence compliment each other in displaying the spectrum of findings in Hirayama disease. A flexion study should form an essential part of the screening protocol in patients with suspected Hirayama disease. Newer sequences such as the 3D-FIESTA may help in reducing imaging time and obviating the need for contrast.

  16. Neural activity related to discrimination and vocal production of consonant and dissonant musical intervals.

    PubMed

    González-García, Nadia; González, Martha A; Rendón, Pablo L

    2016-07-15

    Relationships between musical pitches are described as either consonant, when associated with a pleasant and harmonious sensation, or dissonant, when associated with an inharmonious feeling. The accurate singing of musical intervals requires communication between auditory feedback processing and vocal motor control (i.e. audio-vocal integration) to ensure that each note is produced correctly. The objective of this study is to investigate the neural mechanisms through which trained musicians produce consonant and dissonant intervals. We utilized 4 musical intervals (specifically, an octave, a major seventh, a fifth, and a tritone) as the main stimuli for auditory discrimination testing, and we used the same interval tasks to assess vocal accuracy in a group of musicians (11 subjects, all female vocal students at conservatory level). The intervals were chosen so as to test for differences in recognition and production of consonant and dissonant intervals, as well as narrow and wide intervals. The subjects were studied using fMRI during performance of the interval tasks; the control condition consisted of passive listening. Singing dissonant intervals as opposed to singing consonant intervals led to an increase in activation in several regions, most notably the primary auditory cortex, the primary somatosensory cortex, the amygdala, the left putamen, and the right insula. Singing wide intervals as opposed to singing narrow intervals resulted in the activation of the right anterior insula. Moreover, we also observed a correlation between singing in tune and brain activity in the premotor cortex, and a positive correlation between training and activation of primary somatosensory cortex, primary motor cortex, and premotor cortex during singing. When singing dissonant intervals, a higher degree of training correlated with the right thalamus and the left putamen. Our results indicate that singing dissonant intervals requires greater involvement of neural mechanisms

  17. The trabecular bypass stent in a pseudophakic glaucoma patient: A 1-year follow-up

    PubMed Central

    Fea, Antonio M; Dogliani, Monica; Machetta, Federica; Lale-Lacroix, Gabriella; Brogliatti, Beatrice; Grignolo, Federico M

    2008-01-01

    Purpose To describe the 1-year success of a trabecular stent implant in a pseudophakic glaucoma patient. The stent is implanted through a small corneal incision under gonioscopic control. Intraocular pressure control was reported in cultured human anterior segment. Design Observational case report. Methods We report the case of a patient who was implanted and followed-up for 1 year at the Dipartimento di Fisiopatologia Clinica. The main outcome measures were intraocular pressure and visual field. Results The patient’s intraocular pressure was controlled with topical beta-blockers for 6 months and without therapy for 6 months. Two diurnal curves demonstrated achievement of target pressure during the day. The 1-year visual field was unchanged. Conclusions We are not aware of previous reports of trabecular stent implantation in pseudophakic patients. The trabecular stent had minimal peri-operative morbidity. Identification of the implantation site is challenging and reduction of efficacy over time may occur. PMID:19668446

  18. The trabecular bypass stent in a pseudophakic glaucoma patient: A 1-year follow-up.

    PubMed

    Fea, Antonio M; Dogliani, Monica; Machetta, Federica; Lale-Lacroix, Gabriella; Brogliatti, Beatrice; Grignolo, Federico M

    2008-12-01

    To describe the 1-year success of a trabecular stent implant in a pseudophakic glaucoma patient. The stent is implanted through a small corneal incision under gonioscopic control. Intraocular pressure control was reported in cultured human anterior segment. Observational case report. We report the case of a patient who was implanted and followed-up for 1 year at the Dipartimento di Fisiopatologia Clinica. The main outcome measures were intraocular pressure and visual field. The patient's intraocular pressure was controlled with topical beta-blockers for 6 months and without therapy for 6 months. Two diurnal curves demonstrated achievement of target pressure during the day. The 1-year visual field was unchanged. We are not aware of previous reports of trabecular stent implantation in pseudophakic patients. The trabecular stent had minimal peri-operative morbidity. Identification of the implantation site is challenging and reduction of efficacy over time may occur.

  19. Arthroscopy vs. MRI for a detailed assessment of cartilage disease in osteoarthritis: diagnostic value of MRI in clinical practice

    PubMed Central

    2010-01-01

    Background In patients with osteoarthritis, a detailed assessment of degenerative cartilage disease is important to recommend adequate treatment. Using a representative sample of patients, this study investigated whether MRI is reliable for a detailed cartilage assessment in patients with osteoarthritis of the knee. Methods In a cross sectional-study as a part of a retrospective case-control study, 36 patients (mean age 53.1 years) with clinically relevant osteoarthritis received standardized MRI (sag. T1-TSE, cor. STIR-TSE, trans. fat-suppressed PD-TSE, sag. fat-suppressed PD-TSE, Siemens Magnetom Avanto syngo MR B 15) on a 1.5 Tesla unit. Within a maximum of three months later, arthroscopic grading of the articular surfaces was performed. MRI grading by two blinded observers was compared to arthroscopic findings. Diagnostic values as well as intra- and inter-observer values were assessed. Results Inter-observer agreement between readers 1 and 2 was good (kappa = 0.65) within all compartments. Intra-observer agreement comparing MRI grading to arthroscopic grading showed moderate to good values for readers 1 and 2 (kappa = 0.50 and 0.62, respectively), the poorest being within the patellofemoral joint (kappa = 0.32 and 0.52). Sensitivities were relatively low at all grades, particularly for grade 3 cartilage lesions. A tendency to underestimate cartilage disorders on MR images was not noticed. Conclusions According to our results, the use of MRI for precise grading of the cartilage in osteoarthritis is limited. Even if the practical benefit of MRI in pretreatment diagnostics is unequivocal, a diagnostic arthroscopy is of outstanding value when a grading of the cartilage is crucial for a definitive decision regarding therapeutic options in patients with osteoarthritis. PMID:20406481

  20. Factors associated with postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians

    PubMed Central

    Kim, Young Wan; Kim, Ik Yong

    2016-01-01

    Purpose To identify the factors affecting 30-day postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians. Methods Between 2005 and 2014, a total of 204 consecutive patients aged ≥80 years who underwent major colorectal surgery were included. Results One hundred patients were male (49%) and 52 patients had American Society of Anesthesiologists (ASA) score ≥3 (25%). Combined surgery was performed in 32 patients (16%). Postoperative complications within 30 days after surgery occurred in 54 patients (26%) and 30-day mortality occurred in five patients (2%). Independent risk factors affecting 30-day postoperative complications were older age (≥90 years, hazard ratio [HR] with 95% confidence interval [CI] =4.95 [1.69−14.47], P=0.004), an ASA score ≥3 (HR with 95% CI =4.19 [1.8−9.74], P=0.001), performance of combined surgery (HR with 95% CI =3.1 [1.13−8.46], P=0.028), lower hemoglobin level (<10 g/dL, HR with 95% CI =7.56 [3.07−18.63], P<0.001), and lower albumin level (<3.4 g/dL, HR with 95% CI =3.72 [1.43−9.69], P=0.007). An ASA score ≥3 (HR with 95% CI =2.72 [1.15−6.46], P=0.023), tumor-node-metastasis (TNM) stage IV (HR with 95% CI =3.47 [1.44−8.39], P=0.006), and occurrence of postoperative complications (HR with 95% CI =4.42 [1.39−14.09], P=0.012) were significant prognostic factors for 1-year mortality. Conclusion Patient-related factors (older age, higher ASA score, presence of anemia, and lower serum albumin) and procedure-related factors (performance of combined surgical procedure) increased postoperative complications. Avoidance of 30-day postoperative complications may decrease 1-year mortality. PMID:27279741

  1. Orders on Intervals Over Partially Ordered Sets: Extending Allen's Algebra and Interval Graph Results

    SciTech Connect

    Zapata, Francisco; Kreinovich, Vladik; Joslyn, Cliff A.; Hogan, Emilie A.

    2013-08-01

    To make a decision, we need to compare the values of quantities. In many practical situations, we know the values with interval uncertainty. In such situations, we need to compare intervals. Allen’s algebra describes all possible relations between intervals on the real line, and ordering relations between such intervals are well studied. In this paper, we extend this description to intervals in an arbitrary partially ordered set (poset). In particular, we explicitly describe ordering relations between intervals that generalize relation between points. As auxiliary results, we provide a logical interpretation of the relation between intervals, and extend the results about interval graphs to intervals over posets.

  2. Factors associated with calf muscle endurance recovery 1 year after achilles tendon rupture repair.

    PubMed

    Bostick, Geoff P; Jomha, Nadr M; Suchak, Amar A; Beaupré, Lauren A

    2010-06-01

    Cohort study. To describe calf muscle endurance recovery and to explore factors predictive of poor calf muscle endurance recovery 1 year after surgical repair of an Achilles tendon rupture (ATR). ATR is a common sports-related injury and is often managed with open surgical repair. After ATR repair most patients return to usual activities 6 months after surgery. However, calf endurance impairment can persist up to 6 years, possibly impacting performance of daily activities and sport. A secondary analysis of a 73-patient cohort from a randomized controlled trial assessing the effects of early weight bearing after surgical repair of an ATR was performed. Calf muscle endurance recovery was measured by single-heel raises using a customized counting device at 6 months and 1 year postoperatively. Descriptive statistics were used to outline recovery of calf muscle endurance. Physical and patient-reported outcomes were examined for their association with calf-muscle endurance recovery. Multiple linear regression analysis was performed to explore variables associated with recovery of calf endurance 1 year postoperatively. Mean recovery of calf muscle endurance was 76% at 1 year. Multivariate regression analysis showed an association of being female, reporting no resting pain at 3 months, and physical functioning and calf endurance at 6 months, with better recovery of calf endurance at 1 year. Calf muscle endurance at 1 year remained impaired in a considerable portion of the sample. Pain, gender, and physical functioning are likely important factors in determining recovery of calf muscle endurance. Prognosis, level 2b.J Orthop Sports Phys Ther 2010;40(6):345-351, Epub 15 April 2010. doi:10.2519/jospt.2010.3204.

  3. Economic evaluation and 1-year survival analysis of MARS in patients with alcoholic liver disease.

    PubMed

    Hessel, Franz P; Mitzner, Steffen R; Rief, Jana; Guellstorff, Britta; Steiner, Susanne; Wasem, Jürgen

    2003-01-01

    Objective of this study was to determine 1-year survival, costs and cost-effectiveness of the artificial liver support system Molecular Adsorbent Recirculating System (MARS) in patients with acute-on-chronic liver failure (ACLF) and an underlying alcoholic liver disease. In a case-control study, 13 patients treated with MARS were compared to 23 controls of similar age, sex and severity of disease. Inpatient hospital costs data were extracted from patients' files and hospital's internal costing. Patients and treating GPs were contacted, thus determining resource use and survival 1-year after treatment. Mean 1-year survival time in MARS group was 261 days and 148 days in controls. Kaplan-Meier analysis shows advantages of MARS patients (Logrank: P=0.057). Direct medical costs per patient for initial hospital stay and 1-year follow-up from a payer's perspective were Euro 18,792 for MARS patients and Euro 9638 for controls. The costs per life-year gained are Euro 29,719 (time horizon 1 year). From a societal perspective, the numbers are higher (costs per life-year gained: Euro 79,075), mainly because of the fact that there is no regular reimbursement of MARS and therefore intervention costs were not calculated from payer's perspective. A trade-off between medical benefit and higher costs has to be made, but 1-year results suggest an acceptable cost-effectiveness of MARS. Prolonging the time horizon and including indirect costs, which will be done in future research, would probably improve cost-effectiveness.

  4. XEN Glaucoma Implant with Mitomycin C 1-Year Follow-Up: Result and Complications

    PubMed Central

    Bilgic, Alper; Eltanamly, Rasha

    2017-01-01

    Purpose. To evaluate gel microstent (XEN, Aquesys, Inc) for treatment of primary open angle glaucoma (POAG). Methods. In this prospective interventional study, 13 eyes with POAG underwent XEN implantation with subconjunctival mitomycin-C. Of those eyes, 3 were pseudophakic and 10 underwent simultaneous phacoemulsification and XEN. Patients had uncontrolled IOP, had intolerance to therapy, or had maximal therapy but undergoing cataract extraction. Follow-up visits included IOP, number of medications, vision, and complications and lasted for 1 year. Complete success was defined as IOP reduction ≥20% from preoperative baseline at 1 year without any glaucoma medications while partial success as IOP reduction of ≥20% at 1 year with medications. Results. IOP dropped from 16 ± 4 mmHg pre-op to 9 ± 5, 11 ± 6, 12 ± 5, 12 ± 4, and 12 ± 3 mmHg at 1 week, 1, 3, 6, and 12 months (p = 0.004, 0.026, 0.034, 0.01, and 0.01, Wilcoxon Signed Ranks) consecutively. BCVA (LogMAR) was 0.33 ± 0.34 and improved to 0.13 ± 0.11 at 1 year. Mean number of medications dropped from 1.9 ± 1 preoperatively to 0.3 ± 0.49 (p = 0.003) at 1 year. 42% of eyes achieved complete success and 66% qualified success. Complications included choroidal detachment in 2 eyes, and implant extrusion in 1 eye, and 2 eyes underwent trabeculectomy. Conclusion. XEN implant is an effective surgical treatment for POAG, with significant reduction in IOP and glaucoma medications at 1 year follow-up. PMID:28348884

  5. Evaluation of the management of Hr-HPV+/PapTest- women: results at 1-year recall.

    PubMed

    Chiappetta, Caterina; Puggioni, Chiara; Lendaro, Eugenio; Cacciotti, Jessica; Zaralli, Roberto; Migliore, Giovanna; Bellardini, Paola; Petrozza, Vincenzo; Della Rocca, Carlo; Di Cristofano, Claudio

    2015-01-01

    With cervical cancer screening the choice of 1-year as a period of follow-up in positive high-risk HPV women without cytological lesions is still under discussion. We evaluated the management of these women and the role of HPV genotyping test. We did a cervical cancer screening study of women aged 35-64 with primary high-risk HPV test. Women positive for high-risk HPV with negative cytology were followed-up after 1 year. In this study we selected women with high-risk HPV+/PapTest- resulted high-risk HPV+ at recall and performed the PapTest and HPV genotyping test. The detection rate of squamous high grade (CIN2+) relative to the total screened cohort was 2.1‰, and it was 0.2‰ at the 1-year recall. The colposcopy performed in women referred at the 1-year recall accounted for 48.8% of the total (baseline + 1-year recall), and 84.3% of these women had no cytological lesions. The most frequent hr-HPV genotype detected was HPV16 and 66.7% of co-infections were due to HPV16 and HPV18. 54.5% of women presented a persistent infection at 1-year recall with the same HPV subtype, 50% of persistent infections was due to HPV16 and 16.7% of these were determined to be CIN2+ histological lesions. Our data show that it may be useful to extend the period of follow-up for women hr-HPV+/PapTest- so as to reduce the number of unnecessary colposcopies due to the transitory infections and that the genotyping test could help to identify the persistent infections in which HPV16 is involved.

  6. Standardization of Analysis Sets for Reporting Results from ADNI MRI Data

    PubMed Central

    Wyman, Bradley T.; Harvey, Danielle J.; Crawford, Karen; Bernstein, Matt A.; Carmichael, Owen; Cole, Patricia E.; Crane, Paul; DeCarli, Charles; Fox, Nick C.; Gunter, Jeffrey L.; Hill, Derek; Killiany, Ronald J.; Pachai, Chahin; Schwarz, Adam J.; Schuff, Norbert; Senjem, Matthew L.; Suhy, Joyce; Thompson, Paul M.; Weiner, Michael; Jack, Clifford R.

    2013-01-01

    The ADNI 3D T1-weighted MRI acquisitions provide a rich dataset for developing and testing analysis techniques for extracting structural endpoints. To promote greater rigor in analysis and meaningful comparison of different algorithms, the ADNI MRI Core has created standardized analysis sets of data comprising scans that met minimum quality control requirements. We encourage researchers to test and report their techniques against these data. Standard analysis sets of volumetric scans from ADNI-1 have been created, comprising: screening visits, 1 year completers (subjects who all have screening, 6 and 12 month scans), two year annual completers (screening, 1, and 2 year scans), two year completers (screening, 6 months, 1 year, 18 months (MCI only) and 2 years) and complete visits (screening, 6 months, 1 year, 18 months (MCI only), 2, and 3 year (normal and MCI only) scans). As the ADNI-GO/ADNI-2 data becomes available, updated standard analysis sets will be posted regularly. PMID:23110865

  7. Improved 1-year mortality in elderly patients with a hip fracture following integrated orthogeriatric treatment.

    PubMed

    Folbert, E C; Hegeman, J H; Vermeer, M; Regtuijt, E M; van der Velde, D; Ten Duis, H J; Slaets, J P

    2017-01-01

    To improve the quality of care and reduce the healthcare costs of elderly patients with a hip fracture, surgeons and geriatricians collaborated intensively due to the special needs of these patients. After treatment at the Centre for Geriatric Traumatology (CvGT), we found a significant decrease in the 1-year mortality rate in frail elderly patients compared to the historical control patients who were treated with standard care. The study aimed to evaluate the effect of an orthogeriatric treatment model on elderly patients with a hip fracture on the 1-year mortality rate and identify associated risk factors. This study included patients, aged 70 years and older, who were admitted with a hip fracture and treated in accordance with the integrated orthogeriatric treatment model of the CvGT at the Hospital Group Twente (ZGT) between April 2008 and October 2013. Data registration was carried out by several disciplines using the clinical pathways of the CvGT database. A multivariate logistic regression analysis was used to identify independent risk factors for 1-year mortality. The outcome measures for the 850 patients were compared with those of 535 historical control patients who were managed under standard care between October 2002 and March 2008. The analysis demonstrated that the 1-year mortality rate was 23.2 % (n = 197) in the CvGT group compared to 35.1 % (n = 188) in the historical control group (p < 0.001). Independent risk factors for 1-year mortality were male gender (odds ratio (OR) 1.68), increasing age (OR 1.06), higher American Society of Anesthesiologists (ASA) score (ASA 3 OR 2.43, ASA 4-5 OR 7.05), higher Charlson Comorbidity Index (CCI) (CCI 1-2 OR 1.46, CCI 3-4 OR 1.59, CCI 5 OR 2.71), malnutrition (OR 2.01), physical limitations in activities of daily living (OR 2.35), and decreasing Barthel Index (BI) (OR 0.96). After integrated orthogeriatric treatment, a significant decrease was seen in the 1-year mortality rate in the frail

  8. Pigeons' Choices between Fixed-Interval and Random-Interval Schedules: Utility of Variability?

    ERIC Educational Resources Information Center

    Andrzejewski, Matthew E.; Cardinal, Claudia D.; Field, Douglas P.; Flannery, Barbara A.; Johnson, Michael; Bailey, Kathleen; Hineline, Philip N.

    2005-01-01

    Pigeons' choosing between fixed-interval and random-interval schedules of reinforcement was investigated in three experiments using a discrete-trial procedure. In all three experiments, the random-interval schedule was generated by sampling a probability distribution at an interval (and in multiples of the interval) equal to that of the…

  9. Pigeons' Choices between Fixed-Interval and Random-Interval Schedules: Utility of Variability?

    ERIC Educational Resources Information Center

    Andrzejewski, Matthew E.; Cardinal, Claudia D.; Field, Douglas P.; Flannery, Barbara A.; Johnson, Michael; Bailey, Kathleen; Hineline, Philip N.

    2005-01-01

    Pigeons' choosing between fixed-interval and random-interval schedules of reinforcement was investigated in three experiments using a discrete-trial procedure. In all three experiments, the random-interval schedule was generated by sampling a probability distribution at an interval (and in multiples of the interval) equal to that of the…

  10. Treatment of toxoplasmosis during pregnancy: a multicenter study of impact on fetal transmission and children's sequelae at age 1 year.

    PubMed

    Foulon, W; Villena, I; Stray-Pedersen, B; Decoster, A; Lappalainen, M; Pinon, J M; Jenum, P A; Hedman, K; Naessens, A

    1999-02-01

    Toxoplasmosis during pregnancy can cause fetal infection, with unpredictable sequelae in later life. We measured the effects of prenatal antibiotic therapy on the fetomaternal transmission of Toxoplasma gondii and on the appearance of sequelae in the congenitally infected child at age 1 year. In a multicenter study we investigated consecutive women with Toxoplasma seroconversion during pregnancy. Data were obtained from 144 women recruited in 5 different Toxoplasma reference centers. Through multivariate analysis we assessed the association between transmission and appearance of sequelae as a function of the following parameters: estimated gestational age at infection, administration of antibiotic therapy, duration of antibiotic therapy, and time lapse between infection and the start of antibiotic therapy. Sixty-four of the 144 women (44%) gave birth to a congenitally infected infant. Multivariate analysis showed that transmission was predicted neither by whether antibiotics had been administered nor by the time lapse between infection and the start of antibiotic therapy, but only by the gestational age at which maternal infection occurred (P <.0001). Sequelae were found in 19 children (13%), 9 of whom (6%) had severe sequelae. Administration of antibiotics was predictive of the absence of sequelae (P =.026, odds ratio 0.30, 95% confidence interval 0.104-0.863), in particular the absence of severe sequelae (P =.007, odds ratio 0.14, 95% confidence interval 0.036-0.584). The sooner antibiotics were given after the infection, the less frequently sequelae were seen (P =. 021). Prenatal antibiotic therapy after toxoplasmosis during pregnancy had no impact on the fetomaternal transmission rate but reduced the rate of sequelae among the infected infants. The early start of treatment resulted in a significant reduction in the number of severely affected infants.

  11. A Rights-Based Sexuality Education Curriculum for Adolescents: 1-Year Outcomes From a Cluster-Randomized Trial.

    PubMed

    Rohrbach, Louise A; Berglas, Nancy F; Jerman, Petra; Angulo-Olaiz, Francisca; Chou, Chih-Ping; Constantine, Norman A

    2015-10-01

    The purpose of this study was to evaluate the impact of a rights-based sexuality education curriculum on adolescents' sexual health behaviors and psychosocial outcomes 1 year after participation. Within 10 urban high schools, ninth-grade classrooms were randomized to receive a rights-based curriculum or a basic sex education (control) curriculum. The intervention was delivered across two school years (2011-2012, 2012-2013). Surveys were completed by 1,447 students at pretest and 1-year follow-up. Multilevel analyses examined curriculum effects on behavioral and psychosocial outcomes, including four primary outcomes: pregnancy risk, sexually transmitted infection risk, multiple sexual partners, and use of sexual health services. Students receiving the rights-based curriculum had higher scores than control curriculum students on six of nine psychosocial outcomes, including sexual health knowledge, attitudes about relationship rights, partner communication, protection self-efficacy, access to health information, and awareness of sexual health services. These students also were more likely to report use of sexual health services (odds ratio, 1.37; 95% confidence interval, 1.05-1.78) and more likely to be carrying a condom (odds ratio, 1.97; 95% confidence interval, 1.39-2.80) relative to those receiving the control curriculum. No effects were found for other sexual health behaviors, possibly because of low prevalence of sexual activity in the sample. The curriculum had significant, positive effects on psychosocial and some behavioral outcomes 1 year later, but it might not be sufficient to change future sexual behaviors among younger adolescents, most of whom are not yet sexually active. Booster education sessions might be required throughout adolescence as youth initiate sexual relationships. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  12. In-hospital and 1-year mortality associated with diabetes in patients with acute heart failure: results from the ESC-HFA Heart Failure Long-Term Registry.

    PubMed

    Targher, Giovanni; Dauriz, Marco; Laroche, Cécile; Temporelli, Pier Luigi; Hassanein, Mahmoud; Seferovic, Petar M; Drozdz, Jaroslaw; Ferrari, Roberto; Anker, Stephan; Coats, Andrew; Filippatos, Gerasimos; Crespo-Leiro, Maria G; Mebazaa, Alexandre; Piepoli, Massimo F; Maggioni, Aldo Pietro; Tavazzi, Luigi

    2017-01-01

    The aim of this study was to evaluate the in-hospital and 1-year prognostic impact of diabetes and elevated blood glucose levels at hospital admission in patients with acute heart failure (HF). We studied a multinational cohort of 6926 hospitalized patients with acute HF enrolled in the European Society of Cardiology (ESC) and Heart Failure Association (HFA) Long-Term Registry, of whom 49.4% (n = 3422) had known or previously undiagnosed diabetes (defined as self-reported history, or medication use, or fasting glucose levels ≥7.0 mmol/L or haemoglobin A1c ≥6.5%). Compared with those without diabetes, patients with known or previously undiagnosed diabetes had higher cumulative rates of in-hospital mortality, 1-year mortality, and 1-year HF re-hospitalization that occurred independently of multiple clinical risk factors: in-hospital mortality [6.8 vs. 4.4%; adjusted hazard ratio (HR) 1.774; 95% confidence interval (CI) 1.282-2.456, P < 0.001], 1-year all-cause mortality (27.5 vs. 24%; adjusted HR 1.162; 95% CI 1.020-1.325, P = 0.024), and 1-year hospital re-admissions for HF (23.2 vs. 18.5%; adjusted HR 1.320; 95% CI 1.139-1.530, P < 0.001). Moreover, elevated admission blood glucose concentrations were powerfully prognostic for in-hospital mortality, but not for 1-year mortality or re-hospitalizations, in both patients with and without diabetes. Among patients hospitalized for acute HF, the presence of diabetes is independently associated with an increased risk of in-hospital mortality, 1-year all-cause mortality, and 1-year re-hospitalizations for HF, underscoring the need for more effective and personalized treatments of diabetes in this particularly high-risk patient population. © 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology.

  13. Deep Gray Matter Involvement on Brain MRI Scans Is Associated with Clinical Progression in Multiple Sclerosis

    PubMed Central

    Neema, Mohit; Arora, Ashish; Healy, Brian C.; Guss, Zachary D.; Brass, Steven D.; Duan, Yang; Buckle, Guy J.; Glanz, Bonnie I.; Stazzone, Lynn; Khoury, Samia J.; Weiner, Howard L.; Guttmann, Charles R.G.; Bakshi, Rohit

    2009-01-01

    BACKGROUND Conventional brain MRI lesion measures have unreliable associations with clinical progression in multiple sclerosis (MS). Gray matter imaging may improve clinical-MRI correlations. METHODS We tested if gray matter MRI measures and conventional measures of lesions/atrophy predicted clinical progression in a 4-year longitudinal study of 97 patients with MS. Baseline and follow-up brain MRI were analyzed for basal ganglia and thalamic normalized T2 signal intensity, whole brain T2-hyperintense lesion volume, and whole brain atrophy. Logistic regression tested the ability of baseline or on-study change in MRI to predict disability progression, as reported by area under the receiver operator characteristics curve (AUC). RESULTS Lower caudate T2-intensity at baseline (P = .04; AUC = .69) and on-study decreasing T2-intensity in the putamen (P = .03; AUC = .70) and thalamus (P = .01; AUC = .71) were the MRI variables associated with clinical progression when regression modeling was adjusted for length of follow-up interval, baseline EDSS, disease duration, age, and sex. CONCLUSIONS Gray matter T2-hypointensity, suggestive of excessive iron deposition is associated with worsening disability in patients with MS. Gray matter MRI assessment may be able to capture neurodegenerative aspects of the disease, with more clinical relevance than derived from conventional MRI measures. PMID:19192042

  14. Quantification of liver, pancreas, kidney, and vertebral body MRI-PDFF in non-alcoholic fatty liver disease.

    PubMed

    Idilman, Ilkay S; Tuzun, Ali; Savas, Berna; Elhan, Atilla Halil; Celik, Azim; Idilman, Ramazan; Karcaaltincaba, Musturay

    2015-08-01

    The purpose of the present study was to determine liver, pancreas, kidney, and vertebral fat deposition in NAFLD patients by proton density fat fraction (PDFF) using magnetic resonance imaging (MRI) and to evaluate the relationships among them. A total of 41 biopsy-proven NAFLD patients underwent MRI-PDFF with IDEAL-IQ. MRI protocol included T1-independent volumetric multi-echo gradient-echo imaging with T2* correction and spectral fat modeling. The MR examinations were performed on a 1.5 HDx MRI system. MRI-PDFF measurements were obtained from liver, pancreas, renal cortex and sinus, and vertebral body. Liver biopsy specimens were retrieved from the archives and evaluated by one pathologist according to NASH CRN. The median age of the patients was 47 years. The median interval between liver biopsy and MRI examination was 16 days. Mean liver, pancreas, renal cortex, renal sinus, T12 and L1 vertebral body MRI-PDFFs were 18.7%, 5.7%, 1.7%, 51%, 43.2%, and 43.5%, respectively. No correlation between either liver MRI-PDFF or histological steatosis, and other organ MRI-PDFFs was observed. A good correlation between pancreas and vertebral body MRI-PDFFs, and pancreas and renal sinus MRI-PDFFs was observed. Diabetic patients had higher average pancreas MRI-PDFF compared to non-diabetics (12.2%, vs., 4.8%; P = 0.028). Pancreas and vertebral body MRI-PDFF is well correlated in NAFLD patients and both of them are higher in diabetic patients which may explain increased bone fractures in diabetics. MRI-PDFF can be used to demonstrate fat fractions of different organs and tissues and to understand fat metabolism.

  15. Weighted regression analysis and interval estimators

    Treesearch

    Donald W. Seegrist

    1974-01-01

    A method for deriving the weighted least squares estimators for the parameters of a multiple regression model. Confidence intervals for expected values, and prediction intervals for the means of future samples are given.

  16. Interpregnancy interval and obstetrical complications.

    PubMed

    Shachar, Bat Zion; Lyell, Deirdre J

    2012-09-01

    Obstetricians are often presented with questions regarding the optimal interpregnancy interval (IPI). Short IPI has been associated with adverse perinatal and maternal outcomes, ranging from preterm birth and low birth weight to neonatal and maternal morbidity and mortality. Long IPI has in turn been associated with increased risk for preeclampsia and labor dystocia. In this review, we discuss the data regarding these associations along with recent studies revealing associations of short IPI with birth defects, schizophrenia, and autism. The optimal IPI may vary for different subgroups. We discuss the consequences of short IPI in women with a prior cesarean section, in particular the increased risk for uterine rupture and the considerations regarding a trial of labor in this subgroup. We review studies examining the interaction between short IPI and advanced maternal age and discuss the risk-benefit assessment for these women. Finally, we turn our attention to women after a stillbirth or an abortion, who often desire to conceive again with minimal delay. We discuss studies speaking in favor of a shorter IPI in this group. The accumulated data allow for the reevaluation of current IPI recommendations and management guidelines for women in general and among subpopulations with special circumstances. In particular, we suggest lowering the current minimal IPI recommendation to only 18 months (vs 24 months according to the latest World Health Organization recommendations), with even shorter recommended minimal IPI for women of advanced age and those who conceive after a spontaneous or induced abortion.

  17. Neuroanatomical classification in a population-based sample of psychotic major depression and bipolar I disorder with 1 year of diagnostic stability.

    PubMed

    Serpa, Mauricio H; Ou, Yangming; Schaufelberger, Maristela S; Doshi, Jimit; Ferreira, Luiz K; Machado-Vieira, Rodrigo; Menezes, Paulo R; Scazufca, Marcia; Davatzikos, Christos; Busatto, Geraldo F; Zanetti, Marcus V

    2014-01-01

    The presence of psychotic features in the course of a depressive disorder is known to increase the risk for bipolarity, but the early identification of such cases remains challenging in clinical practice. In the present study, we evaluated the diagnostic performance of a neuroanatomical pattern classification method in the discrimination between psychotic major depressive disorder (MDD), bipolar I disorder (BD-I), and healthy controls (HC) using a homogenous sample of patients at an early course of their illness. Twenty-three cases of first-episode psychotic mania (BD-I) and 19 individuals with a first episode of psychotic MDD whose diagnosis remained stable during 1 year of followup underwent 1.5 T MRI at baseline. A previously validated multivariate classifier based on support vector machine (SVM) was employed and measures of diagnostic performance were obtained for the discrimination between each diagnostic group and subsamples of age- and gender-matched controls recruited in the same neighborhood of the patients. Based on T1-weighted images only, the SVM-classifier afforded poor discrimination in all 3 pairwise comparisons: BD-I versus HC; MDD versus HC; and BD-I versus MDD. Thus, at the population level and using structural MRI only, we failed to achieve good discrimination between BD-I, psychotic MDD, and HC in this proof of concept study.

  18. MRI in ocular drug delivery.

    PubMed

    Li, S Kevin; Lizak, Martin J; Jeong, Eun-Kee

    2008-11-01

    Conventional pharmacokinetic methods for studying ocular drug delivery are invasive and cannot be conveniently applied to humans. The advancement of MRI technology has provided new opportunities in ocular drug-delivery research. MRI provides a means to non-invasively and continuously monitor ocular drug-delivery systems with a contrast agent or compound labeled with a contrast agent. It is a useful technique in pharmacokinetic studies, evaluation of drug-delivery methods, and drug-delivery device testing. Although the current status of the technology presents some major challenges to pharmaceutical research using MRI, it has a lot of potential. In the past decade, MRI has been used to examine ocular drug delivery via the subconjunctival route, intravitreal injection, intrascleral injection to the suprachoroidal space, episcleral and intravitreal implants, periocular injections, and ocular iontophoresis. In this review, the advantages and limitations of MRI in the study of ocular drug delivery are discussed. Different MR contrast agents and MRI techniques for ocular drug-delivery research are compared. Ocular drug-delivery studies using MRI are reviewed.

  19. MRI of plants and foods.

    PubMed

    Van As, Henk; van Duynhoven, John

    2013-04-01

    The importance and prospects for MRI as applied to intact plants and to foods are presented in view of one of humanity's most pressing concerns, the sustainable and healthy feeding of a worldwide increasing population. Intact plants and foods have in common that their functionality is determined by complex multiple length scale architectures. Intact plants have an additional level of complexity since they are living systems which critically depend on transport and signalling processes between and within tissues and organs. The combination of recent cutting-edge technical advances and integration of MRI accessible parameters has the perspective to contribute to breakthroughs in understanding complex regulatory plant performance mechanisms. In food science and technology MRI allows for quantitative multi-length scale structural assessment of food systems, non-invasive monitoring of heat and mass transport during shelf-life and processing, and for a unique view on food properties under shear. These MRI applications are powerful enablers of rationally (re)designed food formulations and processes. Limitations and bottlenecks of the present plant and food MRI methods are mainly related to short T2 values and susceptibility artefacts originating from small air spaces in tissues/materials. We envisage cross-fertilisation of solutions to overcome these hurdles in MRI applications in plants and foods. For both application areas we witness a development where MRI is moving from highly specialised equipment to mobile and downscaled versions to be used by a broad user base in the field, greenhouse, food laboratory or factory.

  20. MRI in ocular drug delivery

    PubMed Central

    Li, S. Kevin; Lizak, Martin J.; Jeong, Eun-Kee

    2008-01-01

    Conventional pharmacokinetic methods for studying ocular drug delivery are invasive and cannot be conveniently applied to humans. The advancement of MRI technology has provided new opportunities in ocular drug-delivery research. MRI provides a means to non-invasively and continuously monitor ocular drug-delivery systems with a contrast agent or compound labeled with a contrast agent. It is a useful technique in pharmacokinetic studies, evaluation of drug-delivery methods, and drug-delivery device testing. Although the current status of the technology presents some major challenges to pharmaceutical research using MRI, it has a lot of potential. In the past decade, MRI has been used to examine ocular drug delivery via the subconjunctival route, intravitreal injection, intrascleral injection to the suprachoroidal space, episcleral and intravitreal implants, periocular injections, and ocular iontophoresis. In this review, the advantages and limitations of MRI in the study of ocular drug delivery are discussed. Different MR contrast agents and MRI techniques for ocular drug-delivery research are compared. Ocular drug-delivery studies using MRI are reviewed. PMID:18186077

  1. The Measurement of the QT Interval

    PubMed Central

    Postema, Pieter G; Wilde, Arthur A.M

    2014-01-01

    The evaluation of every electrocardiogram should also include an effort to interpret the QT interval to assess the risk of malignant arrhythmias and sudden death associated with an aberrant QT interval. The QT interval is measured from the beginning of the QRS complex to the end of the T-wave, and should be corrected for heart rate to enable comparison with reference values. However, the correct determination of the QT interval, and its value, appears to be a daunting task. Although computerized analysis and interpretation of the QT interval are widely available, these might well over- or underestimate the QT interval and may thus either result in unnecessary treatment or preclude appropriate measures to be taken. This is particularly evident with difficult T-wave morphologies and technically suboptimal ECGs. Similarly, also accurate manual assessment of the QT interval appears to be difficult for many physicians worldwide. In this review we delineate the history of the measurement of the QT interval, its underlying pathophysiological mechanisms and the current standards of the measurement of the QT interval, we provide a glimpse into the future and we discuss several issues troubling accurate measurement of the QT interval. These issues include the lead choice, U-waves, determination of the end of the T-wave, different heart rate correction formulas, arrhythmias and the definition of normal and aberrant QT intervals. Furthermore, we provide recommendations that may serve as guidance to address these complexities and which support accurate assessment of the QT interval and its interpretation. PMID:24827793

  2. Min and Max Extreme Interval Values

    ERIC Educational Resources Information Center

    Jance, Marsha L.; Thomopoulos, Nick T.

    2011-01-01

    The paper shows how to find the min and max extreme interval values for the exponential and triangular distributions from the min and max uniform extreme interval values. Tables are provided to show the min and max extreme interval values for the uniform, exponential, and triangular distributions for different probabilities and observation sizes.

  3. Situs anomalies on prenatal MRI.

    PubMed

    Nemec, Stefan F; Brugger, Peter C; Nemec, Ursula; Bettelheim, Dieter; Kasprian, Gregor; Amann, Gabriele; Rimoin, David L; Graham, John M; Prayer, Daniela

    2012-04-01

    Situs anomalies refer to an abnormal organ arrangement, which may be associated with severe errors of development. Due regard being given to prenatal magnetic resonance imaging (MRI) as an adjunct to ultrasonography (US), this study sought to demonstrate the in utero visualization of situs anomalies on MRI, compared to US. This retrospective study included 12 fetuses with situs anomalies depicted on fetal MRI using prenatal US as a comparison modality. With an MRI standard protocol, the whole fetus was assessed for anomalies, with regard to the position and morphology of the following structures: heart; venous drainage and aorta; stomach and intestines; liver and gallbladder; and the presence and number of spleens. Situs inversus totalis was found in 3/12 fetuses; situs inversus with levocardia in 1/12 fetuses; situs inversus abdominis in 2/12 fetuses; situs ambiguous with polysplenia in 3/12 fetuses, and with asplenia in 2/12 fetuses; and isolated dextrocardia in 1/12 fetuses. Congenital heart defects (CHDs), vascular anomalies, and intestinal malrotations were the most frequent associated malformations. In 5/12 cases, the US and MRI diagnoses were concordant. Compared to US, in 7/12 cases, additional MRI findings specified the situs anomaly, but CHDs were only partially visualized in six cases. Our initial MRI results demonstrate the visualization of situs anomalies and associated malformations in utero, which may provide important information for perinatal management. Using a standard protocol, MRI may identify additional findings, compared to US, which confirm and specify the situs anomaly, but, with limited MRI visualization of fetal CHDs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  4. Remote sensing for prediction of 1-year post-fire ecosystem condition

    Treesearch

    Leigh B. Lentile; Alistair M. S. Smith; Andrew T. Hudak; Penelope Morgan; Michael J. Bobbitt; Sarah A. Lewis; Peter R. Robichaud

    2009-01-01

    Appropriate use of satellite data in predicting >1 year post-fire effects requires remote measurement of surface properties that can be mechanistically related to ground measures of post-fire condition. The present study of burned ponderosa pine (Pinus ponderosa) forests in the Black Hills of South Dakota evaluates whether immediate fractional cover estimates of...

  5. The Stability and Structure of Career Decision-Making Profiles: A 1-Year Follow-Up

    ERIC Educational Resources Information Center

    Gati, Itamar; Levin, Nimrod

    2012-01-01

    The Career Decision-Making Profile (CDMP) questionnaire is a multidimensional measure of the way individuals make career decisions, developed as an alternative to the single, most-dominant trait approach. Using a sample of freshmen students, the 2-week reliability (N = 273) and 1-year stability (N = 182) of the CDMP was tested for each of the 12…

  6. Thai Adolescent Survivors 1 Year after the 2004 Tsunami: A Mixed Methods Study

    ERIC Educational Resources Information Center

    Tuicomepee, Arunya; Romano, John L.

    2008-01-01

    This study examined the impact of the 2004 Asian tsunami on 400 Thai adolescents 1 year after the disaster. Quantitative analyses showed that youth behavior problems were positively associated with tsunami experiences and negatively associated with positive family functioning. Tsunami exposure, school connectedness, religious beliefs and…

  7. Intussusception patients older than 1 year tend to have early recurrence after pneumatic enema reduction.

    PubMed

    Wang, Zhe; He, Qiu-ming; Zhang, Hong; Zhong, Wei; Xiao, Wei-qiang; Lu, Lian-wei; Yu, Jia-kang; Xia, Hui-min

    2015-09-01

    To identify age risk factors of early recurrent intussusception after pneumatic enema reduction. Management opinions are proposed. Two thousand two hundred and ninety-five intussusception patients' medical records from January 2009 to December 2011 were retrospectively reviewed and analyzed. Of the 2295 patients, the intussusception of 1917 of them was initially reduced by pneumatic enema, with 127 cases recurring within 72 h. The early recurrence rate is 6.62%. The early recurrence rate of patients younger than 1 year old is 2.1% (22/1032), while the rate for those older than 1 year is 11.9% (105/885). The difference is significant (P = 0.0001). There were no significant differences between age groups older than 1 year. One hundred and seventeen cases of recurrence happened within 48 h, which accounted for 92.1% of all early recurrence. Recurrence patients were treated again with pneumatic enema, with a successful reduction in 93.7%. They were followed up for 2-4 years; the long-term recurrent rate was 11.8% (14/119). No patient had poor prognosis because of delayed treatment. Intussusception patients older than 1 year tend to have greater early recurrence rate after pneumatic enema reduction; 92.1% of the early recurrent cases happened in 48 h. There is no need to hospitalize patients after pneumatic enema reduction. A repeat pneumatic enema is a good choice before surgical approach.

  8. Verbal Labels Modulate Perceptual Object Processing in 1-Year-Old Children

    ERIC Educational Resources Information Center

    Gliga, Teodora; Volein, Agnes; Csibra, Gergely

    2010-01-01

    Whether verbal labels help infants visually process and categorize objects is a contentious issue. Using electroencephalography, we investigated whether possessing familiar or novel labels for objects directly enhances 1-year-old children's neural processes underlying the perception of those objects. We found enhanced gamma-band (20-60 Hz)…

  9. 29 CFR 2530.204-1 - Year of participation for benefit accrual.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ADMINISTRATION, DEPARTMENT OF LABOR MINIMUM STANDARDS FOR EMPLOYEE PENSION BENEFIT PLANS UNDER THE EMPLOYEE... BENEFIT PLANS Participation, Vesting and Benefit Accrual § 2530.204-1 Year of participation for benefit... requirements relating to benefit accrual under a defined benefit pension plan. Some of these requirements...

  10. Thai Adolescent Survivors 1 Year after the 2004 Tsunami: A Mixed Methods Study

    ERIC Educational Resources Information Center

    Tuicomepee, Arunya; Romano, John L.

    2008-01-01

    This study examined the impact of the 2004 Asian tsunami on 400 Thai adolescents 1 year after the disaster. Quantitative analyses showed that youth behavior problems were positively associated with tsunami experiences and negatively associated with positive family functioning. Tsunami exposure, school connectedness, religious beliefs and…

  11. An Analysis of 1-Year Impacts of Youth Transition Demonstration Projects

    ERIC Educational Resources Information Center

    Fraker, Thomas M.; Luecking, Richard G.; Mamun, Arif A.; Martinez, John M.; Reed, Deborah S.; Wittenburg, David C.

    2016-01-01

    This article examines the impacts of the Youth Transition Demonstration, an initiative of the Social Security Administration (SSA) to improve employment outcomes for youth with disabilities. Based on a random assignment design, the analysis uses data from a 1-year follow-up survey and SSA administrative records for 5,203 youth in six research…

  12. Props and children's event reports: the impact of a 1-year delay.

    PubMed

    Salmon, K; Pipe, M E

    1997-06-01

    Three- and 5-year-old children took part in a quasi-medical event in which the child and an adult stranger examined a "sick" teddy bear. Three days and 1 year after the event, children were interviewed in one of three interview conditions; with real items from the event (real props); with toy representations of those items (toy props); or with verbal prompts (no props). After 3 days, both toys and real items facilitated children's reports compared to verbal prompts, but children interviewed with toy props were less accurate than those interviewed with either real items or verbal prompts. After 1 year, the reports of children interviewed with real items remained more accurate than those of children interviewed with toys, although real items did not differentially protect recall from forgetting compared to either toys or verbal prompts. The report of the older children were as accurate at the 1-year delay as at the 3-day delay, whereas the reports of the younger children were particularly susceptible to errors. Correct information was more likely to be repeated across interviews than were errors. New information introduced for the first time after 1 year was highly unreliable for both age groups, whereas that repeated across interviews was highly reliable.

  13. Dialectical Behavior Therapy for Adolescents with Bipolar Disorder: A 1-Year Open Trial

    ERIC Educational Resources Information Center

    Goldstein, Tina R.; Axelson, David A.; Birmaher, Boris; Brent, David A.

    2007-01-01

    Objective: To describe an adapted version of dialectical behavior therapy for adolescents with bipolar disorder. Method: The dialectical behavior therapy intervention is delivered over 1 year and consists of two modalities: family skills training (conducted with individual family units) and individual therapy. The acute treatment period (6 months)…

  14. A Program To Promote Positive Body Image: A 1-Year Follow-Up Evaluation.

    ERIC Educational Resources Information Center

    McVey, Gail L.; Davis, Ron

    2002-01-01

    Evaluated the effectiveness of a program designed to promote body image satisfaction and prevent eating problems in young adolescent girls over a 1-year period. Found no program effect. Found instead, significant increases in body image satisfaction and decreases in eating problem scores over time for participants in both the prevention and…

  15. Outpatient treated burns in infants younger than 1 year in Helsinki during 2005-2009.

    PubMed

    Laitakari, Elina; Koljonen, Virve; Pyörälä, Sari; Rintala, Risto

    2014-05-01

    In general, voluminous data exists concerning burns in children, but the data focusing specially on children less than 1 year of age is sporadic. We therefore focused on examining the special features of burns in children less than 1 year of age. A retrospective study of all outpatient treated burn patients <1 year old at the Hospital for Children and Adolescents, Helsinki, Finland, from January 2005 to December 2009 was performed. During the 5-year period we identified 106 outpatient treated infants with burns, representing 15% of all pediatric burns during the study period. The majority was male and aged 9-12 months. Most of the burns occurred at home, and in most cases a caregiver was present in the injury room. Scalds were the most common type of injury followed by contact burns. The most common source of scald was from cups containing hot drink, and the most common source of contact burn was hot stoves or oven doors. Special attention needs to be targeted toward the prevention of burns in children less than 1 year of age. The majority of the injuries could have been prevented with more vigilance.

  16. A Program To Promote Positive Body Image: A 1-Year Follow-Up Evaluation.

    ERIC Educational Resources Information Center

    McVey, Gail L.; Davis, Ron

    2002-01-01

    Evaluated the effectiveness of a program designed to promote body image satisfaction and prevent eating problems in young adolescent girls over a 1-year period. Found no program effect. Found instead, significant increases in body image satisfaction and decreases in eating problem scores over time for participants in both the prevention and…

  17. 1-year retention rates and performance ratings: comparing associate degree, baccalaureate, and accelerated baccalaureate degree nurses.

    PubMed

    Weathers, Suzanne M; Raleigh, Edith D Hunt

    2013-09-01

    The purpose of this study was to examine 1-year retention and managerial performance ratings of newly licensed RNs (NLRNs) according to nursing education program types (associate degree, traditional baccalaureate, and accelerated 2nd degree baccalaureate). Findings revealed retention and performance differences, suggesting the possibility of tradeoffs related to educational program type when selecting NLRNs for open positions.

  18. Dialectical Behavior Therapy for Adolescents with Bipolar Disorder: A 1-Year Open Trial

    ERIC Educational Resources Information Center

    Goldstein, Tina R.; Axelson, David A.; Birmaher, Boris; Brent, David A.

    2007-01-01

    Objective: To describe an adapted version of dialectical behavior therapy for adolescents with bipolar disorder. Method: The dialectical behavior therapy intervention is delivered over 1 year and consists of two modalities: family skills training (conducted with individual family units) and individual therapy. The acute treatment period (6 months)…

  19. Latent Classes of Adolescent Posttraumatic Stress Disorder Predict Functioning and Disorder after 1 Year

    ERIC Educational Resources Information Center

    Ayer, Lynsay; Danielson, Carla Kmett; Amstadter, Ananda B.; Ruggiero, Ken; Saunders, Ben; Kilpatrick, Dean

    2011-01-01

    Objective: To identify latent classes of posttraumatic stress disorder (PTSD) symptoms in a national sample of adolescents, and to test their associations with PTSD and functional impairment 1 year later. Method: A total of 1,119 trauma-exposed youth aged 12 through 17 years (mean = 14.99 years, 51% female and 49% male) participating in the…

  20. Latent Classes of Adolescent Posttraumatic Stress Disorder Predict Functioning and Disorder after 1 Year

    ERIC Educational Resources Information Center

    Ayer, Lynsay; Danielson, Carla Kmett; Amstadter, Ananda B.; Ruggiero, Ken; Saunders, Ben; Kilpatrick, Dean

    2011-01-01

    Objective: To identify latent classes of posttraumatic stress disorder (PTSD) symptoms in a national sample of adolescents, and to test their associations with PTSD and functional impairment 1 year later. Method: A total of 1,119 trauma-exposed youth aged 12 through 17 years (mean = 14.99 years, 51% female and 49% male) participating in the…

  1. An Analysis of 1-Year Impacts of Youth Transition Demonstration Projects

    ERIC Educational Resources Information Center

    Fraker, Thomas M.; Luecking, Richard G.; Mamun, Arif A.; Martinez, John M.; Reed, Deborah S.; Wittenburg, David C.

    2016-01-01

    This article examines the impacts of the Youth Transition Demonstration, an initiative of the Social Security Administration (SSA) to improve employment outcomes for youth with disabilities. Based on a random assignment design, the analysis uses data from a 1-year follow-up survey and SSA administrative records for 5,203 youth in six research…

  2. Verbal Labels Modulate Perceptual Object Processing in 1-Year-Old Children

    ERIC Educational Resources Information Center

    Gliga, Teodora; Volein, Agnes; Csibra, Gergely

    2010-01-01

    Whether verbal labels help infants visually process and categorize objects is a contentious issue. Using electroencephalography, we investigated whether possessing familiar or novel labels for objects directly enhances 1-year-old children's neural processes underlying the perception of those objects. We found enhanced gamma-band (20-60 Hz)…

  3. Colles' fracture treated with non-bridging external fixation: a 1-year follow-up.

    PubMed

    Andersen, J K; Høgh, A; Gantov, J; Vaesel, M T; Hansen, T Baek

    2009-08-01

    The results in 75 of 105 patients with Older type II/III (AO type A2.2, A3.1, A3.2) Colles' fractures, treated with non-bridging external fixation are presented. The mean age was 67.8 years, and all patients were followed prospectively for 12 months with radiological and functional assessment. No statistically significant loss of radial length, angulation or inclination was seen between the postoperative reduction and the 1-year follow-up examination. The clinical results after 1 year were 66 (88%) excellent/good, nine (12%) fair and 0 (0%) poor according to the modified Gartland and Werley score. Mean visual analogue scale pain score after 1 year was 0.8. In three patients (4%), re-displacement of the fracture occurred and was treated with plating. Non-bridging external fixation offers a reliable method of maintaining radiological reduction of Older type II/III fractures of the distal radius and gives a good functional outcome after 1 year.

  4. Relationship between tongue strength and 1-year life expectancy in elderly people needing nursing care.

    PubMed

    Yajima, Yuri; Kikutani, Takeshi; Tamura, Fumiyo; Yoshida, Mitsuyoshi

    2017-01-05

    Tongue strength is a useful indicator of oral function and has been found to decrease with aging and reduced physical functioning. The present study aimed to assess the relationships of tongue strength with physical function, mental function, and nutritional status, and also between these factors and 1-year outcomes, to determine whether tongue strength is related to life expectancy in elderly people needing nursing care. The subjects were 140 elderly individuals requiring needing nursing care (49 men and 91 women; ≥65 years). The investigated items included sex, age, activities of daily living (ADL), comorbidity, cognitive function, nutritional status, eating function, occlusal support, and tongue strength. Furthermore, a follow-up study was conducted 1 year later, and factors related to death were identified. The mean tongue strength of the total 140 subjects was 20.3 ± 8.6 kPa. Tongue strength was assessed relative to each of the investigated items, using the t test and one-way analysis of variance. Tongue strength was significantly related to ADL, comorbidity, cognitive function, calf circumference, food intake, and occlusal support. Fifteen subjects were found to have died at the 1-year follow-up study. We assessed the relationships of 1-year outcomes with each of the factors examined, and 1-year outcomes were found to be significantly related to ADL and tongue strength.

  5. Evaluation of the diagnostic accuracy of hand and foot MRI for early Rheumatoid Arthritis.

    PubMed

    Nieuwenhuis, Wouter P; van Steenbergen, Hanna W; Mangnus, Lukas; Newsum, Elize C; Bloem, Johan L; Huizinga, Tom W J; le Cessie, Saskia; Reijnierse, Monique; van der Helm-van Mil, Annette H M

    2017-08-01

    To assess the diagnostic value of MRI for early RA. In some RA patients, a classifiable diagnosis cannot be made at first presentation; these patients present with unclassified arthritis (UA). The use of MRI for early diagnosis of RA is recommended, yet the evidence for its reliability is limited. MRI of hand and foot was performed in 589 early arthritis patients included in the Leiden Early Arthritis Clinic (229 presented with RA, 159 with other arthritides and 201 with UA). Symptom-free controls provided a reference for defining an abnormal MRI. In preliminary investigations, MRI of patients who presented with RA was compared with MRI of symptom-free controls and of patients with other arthritides. Thereafter, the value of MRI in early RA diagnosis was determined in UA patients using the 1-year follow-up on fulfilling the 1987 RA criteria and start of disease-modifying drugs as outcomes. Preliminary investigations were promising. Of the UA patients, 14% developed RA and 37% started disease-modifying treatment. MRI-detected tenosynovitis was associated with RA development independent of other types of MRI-detected inflammation [odds ratio (OR) = 7.5, 95% CI: 2.4, 23] and also independent of age and other inflammatory measures (swollen joints, CRP) (OR = 4.2, 95% CI: 1.4, 12.9). Within UA patients, the negative predictive value of abnormal tenosynovitis was 95% (95% CI: 89%, 98%) and the positive predictive value 25% (95% CI: 17%, 35%). The performance was best in the subgroup of UA patients presenting with oligoarthritis (18% developed RA): the positive predictive value was 36% (95% CI: 23%, 52%), the negative predictive value was 98% (95% CI: 88%, 100%), the sensitivity was 93% (95% CI: 70%, 99%) and the specificity was 63% (95% CI: 51%, 74%). MRI contributes to the identification of UA patients who will develop RA, mostly in UA patients presenting with oligoarthritis.

  6. MRI Meets MPI: a bimodal MPI-MRI tomograph.

    PubMed

    Vogel, Patrick; Lother, Steffen; Rückert, Martin A; Kullmann, Walter H; Jakob, Peter M; Fidler, Florian; Behr, Volker C

    2014-10-01

    While magnetic particle imaging (MPI) constitutes a novel biomedical imaging technique for tracking superparamagnetic nanoparticles in vivo, unlike magnetic resonance imaging (MRI), it cannot provide anatomical background information. Until now these two modalities have been performed in separate scanners and image co-registration has been hampered by the need to reposition the sample in both systems as similarly as possible. This paper presents a bimodal MPI-MRI-tomograph that combines both modalities in a single system.MPI and MRI images can thus be acquired without moving the sample or replacing any parts in the setup. The images acquired with the presented setup show excellent agreement between the localization of the nanoparticles in MPI and the MRI background data. A combination of two highly complementary imaging modalities has been achieved.

  7. Mean platelet volume in acute phase of ischemic stroke, as predictor of mortality and functional outcome after 1 year.

    PubMed

    Arévalo-Lorido, José Carlos; Carretero-Gómez, Juana; Álvarez-Oliva, Alejandra; Gutiérrez-Montaño, Concepción; Fernández-Recio, José María; Najarro-Díez, Francisco

    2013-05-01

    Mean platelet volume (MPV) could be a predictor of prognosis after ischemic stroke. Our aim is to investigate the association of MPV with a greater mortality and morbidity (defined as readmissions) after 1 year of follow-up in patients with acute stroke, and with a poor functional outcome in these patients. Patients with ischemic stroke (N = 379) were recruited and assessed for an average of 46.27 weeks. MPV was measured at admission. The sample was divided in thirds according with the tertiles of distribution of MPV. Univariate and multivariate analysis were performed. The median (interquartile range) of MPV by third was 10 (0.7), 11(0.4), and 12 (0.8) fentoliters. Patients within highest third had a significant higher risk of either death or readmission (odds ratio 1.3; 95% confidence interval 1.00-1.7; P < .048) compared with patients within the lowest third. Functional outcome, defined as a modified Rankin Scale score of 3 to 6, was significantly higher (P < .0004) by greater third of MPV. MPV may be an easily available predictor for the prognosis in patients with acute ischemic stroke. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  8. Bivalirudin vs. unfractionated heparin during percutaneous coronary interventions in patients with stable and unstable angina pectoris: 1-year results of the ISAR-REACT 3 trial.

    PubMed

    Schulz, Stefanie; Mehilli, Julinda; Ndrepepa, Gjin; Neumann, Franz-Josef; Birkmeier, Katrin A; Kufner, Sebastian; Richardt, Gert; Berger, Peter B; Schömig, Albert; Kastrati, Adnan

    2010-03-01

    In ISAR-REACT 3, 30-day outcomes in 4570 biomarker negative patients undergoing percutaneous coronary intervention (PCI) > or =2 h after pre-treatment with 600 mg of clopidogrel revealed less bleeding with bivalirudin compared with unfractionated heparin, but no difference in 30-day net clinical benefit. The objective of the present analysis was to assess the impact of bivalirudin vs. heparin on 1-year outcomes in ISAR-REACT 3. The primary outcome for this analysis was the composite of death, myocardial infarction, or target vessel revascularization 1 year after randomization. The composite of death or myocardial infarction was a secondary outcome. At 1 year, the primary outcome occurred in 17.1% of patients assigned to bivalirudin vs. 17.5% assigned to heparin [hazard ratio (HR), 0.98; 95% confidence interval (CI), 0.86-1.13; P = 0.816]. The combined incidence of death or myocardial infarction was 7.7% in the bivalirudin group vs. 6.7% in the heparin group (HR, 1.15; 95% CI, 0.93-1.43; P = 0.200). The mortality rate was 1.9% in the bivalirudin group and 1.7% in the heparin group (HR, 1.10; 95% CI, 0.71-1.70; P = 0.667). At 1 year, no significant differences in the primary outcome were observed with bivalirudin and heparin in any of the subgroups analysed. Bivalirudin and unfractionated heparin during PCI provide comparable outcomes at 1 year in biomarker negative patients undergoing PCI after pre-treatment with 600 mg of clopidogrel. URL www.clinicaltrials.gov; Unique identifier NCT00262054.

  9. Clinical and imaging predictors of 1-year and long-term mortality in light chain (AL) amyloidosis: a 5-year follow-up study.

    PubMed

    Migrino, Raymond Q; Harmann, Leanne; Christenson, Richard; Hari, Parameswaran

    2014-11-01

    Light chain amyloidosis (AL) involves multiorgan failure induced by amyloidogenic light chain proteins, and is associated with high mortality. We aimed to identify clinical, laboratory, and imaging parameters that would predict 1-year and long-term AL mortality. Forty-four biopsy-proven AL patients (61.5 ± 12 years, 20 females) underwent clinical evaluation including laboratory assays, echocardiography, and contrast cardiac magnetic resonance imaging (CMR, n = 31) prior to chemotherapy. Patients were prospectively followed for median duration of 62.7 months (interquartile range 35.5 months). Clinical and laboratory parameters were compared between 1-year survivors and nonsurvivors. Univariate Kaplan-Meier survival plots were calculated followed by stepwise logistic regression analysis to assess independent predictors of long-term survival. Eighteen (40.9 %) patients died within 1 year and an additional 10 subjects died during long-term follow-up. Patients who expired within 1 year presented with more advanced class of heart failure, higher alkaline phosphatase and uric acid, lower limb lead voltage on electrocardiography, shorter left ventricular ejection time (ET) on echocardiography, and a higher proportion of late gadolinium enhancement on CMR. On multivariable analysis, only ET ≤240 ms on echocardiography (hazard ratio (HR) 5.07, 95 % confidence interval (CI) 1.83-14.1, P = 0.002) and New York Heart Association functional class II-IV presentation (HR 1.0058, 95 % CI 1.0014-1.0103, P = 0.01) were independent predictors of AL mortality. In conclusion, AL amyloidosis is associated with high 1-year and long-term mortality. Among clinical, laboratory, and imaging parameters tested, an echocardiographic finding of ET ≤240 ms has independent and additive prognostic value to clinical heart failure evaluation in determining long-term survival of AL patients. This result may be important in the early identification of patients at risk.

  10. Advances in pediatric oncology MRI.

    PubMed

    Olsen, Øystein E

    2013-11-01

    Refined stratification of disease is thought to result in better survival from childhood malignant disease while minimizing the adverse effects of anticancer therapies. There is a potential for magnetic resonance imaging (MRI) to contribute to such stratification by improved tissue characterization, anatomical depiction, staging, and assessment of early treatment response. Recent advances in pediatric MRI outside the central nervous system (CNS) are reviewed in this context. The focus is on new applications for conventional MRI and on clinical implementation of tissue-specific and quantitative techniques. This area is largely unexplored, and potential directions for research are indicated.

  11. A new MRI grading system for chondromalacia patellae.

    PubMed

    Özgen, Ali; Taşdelen, Neslihan; Fırat, Zeynep

    2017-04-01

    Background Chondromalacia patellae is a very common disorder. Although magnetic resonance imaging (MRI) is widely used to investigate patellar cartilage lesions, there is no descriptive MRI-based grading system for chondromalacia patellae. Purpose To propose a new MRI grading system for chondromalacia patellae with corresponding high resolution images which might be useful in precisely reporting and comparing knee examinations in routine daily practice and used in predicting natural course and clinical outcome of the patellar cartilage lesions. Material and Methods High resolution fat-saturated proton density (FS PD) images in the axial plane with corresponding T2 mapping images were reviewed. A detailed MRI grading system covering the deficiencies of the existing gradings has been set and presented on these images. Two experienced observers blinded to clinical data examined 44 knee MR images and evaluated patellar cartilage changes according to the proposed grading system. Inter- and intra-rater validity testing using kappa statistics were calculated. Results A descriptive and detailed grading system with corresponding FS PD and T2 mapping images has been presented. Inter-rater agreement was 0.80 (95% confidence interval [CI], 0.71-0.89). Intra-rater agreements were 0.83 (95% CI, 0.74-0.91) for observer A and 0.79 (95% CI, 0.70-0.88) for observer B (k-values). Conclusion We present a new MRI grading system for chondromalacia patellae with corresponding images and good inter- and intra-rater agreement which might be useful in reporting and comparing knee MRI examinations in daily practice and may also have the potential for using more precisely predicting prognosis and clinical outcome of the patients.

  12. In Vivo Proton Beam Range Verification Using Spine MRI Changes

    SciTech Connect

    Gensheimer, Michael F.; Yock, Torunn I.; Liebsch, Norbert J.; Sharp, Gregory C.; Paganetti, Harald; Madan, Neel; Grant, P. Ellen; Bortfeld, Thomas

    2010-09-01

    Purpose: In proton therapy, uncertainty in the location of the distal dose edge can lead to cautious treatment plans that reduce the dosimetric advantage of protons. After radiation exposure, vertebral bone marrow undergoes fatty replacement that is visible on magnetic resonance imaging (MRI). This presents an exciting opportunity to observe radiation dose distribution in vivo. We used quantitative spine MRI changes to precisely detect the distal dose edge in proton radiation patients. Methods and Materials: We registered follow-up T1-weighted MRI images to planning computed tomography scans from 10 patients who received proton spine irradiation. A radiation dose-MRI signal intensity curve was created using the lateral beam penumbra in the sacrum. This curve was then used to measure range errors in the lumbar spine. Results: In the lateral penumbra, there was an increase in signal intensity with higher dose throughout the full range of 0-37.5 Gy (RBE). In the distal fall-off region, the beam sometimes appeared to penetrate farther than planned. The mean overshoot in 10 patients was 1.9 mm (95% confidence interval, 0.8-3.1 mm), on the order of the uncertainties inherent to our range verification method. Conclusions: We have demonstrated in vivo proton range verification using posttreatment spine MRI changes. Our analysis suggests the presence of a systematic overshoot of a few millimeters in some proton spine treatments, but the range error does not exceed the uncertainty incorporated into the treatment planning margin. It may be possible to extend our technique to MRI sequences that show early bone marrow changes, enabling adaptive treatment modification.

  13. Predictors of Poor Quality of Life 1 Year After Subarachnoid Hemorrhage.

    PubMed

    Taufique, Zahrah; May, Teresa; Meyers, Emma; Falo, Cristina; Mayer, Stephan A; Agarwal, Sachin; Park, Soojin; Connolly, E Sander; Claassen, Jan; Schmidt, J Michael

    2016-02-01

    Risk factors for poor quality of life (QOL) after subarachnoid hemorrhage (SAH) remain poorly described. To identify the frequency and predictors of poor QOL 1 year after SAH. We studied 1-year QOL in a prospectively collected cohort of 1181 consecutively admitted SAH survivors between July 1996 and May 2013. Patient clinical, radiographic, surgical, and acute clinical course information was recorded. Reduced QOL (overall, physical, and psychosocial) at 1 year was assessed with the Sickness Impact Profile and defined as 2 SD below population-based normative Sickness Impact Profile values. Logistic regression leveraging multiple imputation to handle missing data was used to evaluate reduced QOL. Poor overall QOL was observed in 35% of patients. Multivariable analysis revealed that nonwhite ethnicity, high school education or less, history of depression, poor clinical grade (Hunt-Hess Grade ≥3), and delayed infarction were predictors of poor overall and psychosocial QOL. Poor physical QOL was additionally associated with older age, hydrocephalus, pneumonia, and sepsis. At 1 year, patients with poor QOL had increased difficulty concentrating, cognitive dysfunction, depression, and reduced activities of daily living. More than 91% of patients with poor QOL failed to fully return to work. These patients frequently received physical rehabilitation, but few received cognitive rehabilitation or emotional-behavioral support. Reduced QOL affects as many as one-third of SAH survivors 1 year after SAH. Delayed infarction is the most important in-hospital modifiable factor that affects QOL. Increased attention to cognitive and emotional difficulties after hospital discharge may help patients achieve greater QOL.

  14. Effect of Peritoneal Dialysis Modality on the 1-Year Rate of Decline of Residual Renal Function

    PubMed Central

    Kim, Chan Ho; Oh, Hyung Jung; Lee, Mi Jung; Kwon, Young Eun; Kim, Yung Ly; Nam, Ki Heon; Park, Kyoung Sook; An, Seong Yeong; Ko, Kwang Il; Koo, Hyang Mo; Doh, Fa Mee; Han, Seung Hyeok; Yoo, Tae-Hyun; Kim, Beom Seok; Kang, Shin-Wook

    2014-01-01

    Purpose The effect of different peritoneal dialysis (PD) modalities on the decline in residual renal function (RRF) is unclear due to inconsistencies among studies. In particular, the effect of automated peritoneal dialysis (APD) modalities [continuous cyclic peritoneal dialysis (CCPD) and nightly intermittent peritoneal dialysis (NIPD)] on RRF has not been examined in a large cohort. Materials and Methods We conducted a single-center retrospective study to investigate the association between PD modalities and decline in RRF in 142 incident PD patients [34 on CCPD, 36 on NIPD, and 72 on continuous ambulatory peritoneal dialysis (CAPD)]. RRF was measured within 2 months from PD start and at 1 year after PD initiation. Results The RRF at 1 year after PD initiation was 1.98±2.20 mL/min/1.73 m2 in CCPD patients and 3.63±3.67 mL/min/1.73 m2 in NIPD patients, which were moderately lower than 4.23±3.51 mL/min/1.73 m2 in CAPD patients (p=0.064). Moreover, there was no significant difference in the 1-year rate of decline of RRF between CCPD and NIPD patients, although APD patients had a faster 1-year RRF decline rate than CAPD patients (CCPD and NIPD vs. CAPD: -45.68 and -36.69 vs. 1.17%/year, p=0.045). APD was associated with a more rapid decline in RRF in patients with end-stage renal disease undergoing PD, although multivariate analysis attenuated the significance of this finding (β=-31.50; 95% CI, -63.61 to 0.62; p=0.052). Conclusion Our results suggest that CAPD might be more helpful than APD for preserving RRF during the first year of dialysis therapy, although there was no significant difference in the 1-year rate of decline of RRF between the two APD modalities. PMID:24339299

  15. Effect of estrogen therapy for 1 year on thyroid volume and thyroid nodules in postmenopausal women.

    PubMed

    Ceresini, Graziano; Milli, Bruna; Morganti, Simonetta; Maggio, Marcello; Bacchi-Modena, Alberto; Sgarabotto, Maria Paola; Chirico, Carla; Di Donato, Pietro; Campanati, Paolo; Valcavi, Roberto; Ceda, Gian Paolo; Braverman, Lewis E; Valenti, Giorgio

    2008-01-01

    Estrogen receptors are present in thyroid follicular cells in normal and neoplastic tissue. We evaluated changes in total thyroid volume and volume of thyroid nodules in postmenopausal women given either hormone therapy (HT) or no treatment in a 1-year observational follow-up. We studied 33 women receiving HT and 76 women receiving no treatment, comparing total thyroid volume, thyroid nodule volume, and serum concentrations of thyroid-stimulating hormone and estradiol at baseline and 1 year of follow-up. Serum thyroid-stimulating hormone concentrations were not different between groups either at baseline or at 1 year. Estradiol rose significantly in the HT group. The final percent changes in total thyroid volume were comparable between groups (HT, 1.59 +/- 2.56%; no treatment, 1.20 +/- 2.28%). At baseline, nodules were detected in 17 (51.5%) and 33 (43.4%) of women in the HT and no treatment groups, respectively, with no statistically significant difference between groups. The final number of nodules was unchanged or reduced in 88.2% and 81.1% and increased in 11.8% and 18.9% of women in the HT and no treatment groups, respectively, with no differences between groups. Baseline volumes of thyroid nodules were 0.8 +/- 0.4 and 1.4 +/- 0.4 mL in women in the HT and no treatment groups, respectively (P = 0.4). After 1 year the volume of thyroid nodules was unchanged or reduced in 47.1% and 52.8% and increased in 52.9% and 47.2% of women in the HT and no treatment groups, respectively, with no differences between groups. Estrogen administration for 1 year did not affect thyroid volume or the number and volume of thyroid nodules in postmenopausal women.

  16. Dentin caries risk indicators in 1-year-olds. A two year follow-up study.

    PubMed

    Hultquist, Ann Ingemansson; Bågesund, Mats

    2016-11-01

    Early childhood caries (ECC) risk factors are suspected to vary between regions with different caries prevalence. Identify ECC risk factors for 1-year-olds predicting dentin caries at 3 years of age in a region with low caries prevalence. Caries risk was assessed by dental hygienist or dental assistant in 779 one-year-olds. The oral mutans streptococci (MS) score was performed from a tooth surface or (in pre-dentate children) from oral mucosa. A parental questionnaire with questions regarding family factors (siblings with or without caries), general health, food habits (night meals, breastfeeding, other beverage than water), oral hygiene habits and emerged teeth were answered by parents of the 1-year-olds. Dentin caries was assessed when the children were 3-year-olds. Simple and multiple logistic regression analyses were used for identification of caries-associated factors. An increased caries risk was assessed in 4.4% of the 1-year-olds. Dentin caries was found in 2.6% of the 3-year-olds. Caries risk at 1 year was associated with caries at 3 years (OR = 6.5, p = .002). Multiple regression analysis found the variables Beverages other than water (OR = 7.1, p < 0.001), Caries in sibling (OR = 4.8, p = .002), High level of MS (score 2-3) (OR = 3.4, p = .03) and Night meal (OR = 3.0, p = .03) to be associated with caries. The single variables Beverage other than water between meals and Caries in sibling were more reliable than Caries risk assessed performed by dental personnel. Behavioural, family and microbial factors are important when assessing caries risk among 1-year-olds in a region with low caries experience.

  17. Endoscopic sleeve gastroplasty with 1-year follow-up: factors predictive of success

    PubMed Central

    Lopez-Nava, G.; Galvao, M.; Bautista-Castaño, I.; Fernandez-Corbelle, J. P.; Trell, M.

    2016-01-01

    Background and study aims: Bariatric endoscopy has emerged as an aid in the nonsurgical treatment of obesity. The objective of this study is to critically provide the results and follow-up of endoscopic sleeve gastroplasty 1 year after the procedure. Patients and methods: Prospective single-center follow-up study of 25 patients (5 men, 20 women) who underwent flexible endoscopic suturing for endoluminal gastric volume reduction. A multidisciplinary team provided post-procedure care. Patient outcomes were recorded at 1 year after the procedure. Linear regression analysis was done to evaluate the variables associated with best results at 1 year of follow-up. Results: Mean body mass index (BMI) was 38.5 ± 4.6 kg/m2 (range 30 – 47) and mean age 44.5 ± 8.2 years (range 29 – 60). At 1 year, 22 patients continued with the follow-up (2 dropped out at 6 months and 1 at 3 months). There were no major intra-procedural, early, or delayed adverse events. Mean BMI loss was 7.3 ± 4.2 kg/m2, and mean percentage of total body weight loss was 18.7 ± 10.7 at 1 year. In the linear regression analysis, adjusted by initial BMI, variables associated with %TBWL involved the frequency of nutritional (β = 0.563, P = 0.014) and psychological contacts (β = 0.727, P = 0.025). The number of nutritional and psychological contacts were predictive of good weight loss results. Conclusions: Endoscopic sleeve gastroplasty is a feasible, reproducible, and effective procedure to treat obesity. Nutritional and psychological interaction are predictive of success. PMID:26878054

  18. Risk factors for 1-year mortality in patients with nontraumatic intracranial hemorrhage requiring intensive care.

    PubMed

    Junttila, E K; Koskenkari, J; Romppainen, N; Ohtonen, P P; Karttunen, A; Ala-Kokko, T I

    2011-10-01

    Mortality in patients with intracranial hemorrhage remains high. The aim of this study was to determine the 1-year survival and potential risk factors for 1-year mortality in patients with nontraumatic intracranial hemorrhage requiring intensive care. This was a 3-year (2005-2007) retrospective study in a university-level intensive care unit (ICU). Patient characteristics, level of consciousness, and radiological findings of the primary head computed tomography were recorded on admission. Sequential Organ Failure Assessment scores were recorded during the ICU stay. Patients were divided into two groups: subarachnoid hemorrhage (SAH) group and intracerebral hemorrhage (ICH) group. Kaplan-Meier survival curves were constructed, and independent risk factors were determined using Cox proportional hazards regression analyses. Two hundred twenty-nine patients were analyzed. The 1-year mortality rate was 32% in patients with SAH and 44% in patients with ICH. The risk factors for 1-year mortality in both groups were unconsciousness on admission [SAH: hazard ratio (HR) 6.2, P = 0.017 and ICH: HR 3.0, P = 0.004] and renal failure during the ICU stay (SAH: HR 2.5, P = 0.021 and ICH: HR 3.6, P = 0.021). Risk factors specific to the type of hemorrhage were the presence of ICH (HR 2.0, P = 0.033) and diffuse cerebral edema (HR 2.3, P = 0.017) in the SAH group and a prior use of warfarin (HR 5.1, P = 0.016) in the ICH group. In addition to decreased level of consciousness on admission, renal failure during the ICU stay is an independent risk factor for 1-year mortality in nontraumatic SAH as well as ICH. 2011 The Authors Acta Anaesthesiologica Scandinavica, 2011 The Acta Anaesthesiologica Scandinavica Foundation.

  19. Reliability of a spinal metastasis prognostic score to model 1-year survival.

    PubMed

    Goodwin, C Rory; Schoenfeld, Andrew J; Abu-Bonsrah, Nancy A; Garzon-Muvdi, Tomas; Sankey, Eric W; Harris, Mitchel B; Sciubba, Daniel M

    2016-09-01

    Predicting survival after surgery for patients with metastatic spine disease can be challenging, with multiple variables that can influence a patient's overall survival. Predictive models have been developed to assist clinicians in providing a prognosis for patients. Recently, Ghori et al. reported a composite model taking into account a modified Bauer score, preoperative albumin, and ambulatory status of patients with spinal metastasis. Using an independent cohort, we sought to assess the reliability and validity of this composite model to predict 1-year survival in patients diagnosed with metastatic cancer to the spine. This study aimed to assess the reliability and validity of the Ghori et al. composite model to predict 1-year survival in patients diagnosed with metastatic cancer to the spine, using an independent cohort. A retrospective study was carried out. The sample comprised 161 patients with spinal metastasis undergoing surgery. Patients' modified Bauer score, preoperative albumin, and ambulatory status were assessed. This study used a retrospective analysis of 161 patients with spinal metastasis who underwent surgical management from 2007 to 2013. The ability of this composite model to predict 1-year survival was compared with actual patient survival using multivariable logistic regression to control for confounders, as well as post-regression diagnostics. Our analysis revealed significantly lower 1-year mortality among patients with higher composite scores as compared with those with lower scores. Strong associations between scores and survival were appreciated in unadjusted analysis. The final model was able to account for 80% of the variation in the 1-year survival, and there was no evidence of lack of fit. This study demonstrates, in an independent cohort of spinal metastases patients, that a composite model taking into account the ambulatory status, serum albumin, and modified Bauer score is able to better predict postoperative survival. These

  20. Spiritual absence and 1-year mortality after hematopoietic stem cell transplant.

    PubMed

    Pereira, Deidre B; Christian, Lisa M; Patidar, Seema; Bishop, Michelle M; Dodd, Stacy M; Athanason, Rebecca; Wingard, John R; Reddy, Vijay S

    2010-08-01

    Religiosity and spirituality have been associated with better survival in large epidemiologic studies. This study examined the relationship between spiritual absence and 1-year all-cause mortality in allogeneic hematopoietic stem cell transplant (HSCT) recipients. Depression and problematic compliance were examined as possible mediators of a significant spiritual absence-mortality relationship. Eighty-five adults (mean = 46.85 years old, SD = 11.90 years) undergoing evaluation for allogeneic HSCT had routine psychologie evaluation prior to HSCT admission. The Millon Behavioral Medicine Diagnostic was used to assess spiritual absence, depression, and problematic compliance, the psychosocial predictors of interest. Patient status at 1 year and survival time in days were abstracted from medical records. Cox regression analysis was used to examine the relationship between the psychosocial factors of interest and mortality after adjusting for relevant biobehavioral factors. Twenty-nine percent (n = 25) of participants died within 1 year of HSCT. After covarying for disease type, individuals with the highest spiritual absence and problematic compliance scores were significantly more likely to die 1-year post-HSCT (hazard ratio [HR] = 2.49, P = .043 and HR = 3.74, P = .029, respectively), particularly secondary to infection, sepsis, or graft-versus-host disease (GVHD) (HR = 4.56, P = .01 and HR = 5.61, P = .014), relative to those without elevations on these scales. Depression was not associated with 1-year mortality, and problematic compliance did not mediate the relationship between spiritual absence and mortality. These preliminary results suggest that both spiritual absence and problematic compliance may be associated with poorer survival following HSCT. Future research should examine these relations in a larger sample using a more comprehensive assessment of spirituality.

  1. MRI Technologies in Recent Human Brain Mapping

    NASA Astrophysics Data System (ADS)

    Sasaki, Yuka

    The recent magnetic resonance imaging (MRI) technology and techniques used in human brain mapping are remarkable. They are getting, faster, stronger and better. The advanced MRI technologies and techniques include, but not to limited to, the magnetic resonance imaging at higher magnetic field strengths, diffusion tensor imaging, multimodal neuroimaging, and monkey functional MRI. In this article, these advanced MRI techniques are briefly overviewed.

  2. [Standartization of MRI studies in multiple sclerosis].

    PubMed

    Bryukhov, V V; Krotenkova, I A; Morozova, S N; Krotenkova, M V

    2016-01-01

    The use of magnetic resonance imaging (MRI) in patients with multiple sclerosis has markedly increased in recent years. The main task of the MRI studies after the diagnosis of multiple sclerosis is to assess the dynamics of MRI for determining disease progression and monitoring the efficacy of therapy. In this regard, it is very important to obtain the most identical baseline and follow-up MRI that is possible when a single standard protocol is used. This article presents the protocol of brain MRI and spinal cord MRI and interpretation of MRI studies in patients with multiple sclerosis.

  3. Progression of brain atrophy in PSP and CBS over 6 months and 1 year.

    PubMed

    Dutt, Shubir; Binney, Richard J; Heuer, Hilary W; Luong, Phi; Attygalle, Suneth; Bhatt, Priyanka; Marx, Gabe A; Elofson, Jonathan; Tartaglia, Maria C; Litvan, Irene; McGinnis, Scott M; Dickerson, Bradford C; Kornak, John; Waltzman, Dana; Voltarelli, Lisa; Schuff, Norbert; Rabinovici, Gil D; Kramer, Joel H; Jack, Clifford R; Miller, Bruce L; Rosen, Howard J; Boxer, Adam L

    2016-11-08

    To examine the utility and reliability of volumetric MRI in measuring disease progression in the 4 repeat tauopathies, progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS), to support clinical development of new tau-directed therapeutic agents. Six- and 12-month changes in regional MRI volumes and PSP Rating Scale scores were examined in 55 patients with PSP and 33 patients with CBS (78% amyloid PET negative) compared to 30 normal controls from a multicenter natural history study. Longitudinal voxel-based morphometric analyses identified patterns of volume loss, and region-of-interest analyses examined rates of volume loss in brainstem (midbrain, pons, superior cerebellar peduncle), cortical, and subcortical regions based on previously validated atlases. Results were compared to those in a replication cohort of 226 patients with PSP with MRI data from the AL-108-231 clinical trial. Patients with CBS exhibited greater baseline atrophy and greater longitudinal atrophy rates in cortical and basal ganglia regions than patients with PSP; however, midbrain and pontine atrophy rates were similar. Voxel-wise analyses showed distinct patterns of regional longitudinal atrophy in each group as compared to normal controls. The midbrain/pons volumetric ratio differed between diagnoses but remained stable over time. In both patient groups, brainstem atrophy rates were correlated with disease progression measured using the PSP Rating Scale. Volume loss is quantifiable over a period of 6 months in CBS and PSP. Future clinical trials may be able to combine CBS and PSP to measure therapeutic effects. © 2016 American Academy of Neurology.

  4. Magnetic Resonance Imaging (MRI) Safety

    MedlinePlus

    ... radiation. Instead, MRI uses a powerful magnetic field, radio waves, rapidly changing magnetic fields, and a computer to ... in most of the body's tissues. The applied radio waves then cause these protons to produce signals that ...

  5. A tonsillolith seen on MRI.

    PubMed

    el-Sherif, I; Shembesh, F M

    1997-01-01

    A case of a large tonsillolith visualized by magnetic resonance imaging is presented. Although otolaryngologists are well aware of this entity, few radiologists are. The importance of distinguishing tonsilloliths from other structures by MRI is discussed.

  6. Metalloprotein-based MRI probes

    PubMed Central

    Matsumoto, Yuri; Jasanoff, Alan

    2013-01-01

    Metalloproteins have long been recognized as key determinants of endogenous contrast in magnetic resonance imaging (MRI) of biological subjects. More recently, both natural and engineered metalloproteins have been harnessed as biotechnological tools to probe gene expression, enzyme activity, and analyte concentrations by MRI. Metalloprotein MRI probes are paramagnetic and function by analogous mechanisms to conventional gadolinium or iron oxide-based MRI contrast agents. Compared with synthetic agents, metalloproteins typically offer worse sensitivity, but the possibilities of using protein engineering and targeted gene expression approaches in conjunction with metalloprotein contrast agents are powerful and sometimes definitive strengths. This review summarizes theoretical and practical aspects of metalloprotein-based contrast agents, and discusses progress in the exploitation of these proteins for molecular imaging applications. PMID:23376346

  7. Arteriovenous fistula complication following MRI

    PubMed Central

    Kirkman, Danielle; Junglee, Naushad; Mullins, Paul; Macdonald, Jamie Hugo

    2012-01-01

    Health professionals should be aware of medical procedures that cause vascular access complications. This case describes a haemodialysis patient who experienced pain, swelling and bruising over a radiocephalic fistula following MRI. Exactly the same signs and symptoms were evident following a second scan performed 3 months later. Plausible explanations include a radio frequency-induced electrical current being formed at the arteriovenous fistula, or varying gradients of the MRI sequence stimulating peripheral nerves, leading to a site of increased tissue stimulation. Of note, a juxta-anastomotic venous stenosis was confirmed by fistulogram 4 days after the second scan, although whether this access failure was due to the MRI scan per se could not be ascertained. Nevertheless, these previously undocumented observations suggest that careful patient and fistula monitoring is required when completing MRI scans in those with an arteriovenous fistula. PMID:22927271

  8. Arteriovenous fistula complication following MRI.

    PubMed

    Kirkman, Danielle; Junglee, Naushad; Mullins, Paul; Macdonald, Jamie Hugo

    2012-08-27

    Health professionals should be aware of medical procedures that cause vascular access complications. This case describes a haemodialysis patient who experienced pain, swelling and bruising over a radiocephalic fistula following MRI. Exactly the same signs and symptoms were evident following a second scan performed 3 months later. Plausible explanations include a radio frequency-induced electrical current being formed at the arteriovenous fistula, or varying gradients of the MRI sequence stimulating peripheral nerves, leading to a site of increased tissue stimulation. Of note, a juxta-anastomotic venous stenosis was confirmed by fistulogram 4 days after the second scan, although whether this access failure was due to the MRI scan per se could not be ascertained. Nevertheless, these previously undocumented observations suggest that careful patient and fistula monitoring is required when completing MRI scans in those with an arteriovenous fistula.

  9. Prognostic role of D-dimer for in-hospital and 1-year mortality in exacerbations of COPD

    PubMed Central

    Hu, Guoping; Wu, Yankui; Zhou, Yumin; Wu, Zelong; Wei, Liping; Li, Yuqun; Peng, GongYong; Liang, Weiqiang; Ran, Pixin

    2016-01-01

    Background and objective Serum D-dimer is elevated in respiratory disease. The objective of our study was to investigate the effect of D-dimer on in-hospital and 1-year mortality after acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Methods Upon admission, we measured 343 AECOPD patients’ serum D-dimer levels and arterial blood gas analysis, and recorded their clinical characteristics. The level of D-dimer that discriminated survivors and non-survivors was determined using a receiver operator curve (ROC). The risk factors for in-hospital mortality were identified through univariate analysis and multiple logistic regression analyses. To evaluate the predictive role of D-dimer for 1-year mortality, univariate and multivariate Cox regression analyses were performed. Results In all, 28 patients died, and 315 patients survived in the in-hospital period. The group of dead patients had lower pH levels (7.35±0.11 vs 7.39±0.05, P<0.0001), higher D-dimer, arterial carbon dioxide tension (PaCO2), C-reactive protein (CRP), and blood urea nitrogen (BUN) levels (D-dimer 2,244.9±2,310.7 vs 768.2±1,078.4 µg/L, P<0.0001; PaCO2: 58.8±29.7 vs 46.1±27.0 mmHg, P=0.018; CRP: 81.5±66, P=0.001; BUN: 10.20±6.87 vs 6.15±3.15 mmol/L, P<0.0001), and lower hemoglobin levels (118.6±29.4 vs 128.3±18.2 g/L, P=0.001). The areas under the ROC curves of D-dimer for in-hospital death were 0.748 (95% confidence interval (CI): 0.641–0.854). D-dimer ≥985 ng/L was a risk factor for in-hospital mortality (relative risk =6.51; 95% CI 3.06–13.83). Multivariate logistic regression analysis also showed that D-dimer ≥985 ng/L and heart failure were independent risk factors for in-hospital mortality. Both univariate and multivariate Cox regression analyses showed that D-dimer ≥985 ng/L was an independent risk factor for 1-year death (hazard ratio (HR) 3.48, 95% CI 2.07–5.85 for the univariate analysis; and HR 1.96, 95% CI 1.05–3.65 for the multivariate analysis

  10. Comparison of CT and MRI in Diagnosis of Laryngeal Carcinoma with Anterior Vocal Commissure Involvement

    PubMed Central

    Wu, Jian-hui; Zhao, Jing; Li, Zeng-hong; Yang, Wei-qiang; Liu, Qi-hong; Yang, Zhi-yun; Liao, Bing; Li, Xiao-ling; Wang, Bin; Qin, Hao; Luo, Jie; Lv, Ke-xing; Wen, Wei-ping; Lei, Wen-bin

    2016-01-01

    This study aimed to compare the accuracy of CT and MRI in determining the invasion of thyroid cartilage by and the T staging of laryngeal carcinoma with anterior vocal commissure (AVC) involvement. A total of 26 cases of laryngeal carcinomas with AVC involvement from May 2012 to January 2014 underwent enhanced CT and MRI scan, out of whom 6 patients also underwent diffusion-weighted magnetic resonance imaging(DWI). T staging and thyroid cartilage involvement were evaluated. All the surgical specimens underwent serial section and were reviewed by two senior pathologists independently. When compared with pathologic staging, the accuracy was 88.46% (23/26) of MRI scan (with a 95% confidence interval 37~77%) and 57.69% (15/26) of CT scan (with a 95% confidence interval 70~98%), respectively (P < 0.01). We also reported three cases who were misdiagnosed on CT or MRI about either the thyroid cartilage was involved or not, and one case of preliminary study of DWI. Compared to CT, MRI exhibited a higher accuracy rate on T staging of laryngeal carcinomas with AVC involvement. Combined utility of CT and MRI could help improve the accuracy of assessment of thyroid cartilage involvement and T staging of laryngeal carcinomas with AVC involvement. PMID:27480073

  11. In-hospital and 1-year mortality in patients undergoing early surgery for prosthetic valve endocarditis.

    PubMed

    Lalani, Tahaniyat; Chu, Vivian H; Park, Lawrence P; Cecchi, Enrico; Corey, G Ralph; Durante-Mangoni, Emanuele; Fowler, Vance G; Gordon, David; Grossi, Paolo; Hannan, Margaret; Hoen, Bruno; Muñoz, Patricia; Rizk, Hussien; Kanj, Souha S; Selton-Suty, Christine; Sexton, Daniel J; Spelman, Denis; Ravasio, Veronica; Tripodi, Marie Françoise; Wang, Andrew

    2013-09-09

    There are limited prospective, controlled data evaluating survival in patients receiving early surgery vs medical therapy for prosthetic valve endocarditis (PVE). To determine the in-hospital and 1-year mortality in patients with PVE who undergo valve replacement during index hospitalization compared with patients who receive medical therapy alone, after controlling for survival and treatment selection bias. Participants were enrolled between June 2000 and December 2006 in the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS), a prospective, multinational, observational cohort of patients with infective endocarditis. Patients hospitalized with definite right- or left-sided PVE were included in the analysis. We evaluated the effect of treatment assignment on mortality, after adjusting for biases using a Cox proportional hazards model that included inverse probability of treatment weighting and surgery as a time-dependent covariate. The cohort was stratified by probability (propensity) for surgery, and outcomes were compared between the treatment groups within each stratum. Valve replacement during index hospitalization (early surgery) vs medical therapy. In-hospital and 1-year mortality. Of the 1025 patients with PVE, 490 patients (47.8%) underwent early surgery and 535 individuals (52.2%) received medical therapy alone. Compared with medical therapy, early surgery was associated with lower in-hospital mortality in the unadjusted analysis and after controlling for treatment selection bias (in-hospital mortality: hazard ratio [HR], 0.44 [95% CI, 0.38-0.52] and lower 1-year mortality: HR, 0.57 [95% CI, 0.49-0.67]). The lower mortality associated with surgery did not persist after adjustment for survivor bias (in-hospital mortality: HR, 0.90 [95% CI, 0.76-1.07] and 1-year mortality: HR, 1.04 [95% CI, 0.89-1.23]). Subgroup analysis indicated a lower in-hospital mortality with early surgery in the highest surgical propensity quintile (21

  12. Three-dimensional assessment of mandibular advancement 1 year after surgery

    PubMed Central

    de Assis Ribeiro Carvalho, Felipe; Cevidanes, Lucia Helena Soares; Motta, Alexandre Trindade Simões da; de Oliveira Almeida, Marco Antonio; Phillips, Ceib

    2010-01-01

    Introduction This prospective observational study evaluated changes in the 3-dimensional position and remodeling of the mandibular rami, condyles, and chin at splint removal and 1 year after mandibular advancement surgery. Methods Presurgery, splint removal (4–6 weeks postsurgery), and 1-year postsurgery cone-beam computed tomography scans of 27 subjects were used. Superimposition on the cranial base was used to assess positional or remodeling changes in the anatomic regions of interest. Surface distance displacements were visually displayed and quantified by 3-dimensional color maps. A 1-sample t test was used to assess the average postsurgical changes of each region of interest. The level of significance was set at 0.05. Results After antero-inferior chin displacement with surgery (mean, 6.81 ± 3.2 mm at splint removal), the average 1-year post-surgery displacement was not statistically significant (P = 0.44). Postsurgical adaptations greater than 2 mm were observed in 48% of the patients: 16% with an additional anterior-inferior displacement of the chin of 2 to 4 mm, and 4% with ≥4 mm; 20% had postero-superior movement of 2 to 4 mm, and 8% had postero-superior movement of ≥4 mm. The condyles tended to move, on average, ≤2 mm supero-posteriorly with surgery, and this small positional displacement was maintained 1 year postsurgery (right condyle, P = 0.58; left, P = 0.88). The rami exhibited outward (lateral) movements with surgery, with greater displacement of the inferior part of the rami (≥2 mm in 65% of the subjects). This torque of the ramus with surgery was stable 1 year postsurgery. Conclusions Three-dimensional assessment of skeletal changes with mandibular advancement surgery shows that nearly half of the patients have >2 mm change in chin position from splint removal to the 1-year follow-up, with approximately equal chances of anterior and posterior movement. Torque of the rami usually occurs with mandibular advancement surgery. PMID:20381760

  13. Intravesical ureteric reimplantation for primary obstructed megaureter in infants under 1 year of age.

    PubMed

    Jude, Emily; Deshpande, Aniruddh; Barker, Andrew; Khosa, Japinder; Samnakay, Naeem

    2017-02-01

    This study aimed to assess the outcome of intravesical ureteric reimplantation for primary obstructed megaureter (POM) performed in infants under 1 year of age. A retrospective cohort study was carried out of all infants undergoing intravesical ureteric reimplantation surgery for POM at two pediatric centers in the 12 years between 2003 and 2014. Outcomes were compared with those of children aged over 1 year undergoing intravesical reimplantation for POM during this period. Follow-up was until November 2015. Thirty-seven megaureters in 34 infants were reimplanted, at median age 5.2 months (Table). Operative success was 97%, with one out of 34 patients (3%) requiring reoperation for recurrent ureteric obstruction. Renal preservation was high. One patient of 34 (3%), who had bilateral congenital renal dysplasia, showed evidence of decline in renal function. Five patients of 34 (15%) had postoperative urinary tract infections (UTIs). Four (13%) of those toilet trained had some symptoms of lower urinary tract dysfunction (LUTD). Three patients (9%) who had congenitally dysplastic kidneys developed hypertension. Comparatively, 14 children with POM underwent reimplantation over 1 year of age. Operative success was 86%, with two children requiring reoperation for recurrent stenosis. Both had evidence of bladder dysfunction before surgery, and thickened bladder walls noted during surgery. One of 14 (7%) had a decline in ipsilateral renal function after recurrent stenosis. Two (14%) had postoperative UTI. Three (25%) had evidence of LUTD. There are few data about feasibility and long-term outcomes specifically of ureteric reimplantation for POM in infancy. This is the first study to document long-term outcomes of intravesical ureteric reimplantation in infancy for POM. The recently published British Association of Paediatric Urologists consensus statement supports delaying definitive reimplantation surgery for POM that requires intervention until after 1 year of age. There

  14. MRI of the musculoskeletal system.

    PubMed

    Seeger, L L

    1992-04-01

    MRI is rapidly altering the presurgical evaluation for many forms of musculoskeletal pathology, and the indications for MRI will undoubtedly continue to grow. Because of the complexity of this modality and the ability to totally "miss" pathology by the inappropriate choice of imaging plane or pulse sequence, cooperation between the orthopedic surgeon and the radiologist is essential. A close working relationship is required for maximum diagnostic information to be obtained with each examination and for optimal patient care.

  15. Quantitative pharmacologic MRI in mice

    PubMed Central

    Perles-Barbacaru, Teodora-Adriana; Procissi, Daniel; Demyanenko, Andrey V.; Jacobs, Russell E.

    2011-01-01

    Pharmacologic MRI (phMRI) uses functional MRI techniques to provide a non-invasive in vivo measurement of the hemodynamic effects of drugs. The cerebral blood volume change (ΔCBV) serves as a surrogate for neuronal activity via neurovascular coupling mechanisms. By assessing the location and time course of brain activity in mouse mutant studies, phMRI can provide valuable insights into how different behavioral phenotypes are expressed in differing brain activity response to drug challenge. In this report, we evaluate the utility of three different intravascular ultrasmall superparamagnetic iron oxide (USPIO) contrast agents for phMRI using a gradient-echo technique with temporal resolution of one minute at high magnetic field. The tissue half life of the USPIOs was studied using a nonlinear detrending model. All three studied USPIOs are candidates for CBV weighted phMRI-experiments, with r2/r1 ratios ≥ 20 and apparent half-lives ≥ 1.5 h at the described doses. An echo time of about 10 ms or longer results in a fCNR > 75 after USPIO injection, with negligible decrease during 1.5 to 2 hours. phMRI experiments were conducted at 7T using cocaine as a psychotropic substance and acetazolamide, a global vasodilator, as a positive control. Cocaine acts as a dopamine-serotonin-norepinephrine reuptake inhibitor, increasing extracellular concentrations of these neurotransmitters and thus increasing dopaminergic, serotonergic and noradrenergic neurotransmission. phMRI indicated that CBV was reduced in the normal mouse brain after cocaine challenge, with largest effects in nucleus accumbens, while after acetazolamide the blood volume was increased in both cerebral and extra-cerebral tissue. PMID:21793079

  16. Potential Clinical Applications for Spinal Functional MRI

    PubMed Central

    Kornelsen, Jennifer; Mackey, Sean

    2010-01-01

    Functional MRI (fMRI) of the spinal cord is a noninvasive technique for obtaining information regarding spinal cord neuronal function. This article provides a brief overview of recent developments in spinal cord fMRI and outlines potential applications, as well as the limitations that must be overcome, for using spinal fMRI in the clinic. This technique is currently used for research purposes, but significant potential exists for spinal fMRI to become an important clinical tool. PMID:17504642

  17. MRI-Guided Electrophysiology Intervention*

    PubMed Central

    Halperin, Henry R.; Kolandaivelu, Aravindan

    2010-01-01

    Catheter ablation is a first-line treatment for many cardiac arrhythmias and is generally performed under X-ray fluoroscopy guidance. However, current techniques for ablating complex arrhythmias such as atrial fibrillation and ventricular tachycardia are associated with sub-optimal success rates and prolonged radiation exposure. Pre-procedure 3-D magnetic resonance imaging (MRI) has improved understanding of the anatomic basis of complex arrhythmias and is being used for planning and guidance of ablation procedures. A particular strength of MRI compared to other imaging modalities is the ability to visualize ablation lesions. Post-procedure MRI is now being applied to assess ablation lesion location and permanence with the goal of identifying factors leading to procedure success and failure. In the future, intra-procedure real-time MRI, together with the ability to image complex 3-D arrhythmogenic anatomy and target additional ablation to regions of incomplete lesion formation, may allow for more successful treatment of even complex arrhythmias without exposure to ionizing radiation. Development of clinical grade MRI-compatible electrophysiology devices is required to transition intra-procedure MRI from preclinical studies to more routine use in patients. PMID:23908787

  18. [Recent advances in newborn MRI].

    PubMed

    Morel, B; Hornoy, P; Husson, B; Bloch, I; Adamsbaum, C

    2014-07-01

    The accurate morphological exploration of the brain is a major challenge in neonatology that advances in magnetic resonance imaging (MRI) can now provide. MRI is the gold standard if an hypoxic ischemic pathology is suspected in a full term neonate. In prematures, the specific role of MRI remains to be defined, secondary to US in any case. We present a state of the art of hardware and software technical developments in MRI. The increase in magnetic field strength (3 tesla) and the emergence of new MRI sequences provide access to new information. They both have positive and negative consequences on the daily clinical data acquisition use. The semiology of brain imaging in full term newborns and prematures is more extensive and complex and thereby more difficult to interpret. The segmentation of different brain structures in the newborn, even very premature, is now available. It is now possible to dissociate the cortex and basal ganglia from the cerebral white matter, to calculate the volume of anatomical structures, which improves the morphometric quantification and the understanding of the normal and abnormal brain development. MRI is a powerful tool to analyze the neonatal brain. The relevance of the diagnostic contribution requires an adaptation of the parameters of the sequences to acquire and of the image processing methods.

  19. Diffusion MRI in the heart

    PubMed Central

    Mekkaoui, Choukri; Reese, Timothy G.; Jackowski, Marcel P.; Bhat, Himanshu

    2015-01-01

    Diffusion MRI provides unique information on the structure, organization, and integrity of the myocardium without the need for exogenous contrast agents. Diffusion MRI in the heart, however, has proven technically challenging because of the intrinsic non‐rigid deformation during the cardiac cycle, displacement of the myocardium due to respiratory motion, signal inhomogeneity within the thorax, and short transverse relaxation times. Recently developed accelerated diffusion‐weighted MR acquisition sequences combined with advanced post‐processing techniques have improved the accuracy and efficiency of diffusion MRI in the myocardium. In this review, we describe the solutions and approaches that have been developed to enable diffusion MRI of the heart in vivo, including a dual‐gated stimulated echo approach, a velocity‐ (M 1) or an acceleration‐ (M 2) compensated pulsed gradient spin echo approach, and the use of principal component analysis filtering. The structure of the myocardium and the application of these techniques in ischemic heart disease are also briefly reviewed. The advent of clinical MR systems with stronger gradients will likely facilitate the translation of cardiac diffusion MRI into clinical use. The addition of diffusion MRI to the well‐established set of cardiovascular imaging techniques should lead to new and complementary approaches for the diagnosis and evaluation of patients with heart disease. © 2015 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd. PMID:26484848

  20. Hybrid-SPRITE MRI

    NASA Astrophysics Data System (ADS)

    Xiao, Dan; Balcom, Bruce J.

    2013-10-01

    In a FID based frequency encoding MRI experiment the central part of k-space is not generally accessible due to the probe dead time. This portion of k-space is however crucial for image reconstruction. SPRITE (Single Point Ramped Imaging with T1 Enhancement), SPI with a linearly ramped phase encode gradient, has been employed to image short relaxation time systems for many years with great success. It is a robust imaging method in significant measure because it provides acquisition of high quality k-space origin data. We propose a new sampling scheme, termed hybrid-SPRITE, combining phase and frequency encoding to ensure high quality images with reduced acquisition times, reduced gradient duty cycle and increased sensitivity. In hybrid-SPRITE, numerous time domain points are collected to assist image reconstruction. An Inverse Non-uniform Discrete Fourier Transform (INDFT) is employed in 1D applications. A pseudo-polar grid is exploited in 2D hybrid-SPRITE for rapid and accurate image reconstruction.

  1. Oahu Solar Measurement Grid (1-Year Archive): 1-Second Solar Irradiance; Oahu, Hawaii (Data)

    DOE Data Explorer

    Sengupta, M.; Andreas, A.

    2010-03-16

    Seventeen measurement stations in the south western region of the island of Oahu collected data at 1-second intervals over the course of a year. The sensors are located in a 1-kilometer grid and the information then can be used to predict what PV outputs might be at 1-second intervals for medium-sized and large PV systems. This DOE-funded study by NREL supports the Hawaii Clean Energy Initiative (HCEI), a multifaceted program to substantially increase the use of renewable energy in Hawaii.

  2. Giant, dissecting, high-pressure pulmonary artery aneurysm: case report of a 1-year natural course.

    PubMed

    Smalcelj, Anton; Brida, Vojtjeh; Samarzija, Miroslav; Matana, Ante; Margetic, Eduard; Drinkovic, Niksa

    2005-01-01

    We report the rare subchronic clinical course of a giant, dissecting pulmonary artery aneurysm in an oligosymptomatic middle-aged woman who had idiopathic pulmonary hypertension. Diagnosis was simple with the use of echocardiography and multislice computed tomography. Conversely, deciding on the treatment was difficult, because prominent surgeons declined to perform surgical repair of the aneurysm and recommended heart-lung transplantation. Therefore, we were forced to treat our patient medically. She survived for 1 year, including 8 months of treatment with sildenafil, and then died suddenly while awaiting transplantation. Our patient, who had a dissecting, high-pressure pulmonary artery aneurysm, had an unexpectedly stable and uneventful clinical course for 1 year, which, under more favorable circumstances, might have provided enough time for heart-lung transplantation to be performed.

  3. Early Neuropsychological Tests as Correlates of Productivity 1 Year after Traumatic Brain Injury: A Preliminary Matched Case-Control Study

    ERIC Educational Resources Information Center

    Ryu, Won Hyung A.; Cullen, Nora K.; Bayley, Mark T.

    2010-01-01

    This study explored the relative strength of five neuropsychological tests in correlating with productivity 1 year after traumatic brain injury (TBI). Six moderate-to-severe TBI patients who returned to work at 1-year post-injury were matched with six controls who were unemployed after 1 year based on age, severity of injury, and Functional…

  4. Early Neuropsychological Tests as Correlates of Productivity 1 Year after Traumatic Brain Injury: A Preliminary Matched Case-Control Study

    ERIC Educational Resources Information Center

    Ryu, Won Hyung A.; Cullen, Nora K.; Bayley, Mark T.

    2010-01-01

    This study explored the relative strength of five neuropsychological tests in correlating with productivity 1 year after traumatic brain injury (TBI). Six moderate-to-severe TBI patients who returned to work at 1-year post-injury were matched with six controls who were unemployed after 1 year based on age, severity of injury, and Functional…

  5. Intervals in evolutionary algorithms for global optimization

    SciTech Connect

    Patil, R.B.

    1995-05-01

    Optimization is of central concern to a number of disciplines. Interval Arithmetic methods for global optimization provide us with (guaranteed) verified results. These methods are mainly restricted to the classes of objective functions that are twice differentiable and use a simple strategy of eliminating a splitting larger regions of search space in the global optimization process. An efficient approach that combines the efficient strategy from Interval Global Optimization Methods and robustness of the Evolutionary Algorithms is proposed. In the proposed approach, search begins with randomly created interval vectors with interval widths equal to the whole domain. Before the beginning of the evolutionary process, fitness of these interval parameter vectors is defined by evaluating the objective function at the center of the initial interval vectors. In the subsequent evolutionary process the local optimization process returns an estimate of the bounds of the objective function over the interval vectors. Though these bounds may not be correct at the beginning due to large interval widths and complicated function properties, the process of reducing interval widths over time and a selection approach similar to simulated annealing helps in estimating reasonably correct bounds as the population evolves. The interval parameter vectors at these estimated bounds (local optima) are then subjected to crossover and mutation operators. This evolutionary process continues for predetermined number of generations in the search of the global optimum.

  6. Predicting levels of independence with expressing needs and ideas 1 year after severe brain injury.

    PubMed

    Pape, Theresa Louise-Bender; Guernon, Ann; Lundgren, Sandra; Patil, Vijaya; Herrold, Amy A; Smith, Bridget; Blahnik, Melanie; Picon, Linda M; Harton, Brett; Peterson, Michelle; Mallinson, Trudy; Hoffmann, Michael

    2013-08-01

    Severe brain injury (BI) is a catastrophic event often evolving into a complex chronic and severely disabling condition making activity participation possible only with sustained caregiving. One aspect of building sustainable caregiving is early provision of information about expected outcomes germane to patients and their caregivers. An analysis was conducted to determine whether 2 levels of independence with expressing needs and ideas 1-year after severe BI could be predicted using variables available early after injury. The authors examined a subsample (n = 79) of participants of an outcome study who received repeated neurobehavioral evaluations with the Disorders of Consciousness Scale (DOCS) and who were assessed 1 year after injury with the Functional Independence Measures (FIM). Explanatory variables included DOCS measures, patient characteristics, coexisting conditions, and interventions. The outcome is measured with the FIM Expression item. Optimal data analysis was used to construct multivariate classification tree models. The 2nd (p = .004) DOCS visual measure and seizure (p = .004) entered the final model providing 79% accuracy in classifying more or less independence with expressing needs and ideas at 1 year. The model will correctly identify 78% of future severe BI survivors who will have more independence and 82% of persons who will have less independence. For persons incurring severe BI, it is possible to predict, early after injury, more and less independence with expressing needs and ideas 1-year after injury. This evidence is 1 contribution to a larger body of evidence needed to enable early caregiver education about recovery expectations in terms of patient functioning relative to caregiving needs, which in turn will help build sustainable caregiving for this population.

  7. Six-month and 1-year continuation rates following postpartum insertion of implants and intrauterine devices.

    PubMed

    Woo, Irene; Seifert, Sara; Hendricks, Dacia; Jamshidi, Roxanne M; Burke, Anne E; Fox, Michelle C

    2015-12-01

    Studies show immediate postpartum (PP) insertion increases use of contraceptive implants and intrauterine devices (IUDs). Our objective was to compare the satisfaction and continuation rates of the two types of devices at 6 months and 1 year following PP insertion. We enrolled 133 women in a prospective cohort study following immediate PP insertion of an implant or IUD at two academic hospitals during 8 months of 2011. Subjects completed an enrollment survey during hospital admission and a follow-up phone survey 6 months and 1 year PP. At 6 months PP, 72% of subjects provided follow-up information. Implant users were more likely to be using the originally-placed device (40/41, 98% vs. 45/55, 82%, p=0.02); nine women reported IUD expulsions. When accounting for replacement of expelled IUDs, IUD continuation at 6 months was 89% yielding similar continuation rates between groups (p=0.12). At 1 year PP, 51% provided follow-up. Of those, 82% still had a LARC method in place with similar continuation by device type (84% for implants, 81% for IUDs, p=0.96). Overall, satisfaction was similarly high in both groups. Due to IUD expulsion, implants had a higher continuation rate than IUDs six months following immediate PP insertion. After replacement of expelled IUDs, continuation and satisfaction were similar for both devices at 6 months and 1 year. Placement of implants and IUDs immediately PP can lead to high satisfaction. Despite early IUD expulsions, continuation rates were similar to those placed outside of the immediate PP period. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Cognitive and affective assessment in day care versus institutionalized elderly patients: a 1-year longitudinal study

    PubMed Central

    Maseda, Ana; Balo, Aránzazu; Lorenzo–López, Laura; Lodeiro–Fernández, Leire; Rodríguez–Villamil, José Luis; Millán–Calenti, José Carlos

    2014-01-01

    Purpose Cognitive decline and depression are two common mental health problems that may create a need for long-term care among the elderly. In the last decade, the percentage of older adults who receive health care in nursing homes, day care centers, or home support services has increased in Europe. The objectives of this descriptive and nonrandomized longitudinal study were to evaluate and to compare the cognitive and affective evolution of day care versus institutionalized older patients through a 1-year period, and to assess the presence of cognitive and affective impairment as a function of the care setting. Patients and methods Ninety-four patients were assessed at baseline, and 63 (67.0%) were reassessed 1 year later. Neuropsychological assessment included measures of cognitive performance (general cognitive status, visuospatial, and language abilities) and affective status (depressive symptoms). Results Our findings indicated that the majority of the participants (day care and institutionalized patients) had mild–moderate cognitive impairment at baseline, which significantly increased in both groups after 1-year follow-up. However, the rate of change in global cognitive function did not significantly differ between groups over time. Regarding language abilities, naming function maintained among day care patients in comparison with institutionalized patients, who showed worse performance at follow-up. As regards to affective status, results revealed that institutionalized patients had a significant reduction in depressive symptoms at follow-up, when compared to day care patients. Results also highlight the high frequency of cognitive impairment and depressive symptoms regardless of the care setting. Conclusion Our findings revealed a similar global cognitive decline rate between patients receiving day care services and those residing in a nursing home at the 1-year follow-up, and slightly different trajectories in other outcomes such as naming function and

  9. Corneal Aberrations, Contrast Sensitivity, and Light Distortion in Orthokeratology Patients: 1-Year Results.

    PubMed

    Santolaria-Sanz, Elena; Cerviño, Alejandro; González-Méijome, José M

    2016-01-01

    Purpose. To evaluate the corneal higher-order aberrations (HOA), contrast sensitivity function (CSF), and light distortion (LD) in patients undergoing orthokeratology (OK). Methods. Twenty healthy subjects (mean age: 21.40 ± 8 years) with mean spherical equivalent refractive error M = -2.19 ± 0.97 D were evaluated at 1 day, 1 month, and 1 year after starting OK treatment. Monocular LD, photopic monocular CSF, and corneal HOA for 6 mm pupil size were measured. Results. LD showed an increase after the first night (p < 0.05) and recovery to baseline after 1 month, remaining stable after 1 year (p > 0.05). Spherical-like, coma-like, and secondary astigmatism HOA RMS increased significantly (p ≤ 0.022) from baseline to 1-month visit, remaining unchanged over the follow-up. Contrast sensitivity for medium frequencies (3.0, 4.24, and 6.00 cpd) was significantly correlated with LD parameters at baseline (r ≤ -0.529, p < 0.001). However, after 1 year of treatment, this correlation was only statistically significant for 12 cpd spatial frequency (r ≤ -0.565, p < 0.001). Spherical-like RMS for 6 mm pupil size correlated with irregularity of the LD (r = -0.420, p < 0.05) at the 1-year visit. Conclusion. LD experienced by OK patients recovers after one month of treatment and remains stable in the long term while optical aberrations remain significantly higher than baseline.

  10. Corneal Aberrations, Contrast Sensitivity, and Light Distortion in Orthokeratology Patients: 1-Year Results

    PubMed Central

    2016-01-01

    Purpose. To evaluate the corneal higher-order aberrations (HOA), contrast sensitivity function (CSF), and light distortion (LD) in patients undergoing orthokeratology (OK). Methods. Twenty healthy subjects (mean age: 21.40 ± 8 years) with mean spherical equivalent refractive error M = −2.19 ± 0.97 D were evaluated at 1 day, 1 month, and 1 year after starting OK treatment. Monocular LD, photopic monocular CSF, and corneal HOA for 6 mm pupil size were measured. Results. LD showed an increase after the first night (p < 0.05) and recovery to baseline after 1 month, remaining stable after 1 year (p > 0.05). Spherical-like, coma-like, and secondary astigmatism HOA RMS increased significantly (p ≤ 0.022) from baseline to 1-month visit, remaining unchanged over the follow-up. Contrast sensitivity for medium frequencies (3.0, 4.24, and 6.00 cpd) was significantly correlated with LD parameters at baseline (r ≤ −0.529, p < 0.001). However, after 1 year of treatment, this correlation was only statistically significant for 12 cpd spatial frequency (r ≤ −0.565, p < 0.001). Spherical-like RMS for 6 mm pupil size correlated with irregularity of the LD (r = −0.420, p < 0.05) at the 1-year visit. Conclusion. LD experienced by OK patients recovers after one month of treatment and remains stable in the long term while optical aberrations remain significantly higher than baseline. PMID:27867660

  11. Project FLAVOR: 1-Year Outcomes of a Multicultural, School-Based Smoking Prevention Curriculum for Adolescents.

    PubMed

    Unger, Jennifer B; Chou, Chih-Ping; Palmer, Paula H; Ritt-Olson, Anamara; Gallaher, Peggy; Cen, Steven; Lichtman, Kara; Azen, Stanley; Johnson, C Anderson

    2004-02-01

    To evaluate a multicultural smoking prevention curriculum, 16 schools were randomized to receive the multicultural curriculum or a standard curriculum and program effects on 1-year smoking initiation among 1430 never smokers were assessed. Hispanic boys who received the multicultural curriculum were less likely to initiate smoking than were those who received the standard curriculum; effects were insignificant among other groups. The prevention effect among Hispanic boys is encouraging, but additional research is needed to improve prevention effects among other groups.

  12. Proteinuria 1 year after renal transplantation is associated with impaired graft survival in children.

    PubMed

    Rosík, Tomáš; Chadimová, Mária; Dušek, Jiří; Háček, Jaromír; Šimánková, Naděžda; Vondrák, Karel; Zieg, Jakub; Seeman, Tomáš

    2015-10-01

    Proteinuria is a common manifestation of chronic kidney disease (CKD), and there is a high incidence of CDK and its complications following renal transplantation. However, little data are available on the association between proteinuria and graft/patient survival in the paediatric transplant population. The primary aim of this study was to investigate the associations between posttransplant proteinuria and graft/patient survival in children after renal transplantation. In this retrospective study, we screened all 91 children receiving renal allografts at a single institution between 1997 and 2007. The inclusion criteria were a functioning graft at 1 year posttransplant, data availability and no recurrence of focal-segmental glomerulosclerosis. The final cohort included 75 patients. Proteinuria was considered to be pathologic if the urinary protein/creatinine ratio was >30 mg/mmol. Donor and recipient characteristics, data on proteinuria, estimated glomerular filtration rate (eGFR) and rejection episodes were analysed. The most recent of the biopsies performed during the follow-up after 1 year posttransplant were analysed separately in the proteinuric group and the non-proteinuric group. Proteinuria at 1-year posttransplant was pathologic in 35 % of patients. The 5-year graft survival rate was significantly lower in the proteinuric group than in the non-proteinuric group (77 vs. 100 %; p < 0.001). Proteinuria at 1 year posttransplant was associated with reduced long-term graft survival independent of other risk factors, including decreased eGFR or episodes of acute corticosensitive and corticoresistant rejection. The most frequent histologic finding in the proteinuric group was chronic rejection. There was no significant difference in the 5-year patient survival rate between the proteinuric group and the non-proteinuric group. This study emphasizes the importance of proteinuria as a prognostic factor of renal allograft survival in children.

  13. Zonisamide for Weight Reduction in Obese Adults A 1-Year Randomized Controlled Trial

    PubMed Central

    Gadde, Kishore M.; Kopping, Mariko F.; Wagner, H. Ryan; Yonish, Gretchen M.; Allison, David B.; Bray, George A.

    2013-01-01

    SUMMARY Background Obese individuals who have failed to achieve adequate weight loss with lifestyle changes have limited non-surgical therapeutic options. We evaluated the efficacy and tolerability of zonisamide, an antiepileptic drug, for enhancing weight loss in obese patients receiving diet and lifestyle guidance. Methods This was a 1-year randomized, double-blind, placebo-controlled trial conducted between January 2006 and September 2011 at Duke University Medical Center. Patients were 225 obese (mean [SD] body mass index 37.6 [4.9]) women (134 [59.6%]) and men (91 [40.4%]) without diabetes. Interventions were daily dosing with placebo (n=74), zonisamide 200 mg (n=76), orzonisamide 400 mg (n=75), in addition to diet and lifestyle counseling by a dietitian for 1 year. Primary outcome was change in body weight at 1-year. Results Of the 225 randomized patients, 218 (97%) provided 1-year follow-up assessments. Change(least-squares mean) in body weight was -4.0 kg (−3.7%; 95% CI, −5.8 kg to −2.3 kg) for placebo, −4.4 kg (−3.9%; −6.1 to −2.6, P=.79vs placebo) for zonisamide 200 mg, and −7.3 kg (−6.8%; −9.0 to −5.6, P=.009vs placebo) for zonisamide 400 mg. In the categorical analysis,23 (31%) on placebo, 26 (34%; P=.71) on zonisamide 200 mg, and 41 (55%; P=.007) onzonisamide 400 mg achieved ≥5% weight loss; for ≥10% weight loss, the corresponding numbers were 6 (8%), 17 (22%; P=.022), and 24 (32%; P=.001). Gastrointestinal, nervous system and psychiatric adverse events occurred at a higher incidence with zonisamide than with placebo. Conclusion Zonisamide 400 mg/d moderately enhanced weight loss achieved with diet and lifestyle counseling, but had a high incidence of adverse events. PMID:23147455

  14. Development in pain and neurologic complaints after whiplash: a 1-year prospective study.

    PubMed

    Kasch, Helge; Bach, Flemming W; Stengaard-Pedersen, Kristian; Jensen, Troels S

    2003-03-11

    To prospectively examine the course of pain and other neurologic complaints in patients with acute whiplash injury and in controls with acute ankle injury. Patients with acute whiplash (n = 141) and ankle-injured controls (n = 40) were consecutively sampled, and underwent interview and examination after 1 week and 1, 3, 6, and 12 months. Outcome measures were pain intensity, pain frequency, and associated symptoms. Initial overall pain intensity above lower extremities (pain in neck, head, shoulder-arm, and low back) was similar in patients with whiplash (median Visual Analogue Scale [VAS](0-100) of 20 [25th and 75th percentile, 4, 39]) and ankle-injured controls (median VAS(0-100) of 15 [5, 34]). Whiplash-injured patients reported median overall VAS(0-100) pain intensity above lower extremities of 23 (12, 40) after 11 days and 14 (12, 40) after 1 year. Controls reported pain intensity of 0 (0, 4) after 12 days and 0 (0, 9) after 1 year. Reported overall pain frequency above lower extremities was 96% after 11 days and 74% after 1 year in whiplash-injured patients and 33% after 12 days and 47% after 1 year in controls. Associated neurologic symptoms were two to three times more common after whiplash injury. Correlation was found between pain intensity and associated symptoms in whiplash-injured patients but not controls. Pain occurs with high frequency but low intensity after whiplash and ankle injury. Associated neurologic symptoms were not correlated to pain in ankle-injured controls, but were correlated to pain in patients with whiplash injury. Persistent symptoms in whiplash-injured patients may be caused by both specific neck injury-related factors and nonspecific post-traumatic reactions. Disability was only encountered in the whiplash group.

  15. Declining financial capacity in mild cognitive impairment: A 1-year longitudinal study.

    PubMed

    Triebel, K L; Martin, R; Griffith, H R; Marceaux, J; Okonkwo, O C; Harrell, L; Clark, D; Brockington, J; Bartolucci, A; Marson, Daniel C

    2009-09-22

    To investigate 1-year change in financial capacity in relation to conversion from amnestic mild cognitive impairment (MCI) to dementia. Seventy-six cognitively healthy older controls, 25 patients with amnestic MCI who converted to Alzheimer-type dementia during the study period (MCI converters), and 62 patients with MCI who did not convert to dementia (MCI nonconverters) were administered the Financial Capacity Instrument (FCI) at baseline and 1-year follow-up. Performance on the FCI domain and global scores was compared within and between groups using multivariate repeated-measures analyses. At baseline, controls performed better than MCI converters and nonconverters on almost all FCI domains and on both FCI total scores. MCI converters performed below nonconverters on domains of financial concepts, cash transactions, bank statement management, and bill payment and on both FCI total scores. At 1-year follow-up, MCI converters showed significantly greater decline than controls and MCI nonconverters for the domain of checkbook management and for both FCI total scores. The domain of bank statement management showed a strong trend. For both the checkbook and bank statement domains, MCI converters showed declines in procedural skills, such as calculating the correct balance in a checkbook register, but not in conceptual understanding of a checkbook or a bank statement. Declining financial skills are detectable in patients with mild cognitive impairment (MCI) in the year before their conversion to Alzheimer disease. Clinicians should proactively monitor patients with MCI for declining financial skills and advise patients and families about appropriate interventions.

  16. Child Outcomes and Family Characteristics 1 Year After Severe Inflicted or Noninflicted Traumatic Brain Injury

    PubMed Central

    Keenan, Heather T.; Runyan, Desmond K.; Nocera, Maryalice

    2008-01-01

    OBJECTIVE To assess outcomes 1 year after severe traumatic brain injury (TBI) among young children and to compare outcomes between children with inflicted versus noninflicted injuries. STUDY DESIGN Prospective cohort study. METHODS All North Carolina-resident children who were hospitalized between January 2000 and December 2001 in any of the state’s 9 PICUs and who survived a severe TBI that occurred on or before their second birthday were eligible to participate. Child health status, child use of ancillary medical resources, and family characteristics were determined through maternal caregiver interviews ~1 year after injury. Comparisons were made between family characteristics and child outcomes according to injury type. RESULTS Seventy-two interviews of maternal caregivers were completed among 112 survivors (64.3%). Children with inflicted injuries (n = 41) had worse outcomes than did children with noninflicted injuries (n = 31), as measured with the Pediatric Outcome Performance Category and Stein-Jessup Functional Status II (Revised) tools. However, ~50% of children with inflicted injuries had only mild deficits or better. Children with inflicted injuries had a higher use of ancillary medical resources. Families caring for the children did not differ substantively, with a large proportion of single, working, minority mothers. CONCLUSIONS Children with inflicted TBIs had worse outcomes than did children with other TBIs 1 year after injury. However, outcomes for these children were better than those reported previously. Many families caring for children after severe TBI are socially disadvantaged. Interventions to improve child outcomes may include enhanced family support. PMID:16452349

  17. Infants under 1 year of age have a significant risk of burn injury.

    PubMed

    Nguyen, Dai Q A; Tobin, Sean; Dickson, William A; Potokar, Tom S

    2008-09-01

    A wealth of data exists concerning paediatric burn epidemiology in general, but very little exists specifically in infants under 1 year of age, a special group in which mobility begins to develop. A retrospective study of all burn admissions of infants under 1 year old to The Welsh Centre for Burns from January 2003 to January 2006 was performed. During the 3-year period there were 104 new burns cases identified which represents 11.8% of all paediatric admissions. 63.5% (66) were treated as inpatients and 36.5% (38) treated as out-patients. Burns increased in frequency with increasing age and occurred mainly in the home. Scalds were the commonest type of burn in 65% (68) whilst the second most common was contact burns which accounted for 30% (31). The most common source of scald was from cups containing hot drinks (39%) and the most common source of contact burn was radiators/hot water pipes (30%). The mean TBSA was 2.3%, (range 0.5-38%). The frequency of burns in the under 1 year old population highlights a need for emphasis of burn prevention directed to this group. Special attention is needed to look at the specific aetiology of these burns. Starting points for prevention should address the number of burns surrounding hot drinks and bottle warming practices in the case of scalds and the dangers of household radiators and hot water pipes in the case of contact burns.

  18. Associations between disability and employment 1 year after traumatic brain injury in a working age population.

    PubMed

    Andelic, Nada; Stevens, Lillian Flores; Sigurdardottir, Solrun; Arango-Lasprilla, Juan Carlos; Roe, Cecilie

    2012-01-01

    To investigate associations between disability and employment 1 year after traumatic brain injury (TBI) using the International Classification of Functioning, Disability and Health (ICF) as a conceptual model. A prospective study including 93 patients with moderate-to-severe TBI (aged 16-55 year). Disability components of the ICF model (impairments, activity limitations and participation restrictions) and personal factors (age, gender, pre-injury employment status) were used as independent variables. The outcome measure was employment at 1 year post-injury categorized into unemployed and employed groups. Personal factors, impairments (brain injury severity, overall trauma severity and number of impaired body functions) and activity limitations (motor and cognitive abilities) accounted for 57% of the variance in employment outcome. Multivariate analyses showed that the probabilities of being employed 1 year post-injury were 95% lower for patients who were unemployed pre-injury (OR = 0.05), 74% lower for those with more severe brain injury (OR = 0.26) and 82% lower for those with more cognitive limitations (OR = 0.18). Rehabilitation professionals should take into account the importance of the ICF model when planning vocational rehabilitation interventions for individuals with TBI and focus on targeting modifiable aspects related to employment outcome, such as the individual's cognitive ability.

  19. Functional remediation in bipolar disorder: 1-year follow-up of neurocognitive and functional outcome.

    PubMed

    Bonnin, C M; Torrent, C; Arango, C; Amann, B L; Solé, B; González-Pinto, A; Crespo, J M; Tabarés-Seisdedos, R; Reinares, M; Ayuso-Mateos, J L; García-Portilla, M P; Ibañez, Á; Salamero, M; Vieta, E; Martinez-Aran, A

    2016-01-01

    Few randomised clinical trials have examined the efficacy of an intervention aimed at improving psychosocial functioning in bipolar disorder. To examine changes in psychosocial functioning in a group that has been enrolled in a functional remediation programme 1 year after baseline. This was a multicentre, randomised, rater-masked clinical trial comparing three patient groups: functional remediation, psychoeducation and treatment as usual over 1-year follow-up. The primary outcome was change in psychosocial functioning measured by means of the Functioning Assessment Short Test (FAST). Group×time effects for overall psychosocial functioning were examined using repeated-measures ANOVA (trial registration NCT01370668). There was a significant group×time interaction for overall psychosocial functioning, favouring patients in the functional remediation group (F = 3.071, d.f. = 2, P = 0.049). Improvement in psychosocial functioning is maintained after 1-year follow-up in patients with bipolar disorder receiving functional remediation. © The Royal College of Psychiatrists 2016.

  20. How hot is too hot? Live-trapped gray wolf rectal temperatures and 1-year survival

    USGS Publications Warehouse

    Barber-Meyer, Shannon M.; Mech, L. David

    2014-01-01

    The ability of physically restrained and anesthetized wolves to thermoregulate is lessened and could lead to reduced survival, yet no information is available about this subject. Therefore, we analyzed rectal temperatures related to survival 1 year post-capture from 173 adult (non-pup) gray wolves (Canis lupus) captured in modified foot-hold traps for radiocollaring during June–August, 1988–2011, in the Superior National Forest of northeastern Minnesota, USA. The maximum observed rectal temperature (“maxtemp,” ° F, ° C) in each wolf during capture (x = 104.0, 40.0; SD = 2.0, 1.1; min. = 95.9, 35.5; max. = 108, 42.2) was not a significant predictor of survival to 1 year post-capture. Although no weather or morphometric variable was a significant predictor of maxtemps, wolves initially anesthetized with ketamine–xylazine rather than telazol®–xylazine averaged higher maxtemps. This information does not fully address possible effects of high body temperatures related to live-capture and handling of wolves, but it does provide a useful waypoint for future assessments of this relationship and a reassurance to wildlife practitioners that the maxtemps observed in our study did not appear to affect 1-year survival.

  1. Child outcomes and family characteristics 1 year after severe inflicted or noninflicted traumatic brain injury.

    PubMed

    Keenan, Heather T; Runyan, Desmond K; Nocera, Maryalice

    2006-02-01

    To assess outcomes 1 year after severe traumatic brain injury (TBI) among young children and to compare outcomes between children with inflicted versus noninflicted injuries. Prospective cohort study. All North Carolina-resident children who were hospitalized between January 2000 and December 2001 in any of the state's 9 PICUs and who survived a severe TBI that occurred on or before their second birthday were eligible to participate. Child health status, child use of ancillary medical resources, and family characteristics were determined through maternal caregiver interviews approximately 1 year after injury. Comparisons were made between family characteristics and child outcomes according to injury type. Seventy-two interviews of maternal caregivers were completed among 112 survivors (64.3%). Children with inflicted injuries (n = 41) had worse outcomes than did children with noninflicted injuries (n = 31), as measured with the Pediatric Outcome Performance Category and Stein-Jessup Functional Status II (Revised) tools. However, approximately 50% of children with inflicted injuries had only mild deficits or better. Children with inflicted injuries had a higher use of ancillary medical resources. Families caring for the children did not differ substantively, with a large proportion of single, working, minority mothers. Children with inflicted TBIs had worse outcomes than did children with other TBIs 1 year after injury. However, outcomes for these children were better than those reported previously. Many families caring for children after severe TBI are socially disadvantaged. Interventions to improve child outcomes may include enhanced family support.

  2. Predictors of Relapse after Inpatient Opioid Detoxification during 1-Year Follow-Up

    PubMed Central

    2016-01-01

    Introduction. Relapse rate after opioid detoxification is very high. We studied the possibility that predetoxification patient characteristics might predict relapse at follow-up and thus conducted this 1-year follow-up study to assess the predictors of relapse after inpatient opioid detoxification. Materials and Methods. We conducted this study in our tertiary care institute in India over two-year time period (1 Jan 2014 to 31 Dec 2015). Out of 581 patients admitted, 466 patients were considered for study. Results and Discussion. No significant difference was found between relapsed and nonrelapsed patients regarding sociodemographic profile; however substance abuse pattern and forensic history showed significant differences. Relapsed patients abused greater amount and used injections more commonly, as compared to nonrelapsed group. Longer duration of abuse was also a significant risk factor. Patients with past attempt of opioid detoxification and family history (parental or first degree) of alcohol abuse had decreased possibility of maintaining remission during 1-year follow-up. Relapsed patients were found to abuse their spouse or parents. Conclusion. Our study compared profiles of relapsed and nonrelapsed patients after inpatient detoxification and concluded predictors of relapse during 1-year follow-up period. Early identification of predictors of relapse and hence high risk patients might be helpful in designing more effective and focused treatment plan. PMID:27722007

  3. Low social support level is associated with non-adherence to diet at 1 year in the Family Intervention Trial for Heart Health (FIT Heart).

    PubMed

    Aggarwal, Brooke; Liao, Ming; Allegrante, John P; Mosca, Lori

    2010-01-01

    Evaluate the relationship between low social support (SS) and adherence to diet in a cardiovascular disease (CVD) lifestyle intervention trial. Prospective substudy. Blood relatives/cohabitants of hospitalized cardiac patients in a randomized controlled trial (n=458; 66% female, 35% nonwhite, mean age 50 years). Non-adherence to diet using MEDFICTS (Meats, Eggs, Dairy, Fried foods, fat In baked goods, Convenience foods, fats added at the Table, and Snacks) tool; SS using the Enhancing Recovery in Coronary Heart Disease Patients Social Support Instrument. Logistic regression models adjusted for confounders. Significant predictors (P<.05) of non-adherence to diet recommendations at 1 year included low SS, increased body mass index and waist size, lower physical activity, depression, pre-action stages of change, control group assignment, and being male. Those with low SS at baseline 2.7 greater odds of being non-adherent to diet at 1 year vs those with higher SS (95% confidence interval=1.1-6.4); there was no interaction by group assignment. Low SS at baseline was independently associated with non-adherence to diet at 1 year, suggesting that family members with low SS may be at heightened CVD risk as a result of poor dietary adherence. Copyright © 2010 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

  4. Imaging Appearance and Clinical Impact of Preoperative Breast MRI in Pregnancy-Associated Breast Cancer.

    PubMed

    Myers, Kelly S; Green, Lauren A; Lebron, Lizza; Morris, Elizabeth A

    2017-09-01

    The purpose of this study is to describe the imaging features of pregnancy-associated breast cancer (PABC) on breast MRI and to consider the impact of preoperative MRI on patient management. A retrospective review of medical records from January 1994 to May 2014 identified 183 women who presented with a new diagnosis of breast cancer during pregnancy or within 1 year postpartum. MR images were available for 53 of these patients, all of whom were included in the study. Clinical history and available breast images were reviewed. The clinical impact of preoperative breast MRI was also recorded. Of the 53 women, nine (17%) presented during pregnancy and 44 (83%) presented during the first year postpartum. The sensitivity of MRI was 98% (52/53). Among the 53 patients, the most common findings of PABC on MRI included a solitary mass (29 patients [55%]), nonmass enhancement (12 patients [23%]), and multiple masses (eight patients [15%]). For 12 patients (23%), MRI showed a pathologically proven larger tumor size or greater extent of disease than did mammography or ultrasound, with an additional eight patients (15%) having findings suspicious for greater extent of disease but having unavailable pathologic data. Breast MRI changed surgical management for 15 patients (28%), with four patients (8%) requiring a larger lumpectomy, seven (13%) no longer being considered candidates for lumpectomy, two (4%) having contralateral disease, and two (4%) having unsuspected metastasis. Breast MRI had a high sensitivity for PABC in our study population. MRI may play an important role in PABC because it changed the surgical management of 28% of patients.

  5. Hyperpolarized (3) He and (129) Xe MRI: differences in asthma before bronchodilation.

    PubMed

    Svenningsen, Sarah; Kirby, Miranda; Starr, Danielle; Leary, Del; Wheatley, Andrew; Maksym, Geoffrey N; McCormack, David G; Parraga, Grace

    2013-12-01

    To compare hyperpolarized helium-3 ((3) He) and xenon-129 ((129) Xe) MRI in asthmatics before and after salbutamol inhalation. Seven asthmatics provided written informed consent and underwent spirometry, plethysmography, and MRI before and after salbutamol inhalation. (3) He and (129) Xe ventilation defect percent (VDP) and ventilation coefficient of variation (COV) were measured. To characterize the airways spatially related to ventilation defects, wall area percent (WA%) and lumen area (LA) were evaluated for two subjects who had thoracic x-ray computed tomography (CT) acquired 1 year before MRI. Before salbutamol inhalation, (129) Xe VDP (8 ± 5%) was significantly greater than (3) He VDP (6 ± 5%, P = 0.003). Post-salbutamol, there was a significant improvement in both (129) Xe (5 ± 4%, P < 0.0001) and (3) He (4 ± 3%, P = 0.001) VDP, and the improvement in (129) Xe VDP was significantly greater (P = 0.008). (129) Xe MRI COV (Pre: 0.309 ± 0.028, Post: 0.296 ± 0.036) was significantly greater than (3) He MRI COV (Pre: 0.282 ± 0.018, Post: 0.269 ± 0.024), pre- (P < 0.0001) and post-salbutamol (P < 0.0001) and the decrease in COV post-salbutamol was significant ((129) Xe, P = 0.002; (3) He, P < 0.0001). For a single asthmatic, a sub-segmental (129) Xe MRI ventilation defect that was visible only before salbutamol inhalation but not visible using (3) He MRI was spatially related to a remodeled fourth generation sub-segmental airway (WA% = 78%, LA = 2.9 mm(2) ). In asthma, hyperpolarized (129) Xe MRI may help reveal ventilation abnormalities before bronchodilation that are not observed using hyperpolarized (3) He MRI. Copyright © 2013 Wiley Periodicals, Inc.

  6. Capacitated max -Batching with Interval Graph Compatibilities

    NASA Astrophysics Data System (ADS)

    Nonner, Tim

    We consider the problem of partitioning interval graphs into cliques of bounded size. Each interval has a weight, and the weight of a clique is the maximum weight of any interval in the clique. This natural graph problem can be interpreted as a batch scheduling problem. Solving a long-standing open problem, we show NP-hardness, even if the bound on the clique sizes is constant. Moreover, we give a PTAS based on a novel dynamic programming technique for this case.

  7. MRI and comparison mammography: a worthy diagnostic alliance for breast microcalcifications?

    PubMed

    Brnic, Dijana; Brnic, Darko; Simundic, Ivan; Vanjaka Rogosic, Lucija; Tadic, Tade

    2016-04-01

    There is a lack of data concerning diagnostic performance of magnetic resonance imaging (MRI) in patients with new or increasing microcalcifications. To evaluate suspicious microcalcifications by using comparison mammography, MRI, and a combination of both methods. Our study group consisted of 55 patients with mammographically detected BI-RADS (Breast Imaging Reporting and Data System) 3-5 microcalcifications for whom comparison mammograms were available. All patients underwent breast MRI before SVAB (stereotactic vacuum-assisted biopsy). Diagnostic performances of comparison mammography and MRI were evaluated, as well as the combination of the respective imaging findings. Of the 55 microcalcification cases, 35 showed progression and 20 were stable between interval screenings. The negative predictive value (NPV) of comparison mammography was 100%, whereas the NPV of MRI was 92%. However, the specificity of combination of findings was 97%, significantly higher than the 42% specificity of comparison mammography (P < 0.001). Additionally, the positive predictive value of combination of findings was 93% versus 44% of comparison mammography (P = 0.001). A biopsy is recommended when MRI positive lesion corresponding the area of new or increasing mammographic microcalcifications is detected. Patients with stable microcalcifications can continue follow-up mammography, regardless of MRI result. © The Foundation Acta Radiologica 2015.

  8. Confidence Interval Procedures for Reliability Growth Analysis

    DTIC Science & Technology

    1977-06-01

    Plj2s tSAA - TECHNICAL RPORT NO. 197 CONFIDENCE INTERVAL PROCEDURES FOR RELIABILITY, GROWTH ANALYSIS LARRY H. CROW JUNE 1977 APPROVED FOR PUBLIC...dence Intervals for M(T). ¶-. fl [ ] 1 Siion IIS0III0N/AVAI Ale ITY ClOtS Next page is blank. So3 CONFIDENCE INTERVAL PROCIEDURIS• FOR RELTABILITY...and confidence interval procedures for the parameters B and P = X are presented in [l , [2], [4]. In the application of the Weibull process model to

  9. Confidence intervals for the MMPI-2.

    PubMed

    Munley, P H

    1991-08-01

    The confidence intervals for the Minnesota Multiphasic Personality Inventory (MMPI-2) clinical scales were investigated. Based on the clinical scale reliabilities published in the MMPI-2 manual, estimated true scores, standard errors of measurement for estimated true scores, and 95% confidence intervals centered around estimated true scores were calculated at 5-point MMPI-2 T-score intervals. The relationships between obtained T-scores, estimated true T-scores, scale reliabilities, and confidence intervals are discussed. The possible role of error measurement in defining scale high point and code types is noted.

  10. MRI Interscanner Agreement of the Association between the Susceptibility Vessel Sign and Histologic Composition of Thrombi.

    PubMed

    Bourcier, Romain; Détraz, Lili; Serfaty, Jean Michel; Delasalle, Beatrice Guyomarch; Mirza, Mahmood; Derraz, Imad; Toulgoat, Frédérique; Naggara, Olivier; Toquet, Claire; Desal, Hubert

    2017-08-03

    The susceptibility vessel sign (SVS) on magnetic resonance imaging (MRI) is related to thrombus location, composition, and size in acute stroke. No previous study has determined its inter-MRI scanner variability. We aimed to compare the diagnostic accuracy in-vitro of four different MRI scanners for the characterization of histologic thrombus composition. Thirty-five manufactured thrombi analogs of different composition that were histologically categorized as fibrin-dominant, mixed, or red blood cell (RBC)-dominant were scanned on four different MRI units with T2* sequence. Nine radiologists, blinded to thrombus composition and MRI scanner model, classified twice, in a 2-week interval, the SVS of each thrombus as absent, questionable, or present. We calculated the weighted kappa with 95% confidence interval (CI), sensitivity, specificity and accuracy of the SVS on each MRI scanner to detect RBC-dominant thrombi. The SVS was present in 42%, absent in 33%, and questionable in 25% of thrombi. The interscanner agreement was moderate to good, ranging from .45 (CI: .37-.52) to .67 (CI: .61-.74). The correlation between the SVS and the thrombus composition was moderate (κ: .50 [CI: .44-.55]) to good κ: .76 ([CI: .72-.80]). Sensitivity, specificity, and accuracy to identify RBC-dominant clots were significantly different between MRI scanners (P < .001). The diagnostic accuracy of SVS to determine thrombus composition varies significantly among MRI scanners. Normalization of T2*sequences between scanners may be needed to better predict thrombus composition in multicenter studies. Copyright © 2017 by the American Society of Neuroimaging.

  11. Functional MRI for radiotherapy of gliomas.

    PubMed

    Chang, Jenghwa; Narayana, Ashwatha

    2010-08-01

    In this paper, we review the applications of functional magnetic resonance imaging (MRI) for target delineation and critical organ avoidance for brain radiotherapy. In this article we distinguish functional MRI from brain functional MRI (fMRI). Functional MRI includes magnetic resonance spectroscopic imaging (MRSI), perfusion MRI, diffusion tensor imaging (DTI) and brain fMRI. These functional MRI modalities can provide unique metabolic, pathological and physiological information that are not available in anatomic MRI and can potentially improve the treatment outcomes of brain tumors. For example, both choline (Cho) to N-acetylaspartate (NAA) and Cho to creatine (Cr) ratios from MRSI increase with increasing tumor malignancy and can be used to grade gliomas. Relative cerebral blood volume (rCBV) measurements from dynamic susceptibility contrast perfusion magnetic resonance imaging (DSC MRI) are superior to conventional contrast-enhanced MRI in predicting tumor biology and may be even superior to pathologic assessment in predicting patient clinical outcomes. Brain fMRI can help identify and avoid functionally critical areas when constructing treatment plans for brain radiotherapy. In the past, functional MRI measurements have not been routinely used in a clinical arena due to the experimental nature of these imaging modalities. As these methods become more commonly used and effective image co-registration algorithms become available, integration of functional MRI into the treatment process of brain radiotherapy now appears to be clinically feasible, at least in major medical centers.

  12. PET/CT vs. non-contrast CT alone for surveillance 1-year post lobectomy for stage I non-small-cell lung cancer

    PubMed Central

    Dane, Bari; Grechushkin, Vadim; Plank, April; Moore, William; Bilfinger, Thomas

    2013-01-01

    18F-FDG PET/CT was compared with non-contrast chest CT in monitoring for recurrence 1-year after lobectomy of stage 1 non-small-cell lung cancer (NSCLC). For surveillance after treatment with curative intent, current (April 2012) National Comprehensive Cancer network guidelines recommend chest CT with or without contrast every 6-12 months for 2 years, then non-contrast chest CT annually. PET/CT is not currently indicated for routine follow-up. One hundred patients receiving surveillance PET/CT 1-year after lobectomy for the treatment of stage 1a or 1b NSCLC were included in the study. Exclusion criteria included the presence or interval diagnosis of a second malignancy, or surgical treatment more radical than single lobectomy. The non-contrast CT obtained from the 1-year PET/CT was interpreted by an experienced chest radiologist blinded to the PET/CT for evidence of recurrence using the following findings: pulmonary nodule, pleural effusion, pleural mass, adenopathy, and extrathoracic mass. The ecision about recurrence was made solely from the non-contrast CT without PET/CT findings. This was compared with the determination made with PET/CT. The reference standard for determination of recurrence was the multi-disciplinary tumor board who had access to all imaging and clinical data. Recurrence at 1 year was documented in 16 of 90 patients. All 16 recurrences were documented with PET/CT and 9 were found with non-contrast CT. Five of the 7 recurrences missed with non-contrast CT were extrathoracic metastases. Sensitivity of CT and PET/CT for recurrence was 56.3% and 100%, respectively (p = 0.015). Specificity of CT and PET/CT for recurrence was 95.9% and 93.2%, respectively (p = 0.62). PMID:24116349

  13. Ischemia-modified albumin predicts short-term outcome and 1-year mortality in patients attending the emergency department for acute ischemic chest pain.

    PubMed

    Consuegra-Sanchez, Luciano; Bouzas-Mosquera, Alberto; Sinha, Manas K; Collinson, Paul O; Gaze, David C; Kaski, Juan Carlos

    2008-05-01

    The primary study aim was to determine whether ischemia-modified albumin (IMA) predicts adverse outcome in patients attending the emergency department (ED) with acute chest pain. Ischemia-modified albumin is a sensitive marker of myocardial ischemia. However, little is known about its ability to predict outcome in patients presenting to the ED with acute chest pain. We prospectively studied 207 patients who presented to the ED with acute chest pain suggestive of acute coronary syndrome within 3 h of the onset of symptoms. Blood samples for IMA assessment were obtained on admission. We evaluated a 30-day combined end point (cardiac death, myocardial infarction, recurrent angina) and 1-year all-cause mortality. A total of 31 (15%) patients experienced the 30-day composite end point and 16 patients (7.7%) died during the 1-year follow-up. Short-term combined end point (9.6% vs 20.4%, P = 0.03) and 1-year mortality rate (11.7% vs 3.8%, log rank 3.978, P = 0.046) were significantly higher in patients with IMA levels >93.3 U/ml compared to patients with lower IMA. On multivariate analysis, IMA remained an independent predictor of both 30-day combined end point (odds ratio 1.04, 95% confidence interval [CI] 1.01-1.07, P = 0.01) and 1-year mortality (hazard ratio 1.038, 95% CI 1.006-1.070, P = 0.018). Ischemia-modified albumin is an independent predictor of short-and long-term adverse outcomes in patients presenting to the ED with typical acute chest pain.

  14. Troponin T in Prediction of Culprit Lesion Coronary Artery Disease and 1-Year Major Adverse Cerebral and Cardiovascular Events in Patients with Acute Stroke.

    PubMed

    Zeus, Tobias; Ketterer, Ulrike; Leuf, Daniela; Dannenberg, Lisa; Wagstaff, Rabea; Bönner, Florian; Gliem, Michael; Jander, Sebastian; Kelm, Malte; Polzin, Amin

    2016-06-01

    Troponin T (TnT) elevation above the 99th percentile upper reference limit (URL) is considered diagnostic of acute myocardial infarction (MI). Non-specific increases of TnT are frequent in acute stroke patients. However, in these patients, correct diagnosis of MI is crucial because the antithrombotic medications used to treat acute MI might be harmful and produce intracranial bleeding. In this study, we aimed to associate enhanced TnT levels defined by different cutoff values with occurrence of culprit lesion coronary artery disease (CAD) as well as 1-year major adverse cerebral and cardiovascular events (MACCEs). In this cohort study, we investigated 84 consecutive patients with acute ischemic stroke and concomitant MI. TnT levels were measured using a fourth-generation TnT assay. The incidence of culprit lesion CAD was determined by coronary angiography. MACCEs were recorded during 1-year follow-up. Culprit lesion CAD occurred in 55 % of patients, and 1-year MACCE in 37 %. TnT levels above the manufacturers' provided 99th URL (TnT > 0.01) were not associated with culprit lesion CAD (relative risk [RR], 1.3; 95 % confidence interval [CI] 0.96-1.8; P = 0.09). Slightly increased cutoff level (TnT > 0.03) increased specificity and was associated with culprit lesion CAD without decreasing sensitivity (RR, 1.5; 95 % CI 1.1-2.2; P = 0.021) and 1-year MACCE (RR, 1.7; 95 % CI 1.3-2.3; P < 0.001). Slightly increasement of the TnT cutoff level predicted MACCEs and is superior in prediction of culprit lesion CAD in stroke patients without being less sensitive. This finding has to be confirmed in large-scale clinical trials.

  15. Corneal Biomechanical and Anterior Chamber Parameters Variations after 1-year of Transepithelial Corneal Collagen Cross-linking in Eyes of Children with Keratoconus.

    PubMed

    Salman, Abdelrahman Gaber

    2016-01-01

    To assess the changes in corneal hysteresis (CH) and corneal resistance factor (CRF) 1-year following transepithelial corneal collagen cross-linking (CXL) treatment in eyes of children with keratoconus. This case series was conducted in 22 eyes of 22 children. Children aged < 18 years with progressive keratoconus were included. They were treated with transepithelial CXL. Corneal biomechanical and anterior chamber parameters such as CH, CRF, and peak 1 were noted using ocular response analyzer, Pentacam, intraocular lens master, and anterior segment optical coherence tomography before and 1, 3, 6, and 12 months after treatment. Our series had 22 eyes of 22 children with a mean age 15.7 ± 2.1 years. The CH and CRF 1-year after treatment declined (difference of mean 0.1 mmHg (95% confidence interval [CI] 0.04-0.24), P = 0.2] and (difference of mean 0.1 mmHg [95% CI 0.04-0.30], P = 0.3), respectively. Peak 1 and peak 2 increased (difference of mean 0.1 mmHg [95% CI 0.006-0.008], P = 0.2) and (difference of mean 0.1 mmHg [95% CI 0.007-0.006], P = 0.3), respectively. The uncorrected distance visual acuity improved from 0.95 ± 0.34 logMAR to 0.68 ± 0.45 logMAR (P < 0.05). No statistically significant changes during 12 months follow-up were observed in axial length, corneal volume, anterior chamber volume, and anterior chamber depth (P > 0.05). Transepithelial CXL in keratoconus in pediatric age group seems to have good stability in corneal biomechanical parameters after 1-year. Further studies with a larger sample and better study design are recommended to confirm our findings.

  16. Corneal Biomechanical and Anterior Chamber Parameters Variations after 1-year of Transepithelial Corneal Collagen Cross-linking in Eyes of Children with Keratoconus

    PubMed Central

    Salman, Abdelrahman Gaber

    2016-01-01

    Aim: To assess the changes in corneal hysteresis (CH) and corneal resistance factor (CRF) 1-year following transepithelial corneal collagen cross-linking (CXL) treatment in eyes of children with keratoconus. Methods: This case series was conducted in 22 eyes of 22 children. Children aged < 18 years with progressive keratoconus were included. They were treated with transepithelial CXL. Corneal biomechanical and anterior chamber parameters such as CH, CRF, and peak 1 were noted using ocular response analyzer, Pentacam, intraocular lens master, and anterior segment optical coherence tomography before and 1, 3, 6, and 12 months after treatment. Results: Our series had 22 eyes of 22 children with a mean age 15.7 ± 2.1 years. The CH and CRF 1-year after treatment declined (difference of mean 0.1 mmHg (95% confidence interval [CI] 0.04–0.24), P = 0.2] and (difference of mean 0.1 mmHg [95% CI 0.04–0.30], P = 0.3), respectively. Peak 1 and peak 2 increased (difference of mean 0.1 mmHg [95% CI 0.006–0.008], P = 0.2) and (difference of mean 0.1 mmHg [95% CI 0.007–0.006], P = 0.3), respectively. The uncorrected distance visual acuity improved from 0.95 ± 0.34 logMAR to 0.68 ± 0.45 logMAR (P < 0.05). No statistically significant changes during 12 months follow-up were observed in axial length, corneal volume, anterior chamber volume, and anterior chamber depth (P > 0.05). Conclusion: Transepithelial CXL in keratoconus in pediatric age group seems to have good stability in corneal biomechanical parameters after 1-year. Further studies with a larger sample and better study design are recommended to confirm our findings. PMID:26957852

  17. Accuracy of different reconstruction intervals to quantify left ventricular function and mass in cardiac computed tomography examinations.

    PubMed

    Arraiza, M; Azcárate, P M; Arias, J; de Cecco, C N; Pueyo, J C; Rábago, G; Bastarrika, G

    2012-01-01

    To compare the accuracy of cardiac dual-source CT (DSCT) reconstructions obtained at 5% and 10% of the cardiac cycle and MRI for quantifying global left ventricular (LV) function and mass in heart transplant recipients. We prospectively included 23 heart transplant recipients (21 male, mean age 60±11.7 years) who underwent cardiac DSCT and MRI examinations. We compared LV parameters on cardiac DSCT reconstructions obtained at 5% (0%-95%) and 10% (0%-90%) intervals of the cardiac cycle and on double-oblique short-axis MR images. We determined ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and myocardial mass using commercially available semiautomated segmentation analysis software for DSCT datasets and conventional manual contour tracing for MR studies. Using different reconstruction intervals to quantify LV parameters at DSCT resulted in non-significant differences (P>.05). Compared to MRI, DSCT slightly overestimated LV-EDV, ESV, and mass when both 5% (11.5±25.1ml, 6.8±10.9ml, and 28.3±21.6g, respectively) and 10% (mean difference 15.3±26.3ml, 7.4±11.5ml, and 29.3±18.7g, respectively) reconstruction intervals were used. DSCT and MRI estimates of EF and SV were not significantly different. In heart transplant recipients, DSCT allows reliable quantification of LV function and mass compared with MRI, even using 10% interval reconstructions. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  18. Estimating Motion From MRI Data

    PubMed Central

    OZTURK, CENGIZHAN; DERBYSHIRE, J. ANDREW; MCVEIGH, ELLIOT R.

    2007-01-01

    Invited Paper Magnetic resonance imaging (MRI) is an ideal imaging modality to measure blood flow and tissue motion. It provides excellent contrast between soft tissues, and images can be acquired at positions and orientations freely defined by the user. From a temporal sequence of MR images, boundaries and edges of tissues can be tracked by image processing techniques. Additionally, MRI permits the source of the image signal to be manipulated. For example, temporary magnetic tags displaying a pattern of variable brightness may be placed in the object using MR saturation techniques, giving the user a known pattern to detect for motion tracking. The MRI signal is a modulated complex quantity, being derived from a rotating magnetic field in the form of an induced current. Well-defined patterns can also be introduced into the phase of the magnetization, and could be thought of as generalized tags. If the phase of each pixel is preserved during image reconstruction, relative phase shifts can be used to directly encode displacement, velocity and acceleration. New methods for modeling motion fields from MRI have now found application in cardiovascular and other soft tissue imaging. In this review, we shall describe the methods used for encoding, imaging, and modeling motion fields with MRI. PMID:18958181

  19. Compressed sensing for body MRI.

    PubMed

    Feng, Li; Benkert, Thomas; Block, Kai Tobias; Sodickson, Daniel K; Otazo, Ricardo; Chandarana, Hersh

    2017-04-01

    The introduction of compressed sensing for increasing imaging speed in magnetic resonance imaging (MRI) has raised significant interest among researchers and clinicians, and has initiated a large body of research across multiple clinical applications over the last decade. Compressed sensing aims to reconstruct unaliased images from fewer measurements than are traditionally required in MRI by exploiting image compressibility or sparsity. Moreover, appropriate combinations of compressed sensing with previously introduced fast imaging approaches, such as parallel imaging, have demonstrated further improved performance. The advent of compressed sensing marks the prelude to a new era of rapid MRI, where the focus of data acquisition has changed from sampling based on the nominal number of voxels and/or frames to sampling based on the desired information content. This article presents a brief overview of the application of compressed sensing techniques in body MRI, where imaging speed is crucial due to the presence of respiratory motion along with stringent constraints on spatial and temporal resolution. The first section provides an overview of the basic compressed sensing methodology, including the notion of sparsity, incoherence, and nonlinear reconstruction. The second section reviews state-of-the-art compressed sensing techniques that have been demonstrated for various clinical body MRI applications. In the final section, the article discusses current challenges and future opportunities. 5 J. Magn. Reson. Imaging 2017;45:966-987. © 2016 International Society for Magnetic Resonance in Medicine.

  20. Predictors of fatigue over 1 year among people with rheumatoid arthritis.

    PubMed

    Treharne, G J; Lyons, A C; Hale, E D; Goodchild, C E; Booth, D A; Kitas, G D

    2008-08-01

    Fatigue is a systemic feeling of exhaustion that is a common symptom of many chronic illnesses, including the autoimmune inflammatory disease rheumatoid arthritis (RA). We examined predictors of levels of fatigue among people with RA using Leventhal's Common-Sense Model (CSM), which states that cognitive representations of an illness spur (or halt) people's efforts to cope and thereby influence outcomes of the illness. Our use of the CSM was designed in the light of evidence in the literature specific to fatigue in RA. Current fatigue was reported on a 100 mm visual analogue scale (with anchors "No fatigue" and "Unbearable fatigue") by 114 people (73.7% women) with RA at baseline and 1 year later. Baseline employment status, pain, impact of disability, sleep disruption frequency, depressed mood, perceptions of consequences, arthritis self-efficacy and attempts to cope by praying/hoping were also self-reported. Duration of RA and a haematological measure of systemic inflammation (erythrocyte sedimentation rate; ESR) were obtained from hospital records. Unexpectedly, RA duration did not predict fatigue after 1 year, although lower baseline inflammation did (controlling for baseline fatigue and other disease impact variables). This may be due to sampling flares of RA at baseline. Baseline perceptions that RA has severe consequences and is uncontrollable also predicted greater fatigue after 1 year but this relationship was not mediated by praying/hoping. Targeted psychological care to modify perceptions of severe consequences may therefore improve later fatigue for people with RA even when the condition is longstanding, but the mechanisms of any benefit require further investigation.

  1. A comparison of emission calculations using different modeled indicators with 1-year online measurements.

    PubMed

    Lengers, Bernd; Schiefler, Inga; Büscher, Wolfgang

    2013-12-01

    The overall measurement of farm level greenhouse gas (GHG) emissions in dairy production is not feasible, from either an engineering or administrative point of view. Instead, computational model systems are used to generate emission inventories, demanding a validation by measurement data. This paper tests the GHG calculation of the dairy farm-level optimization model DAIRYDYN, including methane (CH₄) from enteric fermentation and managed manure. The model involves four emission calculation procedures (indicators), differing in the aggregation level of relevant input variables. The corresponding emission factors used by the indicators range from default per cow (activity level) emissions up to emission factors based on feed intake, manure amount, and milk production intensity. For validation of the CH₄ accounting of the model, 1-year CH₄ measurements of an experimental free-stall dairy farm in Germany are compared to model simulation results. An advantage of this interdisciplinary study is given by the correspondence of the model parameterization and simulation horizon with the experimental farm's characteristics and measurement period. The results clarify that modeled emission inventories (2,898, 4,637, 4,247, and 3,600 kg CO₂-eq. cow(-1) year(-1)) lead to more or less good approximations of online measurements (average 3,845 kg CO₂-eq. cow(-1) year(-1) (±275 owing to manure management)) depending on the indicator utilized. The more farm-specific characteristics are used by the GHG indicator; the lower is the bias of the modeled emissions. Results underline that an accurate emission calculation procedure should capture differences in energy intake, owing to milk production intensity as well as manure storage time. Despite the differences between indicator estimates, the deviation of modeled GHGs using detailed indicators in DAIRYDYN from on-farm measurements is relatively low (between -6.4% and 10.5%), compared with findings from the literature.

  2. A Prospective, 1-Year Follow-up Study of Postural Tachycardia Syndrome

    PubMed Central

    Kimpinski, Kurt; Figueroa, Juan J.; Singer, Wolfgang; Sletten, David M.; Iodice, Valeria; Sandroni, Paola; Fischer, Philip R.; Opfer-Gehrking, Tonette L.; Gehrking, Jade A.; Low, Phillip A.

    2012-01-01

    Objective To prospectively evaluate patients who met standard criteria for postural tachycardia syndrome (POTS), at baseline and 1-year follow-up, using standard clinical and laboratory methods to assess autonomic function. Methods Fifty-eight patients met the study criteria (orthostatic symptoms and a heart rate increment of ≥30 beats/min on head-up tilt) and completed 12 months of follow-up. All patients were enrolled and completed the study from January 16, 2006, through April 15, 2009. Patients underwent standardized autonomic testing, including head-up tilt, clinical assessment, and validated questionnaires designed to determine the severity of autonomic symptoms. Results Patients were predominantly young females (n=49, 84%), with 20 patients (34%) reporting an antecedent viral infection before onset of symptoms. More than one-third (37%) no longer fulfilled tilt criteria for POTS on follow-up, although heart rate increment on head-up tilt did not differ significantly at 1 year (33.8±15.1 beats/min) compared with baseline (37.8±14.6 beats/min) for the entire cohort. Orthostatic symptoms improved in most patients. Autonomic dysfunction was mild as defined by a Composite Autonomic Severity Score of 3 or less in 55 patients (95%) at baseline and 48 patients (92%) at 1 year. Conclusion To our knowledge, this is the first prospective study of the clinical outcomes of patients with POTS. Orthostatic symptoms improved in our patients, with more than one-third of patients no longer fulfilling tilt criteria for POTS, although the overall group change in heart rate increment was modest. Our data are in keeping with a relatively favorable prognosis in most patients with POTS. PMID:22795533

  3. Comparison of postoperative visual quality after SMILE and LASEK for high myopia: A 1-year outcome

    PubMed Central

    Yu, Manrong; Qiu, Chen; Chen, Minjie; Dai, Jinhui

    2017-01-01

    Purpose To compare the 1-year outcome of visual quality after laser-assisted subepithelial keratomileusis (LASEK) and femtosecond laser-assisted small incision lenticule extraction (SMILE) for high myopia correction. Materials and methods This prospective, comparative study included 24 eyes of 24 patients in the LASEK group, with a mean spherical equivalent (SE) of -7.59 ± 1.32 diopters, and 26 eyes of 26 patients in the SMILE group, with a mean SE of -7.91 ± 1.08 diopters. Visual acuity, corneal topography, contrast sensitivity (CS), and wavefront aberrations were recorded preoperatively and compared with postoperative measurements. Objective scatter index (OSI) and modulation transfer function (MTF) cut-off frequency were measured 1 year postoperatively. Results One year postoperatively, the two groups demonstrated no significant difference in the CS at all spatial frequencies. The increments of higher-order aberrations (HOAs) (HOA = 0.583 ± 0.210 μm), including spherical aberration (SA) (SA = 0.546 ± 0.249 μm), were higher (P < 0.05) in the LASEK group than those in the SMILE group (HOA = 0.451 ± 0.143 μm; SA = 0.450 ± 0.340 μm) after surgery. There were no significant differences in the increments of coma and trefoil aberrations between the two groups. The OSI and MTF cut-off frequency exhibited no significant differences between the two groups postoperatively. No vision-threatening complications were noted at any stage in either group. Conclusions Both LASEK and SMILE are safe and effective surgical options for the correction of high myopia. SMILE has a lower HOAs and SA induction rate 1 year postoperatively. PMID:28771544

  4. Medical care utilization during 1 year prior to death in suicides motivated by physical illnesses.

    PubMed

    Cho, Jaelim; Lee, Won Joon; Moon, Ki Tae; Suh, Mina; Sohn, Jungwoo; Ha, Kyoung Hwa; Kim, Changsoo; Shin, Dong Chun; Jung, Sang Hyuk

    2013-05-01

    Many epidemiological studies have suggested that a variety of medical illnesses are associated with suicide. Investigating the time-varying pattern of medical care utilization prior to death in suicides motivated by physical illnesses would be helpful for developing suicide prevention programs for patients with physical illnesses. Suicides motivated by physical illnesses were identified by the investigator's note from the National Police Agency, which was linked to the data from the Health Insurance Review and Assessment. We investigated the time-varying patterns of medical care utilization during 1 year prior to suicide using repeated-measures data analysis after adjustment for age, gender, area of residence, and socioeconomic status. Among 1994 suicides for physical illness, 1893 (94.9%) suicides contacted any medical care services and 445 (22.3%) suicides contacted mental health care during 1 year prior to suicide. The number of medical care visits and individual medical expenditures increased as the date of suicide approached (p<0.001). The number of medical care visits for psychiatric disorders prior to suicide significantly increased only in 40- to 64-year-old men (p=0.002), women <40 years old (p=0.011) and women 40 to 64 years old (p=0.021) after adjustment for residence, socioeconomic status, and morbidity. Most of the suicides motivated by physical illnesses contacted medical care during 1 year prior to suicide, but many of them did not undergo psychiatric evaluation. This underscores the need for programs to provide psychosocial support to patients with physical illnesses.

  5. Efficacy of risedronate in men with primary and secondary osteoporosis: results of a 1-year study.

    PubMed

    Ringe, J D; Faber, H; Farahmand, P; Dorst, A

    2006-03-01

    Osteoporosis is prevalent in men with an estimated one in eight men older than 50 years suffering from osteoporotic fracture, and a higher mortality rate after fracture among men compared with women. There are few approved therapies for osteoporosis in men. This observational study assesses the efficacy and safety of risedronate in the treatment of men with primary and secondary osteoporosis. A single-center, open label, randomized, prospective 1-year study was conducted in men with primary or secondary osteoporosis. Patients were randomized to risedronate (risedronate 5 mg/day plus calcium 1,000 mg/day and vitamin D 800 IU/day) or control groups (alfacalcidol 1 mug/day plus calcium 500 mg/day or vitamin D 1,000 IU/day plus calcium 800 mg/day). Bone mineral density (BMD) measurements, X-rays of the spine, a medical history and physical exam, and patient self-assessments of back pain were performed at baseline and 12 months. Blinded semi-quantitative fracture assessment was conducted by a radiologist. A total of 316 men with osteoporosis were enrolled in the trial (risedronate, n=158; control, n=158). At 1 year lumbar spine BMD increased by 4.7% in the risedronate group versus an increase of 1.0% in the control group (P<0.001). Significant increases in BMD at the total hip and femoral neck were also observed with risedronate compared with the control group. The incidence of new vertebral fracture in the risedronate group was reduced by 60% versus the control group (P=0.028). Daily treatment with risedronate for 12 months significantly increased BMD at the lumbar spine, femoral neck and total hip and significantly reduced the incidence of new vertebral fractures. This is the first prospective, randomized, controlled trial to demonstrate a significant reduction in vertebral fractures in 1 year in men with primary or secondary osteoporosis.

  6. [Status of iodine nutrition of children until 1 year: consequences on the thyroid function].

    PubMed

    Pouessel, G; Damie, R; Soudan, B; Weill, J; Gottrand, F; Turck, D

    2008-08-01

    Iodine deficiency remains a major public health problem mainly in least-developed countries but also in many industrialized countries. The present study aimed at: (1) evaluating the status of iodine nutrition of children until 1 year in the North region of France; (2) studying risk factors for iodine deficiency; (3) evaluating relationship between iodine deficiency and thyroid disorders. This prospective study was conducted between 1st january and 31st May 2005 in the children's hospital of Lille (North of France) and all hospitalized children until the age of 1 year were enrolled. Urinary iodine assessment was obtained for 95 (83%) of the 114 infants hospitalized during the study period and TSH value was also determined in 57 (60%) of these 114 infants. Median urinary iodine concentration was 328 microg/L (range: 12-1580). Twenty-four (25%) of 95 infants had a high urinary iodine excretion (urinary iodine greater than 400 microg/L). Nineteen (20%) of the 95 infants were iodine deficient (urinary iodine less than 100 microg/L): severe iodine deficiency (less than 20 microg/L; n=5; 5%), moderate iodine deficiency (20-49 microg/L; n=6; 6%), mild iodine deficiency (50-99 microg/L; n=8; 8%). No relationship was found between iodine status and the following data: age, sex, familial thyroid disease history, term and type of delivery, nutritional status, type of feeding at inclusion, chronic disease, familial socioeconomic status. TSH value was high (greater than 5 microU/mL) in 7 (12%) of the 57 infants. Only 1 of these 7 infants was iodine deficient. Only 1 of the 19 infants with iodine deficiency had a high TSH value. Iodine status is not optimal in our population of hospitalized children until the age of 1 year. There is no clear relationship between iodine status and thyroid function.

  7. Is chest CT useful in newborn screened infants with cystic fibrosis at 1 year of age?

    PubMed

    Thia, Lena P; Calder, Alistair; Stocks, Janet; Bush, Andrew; Owens, Catherine M; Wallis, Colin; Young, Carolyn; Sullivan, Yvonne; Wade, Angie; McEwan, Angus; Brody, Alan S

    2014-04-01

    Sensitive outcome measures applicable in different centres to quantify and track early pulmonary abnormalities in infants with cystic fibrosis (CF) are needed both for clinical care and interventional trials. Chest CT has been advocated as such a measure yet there is no validated scoring system in infants. The objectives of this study were to standardise CT data collection across multiple sites; ascertain the incidence of bronchial dilatation and air trapping in newborn screened (NBS) infants with CF at 1 year; and assess the reproducibility of Brody-II, the most widely used scoring system in children with CF, during infancy. A multicentre observational study of early pulmonary lung disease in NBS infants with CF at age 1 year using volume-controlled chest CT performed under general anaesthetic. 65 infants with NBS-diagnosed CF had chest CT in three centres. Small insignificant variations in lung recruitment manoeuvres but significant centre differences in radiation exposures were found. Despite experienced scorers and prior training, with the exception of air trapping, inter- and intraobserver agreement on Brody-II score was poor to fair (eg, interobserver total score mean (95% CI) κ coefficient: 0.34 (0.20 to 0.49)). Only 7 (11%) infants had a total CT score ≥ 12 (ie, ≥ 5% maximum possible) by either scorer. In NBS infants with CF, CT changes were very mild at 1 year, and assessment of air trapping was the only reproducible outcome. CT is thus of questionable value in infants of this age, unless an improved scoring system for use in mild CF disease can be developed.

  8. [Clinical-ultrasonographic assessment in arthroscopic rotator cuff repair after 1-year follow-up].

    PubMed

    Cruz López, Francisco; Gómez Espíndola, Juan Carlos; Almazán Díaz, Arturo; Pineda Villaseñor, Carlos; Briseño Estrada, César Arcadio; Pérez Jiménez, Francisco; Ibarra Ponce de León, José Clemente

    2009-01-01

    Arthroscopic repair of the rotator cuff have shown have shown encouraging clinical results. However, few authors have assessed integrity of repair with ultrasound. The presence of re-rupture by ultrasonography in a rotator cuff repair may not relate to the patient's functional status. We used ultrasonography to assess the prevalence of re-rupture in rotator cuff repairs and its clinical relevance with minimum 1 year postoperatively. Evidence level IV (Case series). We evaluated 27 shoulders that underwent arthroscopic rotator cuff repair. Clinical evaluation was performed using UCLA functional scale, visual analogue scale (UCLA, VAS). Post-operative ultrasound was performed at least 1 year postoperatively. Statistical analysis was done with the SPSS 11.0 software. We examined 27 shoulders, mean age 56.4 (41-78), mean postoperative follow-up 19.6 (12 m-88 m). Clinical assessment with UCLA functional scale results were: good-excellent (77.4%); fair (22.2%). VAS results showed that 44.4% reported VAS of 0; in the range of 1-3 VAS was 55.5% of the patients. Ultrasound evaluation showed no injury in 37%; partial lesion 51.9%, and a total lesion 11.1%. Thirty-three % of the patients with VAS of 0 showed no injury when evaluated by ultrasonography, injury by ultrasound 33.3% with VAS (1-3) 22.2%. UCLA (good-excellent) without injury by ultrasound 33.3% with a 44.4% degree of injury, UCLA (Fair) without injury 3.7%, with some degree of lesion 18.5%. Results no statistically significant difference (p > 0.05). In our series, we find that integrity of rotator cuff postoperative ultrasound, it has no effect on the functional status of patients with postoperative follow-up of at least 1 year, with UCLA and VAS.

  9. For Diabetes Shared Savings Programs, 1 Year of Data Is Not Enough.

    PubMed

    VanArsdale, Lynne; Curran-Everett, Douglas; Haugen, Heather; Smith, Nancy; Atherly, Adam

    2017-04-01

    Fee-for-service payment models are moving toward pay-for-performance designs, many of which rely on shared savings for financial sustainability. Shared savings programs divide the cost savings between health care purchaser and provider based on provider performance. Often, these programs measure provider performance as the delivery of agreed-upon clinical practice guidelines that usually are represented as evidence-based medicine (EBM). Multiyear studies show a negative relationship between total cost and EBM, indicating that long-term shared savings can be substantial. This study explores expectations for the rewards in the first year of a shared savings program. It also indicates the effectiveness of using 1 year of claims to assess cost savings from evidence-based care, especially in a patient population with high turnover. This study analyzed 1956 adults with diabetes insured through Medicaid. Results of linear regression showed that the relationship between total cost of care and each element of evidence-based medical care during a 1-year period was positive (higher cost) or insignificant. The results indicate that diabetes EBM programs cannot expect to see significant cost savings if the evaluation lasts only 1 year or less. The study concludes that improvements in EBM incentive programs could come from investigating the length of time needed to realize cost savings from each element of diabetes EBM. Investigating other factors that could affect the expected amount of cost savings also would benefit these programs, especially factors derived from sources external to insurance program information such as the medical record and care management data.

  10. Trends in respiratory syncytial virus bronchiolitis hospitalizations in children less than 1 year: 2004-2012.

    PubMed

    Sanchez-Luna, Manuel; Elola, Francisco J; Fernandez-Perez, Cristina; Bernal, Jose L; Lopez-Pineda, Adriana

    2016-01-01

    To analyze trends in health outcomes and the influence of risk factors in children under 1 year with acute bronchiolitis due to respiratory syncytial virus (RSV bronchiolitis). A risk-adjustment model for RSV bronchiolitis in-hospital mortality was also developed. Retrospective study of hospitalizations for RSV bronchiolitis in children aged <1 year from 2004 to 2012. We used nationally representative data from the Spanish National Health Service records. Over the study period, the annual hospital discharges for RSV bronchiolitis ranged between 6390 and 8637. The annual in-hospital mortality rate ranged from 120 (2004) to 69 (2012) per 100,000 hospitalizations and the mean length of stay decreased steadily from 6.5 to 5.2 days (p < 0.001); 98.3% of hospitalizations for RSV bronchiolitis were children without risk factors. The in-hospital mortality rate due to RSV bronchiolitis in children with risk factors was 18.8 times higher than non-high-risk children and, in adjusted analyses, the OR of in-hospital mortality due to RSV bronchiolitis was higher than that due to other causes. This study is a retrospective analysis, based on administrative data. It does not include data about pre- or in-hospital treatments, and has the limitations inherent in procedures for determining risk-adjusted mortality rates. Socioeconomic and environmental factors have not been considered in this study. RSV bronchiolitis is a leading cause of hospitalizations for infants under 1 year and has not shown incidence reduction over a 9 year period. Risk factors increase the in-hospital mortality risk and it is higher if the hospitalization cause is RSV bronchiolitis than any other reason.

  11. Environmental exposures and respiratory morbidity among very low birth weight infants at 1 year of life

    PubMed Central

    Halterman, J S; Lynch, K A; Conn, K M; Hernandez, T E; Perry, T T; Stevens, T P

    2016-01-01

    Introduction Preterm infants have a substantially increased risk of developing respiratory illnesses. The goal of this study was to consider the impact of modifiable postnatal exposures on respiratory morbidity among a cohort of very low birth weight (VLBW) infants. Objectives (1) Assess the rates of respiratory morbidity and exposure to indoor respiratory triggers in a population of VLBW infants at 1 year; (2) determine the association between exposures and respiratory morbidity. Methods We enrolled 124 VLBW infants into a prospective cohort study. Parents were called at 1 year to assess respiratory outcomes and environmental exposures. We used bivariate and multivariate analyses to assess the relationship between environmental exposures and acute care for respiratory illnesses. Results At 1 year, 9% of infants had physician-diagnosed asthma, 47% required ≥1 acute visit and 11% required hospitalisation for respiratory illness. The majority of infants (82%) were exposed to at least one indoor respiratory trigger. Infants living with a smoker (61% vs 40%) and infants exposed to pests (62% vs 39%) were more likely than unexposed infants to require acute care for respiratory problems. In a multivariate regression controlling for demographics, birth weight, bronchopulmonary dysplasia, and family history of asthma or allergies, both living with a smoker (OR 2.62; CI 1.09 to 6.29) and exposure to pests (OR 4.41; CI 1.22 to 15.94) were independently associated with the need for acute care for respiratory illnesses. Conclusions In this sample, respiratory morbidity and exposure to triggers were common. VLBW infants may benefit from interventions that decrease exposure to respiratory triggers. PMID:18703545

  12. Staining susceptibility of new calcium aluminate cement (EndoBinder) in teeth: a 1-year in vitro study.

    PubMed

    Garcia, Lucas da Fonseca Roberi; Aguilar, Fabiano Gamero; Rossetto, Hebert Luis; Sabino, Marcio Gomes; Pires-de-Souza, Fernanda de Carvalho Panzeri

    2013-10-01

    To evaluate the staining susceptibility of new calcium aluminate cement (EndoBinder, EB) in teeth, with or without radiopacifying agent, in comparison with mineral trioxide aggregate (MTA). Forty bovine incisors were used. After biomechanical preparation and filling, 2 mm of their fillings were removed for cervical plug fabrication (n = 10): EB without radiopacifier; EndoBinder + Bismuth Oxide (EBBO); Gray mineral trioxide aggregate (GMTA) and White mineral trioxide aggregate (WMTA). After teeth restoration, initial color readout was taken (Easyshade - CIE Lab) on the vestibular face. The teeth were stored in artificial saliva at 37°C for 1 year, and after time intervals of 30, 180, and 360 days, new color readouts were taken to determine color alteration (ΔE) in comparison with the initial readout (baseline). The results (2-way anova repeated measures, Bonferroni - P < 0.05) demonstrated that after 360 days, all groups presented ΔE above the clinically accepted limit (ΔE ≥ 3.3), however, without significant difference among them (P > 0.05). All groups presented decrease in ΔL values over the course of time, and the greatest variation occurred for WMTA, with significant difference in comparison with EB and EBBO (P < 0.05). Some negative features of MTA, such as the high incidence of dental structures staining justify the development of new materials. GMTA, WMTA, and EB with and without radiopacifying agent displayed color alteration (ΔE) after 360 days; however, the luminosity change (ΔL) was lower in EB in comparison with GMTA and WMTA. © 2012 John Wiley & Sons A/S.

  13. Differential expression of plasma microRNA in preeclamptic patients at delivery and 1 year postpartum.

    PubMed

    Murphy, Malia Su-Qin; Casselman, Richard Cary; Tayade, Chandrakant; Smith, Graeme Neil

    2015-09-01

    Preeclampsia (PE) is a hypertensive disorder of pregnancy characterized by widespread maternal endothelial dysfunction. Although clinical signs subside following delivery, long-term risks associated with PE include hypertension, stroke, and cardiovascular disease. MicroRNAs (miRNAs) are emerging as critical regulators of biological function, and while alterations to the miRNAome have been described in the context of pregnancy and PE, the postpartum implications of PE on miRNA expression is unknown. The goal of this study was to characterize circulating miRNA profiles at the time of delivery and at 1 year postpartum for women who did and did not develop PE. Using a targeted reverse transcription polymerase chain reaction approach, selected miRNAs putatively involved in the pathophysiology of PE were examined in 17 normotensive control and 13 PE maternal plasma samples at the time of delivery and 1 year postpartum. Ingenuity Pathway Analysis was used to map putative messenger RNA targets of differentially expressed miRNA to global molecular networks based on gene function. Significant increases (P < .05) in 7 miRNAs with antiangiogenic, inflammatory, and apoptotic functions (miR-98-5p, miR-222-3p, miR-210-3p, miR-155-5p, miR-296-3p, miR-181a-5p, miR-29b-3p) were evident in maternal plasma at the time of severe PE compared to time-matched controls. Plasma samples from individuals who developed mild PE exhibited no changes compared to control samples for the subset of miRNAs analyzed here. Differential expression of plasma miRNA at the time of delivery for women with PE were largely resolved at 1 year postpartum, and reduced expression of only miR-221-3p (P < .05) was evident. Network analysis of putative targets of differentially regulated miRNA identified 11 interacting networks with enrichment for proteins involved in cardiovascular disease, organ system development and function, and cell signaling and interaction. The systemic effect of PE on maternal systems is

  14. Vitamin D Plasma Levels and In-Hospital and 1-Year Outcomes in Acute Coronary Syndromes

    PubMed Central

    De Metrio, Monica; Milazzo, Valentina; Rubino, Mara; Cabiati, Angelo; Moltrasio, Marco; Marana, Ivana; Campodonico, Jeness; Cosentino, Nicola; Veglia, Fabrizio; Bonomi, Alice; Camera, Marina; Tremoli, Elena; Marenzi, Giancarlo

    2015-01-01

    Abstract Deficiency in 25-hydroxyvitamin D (25[OH]D), the main circulating form of vitamin D in blood, could be involved in the pathogenesis of acute coronary syndromes (ACS). To date, however, the possible prognostic relevance of 25 (OH)D deficiency in ACS patients remains poorly defined. The purpose of this prospective study was to assess the association between 25 (OH)D levels, at hospital admission, with in-hospital and 1-year morbidity and mortality in an unselected cohort of ACS patients. We measured 25 (OH)D in 814 ACS patients at hospital presentation. Vitamin D serum levels >30 ng/mL were considered as normal; levels between 29 and 21 ng/mL were classified as insufficiency, and levels < 20 ng/mL as deficiency. In-hospital and 1-year outcomes were evaluated according to 25 (OH)D level quartiles, using the lowest quartile as a reference. Ninety-three (11%) patients had normal 25 (OH)D levels, whereas 155 (19%) and 566 (70%) had vitamin D insufficiency and deficiency, respectively. The median 25 (OH)D level was similar in ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) patients (14.1 [IQR 9.0–21.9] ng/mL and 14.05 [IQR 9.1–22.05] ng/mL, respectively; P = .88). The lowest quartile of 25 (OH)D was associated with a higher risk for several in-hospital complications, including mortality. At a median follow-up of 366 (IQR 364–379) days, the lowest quartile of 25 (OH)D, after adjustment for the main confounding factors, remained significantly associated to 1-year mortality (P < .01). Similar results were obtained when STEMI and NSTEMI patients were considered separately. In ACS patients, severe vitamin D deficiency is independently associated with poor in-hospital and 1-year outcomes. Whether low vitamin D levels represent a risk marker or a risk factor in ACS remains to be elucidated. PMID:25984675

  15. Maintenance of the efficacy of desvenlafaxine in menopausal vasomotor symptoms: a 1-year randomized controlled trial.

    PubMed

    Pinkerton, JoAnn V; Archer, David F; Guico-Pabia, Christine J; Hwang, Eunhee; Cheng, Ru-Fong J

    2013-01-01

    The purpose of this study was to assess the 1-year maintenance of the efficacy of desvenlafaxine 100 mg/day (administered as desvenlafaxine succinate) established on week 12 in a 1-year, double-blind, randomized, placebo-controlled trial in postmenopausal women seeking treatment of bothersome vasomotor symptoms. Primary efficacy endpoints were changes in hot flush (HF) frequency and severity on weeks 12, 26, and 52 in an efficacy substudy population (≥50 moderate and severe HFs per week at baseline). Secondary endpoints were Greene climacteric scale, patient global impression symptom rating, and patient global impression of change scores (weeks 12, 26, and 52) for the main study efficacy population. Safety was assessed throughout the trial. The mean baseline HF frequency (efficacy substudy population, n = 365) was 12 moderate and severe HFs per day; the mean baseline severity score was 2.4. At 1 year, women treated with desvenlafaxine maintained the efficacy established on week 12. Desvenlafaxine reduced HF frequency by 7.47 moderate and severe HFs per day on week 12 (adjusted mean difference from placebo, -2.48; 95% CI, -3.47 to -1.50; P < 0.001) and by 7.70 moderate and severe HFs per day on month 12 (adjusted mean difference from placebo, -2.86; 95% CI, -4.14 to -1.57; P < 0.001). Desvenlafaxine reduced the mean severity score by 0.63 on week 12 (placebo, -0.30; P < 0.001) and by 0.75 on month 12 (placebo, -0.44; P = 0.003). Reductions in Greene Climacteric Scale total score (main study efficacy population, n = 1,950) were significantly greater for desvenlafaxine than for placebo on months 3, 6, and 12 (all P < 0.001). Treatment-emergent adverse event rates were 84% for desvenlafaxine and 79% for placebo (P = 0.006). Full safety results are reported separately. The treatment efficacy of desvenlafaxine 100 mg/day achieved on week 12 in postmenopausal women with vasomotor symptoms is maintained for 1 year.

  16. Sensory training as treatment for focal hand dystonia: a 1-year follow-up.

    PubMed

    Zeuner, Kirsten E; Hallett, Mark

    2003-09-01

    In a prior study, 10 patients with focal hand dystonia learned braille reading as sensory training for 8 weeks. Practice time was 30 to 60 minutes daily. They improved both their spatial acuity using the Grating Orientation Discrimination Task (GOT) and their dystonia using the Fahn scale. Three patients continued training for 1 year. Patients showed further improvement in the GOT, writing a standard paragraph, and self-rating scales. Sensory training lasting longer than 8 weeks may lead to continued improvement. Copyright 2003 Movement Disorder Society

  17. Slower walking speed forecasts increased postoperative morbidity and 1-year mortality across surgical specialties.

    PubMed

    Robinson, Thomas N; Wu, Daniel S; Sauaia, Angela; Dunn, Christina L; Stevens-Lapsley, Jennifer E; Moss, Marc; Stiegmann, Greg V; Gajdos, Csaba; Cleveland, Joseph C; Inouye, Sharon K

    2013-10-01

    The purpose of this study was to determine the relationship between the Timed Up and Go test and postoperative morbidity and 1-year mortality, and to compare the Timed Up and Go to the standard-of-care surgical risk calculators for prediction of postoperative complications. In this prospective cohort study, patients 65 years and older undergoing elective colorectal and cardiac operations with a minimum of 1-year follow-up were included. The Timed Up and Go test was performed preoperatively. This timed test starts with the subject standing from a chair, walking 10 feet, returning to the chair, and ends after the subject sits. Timed Up and Go results were grouped as fast ≤ 10 seconds, intermediate = 11-14 seconds, and slow ≥ 15 seconds. Receiver operating characteristic curves were used to compare the 3 Timed Up and Go groups to current standard-of-care surgical risk calculators at forecasting postoperative complications. This study included 272 subjects (mean age of 74 ± 6 years). Slower Timed Up and Go was associated with increased postoperative complications after colorectal (fast 13%, intermediate 29%, and slow 77%; P < 0.001) and cardiac (fast 11%, intermediate 26%, and slow 52%; P < 0.001) operations. Slower Timed Up and Go was associated with increased 1-year mortality following both colorectal (fast 3%, intermediate 10%, and slow 31%; P = 0.006) and cardiac (fast 2%, intermediate 3%, and slow 12%; P = 0.039) operations. Receiver operating characteristic area under curve of the Timed Up and Go and the risk calculators for the colorectal group was 0.775 (95% CI: 0.670-0.880) and 0.554 (95% CI: 0.499-0.609), and for the cardiac group was 0.684 (95% CI: 0.603-0.766) and 0.552 (95% CI: 0.477-0.626). Slower Timed Up and Go forecasted increased postoperative complications and 1-year mortality across surgical specialties. Regardless of operation performed, the Timed Up and Go compared favorably to the more complex risk calculators at forecasting postoperative

  18. Necessity and Opportunity: the 1-Year Master's ABA Program at Auburn University.

    PubMed

    Johnston, James M

    2016-05-01

    The Auburn University Master of Science program in Applied Behavior Analysis was designed to accommodate not only the requirements of the Behavior Analyst Certification Board for approved course sequences and practicum training, but unavoidable limitations in faculty and other resources. These limitations were incompatible with the more traditional 2-year curriculum model, so a 1-year program was designed that met the necessary conditions. This article describes the resulting academic and practicum curriculum, the key funding mechanisms that allowed the program to develop, and the opportunities and benefits that this model afforded.

  19. Interval and Contour Processing in Autism

    ERIC Educational Resources Information Center

    Heaton, Pamela

    2005-01-01

    High functioning children with autism and age and intelligence matched controls participated in experiments testing perception of pitch intervals and musical contours. The finding from the interval study showed superior detection of pitch direction over small pitch distances in the autism group. On the test of contour discrimination no group…

  20. Optimal Approximation of Quadratic Interval Functions

    NASA Technical Reports Server (NTRS)

    Koshelev, Misha; Taillibert, Patrick

    1997-01-01

    Measurements are never absolutely accurate, as a result, after each measurement, we do not get the exact value of the measured quantity; at best, we get an interval of its possible values, For dynamically changing quantities x, the additional problem is that we cannot measure them continuously; we can only measure them at certain discrete moments of time t(sub 1), t(sub 2), ... If we know that the value x(t(sub j)) at a moment t(sub j) of the last measurement was in the interval [x-(t(sub j)), x + (t(sub j))], and if we know the upper bound D on the rate with which x changes, then, for any given moment of time t, we can conclude that x(t) belongs to the interval [x-(t(sub j)) - D (t - t(sub j)), x + (t(sub j)) + D (t - t(sub j))]. This interval changes linearly with time, an is, therefore, called a linear interval function. When we process these intervals, we get an expression that is quadratic and higher order w.r.t. time t, Such "quadratic" intervals are difficult to process and therefore, it is necessary to approximate them by linear ones. In this paper, we describe an algorithm that gives the optimal approximation of quadratic interval functions by linear ones.

  1. 47 CFR 52.35 - Porting Intervals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 3 2012-10-01 2012-10-01 false Porting Intervals. 52.35 Section 52.35 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) NUMBERING Number Portability § 52.35 Porting Intervals. (a) All telecommunications carriers required by the Commission to port...

  2. SINGLE-INTERVAL GAS PERMEABILITY ESTIMATION

    EPA Science Inventory

    Single-interval, steady-steady-state gas permeability testing requires estimation of pressure at a screened interval which in turn requires measurement of friction factors as a function of mass flow rate. Friction factors can be obtained by injecting air through a length of pipe...

  3. SINGLE-INTERVAL GAS PERMEABILITY ESTIMATION

    EPA Science Inventory

    Single-interval, steady-steady-state gas permeability testing requires estimation of pressure at a screened interval which in turn requires measurement of friction factors as a function of mass flow rate. Friction factors can be obtained by injecting air through a length of pipe...

  4. Interval and Contour Processing in Autism

    ERIC Educational Resources Information Center

    Heaton, Pamela

    2005-01-01

    High functioning children with autism and age and intelligence matched controls participated in experiments testing perception of pitch intervals and musical contours. The finding from the interval study showed superior detection of pitch direction over small pitch distances in the autism group. On the test of contour discrimination no group…

  5. Interpretation of Confidence Interval Facing the Conflict

    ERIC Educational Resources Information Center

    Andrade, Luisa; Fernández, Felipe

    2016-01-01

    As literature has reported, it is usual that university students in statistics courses, and even statistics teachers, interpret the confidence level associated with a confidence interval as the probability that the parameter value will be between the lower and upper interval limits. To confront this misconception, class activities have been…

  6. Safety of measles-containing vaccines in 1-year-old children.

    PubMed

    Klein, Nicola P; Lewis, Edwin; Fireman, Bruce; Hambidge, Simon J; Naleway, Allison; Nelson, Jennifer C; Belongia, Edward A; Yih, W Katherine; Nordin, James D; Hechter, Rulin C; Weintraub, Eric; Baxter, Roger

    2015-02-01

    All measles-containing vaccines are associated with several types of adverse events, including seizure, fever, and immune thrombocytopenia purpura (ITP). Because the measles-mumps-rubella-varicella (MMRV) vaccine compared with the separate measles-mumps-rubella (MMR) and varicella (MMR + V) vaccine increases a toddler's risk for febrile seizures, we investigated whether MMRV is riskier than MMR + V and whether either vaccine elevates the risk for additional safety outcomes. Study children were aged 12 to 23 months in the Vaccine Safety Datalink from 2000 to 2012. Nine study outcomes were investigated: 7 main outcomes (anaphylaxis, ITP, ataxia, arthritis, meningitis/encephalitis, acute disseminated encephalomyelitis, and Kawasaki disease), seizure, and fever. Comparing MMRV with MMR + V, relative risk was estimated by using stratified exact binomial tests. Secondary analyses examined post-MMRV or MMR + V risk versus comparison intervals; risk and comparison intervals were then contrasted for MMRV versus MMR+V. We evaluated 123,200 MMRV and 584,987 MMR + V doses. Comparing MMRV with MMR + V, risks for the 7 main outcomes were not significantly different. Several outcomes had few or zero postvaccination events. Comparing risk versus comparison intervals, ITP risk was higher after MMRV (odds ratio [OR]: 11.3 [95% confidence interval (CI): 1.9 to 68.2]) and MMR + V (OR: 10 [95% CI: 4.5 to 22.5]) and ataxia risk was lower after both vaccines (MMRV OR: 0.8 [95% CI: 0.5 to 1]; MMR + V OR: 0.8 [95% CI: 0.7 to 0.9]). Compared with MMR + V, MMRV increased risk of seizure and fever 7 to 10 days after vaccination. This study did not identify any new safety concerns comparing MMRV with MMR + V or after either the MMRV or the MMR + V vaccine. This study provides reassurance that these outcomes are unlikely after either vaccine. Copyright © 2015 by the American Academy of Pediatrics.

  7. Biomathematics and Interval Analysis: A Prosperous Marriage

    NASA Astrophysics Data System (ADS)

    Markov, S. M.

    2010-11-01

    In this survey paper we focus our attention on dynamical bio-systems involving uncertainties and the use of interval methods for the modelling study of such systems. The kind of envisioned uncertain systems are those described by a dynamical model with parameters bounded in intervals. We point out to a fruitful symbiosis between dynamical modelling in biology and computational methods of interval analysis. Both fields are presently in the stage of rapid development and can benefit from each other. We point out on recent studies in the field of interval arithmetic from a new perspective—the midpoint-radius arithmetic which explores the properties of error bounds and approximate numbers. The midpoint-radius approach provides a bridge between interval methods and the "uncertain but bounded" approach used for model estimation and identification. We briefly discuss certain recently obtained algebraic properties of errors and approximate numbers.

  8. Cardiovascular MRI in thalassemia major.

    PubMed

    Wood, John C; Noetzli, Leila

    2010-08-01

    MRI assessment of myocardial iron and function has revolutionized the treatment of thalassemia major patients. While knowledge of somatic iron stores is vital for iron chelation management, it does not adequately monitor cardiac risk. MRI monitoring of cardiac T2* allows preclinical recognition of myocardial iron, stratifies prospective cardiac risk, and tracks response to modifications in iron chelation therapy. MRI assessment of cardiac function complements T2* measurements by offering highly accurate and reproducible assessments of ventricular function. This manuscript describes the historical context of cardiac toxicity in thalassemia major, the introduction of cardiac T2* methods in the early 2000s, and the impact of these techniques on patient care as well as our fundamental understanding of iron cardiomyopathy. Technical details regarding T2* image acquisition and postprocessing are also discussed. As barriers to widespread implementation are being overcome, cardiac T2* is rapidly transitioning from a clinical research tool to the standard of care.

  9. Age-specific MRI templates for pediatric neuroimaging

    PubMed Central

    Sanchez, Carmen E.; Richards, John E.; Almli, C. Robert

    2012-01-01

    This study created a database of pediatric age-specific MRI brain templates for normalization and segmentation. Participants included children from 4.5 through 19.5 years, totaling 823 scans from 494 subjects. Open-source processing programs (FSL, SPM, ANTS) constructed head, brain and segmentation templates in 6 month intervals. The tissue classification (WM, GM, CSF) showed changes over age similar to previous reports. A volumetric analysis of age-related changes in WM and GM based on these templates showed expected increase/decrease pattern in GM and an increase in WM over the sampled ages. This database is available for use for neuroimaging studies (blindedforreview). PMID:22799759

  10. Improved interval estimation of comparative treatment effects

    NASA Astrophysics Data System (ADS)

    Van Krevelen, Ryne Christian

    Comparative experiments, in which subjects are randomized to one of two treatments, are performed often. There is no shortage of papers testing whether a treatment effect exists and providing confidence intervals for the magnitude of this effect. While it is well understood that the object and scope of inference for an experiment will depend on what assumptions are made, these entities are not always clearly presented. We have proposed one possible method, which is based on the ideas of Jerzy Neyman, that can be used for constructing confidence intervals in a comparative experiment. The resulting intervals, referred to as Neyman-type confidence intervals, can be applied in a wide range of cases. Special care is taken to note which assumptions are made and what object and scope of inference are being investigated. We have presented a notation that highlights which parts of a problem are being treated as random. This helps ensure the focus on the appropriate scope of inference. The Neyman-type confidence intervals are compared to possible alternatives in two different inference settings: one in which inference is made about the units in the sample and one in which inference is made about units in a fixed population. A third inference setting, one in which inference is made about a process distribution, is also discussed. It is stressed that certain assumptions underlying this third type of inference are unverifiable. When these assumptions are not met, the resulting confidence intervals may cover their intended target well below the desired rate. Through simulation, we demonstrate that the Neyman-type intervals have good coverage properties when inference is being made about a sample or a population. In some cases the alternative intervals are much wider than necessary on average. Therefore, we recommend that researchers consider using our Neyman-type confidence intervals when carrying out inference about a sample or a population as it may provide them with more

  11. Cognitive Predictors of Academic Achievement in Young Children 1 Year Following Traumatic Brain Injury

    PubMed Central

    Fulton, John B.; Yeates, Keith Owen; Taylor, H. Gerry; Walz, Nicolay C.; Wade, Shari L.

    2012-01-01

    Objective To examine cognitive predictors of academic achievement in young children with traumatic brain injury (TBI) and orthopedic injury (OI) shortly after injury and 1 year post-injury. Methods Participants included 3 to 6 year old children, 63 with TBI (46 with moderate TBI and 17 with severe TBI) and a comparison group of 80 children with OI. Academic achievement was assessed approximately 1 month and 12 months post injury, using three subtests from the Woodcock-Johnson Tests of Achievement-Third Edition and the School Readiness Composite from the Bracken Basic Concepts Scale-Revised. General intellectual functioning, memory, and executive functions were measured at the initial assessment using standardized tests. Results Hierarchical linear regression was used to predict academic achievement at the initial and 1-year follow-up assessments. Memory and executive functions were significant predictors of academic achievement at both assessments, after controlling for group membership and demographic variables. Executive function remained a significant predictor of some outcomes after taking general intellectual functioning into account. Predictive relationships did not vary across the TBI and OI groups. Similar results were obtained when regression analyses were completed with only TBI participants using the Glasgow Coma Scale (GCS) score as a predictor, although memory and executive functioning were somewhat less robust in predicting academic achievement than before. Conclusions Both memory and executive function predict academic achievement following TBI in preschool children, although some of the associations may be accounted for by general intellectual functioning. PMID:22563873

  12. Does antibiotic elution from PMMA beads deteriorate after 1-year shelf storage?

    PubMed

    Balsamo, Luke H; Whiddon, David R; Simpson, R Bruce

    2007-09-01

    Antibiotic-impregnated polymethylmethacrylate beads are widely used as an adjunct in the treatment of orthopaedic infections. Because there is no commercially available bead in the United States, surgeons must manufacture bead sets at the time of implantation. This can be time consuming and wasteful. We hypothesized antibiotic-impregnated beads would maintain consistent elution for up to 1 year after manufacturing and storage. Tobramycin-impregnated antibiotic beads were manufactured using a bead mold. The antibiotic was either hand-mixed into the polymethylmethacrylate powder (1.2 g/40 g) or came premixed from the factory (1 g/40 g). Packages of beads were gas-sterilized and stored at room temperature. Beads were tested at 0, 1, 2, 3, 6, and 12 months. Antibiotic levels in the eluent from each day of the month were measured. We were unable to detect any difference in the amount of antibiotic elution between beads tested immediately after manufacture and beads manufactured and stored for 6 or 12 months. Beads with hand-mixed antibiotics eluted higher levels of antibiotics than the beads prepared with factory-mixed antibiotics. We conclude antibiotic beads can be made, sterilized, and used after 1 year of storage with no deleterious effect on antibiotic elution characteristics.

  13. Impact of APOE4-CSF Aβ interaction on hippocampal volume loss over 1 year in MCI

    PubMed Central

    Chiang, G.C.; Insel, P.S.; Tosun, D.; Schuff, N.; Truran-Sacrey, D.; Raptentsetsang, S.T.; Thompson, P.M.; Reiman, E.M.; Jack, C.R.; Fox, N.C.; Jagust, W.J.; Harvey, D.J.; Beckett, L.A.; Gamst, A.; Aisen, P.S.; Petersen, R.C.; Weiner, M.W.

    2011-01-01

    Background The majority of studies relating amyloid pathology with brain volumes have been cross-sectional. Apolipoprotein E4 (APOE4), a genetic risk factor for Alzheimer’s disease (AD), is also associated with hippocampal volume loss. No studies have considered the effects of amyloid pathology and APOE4 together on longitudinal volume loss. Methods We evaluated whether an abnormal level of cerebrospinal fluid beta-amyloid (CSF Aβ) and APOE4 carrier status were independently associated with greater hippocampal volume loss over 1 year. We then assessed whether APOE4 status and CSF Aβ acted synergistically, testing the significance of an interaction term in the regression analysis. We included 297 participants: 77 cognitively normal (NC), 144 with mild cognitive impairment (MCI), and 76 with AD. Results An abnormal CSF Aβ level was found to be associated with greater hippocampal volume loss over 1 year in each group. APOE4 was associated with hippocampal volume loss only in the NC and MCI groups. APOE4 carriers with abnormal CSF Aβ in the MCI group acted synergistically to produce disproportionately greater volume loss than noncarriers. Conclusion Baseline CSF Aβ predicts progression of hippocampal volume loss. APOE4 carrier status amplifies the degree of neurodegeneration in MCI. Understanding the effect of interactions between genetic risk and amyloid pathology will be important in clinical trials and our understanding of the disease process. PMID:21889115

  14. Parental spanking of 1-year-old children and subsequent child protective services involvement✩

    PubMed Central

    Lee, Shawna J.; Grogan-Kaylor, Andrew; Berger, Lawrence M.

    2015-01-01

    The majority of U.S. parents spank their children, often beginning when their children are very young. We examined families (N=2,788) who participated in a longitudinal community-based study of new births in urban areas. Prospective analyses examined whether spanking by the child's mother, father, or mother's current partner when the child was 1-year-old was associated with household CPS involvement between age 1 and age 5. Results indicated that 30% of 1-year-olds were spanked at least once in the past month. Spanking at age 1 was associated with increased odds of subsequent CPS involvement (adjusted odds ratio=1.36, 95% CI [1.08, 1.71], p<.01). When compared to non-spanked children, there was a 33% greater probability of subsequent CPS involvement for children who were spanked at age 1. Given the undesirable consequences of spanking children and a lack of empirical evidence to suggest positive effects of physical punishment, professionals who work with families should counsel parents not to spank infants and toddlers. For optimal benefits, efforts to educate parents regarding alternative forms of discipline should begin during the child's first year of life. PMID:24602690

  15. Parental spanking of 1-year-old children and subsequent child protective services involvement.

    PubMed

    Lee, Shawna J; Grogan-Kaylor, Andrew; Berger, Lawrence M

    2014-05-01

    The majority of U.S. parents spank their children, often beginning when their children are very young. We examined families (N=2,788) who participated in a longitudinal community-based study of new births in urban areas. Prospective analyses examined whether spanking by the child's mother, father, or mother's current partner when the child was 1-year-old was associated with household CPS involvement between age 1 and age 5. Results indicated that 30% of 1-year-olds were spanked at least once in the past month. Spanking at age 1 was associated with increased odds of subsequent CPS involvement (adjusted odds ratio=1.36, 95% CI [1.08, 1.71], p<.01). When compared to non-spanked children, there was a 33% greater probability of subsequent CPS involvement for children who were spanked at age 1. Given the undesirable consequences of spanking children and a lack of empirical evidence to suggest positive effects of physical punishment, professionals who work with families should counsel parents not to spank infants and toddlers. For optimal benefits, efforts to educate parents regarding alternative forms of discipline should begin during the child's first year of life. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Prediction of depression and anxiety 1 year after moderate-severe traumatic brain injury.

    PubMed

    Demakis, George J; Hammond, Flora M; Knotts, Allison

    2010-07-01

    This study examined three scales of the Personality Assessment Inventory (PAI; Anxiety, Anxiety-Related Disorders, and Depression) in 88 participants 1 year after they suffered a moderate-severe traumatic brain injury (TBI). Participants were all enrolled in the federally funded Traumatic Brain Injury Model System project at Carolinas Rehabilitation. The following variables were assessed at the time of injury: age, sex, employment and marital status, and length of loss of consciousness. Disability status, using the Disability Rating Scale (DRS), was assessed at the time of discharge from the rehabilitation hospital. A series of three linear regression analyses found that these variables significantly predicted scores on the Anxiety and Anxiety-Related Disorders scales, which accounted for 14% and 17.7% of the variance, respectively. The variables did not significantly predict scores on the Depression scale. Within each regression analysis, DRS was consistently and negatively related to each PAI scale, such that greater disability was associated with better psychological functioning. Such seemingly paradoxical findings are discussed in terms of anosognosia or poor awareness of psychological functioning among those with greater disability 1 year after TBI.

  17. [Maternal perception of her child's weight and unrelated children less than 1 year old].

    PubMed

    Flores-Peña, Yolanda; Aguado-Barrera, Miguel E; Cerda-Flores, Ricardo M; Cortés-Gutiérrez, Elva I; Dávila-Rodríguez, Martha I

    2016-11-01

    To evaluate the maternal perception of their child's weight (MPCW) and perception of unrelated children's weight. Cross-sectional. Maternal and Child Nursing Health Department at 6 Units of Family Medicine. 486 dyads (mother and child under 1 year). The following question was applied: "I think my child is", and images were provided according the child's gender. Children's weight and height were measured. A total of 20.5% of the mothers of overweight (OW) children accurately perceived this situation, while none of the mothers of obese (OB) children did (κ=0.14±0.03, Z=5.36, p=.001). By images, 63.3% of mothers of OW children and 33.3% of mothers of OB children perceived this situation (κ=0.01±0.02, Z=0.73, p=.46). Most mothers selected the image of OW child as the image of a healthy child (κ=-0.04±0.01, Z=-2.65, p=.008), the image of a child under 1 year (κ=-0.01±0.02, Z=-0.86, p=.38) and the image that they would like their child to look like (κ=0.0004±0.01, Z=0.02, p=.98). The mothers do not perceive the OW-OB of their children. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  18. Dialectical Behavior Therapy for Adolescents With Bipolar Disorder: A 1-Year Open Trial

    PubMed Central

    GOLDSTEIN, TINA R.; AXELSON, DAVID A.; BIRMAHER, BORIS; BRENT, DAVID A.

    2010-01-01

    Objective To describe an adapted version of dialectical behavior therapy for adolescents with bipolar disorder. Method The dialectical behavior therapy intervention is delivered over 1 year and consists of two modalities: family skills training (conducted with individual family units) and individual therapy. The acute treatment period (6 months) includes 24 weekly sessions; sessions alternate between the two treatment modalities. Continuation treatment consists of 12 additional sessions tapering in frequency through 1 year. We conducted an open pilot trial of the treatment, designed as an adjunct to pharmacological management, to establish feasibility and acceptability of the treatment for this population. Participants included 10 patients (mean age 15.8 ± 1.5 years, range 14–18) receiving treatment in an outpatient pediatric bipolar specialty clinic. Symptom severity and functioning were assessed quarterly by an independent evaluator. Consumer satisfaction was also assessed posttreatment. Results Feasibility and acceptability of the intervention were high, with 9 of 10 patients completing treatment, 90% of scheduled sessions attended, and high treatment satisfaction ratings. Patients exhibited significant improvement from pre- to posttreatment in suicidality, nonsuicidal self-injurious behavior, emotional dysregulation, and depressive symptoms. Conclusions Dialectical behavior therapy may offer promise as an approach to the psychosocial treatment of adolescent bipolar disorder. PMID:17581446

  19. Worksite Opportunities for Wellness (WOW): effects on cardiovascular disease risk factors after 1 year.

    PubMed

    Racette, Susan B; Deusinger, Susan S; Inman, Cindi L; Burlis, Tamara L; Highstein, Gabrielle R; Buskirk, Trent D; Steger-May, Karen; Peterson, Linda R

    2009-01-01

    To evaluate the effectiveness of a worksite health promotion program on improving cardiovascular disease risk factors. In St Louis, Missouri from 2005 to 2006, 151 employees (134 F, 17 M, 81% overweight/obese) participated in a cohort-randomized trial comparing assessments + intervention (worksite A) with assessments only (worksite B) for 1 year. All participants received personal health reports containing their assessment results. The intervention was designed to promote physical activity and favorable dietary patterns using pedometers, healthy snack cart, WeightWatchers(R) meetings, group exercise classes, seminars, team competitions, and participation rewards. Outcomes included BMI, body composition, blood pressure, fitness, lipids, and Framingham 10-year coronary heart disease risk. 123 participants, aged 45+/-9 yr, with BMI 32.9+/-8.8 kg/m(2) completed 1 year. Improvements (P< or =0.05) were observed at both worksites for fitness, blood pressure, and total-, HDL-, and LDL-cholesterol. Additional improvements occurred at worksite A in BMI, fat mass, Framingham risk score, and prevalence of the metabolic syndrome; only the changes in BMI and fat mass were different between worksites. A multi-faceted worksite intervention promoted favorable changes in cardiovascular disease risk factors, but many of the improvements were achieved with worksite health assessments and personalized health reports in the absence of an intervention.

  20. Worksite Opportunities for Wellness (WOW): Effects on cardiovascular disease risk factors after 1 year

    PubMed Central

    Racette, Susan B.; Deusinger, Susan S.; Inman, Cindi L.; Burlis, Tamara L.; Highstein, Gabrielle R.; Buskirk, Trent D.; Steger-May, Karen; Peterson, Linda R.

    2015-01-01

    Objective To evaluate the effectiveness of a worksite health promotion program on improving cardiovascular disease risk factors. Methods In St Louis, Missouri from 2005 to 2006, 151 employees (134 F, 17 M, 81% overweight/obese) participated in a cohort-randomized trial comparing assessments + intervention (worksite A) with assessments only (worksite B) for 1 year. All participants received personal health reports containing their assessment results. The intervention was designed to promote physical activity and favorable dietary patterns using pedometers, healthy snack cart, WeightWatchers® meetings, group exercise classes, seminars, team competitions, and participation rewards. Outcomes included BMI, body composition, blood pressure, fitness, lipids, and Framingham 10-year coronary heart disease risk. Results 123 participants, aged 45 ± 9 yr, with BMI 32.9 ± 8.8 kg/m2 completed 1 year. Improvements (P ≤ 0.05) were observed at both worksites for fitness, blood pressure, and total-, HDL-, and LDL-cholesterol. Additional improvements occurred at worksite A in BMI, fat mass, Framingham risk score, and prevalence of the metabolic syndrome; only the changes in BMI and fat mass were different between worksites. Conclusion A multi-faceted worksite intervention promoted favorable changes in cardiovascular disease risk factors, but many of the improvements were achieved with worksite health assessments and personalized health reports in the absence of an intervention. PMID:19576927

  1. The relationship of neonatal subclinical electrographic seizures to neurodevelopmental outcome at 1 year of age.

    PubMed

    Kurul, Semra Hiz; Sutcuoglu, Sumer; Yis, Uluc; Duman, Nuray; Kumral, Abdullah; Ozkan, Hasan

    2009-07-01

    To evaluate the influence of 'only electroencephalographic (EEG)' and 'EEG plus clinical' seizures during neonatal period on neurodevelopment of the infants. The long-term digital-video- EEG tracings of the first 3 days of life of 30 neonates were assessed. The babies were subdivided into three groups: Group 1 had neither EEG nor clinical seizures. Group 2 had EEG seizures but no clinical seizures. Group 3 experienced both EEG and clinical seizures. The groups were compared in regard to psychomotor retardation and epilepsy at corrected age of 1 year. The mean birthweight was 1952.50 +/- 978.74 (685-4103) g. The mean gestational age was 32.53 +/- 4.26 (24-40) weeks. In regard to sex, gestational age and birth weight, there was no significant difference between the three groups. Ten percent of newborns in Group 1 and 53.8% of newborns in Group 3 had psychomotor retardation. No babies in Group 2 experienced psychomotor retardation. The differences between the Groups 1 and 3 and Groups 2 and 3 were found statistically significant. Only one baby in Group 3 had epilepsy. In Groups 1 and 2, no babies had epilepsy. The differences between the groups were not significant. Neonatal seizures, but not silent EEG seizures are in relationship with poor neurodevelopmental outcome evaluated at corrected age of 1 year in newborns.

  2. Phase Fluctuations at Goldstone Derived from 1-Year Site Testing Interferometer Data

    NASA Technical Reports Server (NTRS)

    Nessel, James A.; Acosta, Roberto J.; Morabito, David D.

    2009-01-01

    A two-element site test interferometer has been deployed at the NASA Deep Space Network (DSN) tracking complex in Goldstone, California, since May 2007. The interferometer system consists of two offset-fed 1.2 m parabolic reflectors which monitor atmospheric-induced amplitude and phase fluctuations on an unmodulated beacon signal (20.199 GHz) broadcast from a geostationary satellite (Anik F2). The geometry of the satellite and the ground-based infrastructure imposes a 48.5 elevation angle with a separation distance of 256 m along an east-west baseline. The interferometer has been recording phase fluctuation data, to date, for 1 yr with an overall system availability of 95 percent. In this paper, we provide the cumulative distribution functions (CDFs) for 1 year of recorded data, including phase rms, spatial structure function exponent, and surface meteorological measurements: surface wind speed, relative humidity, temperature, barometric pressure, and rain rate. Correlation between surface measurements, phase rms, and amplitude rms at different time scales are discussed. For 1 year, phase fluctuations at the DSN site in Goldstone, are better than 23 for 90 percent of the time (at 48.5 elevation). This data will be used to determine the suitability of the Goldstone site as a location for the Next Generation Deep Space Network.

  3. Induction of Maturogenesis by Partial Pulpotomy: 1 Year Follow-Up

    PubMed Central

    Bacaksiz, A.; Alaçam, A.

    2013-01-01

    In cariously exposed immature permanent teeth, the treatment choice is controversial in pediatric dentistry. Radical root canal treatment usually appears to be the solution for these teeth. Even partial pulpotomy is a vital treatment for traumatically exposed immature permanent teeth; extending the borders of indication towards cariously exposed immature permanent teeth with reversible pulpitis may abolish the necessity of pulpectomy. This article describes the partial pulpotomy of a cariously affected immature permanent teeth and the follow-up for 1 year. A healthy 11-year-old male patient was referred to Gazi University Faculty of Dentistry Department of Pediatric Dentistry. The patient had reversible pulpitis symptoms on teeth numbered 45. At radiographic examination, immature apex and deep caries lesion were observed and partial pulpotomy was performed by using calcium hydroxide to maintain vitality of the pulp and allow continued development of root dentin expecting the root will attain full maturity. Clinical and radiographic follow-up demonstrated a vital pulp besides not only closure of the apex (apexogenesis), but also physiologic root development (maturogenesis) after 1 year. Partial pulpotomy is an optional treatment for cariously exposed immature permanent teeth for preserving vitality and physiological root development. PMID:24324899

  4. Induction of maturogenesis by partial pulpotomy: 1 year follow-up.

    PubMed

    Bacaksiz, A; Alaçam, A

    2013-01-01

    In cariously exposed immature permanent teeth, the treatment choice is controversial in pediatric dentistry. Radical root canal treatment usually appears to be the solution for these teeth. Even partial pulpotomy is a vital treatment for traumatically exposed immature permanent teeth; extending the borders of indication towards cariously exposed immature permanent teeth with reversible pulpitis may abolish the necessity of pulpectomy. This article describes the partial pulpotomy of a cariously affected immature permanent teeth and the follow-up for 1 year. A healthy 11-year-old male patient was referred to Gazi University Faculty of Dentistry Department of Pediatric Dentistry. The patient had reversible pulpitis symptoms on teeth numbered 45. At radiographic examination, immature apex and deep caries lesion were observed and partial pulpotomy was performed by using calcium hydroxide to maintain vitality of the pulp and allow continued development of root dentin expecting the root will attain full maturity. Clinical and radiographic follow-up demonstrated a vital pulp besides not only closure of the apex (apexogenesis), but also physiologic root development (maturogenesis) after 1 year. Partial pulpotomy is an optional treatment for cariously exposed immature permanent teeth for preserving vitality and physiological root development.

  5. Depression and Cognitive Function in Mild Cognitive Impairment: A 1-Year Follow-Up Study.

    PubMed

    Yoon, Seoyoung; Shin, Cheolmin; Han, Changsu

    2017-09-01

    The coexistence of depression with mild cognitive impairment (MCI) seems to increase the risk of dementia. However, the explanations of that relationship have been inconsistent. We investigated cognitive profiles in patients with MCI with and without depression and whether changes in depression symptoms affect cognition longitudinally. For the study, 161 patients with MCI were divided into a depressed group (D+) and a nondepressed group (D-). After 1 year, we redivided the original D- group into D- and newly developed depression (Dd) groups and the D+ group into improved depression (Di) and nonimproved depression (Dn) groups. Neuropsychological tests assessing depression and cognitive domains were performed at baseline and follow-up. When age-adjusted, the D+ group showed significantly poorer performance in general cognition and some subtests regarding memory, executive function, and attention. At the 1-year follow-up, changes in the calculation test ( P = .005) and Controlled Oral Word Test (COWAT; P = .048) were significantly different between groups. Only the Di group showed significant improvement in calculation. The Dn group showed significant decrement in COWAT that was significantly different from that of the Di group, which showed no significant change. Patients with depression having MCI showed poorer cognitive function than nondepressed patients with MCI in some cognitive domains. Improvement in depression was related to improvement or prevention of decline in cognitive measures.

  6. Prospective, 1-year observational study of double-threaded tapered body dental implants with immediate loading.

    PubMed

    Kim, Tae Hyung; Knezevic, Alena; Jorgensen, Michael; Rich, Sandra; Nowzari, Hessam

    2015-07-01

    Unlike conventional loading protocols, the immediate loading of single implants has not been fully investigated. The purpose of this study was to assess the prosthetic and esthetic periimplant mucosal outcomes of immediately restored dental implants during a 1-year follow-up. Twenty participants meeting the established inclusion criteria received double-threaded, tapered body dental implants (SuperLine; Dentium). Implants were placed and stabilized at a minimum of 35 Ncm of torque and restored immediately after the surgery with interim restorations. These were replaced with definitive restorations 6 months after implant placement. Clinical measurements at each visit included resonance frequency analysis, the evaluation of the participants' oral health (gingival and plaque indices), and the esthetic outcome of the interim or definitive restoration. Implants placed in this clinical study had a 100% success rate. The oral health and esthetic outcomes were favorable for all participants. Double-threaded, tapered body dental implants that were placed and immediately restored with fixed interim prostheses and with definitive prostheses after 6 months remained stable and functional after 1 year. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  7. Management of skull fractures in children less than 1 year of age.

    PubMed

    Addioui, Anissa; Saint-Vil, Dickens; Crevier, Louis; Beaudin, Marianne

    2016-07-01

    Management of skull fracture (SF) in pediatric patients varies from observation in the emergency department (ED) to floor admission. Since 2010, a protocol for admitting children with SF specifically to the trauma service was implemented at our institution. The purpose of our study was to review the management of children with SF younger than 1 year of age. Retrospective chart review of all patients between 0 and 1year of age seen in our ED for a SF was done from 2010 to 2013. A total of 180 patients with a mean age of 4.5months (1day-12months) were identified. Of these, 131 patients (73%) were admitted. Mean length of stay was 1.6days. Admitted patients had more depressed (21 vs. 8%) and diastatic (43 vs. 14%) fractures. Fifty-seven children had intracranial hemorrhages (32%) but only 8 patients required non-emergent surgery for depressed fractures. Admission to the trauma service increased from none to 76% with phone follow-ups increasing from 12% to 91%. Instituting a protocol allowed a safer management of patients with SF. Moreover, we argue that asymptomatic infants with isolated SF can be safely discharged home after brief observation in the ED. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Empirical Bayes interval estimates that are conditionally equal to unadjusted confidence intervals or to default prior credibility intervals.

    PubMed

    Bickel, David R

    2012-02-21

    Problems involving thousands of null hypotheses have been addressed by estimating the local false discovery rate (LFDR). A previous LFDR approach to reporting point and interval estimates of an effect-size parameter uses an estimate of the prior distribution of the parameter conditional on the alternative hypothesis. That estimated prior is often unreliable, and yet strongly influences the posterior intervals and point estimates, causing the posterior intervals to differ from fixed-parameter confidence intervals, even for arbitrarily small estimates of the LFDR. That influence of the estimated prior manifests the failure of the conditional posterior intervals, given the truth of the alternative hypothesis, to match the confidence intervals. Those problems are overcome by changing the posterior distribution conditional on the alternative hypothesis from a Bayesian posterior to a confidence posterior. Unlike the Bayesian posterior, the confidence posterior equates the posterior probability that the parameter lies in a fixed interval with the coverage rate of the coinciding confidence interval. The resulting confidence-Bayes hybrid posterior supplies interval and point estimates that shrink toward the null hypothesis value. The confidence intervals tend to be much shorter than their fixed-parameter counterparts, as illustrated with gene expression data. Simulations nonetheless confirm that the shrunken confidence intervals cover the parameter more frequently than stated. Generally applicable sufficient conditions for correct coverage are given. In addition to having those frequentist properties, the hybrid posterior can also be motivated from an objective Bayesian perspective by requiring coherence with some default prior conditional on the alternative hypothesis. That requirement generates a new class of approximate posteriors that supplement Bayes factors modified for improper priors and that dampen the influence of proper priors on the credibility intervals. While

  9. [MRI of the pineal gland].

    PubMed

    Langevad, Line; Madsen, Camilla Gøbel; Siebner, Hartwig; Garde, Ellen

    2014-11-10

    The pineal gland (CP) is located centrally in the brain and produces melatonin. Cysts and concrements are frequent findings on MRI but their significance is still unclear. The visualization of CP is difficult due to its location and surrounding structures and so far, no standardized method exists. New studies suggest a correlation between CP-morphology and melatonin secretion as well as a connection between melatonin, disturbed circadian rhythm, and the development of cancer and cardiovascular diseases, underlining the need for a standardized approach to CP on MRI.

  10. MRI EVALUATION OF KNEE CARTILAGE

    PubMed Central

    Rodrigues, Marcelo Bordalo; Camanho, Gilberto Luís

    2015-01-01

    Through the ability of magnetic resonance imaging (MRI) to characterize soft tissue noninvasively, it has become an excellent method for evaluating cartilage. The development of new and faster methods allowed increased resolution and contrast in evaluating chondral structure, with greater diagnostic accuracy. In addition, physiological techniques for cartilage assessment that can detect early changes before the appearance of cracks and erosion have been developed. In this updating article, the various techniques for chondral assessment using knee MRI will be discussed and demonstrated. PMID:27022562

  11. Fetal MRI: A pictorial essay

    PubMed Central

    Rathee, Sapna; Joshi, Priscilla; Kelkar, Abhimanyu; Seth, Nagesh

    2016-01-01

    Ultrasonography (USG) is the primary method for antenatal fetal evaluation. However, fetal magnetic resonance imaging (MRI) has now become a valuable adjunct to USG in confirming/excluding suspected abnormalities and in the detection of additional abnormalities, thus changing the outcome of pregnancy and optimizing perinatal management. With the development of ultrafast sequences, fetal MRI has made remarkable progress in recent times. In this pictorial essay, we illustrate a spectrum of structural abnormalities affecting the central nervous system, thorax, genitourinary and gastrointestinal tract, as well as miscellaneous anomalies. Anomalies in twin gestations and placental abnormalities have also been included. PMID:27081224

  12. Prediction of Cognitive Decline in Healthy Older Adults using fMRI

    PubMed Central

    Woodard, John L.; Seidenberg, Michael; Nielson, Kristy A.; Smith, J. Carson; Antuono, Piero; Durgerian, Sally; Guidotti, Leslie; Zhang, Qi; Butts, Alissa; Hantke, Nathan; Lancaster, Melissa; Rao, Stephen M.

    2010-01-01

    Few studies have examined the extent to which structural and functional MRI, alone and in combination with genetic biomarkers, can predict future cognitive decline in asymptomatic elders. This prospective study evaluated individual and combined contributions of demographic information, genetic risk, hippocampal volume, and fMRI activation for predicting cognitive decline after an 18-month retest interval. Standardized neuropsychological testing, an fMRI scans semantic memory task (famous name discrimination), and structural MRI (sMRI) were performed on 78 healthy elders (73% female; mean age = 73 years, range = 65 to 88 years). Positive family history of dementia and presence of one or both apolipoprotein E (APOE) ε4 alleles occurred in 51.3% and 33.3% of the sample, respectively. Hippocampal volumes were traced from sMRI scans. At follow-up, all participants underwent a repeat neuropsychological examination. At 18 months, 27 participants (34.6%) declined by at least 1 SD on one of three neuropsychological measures. Using logistic regression, demographic variables (age, years of education, gender) and family history of dementia did not predict future cognitive decline. Greater fMRI activity, absence of an APOE ε4 allele, and larger hippocampal volume were associated with reduced likelihood of cognitive decline. The most effective combination of predictors involved fMRI brain activity and APOE ε4 status. Brain activity measured from task-activated fMRI, in combination with APOE ε4 status, was successful in identifying cognitively intact individuals at greatest risk for developing cognitive decline over a relatively brief time period. These results have implications for enriching prevention clinical trials designed to slow AD progression. PMID:20634590

  13. Magnetic Resonance Imaging (MRI): Brain (For Parents)

    MedlinePlus

    ... to 2-Year-Old Magnetic Resonance Imaging (MRI): Brain KidsHealth > For Parents > Magnetic Resonance Imaging (MRI): Brain ... child may be given headphones to listen to music or earplugs to block the noise, and will ...

  14. Magnetic Resonance Imaging (MRI) (For Teens)

    MedlinePlus

    ... away. A radiologist (a doctor trained to understand MRI scans) needs to look at the images. The radiologist ... TOPIC Medical Tests: What to Expect (Video) CAT Scan (Video) MRI (Video) Questions to Ask Your Doctor Taking Charge ...

  15. Echocardiographic Findings Predict In-Hospital and 1-Year Mortality in Left-Sided Native Valve Staphylococcus aureus Endocarditis: Analysis From the International Collaboration on Endocarditis-Prospective Echo Cohort Study.

    PubMed

    Lauridsen, Trine K; Park, Lawrence; Tong, Steven Y C; Selton-Suty, Christine; Peterson, Gail; Cecchi, Enrico; Afonso, Luis; Habib, Gilbert; Paré, Carlos; Tamin, Syahidah; Dickerman, Stuart; Bayer, Arnold S; Johansson, Magnus C; Chu, Vivian H; Samad, Zainab; Bruun, Niels E; Fowler, Vance G; Crowley, Anna Lisa

    2015-07-01

    Staphylococcus aureus left-sided native valve infective endocarditis (LNVIE) has higher complication and mortality rates compared with endocarditis from other pathogens. Whether echocardiographic variables can predict prognosis in S aureus LNVIE is unknown. Consecutive patients with LNVIE, enrolled between January 2000 and September 2006, in the International Collaboration on Endocarditis were identified. Subjects without S aureus IE were matched to those with S aureus IE by the propensity of having S aureus. Survival differences were determined using log-rank significance tests. Independent echocardiographic predictors of mortality were identified using Cox-proportional hazards models that included inverse probability of treatment weighting and surgery as a time-dependent covariate. Of 727 subjects with LNVIE and 1-year follow-up, 202 had S aureus IE. One-year survival rates were significantly lower for patients with S aureus IE overall (57% S aureus IE versus 80% non-S aureus IE; P<0.001) and in the propensity-matched cohort (59% S aureus IE versus 68% non-S aureus IE; P<0.05). Intracardiac abscess (hazard ratio, 2.93; 95% confidence interval, 1.52-5.40; P<0.001) and left ventricular ejection fraction <40% (odds ratio, 3.01; 95% confidence interval, 1.35-6.04; P=0.004) were the only independent echocardiographic predictors of in-hospital mortality in S aureus LNVIE. Valve perforation (hazard ratio, 2.16; 95% confidence interval, 1.21-3.68; P=0.006) and intracardiac abscess (hazard ratio, 2.25; 95% confidence interval, 1.26-3.78; P=0.004) were the only independent predictors of 1-year mortality. S aureus is an independent predictor of 1-year mortality in subjects with LNVIE. In S aureus LNVIE, intracardiac abscess and left ventricular ejection fraction <40% independently predicted in-hospital mortality and intracardiac abscess and valve perforation independently predicted 1-year mortality. © 2015 American Heart Association, Inc.

  16. Approximate Subject Specific Pseudo MRI from an Available MRI Dataset for MEG Source Imaging.

    PubMed

    Gohel, Bakul; Lim, Sanghyun; Kim, Min-Young; Kwon, Hyukchan; Kim, Kiwoong

    2017-01-01

    Computation of headmodel and sourcemodel from the subject's MRI scan is an essential step for source localization of magnetoencephalography (MEG) (or EEG) sensor signals. In the absence of a real MRI scan, pseudo MRI (i.e., associated headmodel and sourcemodel) is often approximated from an available standard MRI template or pool of MRI scans considering the subject's digitized head surface. In the present study, we approximated two types of pseudo MRI (i.e., associated headmodel and sourcemodel) using an available pool of MRI scans with the focus on MEG source imaging. The first was the first rank pseudo MRI; that is, the MRI scan in the dataset having the lowest objective registration error (ORE) after being registered (rigid body transformation with isotropic scaling) to the subject's digitized head surface. The second was the averaged rank pseudo MRI that is generated by averaging of headmodels and sourcemodels from multiple MRI scans respectively, after being registered to the subject's digitized head surface. Subject level analysis showed that the mean upper bound of source location error for the approximated sourcemodel in reference to the real one was 10 ± 3 mm for the averaged rank pseudo MRI, which was significantly lower than the first rank pseudo MRI approach. Functional group source response in the brain to visual stimulation in the form of event-related power (ERP) at the time latency of peak amplitude showed noticeably identical source distribution for first rank pseudo MRI, averaged rank pseudo MRI, and real MRI. The source localization error for functional peak response was significantly lower for averaged rank pseudo MRI compared to first rank pseudo MRI. We conclude that it is feasible to use approximated pseudo MRI, particularly the averaged rank pseudo MRI, as a substitute for real MRI without losing the generality of the functional group source response.

  17. Approximate Subject Specific Pseudo MRI from an Available MRI Dataset for MEG Source Imaging

    PubMed Central

    Gohel, Bakul; Lim, Sanghyun; Kim, Min-Young; Kwon, Hyukchan; Kim, Kiwoong

    2017-01-01

    Computation of headmodel and sourcemodel from the subject's MRI scan is an essential step for source localization of magnetoencephalography (MEG) (or EEG) sensor signals. In the absence of a real MRI scan, pseudo MRI (i.e., associated headmodel and sourcemodel) is often approximated from an available standard MRI template or pool of MRI scans considering the subject's digitized head surface. In the present study, we approximated two types of pseudo MRI (i.e., associated headmodel and sourcemodel) using an available pool of MRI scans with the focus on MEG source imaging. The first was the first rank pseudo MRI; that is, the MRI scan in the dataset having the lowest objective registration error (ORE) after being registered (rigid body transformation with isotropic scaling) to the subject's digitized head surface. The second was the averaged rank pseudo MRI that is generated by averaging of headmodels and sourcemodels from multiple MRI scans respectively, after being registered to the subject's digitized head surface. Subject level analysis showed that the mean upper bound of source location error for the approximated sourcemodel in reference to the real one was 10 ± 3 mm for the averaged rank pseudo MRI, which was significantly lower than the first rank pseudo MRI approach. Functional group source response in the brain to visual stimulation in the form of event-related power (ERP) at the time latency of peak amplitude showed noticeably identical source distribution for first rank pseudo MRI, averaged rank pseudo MRI, and real MRI. The source localization error for functional peak response was significantly lower for averaged rank pseudo MRI compared to first rank pseudo MRI. We conclude that it is feasible to use approximated pseudo MRI, particularly the averaged rank pseudo MRI, as a substitute for real MRI without losing the generality of the functional group source response. PMID:28848418

  18. The microanalysis of fixed-interval responding

    PubMed Central

    Gentry, G. David; Weiss, Bernard; Laties, Victor G.

    1983-01-01

    The fixed-interval schedule of reinforcement is one of the more widely studied schedules in the experimental analysis of behavior and is also a common baseline for behavior pharmacology. Despite many intensive studies, the controlling variables and the pattern of behavior engendered are not well understood. The present study examined the microstructure and superstructure of the behavior engendered by a fixed-interval 5- and a fixed-interval 15-minute schedule of food reinforcement in the pigeon. Analysis of performance typical of fixed-interval responding indicated that the scalloped pattern does not result from smooth acceleration in responding, but, rather, from renewed pausing early in the interval. Individual interresponse-time (IRT) analyses provided no evidence of acceleration. There was a strong indication of alternation in shorter-longer IRTs, but these shorter-longer IRTs did not occur at random, reflecting instead a sequential dependency in successive IRTs. Furthermore, early in the interval there was a high relative frequency of short IRTs. Such a pattern of early pauses and short IRTs does not suggest behavior typical of reinforced responding as exemplified by the pattern found near the end of the interval. Thus, behavior from clearly scalloped performance can be classified into three states: postreinforcement pause, interim behavior, and terminal behavior. PMID:16812324

  19. Microanalysis of fixed-interval responding

    SciTech Connect

    Gentry, G.D.; Weiss, B.; Laties, V.G.

    1983-03-01

    The fixed-interval schedule of reinforcement is one of the more widely studied schedules in the experimental analysis of behavior and is also a common baseline for behavior pharmacology. Despite many intensive studies, the controlling variables and the pattern of behavior engendered are not well understood. The present study examined the microstructure and superstructure of the behavior engendered by a fixed-interval 5- and a fixed-interval 15-minute schedule of food reinforcement in the pigeon. Analysis of performance typical of fixed-interval responding indicated that the scalloped pattern does not result from smooth acceleration in responding, but, rather, from renewed pausing early in the interval. Individual interresponse-time (IRT) analyses provided no evidence of acceleration. There was a strong indication of alternation is shorter-longer IRTs, but these shorter-longer IRTs did not occur at random, reflecting instead a sequential dependency in successive IRTs. Furthermore, early in the interval there was a high relative frequency of short IRTs. Such a pattern of early pauses and short IRTs does not suggest behavior typical of reinforced responding as exemplified by the pattern found near the end of the interval. Thus, behavior from clearly scalloped performance can be classified into three states: postreinforcement pause, interim behavior, and terminal behavior. 31 references, 11 figures, 4 tables.

  20. Bipolar control in fixed interfood intervals

    PubMed Central

    Palya, William L.

    1993-01-01

    The ability of stimuli correlated with successive periods in a fixed interfood interval to support a response that produced or removed them was examined using pigeons. The degree to which those correlated stimuli elicited directed key pecks was also obtained. Stimuli early in the interval functioned as negative reinforcers, and stimuli late in the interval functioned as positive reinforcers. Stimuli correlated with successively later portions of the second half of the interval supported successively higher rates of elicited pecking and, with the exception of the final stimulus, supported successively higher rates of stimulus production. Stimuli in successively earlier portions of the first half of the interval supported successively higher rates of correlated-stimulus removal. This effect occurred in spite of the addition of a conjoint variable-interval dependency for food. An ogive fit to the mean normalized response distributions resulted in r2s demonstrating that most of the variance in the temporal organization of the behavior was accounted for. The findings were taken to indicate that fixed interfood intervals establish bipolar control. PMID:16812702

  1. Acceleration-induced electrocardiographic interval changes.

    PubMed

    Whinnery, C C; Whinnery, J E

    1988-02-01

    The electrocardiographic intervals (PR, QRS, QT, and RR) before, during, and post +Gz stress were measured in 24 healthy male subjects undergoing +Gz centrifuge exposure. The PR and QRS intervals responded in a predictable manner, shortening during stress and returning to baseline resting values post-stress. The QT interval, however, was not observed to be dependent solely on heart rate. Bazett's formula, which was developed to correct for heart rate variability, did not adequately result in a homogeneous correction of the QT interval for each stress-related period. During +Gz stress, the QT was shortened, and the QTc prolonged. The QT interval remained shortened even though the heart rate returned to baseline (with the QTc undercorrected) in the post-stress period. The QT (QTc) interval variations probably reflect the effects of both heart rate and autonomic balance during and after +Gz stress, and may provide a measure of the prevailing autonomic (sympathetic or parasympathetic) tone existing at a given point associated with +Gz stress. These electrocardiographic interval changes define the normal response for healthy individuals. Individuals with exaggerated autonomic responses could be identified by comparing their responses to these normal responses resulting from +Gz stress.

  2. A survey on abnormal uterine bleeding among radiographers with frequent MRI exposure using intrauterine contraceptive devices.

    PubMed

    Huss, A; Schaap, K; Kromhout, H

    2017-04-25

    Based on a previous case report of menometrorrhagia (prolonged/excessive uterine bleeding, occurring at irregular and/or frequent intervals) in MRI workers with intrauterine devices (IUDs), it was evaluated whether this association could be confirmed. A survey was performed among 381 female radiographers registered with their national association. Logistic regression was used to analyze associations of abnormal uterine bleeding with the frequency of working with MRI scanners, presence near the scanner/in the scanner room during image acquisition, and with scanner strength or type. A total of 68 women reported using IUDs, and 72 reported abnormal uterine bleeding. Compared with unexposed women not using IUDs, the odds ratio in women with IUDs working with MRI scanners was 2.09 (95% confidence interval 0.83-3.66). Associations were stronger if women working with MRI reported being present during image acquisition (odds ratio 3.43, 95% CI 1.26-9.34). Associations with scanner strength or type were not consistent. Radiographers using IUDs who are occupationally exposed to stray fields from MRI scanners report abnormal uterine bleeding more often than their co-workers without an IUD, or nonexposed co-workers with an IUD. In particular, radiographers present inside the scanner room during image acquisition showed an increased risk. Magn Reson Med, 2017. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  3. Magnetic Resonance Fingerprinting with short relaxation intervals.

    PubMed

    Amthor, Thomas; Doneva, Mariya; Koken, Peter; Sommer, Karsten; Meineke, Jakob; Börnert, Peter

    2017-09-01

    The aim of this study was to investigate a technique for improving the performance of Magnetic Resonance Fingerprinting (MRF) in repetitive sampling schemes, in particular for 3D MRF acquisition, by shortening relaxation intervals between MRF pulse train repetitions. A calculation method for MRF dictionaries adapted to short relaxation intervals and non-relaxed initial spin states is presented, based on the concept of stationary fingerprints. The method is applicable to many different k-space sampling schemes in 2D and 3D. For accuracy analysis, T1 and T2 values of a phantom are determined by single-slice Cartesian MRF for different relaxation intervals and are compared with quantitative reference measurements. The relevance of slice profile effects is also investigated in this case. To further illustrate the capabilities of the method, an application to in-vivo spiral 3D MRF measurements is demonstrated. The proposed computation method enables accurate parameter estimation even for the shortest relaxation intervals, as investigated for different sampling patterns in 2D and 3D. In 2D Cartesian measurements, we achieved a scan acceleration of more than a factor of two, while maintaining acceptable accuracy: The largest T1 values of a sample set deviated from their reference values by 0.3% (longest relaxation interval) and 2.4% (shortest relaxation interval). The largest T2 values showed systematic deviations of up to 10% for all relaxation intervals, which is discussed. The influence of slice profile effects for multislice acquisition is shown to become increasingly relevant for short relaxation intervals. In 3D spiral measurements, a scan time reduction of 36% was achieved, maintaining the quality of in-vivo T1 and T2 maps. Reducing the relaxation interval between MRF sequence repetitions using stationary fingerprint dictionaries is a feasible method to improve the scan efficiency of MRF sequences. The method enables fast implementations of 3D spatially resolved

  4. Fast transfer of crossmodal time interval training.

    PubMed

    Chen, Lihan; Zhou, Xiaolin

    2014-06-01

    Sub-second time perception is essential for many important sensory and perceptual tasks including speech perception, motion perception, motor coordination, and crossmodal interaction. This study investigates to what extent the ability to discriminate sub-second time intervals acquired in one sensory modality can be transferred to another modality. To this end, we used perceptual classification of visual Ternus display (Ternus in Psychol Forsch 7:81-136, 1926) to implicitly measure participants' interval perception in pre- and posttests and implemented an intra- or crossmodal sub-second interval discrimination training protocol in between the tests. The Ternus display elicited either an "element motion" or a "group motion" percept, depending on the inter-stimulus interval between the two visual frames. The training protocol required participants to explicitly compare the interval length between a pair of visual, auditory, or tactile stimuli with a standard interval or to implicitly perceive the length of visual, auditory, or tactile intervals by completing a non-temporal task (discrimination of auditory pitch or tactile intensity). Results showed that after fast explicit training of interval discrimination (about 15 min), participants improved their ability to categorize the visual apparent motion in Ternus displays, although the training benefits were mild for visual timing training. However, the benefits were absent for implicit interval training protocols. This finding suggests that the timing ability in one modality can be rapidly acquired and used to improve timing-related performance in another modality and that there may exist a central clock for sub-second temporal processing, although modality-specific perceptual properties may constrain the functioning of this clock.

  5. Patient-centeredness and quality management in Dutch diabetes care organizations after a 1-year intervention.

    PubMed

    Campmans-Kuijpers, Marjo Je; Lemmens, Lidwien C; Baan, Caroline A; Rutten, Guy Ehm

    2016-01-01

    More focus on patient-centeredness in care for patients with type 2 diabetes requests increasing attention to diabetes quality management processes on patient-centeredness by managers in primary care groups and outpatient clinics. Although patient-centered care is ultimately determined by the quality of interactions between patients and clinicians at the practice level, it should be facilitated at organizational level too. This nationwide study aimed to assess the state of diabetes quality management on patient-centeredness at organizational level and its possibilities to improve after a tailored intervention. This before-after study compares the quality management on patient-centeredness within Dutch diabetes care groups and outpatient clinics before and after a 1-year stepwise intervention. At baseline, managers of 51 diabetes primary care groups and 28 outpatient diabetes clinics completed a questionnaire about the organization's quality management program. Patient-centeredness (0%-100%) was operationalized in six subdomains: facilitating self-management support, individualized care plan support, patients' access to medical files, patient education policy, safeguarding patients' interests, and formal patient involvement. The intervention consisted of feedback and benchmark and if requested a telephone call and/or a consultancy visit. After 1 year, the managers completed the questionnaire again. The 1-year changes were examined by dependent (non) parametric tests. Care groups improved significantly on patient-centeredness (from 47.1% to 53.3%; P=0.002), and on its subdomains "access to medical files" (from 42.0% to 49.4%), and "safeguarding patients' interests" (from 58.1% to 66.2%). Outpatient clinics, which scored higher at baseline (66.7%) than care groups, did not improve on patient-centeredness (65.6%: P=0.54) or its subdomains. "Formal patient involvement" remained low in both care groups (23.2%) and outpatient clinics (33.9%). After a simple intervention

  6. North American trial results at 1 year with the Sorin Freedom SOLO pericardial aortic valve.

    PubMed

    Heimansohn, David; Roselli, Eric E; Thourani, Vinod H; Wang, Shaohua; Voisine, Pierre; Ye, Jian; Dabir, Reza; Moon, Michael

    2016-02-01

    A North American prospective, 15-centre Food and Drug Administration (FDA) valve trial was designed to assess the safety and effectiveness of the Freedom SOLO stentless pericardial aortic valve in the treatment of surgical aortic valve disease. Beginning in 2010, 251 patients (mean: 74.7 ± 7.5 years), were recruited in the Freedom SOLO aortic valve trial. One hundred eighty-nine patients have been followed for at least 1 year and are the basis for this review. Preoperatively, 54% of patients had NYHA functional class III or IV symptoms, and the majority of patients had a normal ejection fraction (EF) (median EF = 61%). Concomitant procedures were performed in 61.9% of patients, with coronary artery bypass grafting (CABG) (48.7%) being the most common followed by a MAZE procedure (13.7%). Reoperations were performed in 8.5% of patients in the study. The entire cohort of 251 patients enrolled had 7 deaths prior to 30 days, 2 of which were valve-related (aspiration pneumonia and sudden death) and 5 were not valve-related. There were 11 deaths after 30 days, 1 valve-related (unknown cardiac death) and 10 not valve-related. Five valves were explanted, 3 early (endocarditis, acute insufficiency and possible root dissection) and 2 late (endocarditis). Thirty-day adverse events include arrhythmias requiring permanent pacemaker (4.2%), thromboembolic events (3.7%) and thrombocytopenia (7.4%). One-year follow-up of all 189 patients demonstrated mean gradients for valve sizes 19, 21, 23, 25 and 27 mm of 11.7, 7.8, 6.3, 4.6 and 5.0 mmHg, respectively. Effective orifice areas for the same valve sizes were 1.2, 1.3, 1.6, 1.8 and 1.9 cm(2), respectively. Ninety-six percent of patients (181/189) were in NYHA class I or II at the 1-year follow-up. The Freedom SOLO stentless pericardial aortic valve demonstrated excellent haemodynamics and a good safety profile out to the 1 year of follow-up. © The Author 2015. Published by Oxford University Press on behalf of the European

  7. Adhesive performance of a multi-mode adhesive system: 1-year in vitro study.

    PubMed

    Marchesi, Giulio; Frassetto, Andrea; Mazzoni, Annalisa; Apolonio, Fabianni; Diolosà, Marina; Cadenaro, Milena; Di Lenarda, Roberto; Pashley, David H; Tay, Franklin; Breschi, Lorenzo

    2014-05-01

    The aim of this study was to investigate the adhesive stability over time of a multi-mode one-step adhesive applied using different bonding techniques on human coronal dentine. The hypotheses tested were that microtensile bond strength (μTBS), interfacial nanoleakage expression and matrix metalloproteinases (MMPs) activation are not affected by the adhesive application mode (following the use of self-etch technique or with the etch-and-rinse technique on dry or wet dentine) or by ageing for 24h, 6 months and 1year in artificial saliva. Human molars were cut to expose middle/deep dentine and assigned to one of the following bonding systems (N=15): (1) Scotchbond Universal (3M ESPE) self-etch mode, (2) Scotchbond Universal etch-and-rinse technique on wet dentine, (3) Scotchbond Universal etch-and-rinse technique on dry dentine, and (4) Prime&Bond NT (Dentsply De Trey) etch-and-rinse technique on wet dentine (control). Specimens were processed for μTBS test in accordance with the non-trimming technique and stressed to failure after 24h, 6 months or 1 year. Additional specimens were processed and examined to assay interfacial nanoleakage and MMP expression. At baseline, no differences between groups were found. After 1 year of storage, Scotchbond Universal applied in the self-etch mode and Prime&Bond NT showed higher μTBS compared to the other groups. The lowest nanoleakage expression was found for Scotchbond Universal applied in the self-etch mode, both at baseline and after storage. MMPs activation was found after application of each tested adhesive. The results of this study support the use of the self-etch approach for bonding the tested multi-mode adhesive system to dentine due to improved stability over time. Improved bonding effectiveness of the tested universal adhesive system on dentine may be obtained if the adhesive is applied with the self-etch approach. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Surgical versus nonsurgical treatment of women with pelvic floor dysfunction: patient centered goals at 1 year.

    PubMed

    Hullfish, Kathie L; Bovbjerg, Viktor E; Gurka, Matthew J; Steers, William D

    2008-06-01

    In women with pelvic floor dysfunction we assessed the degree to which treatment (surgical vs nonsurgical) was associated with achievement of patient centered goals, satisfaction with care and quality of life. In this prospective cohort study between September 2003 and December 2004 we recruited women during their first referral visit for pelvic floor dysfunction treatment at our outpatient Urogynecology Clinic. At the first visit women enumerated up to 5 personal treatment goals, and anchored each goal by anticipating best and worst possible outcomes. At 12-month followup women were asked to indicate the level of goal attainment (-2 worst outcome, +2 best outcome). At baseline and followup women completed short forms of the Incontinence Impact Questionnaire and Urogenital Distress Inventory (range 0 to 100, high scores indicating greater impact or distress). Patients indicated the level of treatment satisfaction on a 4-level ordinal scale. Of the 127 study participants with complete data 46 (36.2%) were treated surgically and 81 (63.8%) were treated nonsurgically. There were no major demographic differences between the 2 groups in terms of age, race, weight, prior pelvic floor dysfunction surgery and vaginal parity. The surgical group was more likely to have received a baseline diagnosis of pelvic organ prolapse (80% vs 60%, p = 0.0259) and be postmenopausal (89% vs 72%, p = 0.0261). There were no significant differences in the distribution of goal type (symptom relief, activity, self-image, general health) by treatment status (p = 0.1074). Using logistic regression to adjust for age and baseline diagnosis, surgically treated patients at 1 year were significantly more likely to report complete primary goal attainment (OR 4.42, p = 0.0154) and complete treatment satisfaction (OR 6.12, p = 0.0109). For all participants 1-year Incontinence Impact Questionnaire-7 and Urogenital Distress Inventory-6 scores were significantly correlated with primary goal attainment

  9. Patient-centeredness and quality management in Dutch diabetes care organizations after a 1-year intervention

    PubMed Central

    Campmans-Kuijpers, Marjo JE; Lemmens, Lidwien C; Baan, Caroline A; Rutten, Guy EHM

    2016-01-01

    Background More focus on patient-centeredness in care for patients with type 2 diabetes requests increasing attention to diabetes quality management processes on patient-centeredness by managers in primary care groups and outpatient clinics. Although patient-centered care is ultimately determined by the quality of interactions between patients and clinicians at the practice level, it should be facilitated at organizational level too. This nationwide study aimed to assess the state of diabetes quality management on patient-centeredness at organizational level and its possibilities to improve after a tailored intervention. Methods This before–after study compares the quality management on patient-centeredness within Dutch diabetes care groups and outpatient clinics before and after a 1-year stepwise intervention. At baseline, managers of 51 diabetes primary care groups and 28 outpatient diabetes clinics completed a questionnaire about the organization’s quality management program. Patient-centeredness (0%–100%) was operationalized in six subdomains: facilitating self-management support, individualized care plan support, patients’ access to medical files, patient education policy, safeguarding patients’ interests, and formal patient involvement. The intervention consisted of feedback and benchmark and if requested a telephone call and/or a consultancy visit. After 1 year, the managers completed the questionnaire again. The 1-year changes were examined by dependent (non) parametric tests. Results Care groups improved significantly on patient-centeredness (from 47.1% to 53.3%; P=0.002), and on its subdomains “access to medical files” (from 42.0% to 49.4%), and “safeguarding patients’ interests” (from 58.1% to 66.2%). Outpatient clinics, which scored higher at baseline (66.7%) than care groups, did not improve on patient-centeredness (65.6%: P=0.54) or its subdomains. “Formal patient involvement” remained low in both care groups (23.2%) and

  10. Characteristics associated with satisfaction with life 1 year post traumatic brain injury in a population of Hispanic individuals.

    PubMed

    Ketchum, Jessica M; Almaz Getachew, Mimi; Krch, Denise; Kolakowsky-Hayner, Stephanie A; Baños, James H; Lequerica, Anthony; Wright, Jerry; Arango-Lasprilla, Juan Carlos

    2012-01-01

    To determine which demographic, injury, rehabilitation, and follow-up characteristics are associated with satisfaction with life in a population of Hispanic individuals 1 year post-traumatic brain injury (TBI). Retrospective study. Longitudinal dataset of the TBI Model Systems National Database. 291 Hispanic adults with TBIs occurring between 1999 and 2008 having year 1 follow-up data. Satisfaction with Life Scale (SWLS) measured 1 year post-TBI. The relationships between SWLS 1 year post-injury and a variety of demographic, injury, rehabilitation, and follow-up characteristics were modeled using generalized linear models. The final multivariable model explained 25.2% of variability in SWLS (F (7, 261)=12.6, p < 0.001) and included quadratic effects for both age at injury and FIM cognitive scores 1 year post-injury, as well as effects for associated SCI and employment status 1 year post-injury (all p-values ≤ 0.036). In general, higher age, no associated SCI, not being unemployed at 1 year post-injury, and very high or very low FIM cognitive scores were associated with greater SWLS scores 1 year post-injury. These results suggest a variety of demographic, injury, and follow-up characteristics are related with SWLS 1 year post-TBI in Hispanic individuals. Focusing rehabilitation efforts on improving cognition and vocational skills may improve SWLS in Hispanics 1 year post-TBI.

  11. Caries risks and appropriate intervals between bitewing x-ray examinations in schoolchildren.

    PubMed

    Steiner, Marcel; Bühlmann, Saskia; Menghini, Giorgio; Imfeld, Carola; Imfeld, Thomas

    2011-01-01

    Short intervals between bitewing examinations favor the timely detection of lesions on approximal surfaces. Long intervals reduce the exposure to radiation. Thus, the question arises which intervals between bite-wing examinations are appropriate. The length of intervals between bitewing examinations should be adapted to the caries risk on approximal surfaces of molars and premolars. In order to estimate the caries risk in the Swiss school population, longitudinal data of 591 schoolchildren from the Canton (County) of Zurich were analyzed. These schoolchildren had been examined at 4-year intervals. The proportion of 7-year-olds with caries increment on approximal surfaces within 4 years was 7.1%, i.e., the caries risk in the population was 7.1%. In the 11-year-olds, the caries risk was 17.60%. Seven-year-olds without caries experience on selected approximal surfaces had a low caries risk of 2.2%. However, 7-year-olds with caries experience on selected approximal surfaces had a high risk of 24.2%. The same applied to 11-year-olds: those without caries experience had a low risk (7.5%), and those with caries experience had a high risk (38.5%). For the 7-year-old schoolchildren without any caries experience, an x-ray interval of 8 years is proposed. For the 7-year-old schoolchildren with caries experience, an x-ray interval of 1 year is proposed.

  12. Advanced Interval Management: A Benefit Analysis

    NASA Technical Reports Server (NTRS)

    Timer, Sebastian; Peters, Mark

    2016-01-01

    This document is the final report for the NASA Langley Research Center (LaRC)- sponsored task order 'Possible Benefits for Advanced Interval Management Operations.' Under this research project, Architecture Technology Corporation performed an analysis to determine the maximum potential benefit to be gained if specific Advanced Interval Management (AIM) operations were implemented in the National Airspace System (NAS). The motivation for this research is to guide NASA decision-making on which Interval Management (IM) applications offer the most potential benefit and warrant further research.

  13. Interval arithmetic in power flow analysis

    SciTech Connect

    Wang, Z.; Alvarado, F.L. )

    1992-08-01

    The power flow is the fundamental tool for the study of power systems. The data for this problem are subject to uncertainty. This paper uses interval arithmetic to solve the power flow problem. Interval arithmetic takes into consideration the uncertainty of the nodal information, and is able to provide strict bounds for the solution to the problem: all possible solutions are included within the bounds given by interval arithmetic. Results are compared with those obtainable by Monte Carlo simulations and by the use of stochastic power flows.

  14. Learned interval time facilitates associate memory retrieval

    PubMed Central

    van de Ven, Vincent; Kochs, Sarah; Smulders, Fren; De Weerd, Peter

    2017-01-01

    The extent to which time is represented in memory remains underinvestigated. We designed a time paired associate task (TPAT) in which participants implicitly learned cue–time–target associations between cue–target pairs and specific cue–target intervals. During subsequent memory testing, participants showed increased accuracy of identifying matching cue–target pairs if the time interval during testing matched the implicitly learned interval. A control experiment showed that participants had no explicit knowledge about the cue–time associations. We suggest that “elapsed time” can act as a temporal mnemonic associate that can facilitate retrieval of events associated in memory. PMID:28298554

  15. Dynamic Contrast-Enhanced MRI Evaluation of Cerebral Cavernous Malformations

    PubMed Central

    Hart, B. L.; Taheri, S.; Rosenberg, G. A.; Morrison, L. A.

    2013-01-01

    The aim of this study is to quantitatively evaluate the behavior of CNS cavernous malformations (CCMs) using a dynamic contrast-enhanced MRI (DCEMRI) technique sensitive for slow transfer rates of gadolinium. The prospective study was approved by the institutional review board and was HIPPA compliant. Written informed consent was obtained from 14 subjects with familial CCMs (4 men and 10 women, ages 22–76 years, mean 48.1 years). Following routine anatomic MRI of the brain, DCEMRI was performed for six slices, using T1 mapping with partial inversion recovery (TAPIR) to calculate T1 values, following administration of 0.025 mmol/kg gadolinium DTPA. The transfer rate (Ki) was calculated using the Patlak model, and Ki within CCMs was compared to normal-appearing white matter as well as to 17 normal control subjects previously studied. All subjects had typical MRI appearance of CCMs. Thirty-nine CCMs were studied using DCEMRI. Ki was low or normal in 12 lesions and elevated from 1.4 to 12 times higher than background in the remaining 27 lesions. Ki ranged from 2.1E–6 to 9.63E–4 min−1, mean 3.55E–4. Normal-appearing white matter in the CCM patients had a mean Ki of 1.57E–4, not statistically different from mean WM Ki of 1.47E–4 in controls. TAPIR-based DCEMRI technique permits quantifiable assessment of CCMs in vivo and reveals considerable differences not seen with conventional MRI. Potential applications include correlation with biologic behavior such as lesion growth or hemorrage, and measurement of drug effects. PMID:24323376

  16. Sampling Theory and Confidence Intervals for Effect Sizes: Using ESCI To Illustrate "Bouncing"; Confidence Intervals.

    ERIC Educational Resources Information Center

    Du, Yunfei

    This paper discusses the impact of sampling error on the construction of confidence intervals around effect sizes. Sampling error affects the location and precision of confidence intervals. Meta-analytic resampling demonstrates that confidence intervals can haphazardly bounce around the true population parameter. Special software with graphical…

  17. Interval Estimates of Multivariate Effect Sizes: Coverage and Interval Width Estimates under Variance Heterogeneity and Nonnormality

    ERIC Educational Resources Information Center

    Hess, Melinda R.; Hogarty, Kristine Y.; Ferron, John M.; Kromrey, Jeffrey D.

    2007-01-01

    Monte Carlo methods were used to examine techniques for constructing confidence intervals around multivariate effect sizes. Using interval inversion and bootstrapping methods, confidence intervals were constructed around the standard estimate of Mahalanobis distance (D[superscript 2]), two bias-adjusted estimates of D[superscript 2], and Huberty's…

  18. Intraoperative cervical treatment does not affect the prevalence of vaginal bleeding 1 year postoperatively after subtotal hysterectomy. A register study from the Swedish National Register for Gynecological Surgery.

    PubMed

    Borendal Wodlin, Ninnie

    2017-09-02

    The objectives were to establish the prevalence of persistent vaginal bleeding following subtotal hysterectomy, to analyze the effect of intraoperative cervical treatment on the occurrence of persistent vaginal bleeding, and to evaluate the impact of persistent vaginal bleeding on the patient-reported opinion concerning result of surgery and medical condition. Retrospective study with data from the Swedish National Register for Gynecological Surgery including 5240 women undergoing subtotal hysterectomy for benign conditions between January 2004 and June 2016. Demographic and clinical data were obtained from the pre- and perioperative forms. Data concerning occurrence of persistent vaginal bleeding, rating of medical condition and contentment with result of surgery were collected from the 1-year inquiry form. Statistical analyses were performed with multivariable logistic regression models. The results are presented as adjusted odd ratios and 95% confidence intervals. Persistent vaginal bleeding occurred in 18.6%. Intraoperative cervical treatment did not affect the frequency of persistent vaginal bleeding (adjusted odds ratio 1.48; 95% confidence interval 0.93-2.37). More than 90% were satisfied with the result of the hysterectomy, but women with persistent vaginal bleeding were less content compared with those without persistent vaginal bleeding (adjusted odds ratio 0.42; 95% confidence interval 0.26-0.67). The self-perception of the medical condition did not differ between the women with and without persistent vaginal bleeding (adjusted odds ratio 1.16; 95% confidence interval 0.33-4.12). Nearly two in ten women may expect persistent vaginal bleeding following subtotal hysterectomy, and cervical treatment intraoperatively did not affect this. More than 90% were satisfied with the result but women with persistent vaginal bleeding were less content. Preoperative information on this risk of persistent vaginal bleeding may be important when choosing hysterectomy

  19. Pineal cysts: an incidental MRI finding?

    PubMed Central

    Di Costanzo, A; Tedeschi, G; Di Salle, F; Golia, F; Morrone, R; Bonavita, V

    1993-01-01

    The incidence of pineal cysts (PC) in "standard" MRI was reviewed. Seven cases of PC were found from 400 consecutive MRI examinations. PC did not produce clinically relevant symptoms in any of the patients. Our data, as well as those emerging from a critical review of the literature, suggest that PC are often asymptomatic and represent an incidental MRI finding. Images PMID:8437012

  20. Cervical Spine MRI in Abused Infants.

    ERIC Educational Resources Information Center

    Feldman, Kenneth W.; And Others

    1997-01-01

    This study attempted to use cervical spine magnetic resonance imaging (MRI) to detect cord injury in 12 dead children with head injury from child abuse. Eighty percent of children autopsied had small cervical spine hemorrhages; MRI did not identify them and did not identify cord injury in any child studied, indicating that MRI scans are probably…

  1. Cervical Spine MRI in Abused Infants.

    ERIC Educational Resources Information Center

    Feldman, Kenneth W.; And Others

    1997-01-01

    This study attempted to use cervical spine magnetic resonance imaging (MRI) to detect cord injury in 12 dead children with head injury from child abuse. Eighty percent of children autopsied had small cervical spine hemorrhages; MRI did not identify them and did not identify cord injury in any child studied, indicating that MRI scans are probably…

  2. Clinical Evaluation of the Retention of Different Pit and Fissure Sealants: A 1-Year Study

    PubMed Central

    Kumaran, Parvathy

    2013-01-01

    ABSTRACT Objective: The aim of this study was to evaluate the retention of different pit and fissure sealants on the first permanent molars over a period of one year. Materials and methods: In this study, a total of 40 children with all first permanent molars erupted received four different pit and fissure sealants. The children were evaluated at 6 and 12 months. Results: The data was subjected to Chi-square test and Kaplan Meier survival analysis. The p-value was calculated using Wilcoxon matched-pairs signed-rank test. Conclusion: The retention rates of resin-based sealants were superior to that of glass ionomer sealant. How to cite this article: Kumaran P. Clinical Evaluation of the Retention of Different Pit and Fissure Sealants: A 1-Year Study. Int J Clin Pediatr Dent 2013;6(3):183-187. PMID:25206219

  3. Substance Use Disorder Counselors’ Job Performance and Turnover after 1 Year: Linear or Curvilinear Relationship?1

    PubMed Central

    Laschober, Tanja C.; de Tormes Eby, Lillian Turner

    2013-01-01

    The main goals of the current study were to investigate whether there are linear or curvilinear relationships between substance use disorder counselors’ job performance and actual turnover after 1 year utilizing four indicators of job performance and three turnover statuses (voluntary, involuntary, and no turnover as the reference group). Using longitudinal data from 440 matched counselor-clinical supervisor dyads, results indicate that overall, counselors with lower job performance are more likely to turn over voluntarily and involuntarily than not to turn over. Further, one of the job performance measures shows a significant curvilinear effect. We conclude that the negative consequences often assumed to be “caused” by counselor turnover may be overstated because those who leave both voluntarily and involuntarily demonstrate generally lower performance than those who remain employed at their treatment program. PMID:22527711

  4. Cognitive dysfunction at baseline predicts symptomatic 1-year outcome in first-episode schizophrenics.

    PubMed

    Moritz, S; Krausz, M; Gottwalz, E; Lambert, M; Perro, C; Ganzer, S; Naber, D

    2000-01-01

    The present study addresses the consequences of cognitive disturbances on symptomatic outcome. Fifty-three first-episode schizophrenics were reassessed (n = 32) 1 year after admission. Simple regression analyses revealed that several self-perceived cognitive deficits at baseline as measured with the Frankfurt Complaint Questionnaire significantly predicted increased Brief Psychiatric Rating Scale global scores at follow-up (p = 0.05 to p = 0.005). A stepwise regression analysis proved memory dysfunction to be the strongest predictor of symptomatic worsening (p = 0.005). It is suggested that the exploration and treatment of neuropsychological deficits in schizophrenia is of great clinical importance with regard to its impact on both functional and symptomatic outcome in schizophrenia.

  5. Whooping cough in South-East Romania: a 1-year study.

    PubMed

    Dinu, Sorin; Guillot, Sophie; Dragomirescu, Cristiana Cerasella; Brun, Delphine; Lazăr, Stefan; Vancea, Geta; Ionescu, Biatrice Mariana; Gherman, Mariana Felicia; Bjerkestrand, Andreea-Florina-Dana; Ungureanu, Vasilica; Guiso, Nicole; Damian, Maria

    2014-03-01

    The incidence of whooping cough in Romania is substantially underestimated, and, as noted by the health authorities, this is mostly due to the lack of both awareness and biological diagnosis. We conducted a 1-year study in Bucharest in order to assess the circulation of Bordetella pertussis, the main etiological agent of whooping cough. Fifty-one subjects suspected of whooping cough were enrolled. Culture, real-time PCR, and enzyme-linked immunosorbent assay were used for laboratory diagnosis. Whooping cough patients (63%) were distributed among all age groups, and most were unvaccinated, incompletely vaccinated, or had been vaccinated more than 5 years previously. Bordetella holmesii DNA was detected in 22% of the bordetellosis cases; these patients included adults; teenagers; and, surprisingly, young children. B. pertussis isolates were similar to the clinical isolates currently circulating elsewhere in Europe. One isolate does not express pertactin, an antigen included in some acellular pertussis vaccines.

  6. Diversion Alert: 1-Year Evaluation Across Northern New England, 2013–2014

    PubMed Central

    Desrosiers, Clare

    2016-01-01

    This report describes Diversion Alert, a unique online tool aimed at reducing misuse and diversion of prescription drugs, and reports the results of a 1-year evaluation of Diversion Alert’s impact in Maine. We used a quasi-experimental research design to compare survey data in Maine with those of neighboring states (New Hampshire and Vermont, 2013 and 2014). Compared with their counterparts in New Hampshire and Vermont who did not use Diversion Alert, prescribers and pharmacists in Maine who used Diversion Alert increased their communication with patients and other providers involved in their patients’ care, became aware of patients arrested for prescription drugs possession or diversion, used best practices associated with prevention or detection of addiction and diversion more frequently, and attributed positive changes in their prescribing practices to Diversion Alert. In combination with other state and federal programs, Diversion Alert may be an effective tool to help prevent the misuse of opioid medications. PMID:27880633

  7. Endocrine responses to overreaching before and after 1 year of weightlifting.

    PubMed

    Fry, A C; Kraemer, W J; Stone, M H; Warren, B J; Fleck, S J; Kearney, J T; Gordon, S E

    1994-12-01

    Nine elite male junior weightlifters (mean age 17.6 +/- 0.3 yrs) performed weightlifting tests before (Test 1) and after (Test 2) 1 week of increased training volume (overreaching) and repeated the protocol after 1 year of their training program. Strength increased by Year 2 (p < 0.05) but did not change during either week of increased training volume. The 1-week overreaching stimulus resulted in attenuated exercise-induced testosterone concentrations during Year 1, but augmented exercise-induced testosterone concentrations during Year 2. Testosterone concentrations at 7 a.m. decreased for only Year 1. For both years, the 1-week overreaching stimulus increased cortisol at 7 a.m, indicative of the increased training volumes. Testosterone/cortisol was not affected by increased training volume for either year. One year of chronic weightlifting and prior exposure to the overreaching stimulus appears to decrease the detrimental effects of stressful training on the endocrine system.

  8. JASON 1: lessons learned from the development and 1 year in orbit

    NASA Astrophysics Data System (ADS)

    Lafon, Thierry

    2005-01-01

    The JASON-1 small satellite was launched in December 2001 and has performed successfully since then, with in-flight performances exceeding expectations. The JASON-1 mission is dedicated to ocean and climate forecasting, in continuation with the successful TOPEX-POSEIDON satellite, launched in 1992. This project is in cooperation between NASA and CNES. JASON-1 is the first satellite based on the small PROTEUS bus, a cooperative partnership between CNES and ALCATEL Space Industries. This project was initiated in 1993 and in 1996 entered its developmental phase. At that time, the Faster, Better, Cheaper guidelines were driving the decisions and thus strong budgetary and schedule constraints were placed on the project while keeping ambitious technical performances. After more than 1 year of Jason operations in orbit, this paper gives a synthetic view of the major project achievement with respect to the initial requirements with a focus on advantages and drawbacks of a fast-paced development and qualification.

  9. Infant Aphakia Treatment Study: Effects of persistent fetal vasculature on outcome at 1 year of age

    PubMed Central

    Morrison, David G.; Wilson, M. Edward; Trivedi, Rupal H.; Lambert, Scott R.; Lynn, Michael J.

    2011-01-01

    Background The Infant Aphakia Treatment Study (IATS) is a randomized trial comparing the treatment of unilateral congenital cataract with primary intraocular lens (IOL) implantation versus aphakic contact lens (CL). The purpose of this study was to compare the outcomes for infants with lens opacity associated with persistent fetal vasculature (PFV) to those without. Methods Retrospective subgroup analysis of grating visual acuity at 1 year of age and adverse events up to 1 year after surgery in eyes identified intraoperatively as having evidence of mild PFV from the IATS. Results Of 83 infants, 18 (22%: 11 CL, 7 IOL) had PFV. Median logMAR visual acuity was 0.88 for patients with PFV and 0.80 for patients without PFV (P = 0.46). One or more adverse events up to one year after surgery occurred in 12 infants (67%) with PFV and 30 infants (46%) without PFV (P = 0.18). The incidence of adverse events was significantly higher in patients with PFV compared to patients without PFV in the CL group (55% vs 20%, P = 0.049) but not in the IOL group (86% vs 71%, P = 0.65), possibly because all children receiving IOLs had higher rates of adverse events when compared to aphakic children (73% vs 29%, P < 0.001). Conclusions Aphakic infants with mild PFV treated with CL had a higher incidence of adverse events following lensectomy compared to children with other forms of unilateral congenital cataract; nevertheless, similar visual outcomes at one year after surgery were obtained. PMID:22108353

  10. Persistent problems 1 year after mild traumatic brain injury: a longitudinal population study in New Zealand

    PubMed Central

    Theadom, Alice; Parag, Varsha; Dowell, Tony; McPherson, Kathryn; Starkey, Nicola; Barker-Collo, Suzanne; Jones, Kelly; Ameratunga, Shanthi; Feigin, Valery L

    2016-01-01

    Background Mild traumatic brain injury (mTBI) is a common problem in general practice settings, yet previous research does not take into account those who do not attend hospital after injury. This is important as there is evidence that effects may be far from mild. Aim To determine whether people sustain any persistent effects 1 year after mTBI, and to identify the predictors of health outcomes. Design and setting A community-based, longitudinal population study of an mTBI incidence cohort (n = 341) from a mixed urban and rural region (Hamilton and Waikato Districts) of the North Island of New Zealand (NZ). Method Adults (>16 years) completed assessments of cognitive functioning, global functioning, post-concussion symptoms, mood, and quality of life over the year after injury. Results Nearly half of participants (47.9%) reported experiencing four or more post-concussion symptoms 1 year post-injury. Additionally, 10.9% of participants revealed very low cognitive functioning. Levels of anxiety, depression, or reduced quality of life were comparable with the general population. Having at least one comorbidity, history of brain injury, living alone, non-white ethnic group, alcohol and medication use, and being female were significant predictors of poorer outcomes at 12 months. Conclusion Although some people make a spontaneous recovery after mTBI, nearly half continue to experience persistent symptoms linked to their injury. Monitoring of recovery from mTBI may be needed and interventions provided for those experiencing persistent difficulties. Demographic factors and medical history should be taken into account in treatment planning. PMID:26719482

  11. Depression Treatment and 1-Year Mortality Following Acute Myocardial Infarction: Insights from the TRIUMPH Registry.

    PubMed

    Smolderen, Kim G; Buchanan, Donna M; Gosch, Kensey; Whooley, Mary A; Chan, Paul S; Vaccarino, Viola; Parashar, Susmita; Shah, Amit J; Ho, P Michael; Spertus, John A

    2017-02-16

    Background -Depression among patients with acute myocardial infarction (AMI) is prevalent and associated with an adverse quality of life and prognosis. Despite recommendations from some national organizations to screen for depression, it is unclear whether treatment of depression in patients with AMI is associated with better outcomes. We aimed to determine whether prognosis of patients with treated vs. untreated depression differs. Methods -The TRIUMPH study is an observational multi-center cohort study that enrolled 4,062 patients aged ≥18 years with AMI between April 11, 2005 and December 31, 2008 from 24 US hospitals. Research coordinators administered the Patient Health Questionnaire-9 (PHQ-9) during the index AMI admission. Depression was defined by a PHQ-9 score of ≥10. Depression was categorized as 'treated' if there was documentation of a discharge diagnosis, medication prescribed for depression, or referral for counseling, and as 'untreated' if none of these three criteria were documented in the medical records despite a PHQ score ≥10. One-year mortality was compared between patients with AMI having: (1) no depression (PHQ-9 <10; reference); (2) treated depression; and (3) untreated depression adjusting for demographics, AMI severity, and clinical factors. Results -Overall, 759 (18.7%) patients met PHQ-9 criteria for depression and 231 (30.4%) were treated. Compared with 3303 patients without depression, the 231 patients with treated depression had 1-year mortality rates that were not different (6.1% vs. 6.7%, adjusted HR=1.12, 95% CI: 0.63-1.99). In contrast, the 528 patients with untreated depression had higher 1-year mortality when compared with patients without depression (10.8% vs. 6.1%, adjusted HR=1.91, 95%CI 1.39-2.62). Conclusions -Although depression in patients with AMI is associated with increased long-term mortality, this association may be confined to patients with untreated and untreated depression.

  12. Effects of a 1-year exercise training program on myocardial ischemia in patients after myocardial infarction.

    PubMed

    Ridocci, F; Velasco, J A; Echánove, I; Soriano, G; Cruz Torregrosa, M; Payá, R; Quesada, A

    1992-01-01

    To determine the effects of exercise training on exercise-induced ischemia in patients following myocardial infarction, the experience of 13 patients with exercise-induced ST depression, who were moderate-to-high intensity trained for 1 year, has evaluated. After training, the maximum ST depression was significantly less (1.9 +/- 0.8 vs. 1.1 +/- 0.8 mm; p < 0.01), despite an increased maximal rate-pressure product (RPP; heart rate x blood pressure/100; 241.3 +/- 44 vs. 262.0 +/- 58; p < 0.01). For the onset of 0.1 mV of ST depression, we found a significant increase in RPP from 204.1 +/- 34.7 to 234.1 +/- 49.4 (p < 0.01) and also in heart rate (117.1 +/- 15.1 vs. 125.1 +/- 21.7 b.p.m.; p < 0.05), blood pressure (167.6 +/- 18 vs. 180.3 +/- 18 mm Hg; p < 0.01) and workload (93.8 +/- 17.4 vs. 121.1 +/- 23.2 W; p < 0.01). The relationship between ST depression and RPP (RPP/STmax) was favorably modified after training. The ratio RPP/STmax improved significantly from 143.6 +/- 49.4 to 209.1 +/- 69.5 (p < 0.0001). These findings support the hypothesis that a 1-year moderate-to-high training program in some patients following myocardial infarction can elicit adaptations that may well be attributed, at least in part, to an improvement in coronary blood flow.

  13. Predictors for 1-year mortality following hip fracture: a retrospective review of 465 consecutive patients.

    PubMed

    Heyes, G J; Tucker, A; Marley, D; Foster, A

    2017-02-01

    In Europe, trauma admissions and in particular hip fractures are on the rise. In recent years, health care systems have placed particular emphasis, including financial incentives, on delivering patients quickly and safely to surgery. At our unit, we have observed that hip fracture patients appear to be at significant risk of mortality even up to a year following injury. This study reviews a consecutive population of hip fracture patients to identify predictors of excess risk. Four hundred and sixty-five consecutive patients were treated over a 2-year period at our district general hospital with no ward-based orthogeriatricians. Follow-up was for 1 year following hip fracture admission. Statistical analysis of variables and their influence on 1-year mortality were performed by calculating odd's ratio (OR) using a logistic regression model and a p value <0.05 was considered statistically significant. Four patients were lost to follow-up, 18 patients (4.1 %) were managed conservatively, 16 were too unwell for surgery and their mortality rate at 1 year was 50 %. Following hip fracture, we found an overall 1-year mortality rate of 15.1 %. Patients with a time to surgery ≥36 h were at significantly increased risk of mortality even up to 1 year. We did not identify a further reduction in mortality in those operated on within 24 h. Raised ORs (p > 0.05) were found with increasing comorbidity, surgery type, independence on discharge, alcohol ingestion, history of smoking, readmission and several biochemical markers. Minimising mortality risk, even over the longer term, should begin on admission with prompt optimisation of any acute medical or biochemical abnormalities, followed by early surgery and intensive rehabilitation to maintain patients' functional independence.

  14. Glomerular filtration rate in patients with atrial fibrillation and 1-year outcomes

    PubMed Central

    Boriani, Giuseppe; Laroche, Cécile; Diemberger, Igor; Popescu, Mircea Ioachim; Rasmussen, Lars Hvilsted; Petrescu, Lucian; Crijns, Harry J. G. M.; Tavazzi, Luigi; Maggioni, Aldo P.; Lip, Gregory Y. H.

    2016-01-01

    We assessed 1-year outcomes in patients with atrial fibrillation enrolled in the EurObservational Research Programme AF General Pilot Registry (EORP-AF), in relation to kidney function, as assessed by glomerular filtration rate (eGFR). In a cohort of 2398 patients (median age 69 years; 61% male), eGFR (ml/min/1.73 m2) calculated using the CKD-EPI formula was ≥80 in 35.1%, 50–79 in 47.2%, 30–49 in 13.9% and <30 in 3.7% of patients. In a logistic regression analysis, eGFR category was an independent predictor of stroke/TIA or death, with elevated odds ratios associated with severe to mild renal impairment, ie. eGFR < 30 ml/min/1.73 m2 [OR 3.641, 95% CI 1.572–8.433, p < 0.0001], 30–49 ml/min/1.73 m2 [OR 3.303, 95% CI 1.740–6.270, p = 0.0026] or 50–79 ml/min/1.73 m2 [OR 2.094, 95% CI 1.194–3.672, p = 0.0003]. The discriminant capability for the risk of death was tested among various eGFR calculation algorithms: the best was the Cockcroft-Gault equation adjusted for BSA, followed by Cockcroft-Gault equation, and CKD-EPI equation, while the worst was the MDRD equation. In conclusion in this prospective observational registry, renal function was a major determinant of adverse outcomes at 1 year, and even mild or moderate renal impairments were associated with an increased risk of stroke/TIA/death. PMID:27466080

  15. Minimally invasive facet restoration implant for chronic lumbar zygapophysial pain: 1-year outcomes

    PubMed Central

    2014-01-01

    Background The zygapophysial (facet) joint is the primary pain generator in one third of chronic low back pain cases. Current treatment options include temporarily palliative nonsurgical approaches, facet injections, radiofrequency denervation, and, rarely, lumbar arthrodesis. The purpose of this study was to assess the safety and effectiveness of a minimally invasive implant intended to restore facet joint function in patients with chronic lumbar facetogenic pain. Methods This prospective, multi-center feasibility study enrolled patients with confirmed lumbar facetogenic joint pain at 1 or 2 levels who underwent at least 6 months of unsuccessful nonoperative care. Patients received a minimally invasive implant (Glyder® Facet Restoration Device, Zyga Technology, Inc., Minnetonka, MN) intended to restore facet joint function while preserving the native anatomy. Main outcomes included back pain severity using a visual analogue scale, back-specific disability using the Oswestry Disability Index (ODI), and adverse events adjudicated by an independent Clinical Events Committee. Results Of 40 enrolled patients, 37 patients received the facet restoration implant and 34 patients had complete 1-year follow-up data available. Over the 1-year follow-up period, back pain severity decreased 41% and ODI decreased 34%, on average. Freedom from a device- or procedure-related serious adverse event through 1 year was 84%. Implant migration was observed in 3 patients and implant expulsion from the facet joint occurred in 3 patients. In total, 2 (5.4%) patients underwent implant removal through 1 year post-treatment. Conclusions A minimally invasive facet restoration implant is a promising treatment option in select patients with chronic lumbar zygapophysial pain who have exhausted nonsurgical treatments, with therapeutic benefit persisting at 1 year follow-up. PMID:26628910

  16. Health of Medicare Advantage plan enrollees at 1 year after Hurricane Katrina.

    PubMed

    Burton, Lynda C; Skinner, Elizabeth A; Uscher-Pines, Lori; Lieberman, Richard; Leff, Bruce; Clark, Rebecca; Yu, Qilu; Lemke, Klaus W; Weiner, Jonathan P

    2009-01-01

    To assess the effects of Hurricane Katrina on mortality, morbidity, disease prevalence, and service utilization during 1 year in a cohort of 20,612 older adults who were living in New Orleans, Louisiana, before the disaster and who were enrolled in a managed care organization (MCO). Observational study comparing mortality, morbidity, and service use for 1 year before and after Hurricane Katrina, augmented by a stratified random sample of 303 enrollees who participated in a telephone survey after Hurricane Katrina. Sources of data for health and service use were MCO claims. Mortality was based on reports to the MCO from the Centers for Medicare & Medicaid Services; morbidity was measured using adjusted clinical groups case-mix methods derived from diagnoses in ambulatory and hospital claims data. Mortality in the year following Hurricane Katrina was not significantly elevated (4.3% before vs 4.9% after the hurricane). However, overall morbidity increased by 12.6% (P <.001) compared with a 3.4% increase among a national sample of Medicare managed care enrollees. Nonwhite subjects from Orleans Parish experienced a morbidity increase of 15.9% (P <.001). The prevalence of numerous treated medical conditions increased, and emergency department visits and hospitalizations remained significantly elevated during the year. The enormous health burden experienced by older individuals and the disruptions in service utilization reveal the long-term effects of Hurricane Katrina on this vulnerable population. Although quick rebuilding of the provider network may have attenuated more severe health outcomes for this managed care population, new policies must be introduced to deal with the health consequences of a major disaster.

  17. The Effect of Clozapine on Hematological Indices: A 1-Year Follow-Up Study.

    PubMed

    Lee, Jimmy; Takeuchi, Hiroyoshi; Fervaha, Gagan; Powell, Valerie; Bhaloo, Amaal; Bies, Robert; Remington, Gary

    2015-10-01

    Clozapine is the antipsychotic of choice for treatment-resistant schizophrenia and is linked to a need for mandatory hematological monitoring. Besides agranulocytosis, other hematological aberrations have resulted in premature termination in some cases. Considering clozapine's role in immunomodulation, we proceeded to investigate the impact of clozapine on the following 3 main hematological cell lines: red blood cells, platelets, white blood cells (WBCs), and its differential counts. Data were extracted from patients initiated on clozapine between January 2009 and December 2010 at a single hospital. Patients with a preclozapine complete blood count, who were receiving clozapine during the 1-year follow-up period, were included in the present investigation. Counts of red blood cells, platelets, WBC, and its differential including neutrophils, lymphocytes, monocytes, eosinophils, and basophils were extracted and trajectories plotted. One hundred one patients were included in this study and 66 remained on clozapine at the end of 1 year. There was a synchronized but transient increase in WBC, neutrophils, monocytes, eosinophils, basophils, and platelets beginning as early as the first week of clozapine treatment. There were no cases of agranulocytosis reported in this sample, and five developed neutropenia. A spike in neutrophils immediately preceded the onset of neutropenia in three of the five. The cumulative incidence rates were 48.9% for neutrophilia, 5.9% for eosinophilia, and 3% each for thrombocytosis and thrombocytopenia. Early hematological aberrations are visible across a range of cell lines, primarily of the myeloid lineage. These disturbances are transient and are probably related to clozapine's immunomodulatory properties. We do not suggest discontinuing clozapine as a consequence of the observed aberrations.

  18. Enteroaggregative Escherichia coli in Daycare—A 1-Year Dynamic Cohort Study

    PubMed Central

    Hebbelstrup Jensen, Betina; Stensvold, Christen R.; Struve, Carsten; Olsen, Katharina E. P.; Scheutz, Flemming; Boisen, Nadia; Röser, Dennis; Andreassen, Bente U.; Nielsen, Henrik V.; Schønning, Kristian; Petersen, Andreas M.; Krogfelt, Karen A.

    2016-01-01

    Enteroaggregative Escherichia coli (EAEC) has been associated with persistent diarrhea, reduced growth acceleration, and failure to thrive in children living in developing countries and with childhood diarrhea in general in industrialized countries. The clinical implications of an EAEC carrier-status in children in industrialized countries warrants clarification. To investigate the pathological significance of an EAEC carrier-state in the industrialized countries, we designed a 1-year dynamic cohort study and performed follow-up every second month, where the study participants submitted a stool sample and answered a questionnaire regarding gastrointestinal symptoms and exposures. Exposures included foreign travel, consumption of antibiotics, and contact with a diseased animal. In the capital area of Denmark, a total of 179 children aged 0–6 years were followed in a cohort study, in the period between 2009 and 2013. This is the first investigation of the incidence and pathological significance of EAEC in Danish children attending daycare facilities. Conventional microbiological detection of enteric pathogens was performed at Statens Serum Institute, Copenhagen, Denmark, and at Hvidovre Hospital, Copenhagen, Denmark. Parents completed questionnaires regarding gastrointestinal symptoms. The EAEC strains were further characterized by serotyping, phylogenetic analysis, and susceptibility testing. EAEC was detected in 25 (14%) of the children during the observational period of 1 year. One or more gastrointestinal symptoms were reported from 56% of the EAEC-positive children. Diarrhea was reported in six (24%) of the EAEC positive children, but no cases of weight loss, and general failure to thrive were observed. The EAEC strains detected comprised a large number of different serotypes, confirming the genetic heterogeneity of this pathotype. EAEC was highly prevalent (n = 25, 14%) in Danish children in daycare centers and was accompanied by gastrointestinal symptoms in

  19. Changes in psychosocial functioning 1 year after mastectomy alone, delayed breast reconstruction, or immediate breast reconstruction.

    PubMed

    Metcalfe, Kelly A; Semple, John; Quan, May-Lynn; Vadaparampil, Susan T; Holloway, Claire; Brown, Mitch; Bower, Bethanne; Sun, Ping; Narod, Steven A

    2012-01-01

    In this study, we report on the changes in psychosocial functioning over 1 year following breast cancer surgery in 3 groups of women, including those with mastectomy alone, those with mastectomy and immediate reconstruction, and those with delayed reconstruction. Women with breast cancer at 2 teaching hospitals in Ontario who were undergoing mastectomy alone, mastectomy with immediate reconstruction, or delayed reconstruction were asked to complete a battery of psychosocial questionnaires at their preoperative appointment and 1 year following surgery. A total of 190 women consented to participate in the study and completed the presurgical questionnaires. There were no presurgical differences between the 3 groups in quality of life, anxiety, depression, or sexual functioning. However, women who were undergoing delayed breast reconstruction (i.e., already had a mastectomy) had higher levels of body stigma (P = 0.01), body concerns (P = 0.002), and transparency (P = 0.002) than women who were undergoing mastectomy alone or mastectomy with immediate reconstruction. Of these women, 158 (83.2%) completed the 1-year follow-up. There were no significant differences in any of the psychosocial functioning scores between the 3 groups. Contrary to the assumed psychological benefits of breast reconstruction, psychological distress was evident among women regardless of reconstruction or timing of reconstruction. Further, psychosocial functioning (including quality of life, sexual functioning, cancer-related distress, body image, depression, and anxiety) was not different at 1-year postsurgery between women with mastectomy alone, mastectomy with immediate reconstruction, and delayed reconstruction. These results suggest that women need psychosocial support after breast cancer diagnosis, even if they have breast reconstruction.

  20. Perinatal dioxin exposure and the neurodevelopment of Vietnamese toddlers at 1 year of age.

    PubMed

    Pham, Tai The; Nishijo, Muneko; Nguyen, Anh Thi Nguyet; Tran, Nghi Ngoc; Van Hoang, Luong; Tran, Anh Hai; Nguyen, Trung Viet; Nishijo, Hisao

    2015-12-01

    Dioxin concentrations remain elevated in both the environment and in humans residing near former US Air Force bases in South Vietnam. This may potentially have adverse health effects, particularly on infant neurodevelopment. We followed 214 infants whose mothers resided in a dioxin-contaminated area in Da Nang, Vietnam, from birth until 1 year of age. Perinatal exposure to dioxins was estimated from toxic equivalent (TEQ) levels of polychlorinated dibenzodioxins and polychlorinated dibenzofurans (PCDDs/Fs-TEQ), and 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TetraCDD) concentrations in breast milk. In infants, daily dioxin intake (DDI) was used as an index of postnatal exposure through breastfeeding. Neurodevelopment of toddlers was assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). No significant differences in neurodevelopmental scores were exhibited for cognitive, language or motor functions between four exposure groups of PCDDs/Fs-TEQ or 2,3,7,8-TetraCDD. However, social-emotional scores were decreased in the high PCDDs/Fs-TEQ group and the high 2,3,7,8-TetraCDD group compared with those with mild exposure, after adjusting for confounding factors. Cognitive scores in the mild, moderate, and high DDI groups were significantly higher than those in low DDI group, but there were no differences in cognitive scores among the three higher DDI groups. These results suggest that perinatal exposure to dioxins may affect social-emotional development of 1-year-old toddlers, without diminishing global neurodevelopmental function.

  1. Identifying groups at risk for 1-year membership termination from a fitness center at enrollment.

    PubMed

    Hooker, Stephanie A; Ross, Kaile M; Ranby, Krista W; Masters, Kevin S; Peters, John C; Hill, James O

    2016-12-01

    The vast majority of Americans do not engage in adequate regular physical activity despite its well-known health benefits. Even when individuals attempt to become more active by joining a fitness center, estimates suggest that nearly half terminate their membership within the first 6 months. A better understanding of who is at risk for early membership termination upon joining may help researchers develop targeted interventions to improve the likelihood that individuals will successfully maintain memberships and physical activity. This study's purpose was to identify, based on a wellness assessment (WA) used in fitness centers, individuals at risk for fitness membership termination prior to 1-year. Center members (N = 441; Mage = 41.9, SD = 13.1; 74.4% female) completed a comprehensive WA of stress, life satisfaction, physical fitness, metabolic health, and sleep quality at the beginning of their memberships and were followed for one year. Latent class analyses utilized the WA to identify four groups: (a) healthy, (b) unhealthy, (c) poor psychological wellness, and (d) poor physical wellness. Participants in the poor psychological wellness group (OR = 2.24, p = 0.007) and the unhealthy group (OR = 2.40, p = 0.037) were significantly more likely to terminate their memberships at 1-year as compared to the healthy group. Participants with poor physical wellness visited the fitness center less frequently than healthy participants (p < 0.01). Results suggest that poor psychological wellness is a risk factor for terminating memberships, whereas poor physical wellness is not. Future studies should replicate these latent classes and develop targeted interventions to address psychological wellness as a method to improve fitness membership retention.

  2. [Functional echocardiography in neonatal intensive care: 1 year experience in a unit in Spain].

    PubMed

    Corredera, A; Rodríguez, M J; Arévalo, P; Llorente, B; Moro, M; Arruza, L

    2014-09-01

    Several publications highlight the usefulness of functional echocardiography (FnECHO) in neonatal intensive care. Data is lacking on its use in units neonatal in Spain. To evaluate frequency of use, patient characteristics, indications, measurements, and impact on patient management of FnECHO in a neonatal intensive care unit (NICU) in Spain over a 1 year period. A retrospective study conducted in NICU patients during 1 year. gestational age, birthweight, admission criteria, days of life at examination, indication for FnECHO, parameters assessed, and treatment modifications. 168 echocardiographic studies were performed in 50 patients (mean 3,4. SD 2,83). The most frequent indication was patent ductus (PDA) assessment (58.3%), followed by hemodynamic instability (22.2%). The results of FnECHO modified treatment in 62 cases (36.9%). In 17.4% of them treatment with ibuprofen was initiated, and in 1.2% it was discontinued. In 10.8% of the cases, the results of FnECHO modified hemodynamic support. Echocardiographic evaluation included: assessment of presence/hemodynamic significance of PDA (100%); myocardiac function: ejection fraction/shortening fraction (EF/SF) 23.8%, left ventricular output 24.4%, right ventricular output 21.4%, systemic blood flow 42.3%; and signs of pulmonary hypertension 7.7%. FnECHO is frequently used in the NICU, and in many cases it guides treatment. PDA assessment and hemodynamic instability are the most frequent indications. It still needs to be elucidated if the use of FnECHO modifies patient outcomes. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  3. Sustained sympathetic and blood pressure reduction 1 year after renal denervation in patients with resistant hypertension.

    PubMed

    Hering, Dagmara; Marusic, Petra; Walton, Antony S; Lambert, Elisabeth A; Krum, Henry; Narkiewicz, Krzysztof; Lambert, Gavin W; Esler, Murray D; Schlaich, Markus P

    2014-07-01

    Renal denervation (RDN) reduces muscle sympathetic nerve activity (MSNA) and blood pressure (BP) in resistant hypertension. Although a persistent BP-lowering effect has been demonstrated, the long-term effect on MSNA remains elusive. We investigated whether RDN influences MSNA over time. Office BP and MSNA were obtained at baseline, 3, 6, and 12 months after RDN in 35 patients with resistant hypertension. Office BP averaged 166±22/88±19 mm Hg, despite the use of an average of 4.8±2.1 antihypertensive drugs. Baseline MSNA was 51±11 bursts/min ≈2- to 3-fold higher than the level observed in healthy controls. Mean office systolic and diastolic BP significantly decreased by -12.6±18.3/-6.5±9.2, -16.1±25.6/-8.6±12.9, and -21.2±29.1/-11.1±12.9 mm Hg (P<0.001 for both systolic BP and diastolic BP) with RDN at 3-, 6-, and 12-month follow-up, respectively. MSNA was reduced by -8±12, -6±12, and -6±11 bursts/min (P<0.01) at 3-, 6-, and 12-month follow-up. The reduction in MSNA was maintained, despite a progressive fall in BP over time. No such changes were observed in 7 control subjects at 6-month follow-up. These findings confirm previous reports on the favorable effects of RDN on elevated BP and demonstrate sustained reduction of central sympathetic outflow ≤1-year follow-up in patients with resistant hypertension and high baseline MSNA. These observations are compatible with the hypothesis of a substantial contribution of afferent renal nerve signaling to increased BP in resistant hypertension and argue against a relevant reinnervation at 1 year after procedure.

  4. Qualitative Examination of Adolescent Health-Related Quality of Life at 1 Year Postconcussion.

    PubMed

    Iadevaia, Cheree; Roiger, Trevor; Zwart, Mary Beth

    2015-11-01

    Moderate to severe traumatic brain injuries can negatively influence health-related quality of life (HRQOL) in adolescent patients. The effect of sport-related concussion on adolescent HRQOL remains unclear. To investigate the perceptions of adolescent student-athletes and their parents regarding the adolescents' HRQOL 1 year after sport-related concussion. Qualitative study. Secondary school. Seven adolescent student-athletes (age range, 12-16 years) who sustained a sport-related concussion at least 1 year (15.3 ± 2.8 months) before the study participated along with their primary care-giving parents (n = 7). Fourteen semistructured face-to-face interviews (7 adolescents, 7 parents) were completed. Interviews were transcribed and inductively analyzed by a team of 3 athletic trainers with 32 combined years of professional experience. Themes were negotiated through a consensual review process. Participant checks were completed to ensure trustworthiness of the results. Four major themes emerged from the interviews: (1) significant effect of symptoms, (2) feelings of frustration, (3) influence on school attendance and activities, and (4) nature of interpersonal and team relationships. Participants indicated that the physical symptoms of the concussion substantially affected their emotional and academic function. The influence of the concussion on social interactions seemed to depend on the nature of interpersonal relationships. Sport-related concussion can negatively influence physical and emotional function, academics, and interpersonal interactions as perceived by adolescent student-athletes and their parents. Education of parents and their children, school professionals, coaches, and teammates remains critical to effectively recognize and manage sport-related concussion. Secondary school districts also play a critical role in the concussion-management process by establishing and implementing accommodation policies that alleviate student concerns about falling

  5. Safety and efficacy of nurse-controlled analgesia in patients less than 1 year of age

    PubMed Central

    Walia, Hina; Tumin, Dmitry; Wrona, Sharon; Martin, David; Bhalla, Tarun; Tobias, Joseph D

    2016-01-01

    Background The management of acute pain presents unique challenges in the younger pediatric population. Although patient-controlled devices are frequently used in patients ≥6 years of age, alternative modes of analgesic delivery are needed in infants. Objective To examine the safety and efficacy of nurse-controlled analgesia (NCA) in neonates less than 1 year of age. Methods Data from patients <1 year of age receiving NCA as ordered by the Acute Pain Service at our institution were collected over a 5-year period and reviewed retrospectively. The primary outcomes were activation of the institution’s Rapid Response Team (RRT) or Code Blue, signifying severe adverse events. Pain score after NCA initiation was a secondary outcome. Results Among 338 girls and 431 boys, the most common opioid used for NCA was fentanyl, followed by morphine and hydromorphone. There were 39 (5%) cases involving RRT or Code Blue activation, of which only one (Code Blue) was activated due to a complication of NCA (apnea). Multivariable logistic regression demonstrated morphine NCA to be associated with greater odds of RRT activation (OR=3.29, 95% CI=1.35, 8.03, P=0.009) compared to fentanyl NCA. There were no statistically significant differences in pain scores after NCA initiation across NCA agents. Conclusion NCA is safe in neonates and infants, with comparable efficacy demonstrated for the three agents used. The elevated incidence of RRT activation in patients receiving morphine suggests caution in its use and consideration of alternative agents in this population. PMID:27358574

  6. Turning 1 Year of Age in a Low Socioeconomic Environment: A Portrait of Disadvantage.

    PubMed

    Hurt, Hallam; Betancourt, Laura M

    2017-09-01

    In the United States today, 16 million children are growing up poor. Few studies report multiple environmental factors associated with poverty during the first year of life and effects on infant development. To evaluate maternal, home, and neighborhood environment of low and higher socioeconomic status (SES) infants from birth to 1 year and to evaluate the impact of SES and environment on infant developmental outcome at 1 year. Low (n = 30) and higher SES (n = 30) African-American mothers and their healthy term gestation female infants were prospectively compared for environmental characteristics and infant developmental outcome. Wechsler Adult Intelligence Scale-IV (WAIS-IV); Beck Depression Inventory; Perceived Stress Scale; Parenting Stress Index-Fourth Edition (PSI-4); Social Support Scale; Home Observation Measurement of the Environment (HOME); Household Food Insecurity (HFI); Concentrated Neighborhood Disadvantage (CND). Bayley Scales of Infant Development Third Edition (BSID-III); Preschool Language Scale (PLS-5). Environmental risk was greater for low compared with higher SES: lower WAIS-IV (p < .001); higher PSI-4 total (p = .003); lower HOME total and 3 subscales (p < .002); higher HFI (p = .012); and higher CND (p = .027). Low SES infant outcomes differed from higher SES: lower BSID-III Cognitive Composite (p = .005), PLS-5 Total Language (p ≤ .017), and Auditory Comprehension (p ≤ .008). In regressions, after controlling for SES, effects of environmental factors were not found. By age 1, low SES infants had been exposed to greater environmental disadvantage and already exhibited poorer developmental functioning than higher SES infants. These findings suggest that support for families and children from impoverished circumstances cannot begin too early.

  7. An Online Drug Abuse Prevention Program for Adolescent Girls: Posttest and 1-Year Outcomes.

    PubMed

    Schwinn, Traci M; Schinke, Steven P; Hopkins, Jessica; Keller, Bryan; Liu, Xiang

    2017-07-28

    Early adolescent girls' rates of drug use have matched, and in some instances, surpassed boys' rates. Though girls and boys share risk factors for drug use, girls also have gender-specific risks. Tailored interventions to prevent girls' drug use are warranted. This study developed and tested a web-based, drug abuse prevention program for adolescent girls. The nationwide sample of 13- and 14-year-old girls (N = 788) was recruited via Facebook ads. Enrolled girls were randomly assigned to the intervention or control condition. All girls completed pretest measures online. Following pretest, intervention girls interacted with the 9-session, gender-specific prevention program online. The program aimed to reduce girls' drug use and associated risk factors by improving their cognitive and behavioral skills around such areas as coping with stress, managing mood, maintaining a healthy body image, and refusing drug use offers. Girls in both conditions again completed measures at posttest and 1-year follow-up. At posttest, and compared to girls in the control condition, girls who received the intervention smoked fewer cigarettes and reported higher self-esteem, goal setting, media literacy, and self-efficacy. At 1-year follow-up, and compared to girls in the control condition, girls who received the intervention reported engaging in less binge drinking and cigarette smoking; girls assigned to the intervention condition also had higher alcohol, cigarette, and marijuana refusal skills, coping skills, and media literacy and lower rates of peer drug use. This study's findings support the use of tailored, online drug abuse prevention programming for early adolescent girls.

  8. Getting an MRI (For Kids)

    MedlinePlus Videos and Cool Tools

    ... de una resonancia magnética, RM (video) An MRI (magnetic resonance imaging) scan creates detailed pictures of the inside of the body. The test is painless. All you'll need to do is hold still for several minutes at a time so the pictures ... Photo Library, Science Source Images, Shutterstock, and Clipart.com

  9. Magnetic Resonance Imaging (MRI) -- Head

    MedlinePlus

    ... provides detailed images of blood vessels in the brain—often without the need for contrast material. See the MRA page for more information. MRI can detect stroke at a very early stage by mapping the motion of water molecules in the tissue. ...

  10. Remembering September 11th: the role of retention interval and rehearsal on flashbulb and event memory.

    PubMed

    Shapiro, Lauren R

    2006-02-01

    Retention interval and rehearsal effects on flashbulb and event memory for 11th September 2001 (9/11) were examined. In Experiment 1, college students were assessed three times (Groups 1 and 2) or once (Group 3) over 11 weeks. In Experiment 2, three new groups assessed initially at 23 weeks (Group 4), 1 year (Group 5), or 2 years (Group 6) were compared at 1 year and at 2 years with subsamples of those assessed previously. No effects of retention interval length or rehearsal were found for flashbulb memory, which contained details at each assessment. Event memory, but not consistency, was detrimentally affected by long retention intervals, but improved with rehearsal. Recall was higher for the reception event than for the main events. Also, consistency from 1 day to 11 weeks, but not 1 year to 2 years, was higher for flashbulb memory than for event memory. Event recall was enhanced when respondents conceived of their memory as vivid, frozen, and encompassing a longer period of time. Positive correlations were found for event memory with confidence in accuracy and with rehearsal through discussion at 2 years.

  11. Travel Burden to Breast MRI and Utilization: Are Risk and Sociodemographics Related?

    PubMed

    Onega, Tracy; Lee, Christoph I; Benkeser, David; Alford-Teaster, Jennifer; Haas, Jennifer S; Tosteson, Anna N A; Hill, Deirdre; Shi, Xun; Henderson, Louise M; Hubbard, Rebecca A

    2016-06-01

    Mammography, unlike MRI, is relatively geographically accessible. Additional travel time is often required to access breast MRI. However, the amount of additional travel time and whether it varies on the basis of sociodemographic or breast cancer risk factors is unknown. The investigators examined screening mammography and MRI between 2005 and 2012 in the Breast Cancer Surveillance Consortium by (1) travel time to the closest and actual mammography facility used and the difference between the two, (2) women's breast cancer risk factors, and (3) sociodemographic characteristics. Logistic regression was used to examine the odds of traveling farther than the closest facility in relation to women's characteristics. Among 821,683 screening mammographic examinations, 76.6% occurred at the closest facility, compared with 51.9% of screening MRI studies (n = 3,687). The median differential travel time among women not using the closest facility for mammography was 14 min (interquartile range, 8-25 min) versus 20 min (interquartile range, 11-40 min) for breast MRI. Differential travel time for both imaging modalities did not vary notably by breast cancer risk factors but was significantly longer for nonurban residents. For non-Hispanic black compared with non-Hispanic white women, the adjusted odds of traveling farther than the closest facility were 9% lower for mammography (odds ratio, 0.91; 95% confidence interval, 0.87-0.95) but more than two times higher for MRI (odds ratio, 2.64; 95% confidence interval, 1.36-5.13). Breast cancer risk factors were not related to excess travel time for screening MRI, but sociodemographic factors were, suggesting the possibility that geographic distribution of advanced imaging may exacerbated disparities for some vulnerable populations. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  12. Interval cancers in nasopharyngeal carcinoma screening: comparing two screening intervals after a negative initial screening result.

    PubMed

    Chen, Feng; Huang, Qi-Hong; Fang, Fang; Liu, Zhi-Wei; Liu, Ke; Xie, Shang-Hang; Liu, Qing; Hong, Ming-Huang; Liao, Zhen-Er; Ye, Wei-Min; Zeng, Yi-Xin; Cao, Su-Mei

    2012-12-01

    To examine the optimal screening interval among the individuals who received a negative Epstein-Barr virus immunoglobulin A antibodies against viral capsid antigen (VCA-IgA) serum test result and who comprised the majority of the population screened for nasopharyngeal carcinoma (NPC). Screening was performed in Sihui, Guangdong, China, offering a repeated screening for participants with an initial negative test either after 4-5 years in one centre (short interval centre), or 9-10 years in another (long interval centre). The characteristics and incidence rates (IRs) of interval NPCs (defined as cases diagnosed outside the screening protocol while within the screening interval) were compared between these two centres. Standard incidence ratios (SIRs) were also calculated using the general Sihui population as the reference. Seven interval NPCs were detected in the short interval centre (IR: 17.8/10(5) person-years) and 20 in the long interval centre (IR: 20.8/10(5) person-years during the first four years and 43.5/10(5) person-years during the remaining years). The SIR in the short interval centre was 0.43 (95% confidence interval [CI]: 0.17-0.89); SIR in the long interval centre was 0.47 (95% CI: 0.17-1.02) during the first four years and 0.90 (95% CI: 0.49-1.51) during the remaining years. No aggressive interval NPC was observed in the short interval centre; four were identified in the long interval centre. The incidence of NPC, especially aggressive NPC, was low during the first few years after a negative screening; the incidence increased to the general population level afterwards. A screening interval of 4-5 years may therefore be more suitable than 9-10 years after a negative VCA-IgA test in NPC screening.

  13. Can Dynamic Contrast-Enhanced MRI (DCE-MRI) and Diffusion-Weighted MRI (DW-MRI) Evaluate Inflammation Disease

    PubMed Central

    Zhu, Jianguo; Zhang, Faming; Luan, Yun; Cao, Peng; Liu, Fei; He, Wenwen; Wang, Dehang

    2016-01-01

    Abstract The aim of the study was to investigate diagnosis efficacy of dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted MRI (DW-MRI) in Crohn's disease (CD). To find out the correlations between functional MRI parameters including Ktrans, Kep, Ve, Vp, and apparent diffusion coefficient (ADC) with a serologic biomarker. The relationships between pharmacokinetic parameters and ADC were also studied. Thirty-two patients with CD (22 men, 10 women; mean age: 30.5 years) and 18 healthy volunteers without any inflammatory disease (10 men, 8 women; mean age, 34.11 years) were enrolled into this approved prospective study. Pearson analysis was used to evaluate the correlation between Ktrans, Kep, Ve, Vp, and C-reactive protein (CRP), ADC, and CRP respectively. The diagnostic efficacy of the functional MRI parameters in terms of sensitivity and specificity were analyzed by receiver operating characteristic (ROC) curve analyses. Optimal cut-off values of each functional MRI parameters for differentiation of inflammatory from normal bowel were determined according to the Youden criterion. Mean value of Ktrans in the CD group was significantly higher than that of normal control group. Similar results were observed for Kep and Ve. On the contrary, the ADC value was lower in the CD group than that in the control group. Ktrans and Ve were shown to be correlated with CRP (r = 0.725, P < 0.001; r = 0.533, P = 0.002), meanwhile ADC showed negative correlation with CRP (r = −0.630, P < 0.001). There were negative correlations between the pharmacokinetic parameters and ADC, such as Ktrans to ADC (r = −0.856, P < 0.001), and Ve to ADC (r = −0.451, P = 0.01). The area under the curve (AUC) was 0.994 for Ktrans (P < 0.001), 0.905 for ADC (P < 0.001), 0.806 for Ve (P < 0.001), and 0.764 for Kep (P = 0.002). The cut-off point of the Ktrans was found to be 0.931 min–1. This value provided the best trade-off between

  14. A robust measure of food web intervality

    PubMed Central

    Stouffer, Daniel B.; Camacho, Juan; Amaral, Luís A. Nunes

    2006-01-01

    Intervality of a food web is related to the number of trophic dimensions characterizing the niches in a community. We introduce here a mathematically robust measure for food web intervality. It has previously been noted that empirical food webs are not strictly interval; however, upon comparison to suitable null hypotheses, we conclude that empirical food webs actually do exhibit a strong bias toward contiguity of prey, that is, toward intervality. Further, our results strongly suggest that empirically observed species and their diets can be mapped onto a single dimension. This finding validates a critical assumption in the recently proposed static niche model and provides guidance for ongoing efforts to develop dynamic models of ecosystems. PMID:17146055

  15. Intact Interval Timing in Circadian CLOCK Mutants

    PubMed Central

    Cordes, Sara; Gallistel, C. R.

    2008-01-01

    While progress has been made in determining the molecular basis for the circadian clock, the mechanism by which mammalian brains time intervals measured in seconds to minutes remains a mystery. An obvious question is whether the interval timing mechanism shares molecular machinery with the circadian timing mechanism. In the current study, we trained circadian CLOCK +/− and −/− mutant male mice in a peak-interval procedure with 10 and 20-s criteria. The mutant mice were more active than their wild-type littermates, but there were no reliable deficits in the accuracy or precision of their timing as compared with wild-type littermates. This suggests that expression of the CLOCK protein is not necessary for normal interval timing. PMID:18602902

  16. Efficient Computation Of Confidence Intervals Of Parameters

    NASA Technical Reports Server (NTRS)

    Murphy, Patrick C.

    1992-01-01

    Study focuses on obtaining efficient algorithm for estimation of confidence intervals of ML estimates. Four algorithms selected to solve associated constrained optimization problem. Hybrid algorithms, following search and gradient approaches, prove best.

  17. Application of Interval Analysis to Error Control.

    DTIC Science & Technology

    1976-09-01

    We give simple examples of ways in which interval arithmetic can be used to alert instabilities in computer algorithms , roundoff error accumulation, and even the effects of hardware inadequacies. This paper is primarily tutorial. (Author)

  18. Efficient Computation Of Confidence Intervals Of Parameters

    NASA Technical Reports Server (NTRS)

    Murphy, Patrick C.

    1992-01-01

    Study focuses on obtaining efficient algorithm for estimation of confidence intervals of ML estimates. Four algorithms selected to solve associated constrained optimization problem. Hybrid algorithms, following search and gradient approaches, prove best.

  19. A robust measure of food web intervality.

    PubMed

    Stouffer, Daniel B; Camacho, Juan; Amaral, Luís A Nunes

    2006-12-12

    Intervality of a food web is related to the number of trophic dimensions characterizing the niches in a community. We introduce here a mathematically robust measure for food web intervality. It has previously been noted that empirical food webs are not strictly interval; however, upon comparison to suitable null hypotheses, we conclude that empirical food webs actually do exhibit a strong bias toward contiguity of prey, that is, toward intervality. Further, our results strongly suggest that empirically observed species and their diets can be mapped onto a single dimension. This finding validates a critical assumption in the recently proposed static niche model and provides guidance for ongoing efforts to develop dynamic models of ecosystems.

  20. Pretreatment clinical and psychosocial predictors of remission from depression after short-term psychodynamic psychotherapy and solution-focused therapy: a 1-year follow-up study.

    PubMed

    Marttunen, Mauri; Valikoski, Maarit; Lindfors, Olavi; Laaksonen, Maarit A; Knekt, Paul

    2008-03-01

    The mutual importance of different predictors of remission was studied in 163 outpatients with depression receiving either short-term psychodynamic psychotherapy or solution-focused therapy. After a 1-year follow-up, the percentage of remission significantly varied between sociodemographic subgroups and was dependent on severity of symptoms, personality disorder, and psychosocial factors but not on psychiatric history, previous psychiatric treatment, or type of therapy received. Simultaneous study showed that the most significant predictors were sense of coherence (based on Sense of Coherence Scale [SOCS]), symptom severity (based on Symptom Checklist-90 [SCL-90] Global Severity Index [GSI]), and education. The relative risks of remission between the lowest and highest quartiles of SOCS and SCL-90 GSI were 0.06 and 0.22 (95% confidence intervals = 0.01-0.35 and 0.05-0.97), respectively. In conclusion, several background factors, especially sense of coherence, predict remission.

  1. Periodicity In The Intervals Between Primes

    DTIC Science & Technology

    2015-07-02

    statistically strong periodicity is identified in the counting function giving the total number of intervals of a certain size. The nature of the periodic...positive intervals among the first n<=10^6 prime numbers as a probe of the global nature of the sequence of primes. A statistically strong periodicity is...Let x = x1, x2, . . . be an increasing sequence of real numbers which may be either finite or infinitely long. Throughout the following every bold

  2. Interval and contour processing in autism.

    PubMed

    Heaton, Pamela

    2005-12-01

    High functioning children with autism and age and intelligence matched controls participated in experiments testing perception of pitch intervals and musical contours. The finding from the interval study showed superior detection of pitch direction over small pitch distances in the autism group. On the test of contour discrimination no group differences emerged. These findings confirm earlier studies showing facilitated pitch processing and a preserved ability to represent small-scale musical structures in autism.

  3. Analysis of surgical and MRI factors associated with cerebellar mutism.

    PubMed

    Sergeant, Anjali; Kameda-Smith, Michelle Masayo; Manoranjan, Branavan; Karmur, Brij; Duckworth, JoAnn; Petrelli, Tina; Savage, Katey; Ajani, Olufemi; Yarascavitch, Blake; Samaan, M Constantine; Scheinemann, Katrin; Alyman, Cheryl; Almenawer, Saleh; Farrokhyar, Forough; Fleming, Adam J; Singh, Sheila Kumari; Stein, Nina

    2017-07-01

    The surgical risk factors and neuro-imaging characteristics associated with cerebellar mutism (CM) remain unclear and require further investigation. Therefore, we aimed to examine surgical and MRI findings associated with CM in children following posterior fossa tumor resection. Using our data registry, we retrospectively collected data from pediatric patients who acquired CM and were matched based on age and pathology type with individuals who did not acquire CM after posterior fossa surgery. The strength of association between surgical and MRI variables and CM were examined using odds ratios (ORs) and corresponding 95% confidence intervals (CIs). A total of 22 patients (11 with and 11 without CM) were included. Medulloblastoma was the most common pathology among CM patients (91%); the remaining 9% were diagnosed with a pilocytic astrocytoma. Tumor attachment to the floor of the fourth ventricle (OR 6; 95% CI 0.7-276), calcification/hemosiderin deposition (OR 7; 95% CI 0.9-315.5), and post-operative peri-ventricular ischemia on MRI (OR 5; 95% CI 0.5-236.5) were found to have the highest measures of association with CM. Our results may suggest that tumor attachment to the floor of the fourth ventricle, pathological calcification, and post-operative ischemia have a relatively higher prevalence in patients with CM. Collectively, our work calls for a larger multi-institutional cohort study of CM patients to encourage further investigation of the determinants and management of CM in order to potentially minimize its development and predict onset.

  4. MRI bone oedema predicts eight year tendon function at the wrist but not the requirement for orthopaedic surgery in rheumatoid arthritis

    PubMed Central

    Zheng, S; Robinson, E; Yeoman, S; Stewart, N; Crabbe, J; Rouse, J; McQueen, F M

    2006-01-01

    Objective To investigate the role of early magnetic resonance imaging (MRI) of the wrist in predicting functional outcome in rheumatoid arthritis. Methods MRI scans of the dominant wrist were scored for synovitis, tendon inflammation, bone oedema, and erosion at first presentation (n = 42), at 1 year (n = 42), and at 6 years (n = 31). At 8 years, clinical reassessment (n = 28) was undertaken. Tendon function was graded 0–3 for movement, tendon sheath swelling, and pain on resistance at nine flexor and extensor tendons of the hand. Hand function was also assessed using the Sollerman grip test. The requirement for joint or tendon surgery by 8 years was determined by telephone survey in 39 of the original 42 patients. Results At 8 years, tendon function was highly correlated with hand function (Sollerman score, R = −0.51, p = 0.005) and global function (health assessment questionnaire score, R = 0.53, p = 0.004). Using a model incorporating baseline and 1 year MRI scores, the MRI bone oedema score was strongly predictive of tendon function at 8 years (χ22 = 15.3, p = 0.0005), as was the MRI bone erosion score (χ22 = 9.23, p = 0.01). Hand function was also predicted by the baseline MRI erosion score (p = 0.02). MRI variables did not predict the requirement for surgery, but patients who had surgery were more likely to show progression of MRI bone erosion scores between baseline and 1 year (p = 0.008). Conclusions Extensive MRI bone oedema and erosions at the wrist in early rheumatoid arthritis predict tendon dysfunction and impaired hand function in the medium term but not the requirement for joint or tendon surgery. PMID:16219706

  5. Establishing reference intervals in the coagulation laboratory.

    PubMed

    Castellone, D D

    2017-05-01

    Obtaining a reference interval (RI) is a challenge for any laboratory and becomes more complicated in the coagulation laboratory due to testing on samples with limited stability on reagents that are poorly standardized. Reference intervals are required to be able to evaluate results in relation to a patients' hemostatic disorder. This becomes one of the most important tasks conducted in the coagulation laboratory. However, many laboratories lack the time, finances and in many cases the expertise to conduct this study. Many RI are obtained from package inserts, or from publications written by experts in lieu of laboratories conducting their own studies. An overview of validating reference intervals and options for verifying or transference of reference intervals is discussed. Based on the confidence interval and the acceptability of risk laboratories are willing to accept, coagulation laboratories have options to conduct robust studies for their RI. Data mining or global reference studies may help to provide data for age specific ranges. Pre-analytical variables and selection of healthy subjects have the largest impact on coagulation testing outcomes and need to be well controlled during the establishment of reference intervals. Laboratories have options in lieu of conducting a full validation on how to verify RI based on smaller RI studies or transference of RI after determining compatibility of the original RI study. © 2017 John Wiley & Sons Ltd.

  6. Recurrence interval analysis of trading volumes.

    PubMed

    Ren, Fei; Zhou, Wei-Xing

    2010-06-01

    We study the statistical properties of the recurrence intervals τ between successive trading volumes exceeding a certain threshold q. The recurrence interval analysis is carried out for the 20 liquid Chinese stocks covering a period from January 2000 to May 2009, and two Chinese indices from January 2003 to April 2009. Similar to the recurrence interval distribution of the price returns, the tail of the recurrence interval distribution of the trading volumes follows a power-law scaling, and the results are verified by the goodness-of-fit tests using the Kolmogorov-Smirnov (KS) statistic, the weighted KS statistic and the Cramér-von Mises criterion. The measurements of the conditional probability distribution and the detrended fluctuation function show that both short-term and long-term memory effects exist in the recurrence intervals between trading volumes. We further study the relationship between trading volumes and price returns based on the recurrence interval analysis method. It is found that large trading volumes are more likely to occur following large price returns, and the comovement between trading volumes and price returns is more pronounced for large trading volumes.

  7. [The QT interval: standardization, limits and interpretation].

    PubMed

    Ouali, S; Ben Salem, H; Gribaa, R; Kacem, S; Hammas, S; Fradi, S; Neffeti, E; Remedi, F; Boughzela, E

    2012-02-01

    Despite clinical importance of ventricular repolarisation, it remains difficult to analyse. Conventionally, quantification of the electrocardiographic ventricular repolarization is usually performed with reference to axis of the T wave and QT interval duration. A variety of factors can prolong the QT interval, such as drug effects, electrolyte imbalances, and myocardial ischemia. The biggest risk with prolongation of the QT interval is the development of torsades de pointes. Commonly accepted reference ranges for the electrocardiogram (ECG) have been in use, with little change, for many years. Populations throughout the world present several differences: age, ethnic compositions, and are exposed to different environmental factors. Recent studies have reported reference data for QT interval in healthy population and have evaluated the influence of age, gender, QRS duration and heart rate on this interval. In this review, we address several issues relative to the measurement, and interpretation of QT interval and its adjustment for rate, age, gender and QRS duration. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  8. Non-Sedated Rapid Volumetric Proton Density MRI Predicts Neonatal Brachial Plexus Birth Palsy Functional Outcome.

    PubMed

    Shen, Peter Y; Nidecker, Anna E; Neufeld, Ethan A; Lee, Paul S; James, Michelle A; Bauer, Andrea S

    2017-03-01

    The current prognostic biomarker of functional outcome in brachial plexus birth palsy is serial clinical examination throughout the first 6 months of age. This can delay surgical treatment and prolong parental anxiety in neonates who will recover spontaneously. A potentially superior biomarker is a volumetric proton density MRI performed at clinical presentation and within the first 12 weeks of life, providing a high spatial and contrast resolution examination in 4 minutes. Nine neonates ranging in age from 4 to 9 weeks who presented with brachial plexus birth palsy were enrolled. All subjects underwent non-sedated 3 Tesla MRI with Cube Proton Density MRI sequence at the same time as their initial clinical visit. Serial clinical examinations were conducted at routine 4 week intervals and the functional performance scores were recorded. MRI findings were divided into pre-ganglionic and post-ganglionic injuries and a radiological scoring system (Shriners Radiological Score) was developed for this study. Proton Density MRI was able to differentiate between pre-ganglionic and post-ganglionic injuries. Radiological scores (Shriners Radiological Score) correlated better with functional performance at 6 months of age (P = .022) than the initial clinical examinations (Active Movement Scale P = .213 and Toronto P = .320). Rapid non-sedated volumetric Cube Proton Density MRI protocol performed at initial clinical presentation can accurately grade severity of brachial plexus birth palsy injury and predict functional performance at 6 months of age. Copyright © 2016 by the American Society of Neuroimaging.

  9. Influence of gradient acoustic noise on fMRI response in the human visual cortex.

    PubMed

    Zhang, Nanyin; Zhu, Xiao-Hong; Chen, Wei

    2005-08-01

    A paired-stimuli paradigm combined with fMRI was utilized to study the effect of gradient acoustic noise on fMRI response in the human primary visual cortex (V1) in terms of the auditory-visual cross-modal neural interaction. The gradient noise generated during the fMRI acquisition was used as the primary stimulus, and a single flashing light was used as the secondary stimulus. An interstimulus interval (ISI) separated the two. Six tasks were designed with different ISIs ranging from 50 to 700 ms. Both BOLD signal intensity and the number of activated pixels in V1 were analyzed and examined, and they showed a significant reduction when the gradient noise preceded the flashing light by approximately 300 ms. These results indicate that the gradient acoustic noise generated during fMRI acquisitions does interfere with neural behavior and the BOLD signal in the human visual cortex. This interference is modulated by the delay between the gradient noise and visual stimulation, and it can be studied quantitatively when the stimulation paradigm is designed appropriately. This study provides evidence of the auditory-visual interaction during fMRI studies, and the results should have an impact on fMRI applications.

  10. Probability Distribution for Flowing Interval Spacing

    SciTech Connect

    S. Kuzio

    2004-09-22

    Fracture spacing is a key hydrologic parameter in analyses of matrix diffusion. Although the individual fractures that transmit flow in the saturated zone (SZ) cannot be identified directly, it is possible to determine the fractured zones that transmit flow from flow meter survey observations. The fractured zones that transmit flow as identified through borehole flow meter surveys have been defined in this report as flowing intervals. The flowing interval spacing is measured between the midpoints of each flowing interval. The determination of flowing interval spacing is important because the flowing interval spacing parameter is a key hydrologic parameter in SZ transport modeling, which impacts the extent of matrix diffusion in the SZ volcanic matrix. The output of this report is input to the ''Saturated Zone Flow and Transport Model Abstraction'' (BSC 2004 [DIRS 170042]). Specifically, the analysis of data and development of a data distribution reported herein is used to develop the uncertainty distribution for the flowing interval spacing parameter for the SZ transport abstraction model. Figure 1-1 shows the relationship of this report to other model reports that also pertain to flow and transport in the SZ. Figure 1-1 also shows the flow of key information among the SZ reports. It should be noted that Figure 1-1 does not contain a complete representation of the data and parameter inputs and outputs of all SZ reports, nor does it show inputs external to this suite of SZ reports. Use of the developed flowing interval spacing probability distribution is subject to the limitations of the assumptions discussed in Sections 5 and 6 of this analysis report. The number of fractures in a flowing interval is not known. Therefore, the flowing intervals are assumed to be composed of one flowing zone in the transport simulations. This analysis may overestimate the flowing interval spacing because the number of fractures that contribute to a flowing interval cannot be

  11. MRI of the placenta - a short review.

    PubMed

    Dekan, Sabine; Linduska, Nina; Kasprian, Gregor; Prayer, Daniela

    2012-05-01

    While ultrasound is still the gold standard method of placental investigation, magnetic resonance imaging (MRI) has certain benefits. In advanced gestational age, obese women, and posterior placental location, MRI is advantageous due to the larger field of view and its multiplanar capabilities. Some pathologies are seen more clearly in MRI, such as infarctions and placental invasive disorders. The future development is towards functional placental MRI. Placental MRI has become an important complementary method for evaluation of placental anatomy and pathologies contributing to fetal problems such as intrauterine growth restriction.

  12. Analysis of regression confidence intervals and Bayesian credible intervals for uncertainty quantification

    NASA Astrophysics Data System (ADS)

    Lu, Dan; Ye, Ming; Hill, Mary C.

    2012-09-01

    Confidence intervals based on classical regression theories augmented to include prior information and credible intervals based on Bayesian theories are conceptually different ways to quantify parametric and predictive uncertainties. Because both confidence and credible intervals are used in environmental modeling, we seek to understand their differences and similarities. This is of interest in part because calculating confidence intervals typically requires tens to thousands of model runs, while Bayesian credible intervals typically require tens of thousands to millions of model runs. Given multi-Gaussian distributed observation errors, our theoretical analysis shows that, for linear or linearized-nonlinear models, confidence and credible intervals are always numerically identical when consistent prior information is used. For nonlinear models, nonlinear confidence and credible intervals can be numerically identical if parameter confidence regions defined using the approximate likelihood method and parameter credible regions estimated using Markov chain Monte Carlo realizations are numerically identical and predictions are a smooth, monotonic function of the parameters. Both occur if intrinsic model nonlinearity is small. While the conditions of Gaussian errors and small intrinsic model nonlinearity are violated by many environmental models, heuristic tests using analytical and numerical models suggest that linear and nonlinear confidence intervals can be useful approximations of uncertainty even under significantly nonideal conditions. In the context of epistemic model error for a complex synthetic nonlinear groundwater problem, the linear and nonlinear confidence and credible intervals for individual models performed similarly enough to indicate that the computationally frugal confidence intervals can be useful in many circumstances. Experiences with these groundwater models are expected to be broadly applicable to many environmental models. We suggest that for

  13. Clinical Utility of Breast MRI in the Diagnosis of Malignancy After Inconclusive or Equivocal Mammographic Diagnostic Evaluation.

    PubMed

    Giess, Catherine S; Chikarmane, Sona A; Sippo, Dorothy A; Birdwell, Robyn L

    2017-06-01

    The purpose of this study was to determine the clinical utility of breast MRI for diagnosing malignancy in women with equivocal mammographic findings but no symptoms. Retrospective review of an institutional MRI database of 7332 contrast-enhanced breast MRI examinations from January 1, 2009, through December 31, 2012, yielded the records of 296 (4.0%) examinations of 294 women without symptoms who underwent MRI for mammographic findings uncertain at diagnostic evaluation. Imaging findings, histopathologic results, and patient demographics were obtained from the electronic medical record. The mean patient age was 55 years (range, 29-83 years). Mammographic lesion type (n = 294) included 89 focal asymmetries, 76 asymmetries, 64 masses, 44 architectural distortions, 17 surgical scar versus lesion, and four miscellaneous lesions. Diagnostic ultrasound, performed on 286 of 294 (97.3%) lesions at mammographic evaluation, showed an ultrasound correlate in 37 (12.9%) lesions, equivocal correlate in 48 (16.8%), and no ultrasound correlate in 201 (70.3%). MRI examination of 294 index lesions showed a correlate in 133 (45.2%) and no correlate in 161 (54.8%). Forty of 294 (13.6%) index lesions were malignant, 37 (92.5%) with an MRI correlate and three (7.5%) without an MRI correlate. Among 250 patients who underwent biopsy or had 2 or more years of imaging stability, the sensitivity, specificity, negative predictive value, and positive predictive value of breast MRI for malignancy were 92.5%, 62.4%, 97.8%, and 31.9%. Forty-four of 294 (15.0%) patients had lesions incidentally found at MRI; 7 of 41 (17.1%) lesions that were biopsied or were stable for at least 1 year were malignant. Problem-solving breast MRI for inconclusive mammographic findings helps identify malignancies with high sensitivity and a high negative predictive value.

  14. [Factors associated with fulfillment of growth and development monitoring for children <1 year of age in health centers in Amazonas, Loreto and Pasco].

    PubMed

    Gonzales-Achuy, Elena; Huamán-Espino, Lucio; Aparco, Juan Pablo; Pillaca, Jenny; Gutiérrez, César

    2016-06-01

    To identify the factors associated with growth and development monitoring (CRED) fulfillment for children <1 year in Ministry of Health (MINSA) health centers in Amazonas, Loreto, and Pasco, Peru between January and December 2012. A paired case-control study was performed. A case was the child who did not complete 11 of the CRED checks until the age of 11 months and, as a control, that child with 11 CRED checks with the same age. The correlation among factors with CRED fulfillment was determined using the McNemar test (p < 0.05) and odds ratio (OR) was used to determine the strength of the associations for paired samples (95% confidence interval [CI]). After the control of various variables, seven factors had significant association with CRED monitoring fulfillment. The common factor in the three regions studied was that the child were not attended some time, which was associated, three to five times, with the chance of not fulfilling the CRED checks in Loreto and Pasco; in Amazonas, the opposite effect was observed (OR, 0.58; 95% CI, 0.41-0.81). The factors related to CRED fulfillment in children <1 year of age varied among regions. One of the main identified obstacles is the multiple functions that must be performed by professionals working in CRED, owing to which, child care opportunities are lost. Hence, adequate staffing must be ensured while instilling ever-present proper patient treatment.

  15. Validation of the 6-Month GRACE Score in Predicting 1-Year Mortality of Patients With Acute Coronary Syndrome Admitted to the Arabian Gulf Hospitals.

    PubMed

    Thalib, Lukman; Furuya-Kanamori, Luis; AlHabib, Khalid F; Alfaleh, Hussam F; AlShamiri, Mostafa Q; Amin, Haitham; Al Suwaidi, Jassim; Sulaiman, Kadhim; Almahmeed, Wael; Alsheikh-Ali, Alawi A; Al-Motarreb, Ahmed; Doi, Suhail A R

    2017-03-01

    Acute coronary syndromes (ACS) are the most common cardiovascular diseases and are associated with a significant risk of mortality and morbidity. The Global Registry of Acute Coronary Events (GRACE) risk score postdischarge is a widely used ACS prediction model for risk of mortality (low, intermediate, and high); however, it has not yet been validated in patients from the Arabian Gulf. This prospective multicenter study (second Gulf Registry of Acute Coronary Events) provides detailed information of the GRACE risk score postdischarge in patients from the Arabian Gulf. Its prognostic utility was validated at 1-year follow-up in over 5000 patients with ACS from 65 hospitals in 6 Arabian Gulf countries (Bahrain, Saudi Arabia, Qatar, Oman, United Arab Emirates, and Yemen). Overall, the goodness of fit (Hosmer and Lemeshow statistic P value = .826), calibration, and discrimination (area under the receiver operating characteristic curve = 0.695; 95% confidence interval: 0.668-0.722) were good. The GRACE risk score postdischarge can be used to stratify 1 year mortality risk in the Arabian Gulf population; it does not require further calibration and has a good discriminatory ability.

  16. Impaired glucose regulation predicted 1-year mortality of Chinese patients with ischemic stroke: data from abnormal glucose regulation in patients with acute stroke across China.

    PubMed

    Jia, Qian; Liu, Gaifen; Zheng, Huaguang; Zhao, Xingquan; Wang, Chunxue; Wang, Yilong; Liu, Liping; Wang, Yongjun

    2014-05-01

    It remains uncertain if impaired glucose regulation (IGR) as a predictor for stroke outcomes. This study aimed at observing the effect of IGR on the 1-year outcomes in Chinese patients with ischemic stroke. Patients with acute ischemic stroke were recruited consecutively in multihospitals across China. Oral glucose tolerance test was performed to identify IGR. Cox proportion hazard model was performed to investigate the effect of IGR on 1-year mortality or stroke recurrence in patients with ischemic stroke. The study recruited 2639 patients with ischemic stroke. IGR was shown as an independent risk factor for the mortality of patients with ischemic stroke (hazard ratio [95% confidence interval], 3.088 [1.386-6.884]; P=0.006). However, IGR showed no significant effects on the dependency or stroke recurrence of patients (P=0.540 and 0.618, respectively). IGR was an independent predictor for the mortality of patients with ischemic stroke. IGR should be highlighted and intervened actively in the patients with ischemic stroke.

  17. Serum 25-hydroxyvitamin D level and risk of falls in Japanese community-dwelling elderly women: a 1-year follow-up study.

    PubMed

    Shimizu, Y; Kim, H; Yoshida, H; Shimada, H; Suzuki, T

    2015-08-01

    The present prospective follow-up study among 1,393 community-dwelling elderly women aged 75 years or older was conducted to clarify the association between serum 25-hydroxyvitamin D (25(OH)D) level and risk of falls. Lower serum 25(OH)D, particularly level <20 ng/mL, was significantly associated with an increased risk of falls. Serum 25(OH)D level has been revealed to be important factor not only for skeletal health but also for fall prevention among the elderly. Our previous cross-sectional study indicated that low serum 25(OH)D level is associated with inferior physical performance and falls among elderly Japanese women. The present prospective study was designed to clarify the association between serum 25(OH)D level and risk of falls before and after 1 year of follow-up. The community-dwelling elderly women aged 75 years or older (N = 1,393) who participated in a mass health examination were followed 1 year later by a mailed self-administered questionnaire. Responses were obtained from 1,285 subjects (response rate = 92.2%). The incidence of falls at baseline and at 1-year follow-up was 18.8 and 24.4%, respectively. The baseline prevalence of serum 25(OH)D <20 ng/mL was 35.2%. Odds ratios (95% confidence intervals) in the lowest tertile of serum 25(OH)D (<20 ng/mL) compared with those in the highest tertile (≥25 ng/mL) were 1.40 (1.01-1.94) for any falls and 1.47 (0.93-2.32) for recurrent falls vs. no falls adjusted for potential risk factors. Among elderly Japanese women, the lower serum 25(OH)D, particularly level <20 ng/mL, was significantly associated with an increased risk of falls.

  18. Vertebral Augmentation with Nitinol Endoprosthesis: Clinical Experience in 40 Patients with 1-Year Follow-up

    SciTech Connect

    Anselmetti, Giovanni Carlo; Manca, Antonio; Marcia, Stefano; Chiara, Gabriele; Marini, Stefano; Baroud, Gamal; Regge, Daniele; Montemurro, Filippo

    2013-05-08

    PurposeThis study was designed to assess the clinical outcomes of patients treated by vertebral augmentation with nitinol endoprosthesis (VNE) to treat painful vertebral compression fractures.MethodsForty patients with one or more painful osteoporotic VCF, confirmed by MRI and accompanied by back-pain unresponsive to a minimum 2 months of conservative medical treatment, underwent VNE at 42 levels. Preoperative and postoperative pain measured with Visual Analog Scale (VAS), disability measured by Oswestry Disability Index (ODI), and vertebral height restoration (measured with 2-dimensional reconstruction CT) were compared at last follow-up (average follow-up 15 months). Cement extravasation, subsequent fractures, and implant migration were recorded.ResultsLong-term follow-up was obtained in 38 of 40 patients. Both VAS and ODI significantly improved from a median of 8.0 (range 5–10) and 66 % (range 44–88 %) to 0.5 (range 0–8) and 6 % (range 6–66 %), respectively, at 1 year (p < 0.0001). Vertebral height measurements comparing time points increased in a statistically significant manner (ANOVA, p < 0.001). Overall cement extravasation rate was 9.5 %. Discal and venous leakage rates were 7.1 and 0 % respectively. No symptomatic extravasations occurred. Five of 38 (13.1 %) patients experienced new spontaneous, osteoporotic fractures. No device change or migration was observed.ConclusionsVNE is a safe and effective procedure that is able to provide long-lasting pain relief and durable vertebral height gain with a low rate of new fractures and cement leakages.

  19. Advances in Clinical PET/MRI Instrumentation.

    PubMed

    Herzog, Hans; Lerche, Christoph

    2016-04-01

    In 2010, the first whole-body PET/MRI scanners installed for clinical use were the sequential Philips PET/MRI with PMT-based, TOF-capable technology and the integrated simultaneous Siemens PET/MRI. Avalanche photodiodes as non-magneto-sensitive readout electronics allowed PET integrated within the MRI. The experiences with these scanners showed that improvements of software aspects, such as attenuation correction, were necessary and that efficient protocols combining optimally PET and MRI must be still developed. In 2014, General Electric issued an integrated PET/MRI with SiPM-based PET detectors, allowing TOF-PET. Looking at the MRI components of current PET/MR imaging systems, primary improvements come from sequences and new coils.

  20. The predictive value of malnutrition - inflammation score on 1-year mortality in Turkish maintenance hemodialysis patients.

    PubMed

    Kara, Ekrem; Sahutoglu, Tuncay; Ahbap, Elbis; Sakaci, Tamer; Koc, Yener; Basturk, Taner; Sevinc, Mustafa; Akgol, Cuneyt; Unsal, Abdulkadir

    2016-08-01

    The aim of this study was to evaluate the predictive value of malnutrition-inflammation score (MIS) on short-term mortality and to identify the best cut-off point in the Turkish maintenance hemodialysis (MHD) population. A total of 100 patients on MHD were included in this prospective single-center study. Demographic, anthropometric, and biochemical data were obtained from all patients. The study population was followed up as a 12-month prospective cohort to evaluate mortality as the primary outcome. Median (IQR) age and HD vintage of 100 patients (M/F: 52/48) were 53 (39.5 - 67) years and 53.5 (11 - 104.7) months, respectively. Deceased patients (n = 7) had significantly older age (years) (50 (38.5 - 63.5) vs. 70 (62 - 82), respectively, p = 0.001), lower spKt/V (1.60 (1.40 - 1.79) vs. 1.35 (0.90 - 1.50), respectively, p = 0.002), lower triceps skinfold thickness (14 (10 - 19) vs. 9 (7 - 11), respectively, p = 0.021) and higher MIS (5 (4 - 7) vs. 10 (7 - 11), respectively, p = 0.013). In the ROC analysis, we found that the optimal cut-off value of MIS for predicting death was 6.5 with 85.7% sensitivity and 62.4% specificity (positive and negative predictive values were 0.6951 and 0.8136, respectively). Advanced age, low spKt/V, and high MIS were found to be predictors of mortality in multivariate logistic regression analysis. The 1-year mortality rate was significantly higher in MIS > 6.5 group compared to the MIS ≤ 6.5 group (14,3% (6/41) vs. 1.6% (1/59), respectively). Compared to MIS ≤ 6.5 group, 1 year survival time of the patients with MIS > 6.5 was found to be significantly lower (47.8 ± 0.16 vs. 43.6 ± 1.63 weeks, respectively, p (log-rank) = 0.012). MIS is a robust and independent predictor of short-term mortality in MHD patients. Patients with MIS > 6.5 had a significant risk, and additional risk factors associated with short-term mortality were advanced age and low spKt/V.

  1. Experience with cinacalcet in primary hyperparathyroidism: results after 1 year of treatment

    PubMed Central

    García-Martín, Antonia; Luque-Pazos, Alessandra

    2013-01-01

    Objectives: To assess the characteristics of patients with primary hyperparathyroidism (PHPT) treated with cinacalcet and to evaluate its efficacy in reducing serum calcium and parathyroid hormone (PTH) concentrations after 1 year of treatment. Methods: The study included 20 patients with PHPT who had completed at least 12 months of treatment with cinacalcet (eight patients for refusal of parathyroidectomy, three for surgery not possible due to comorbidities and nine for progressive hypercalcemia prior to surgery). We recorded clinical and biochemical data at baseline, and after 3, 6 and 12 months of treatment. We also monitored adverse events. Cinacalcet was administered in increasing doses until normal serum calcium was reached or side effects preventing a further increase occurred. Results: After 3 months of treatment, serum calcium significantly decreased (11.73 ± 0.85 versus 10.71 ± 1.63 mg/dl, p < 0.001) and serum phosphorus significantly increased (2.41 ± 0.48 versus 2.63 ± 0.70 mg/dl, p = 0.004) while no significant change occurred in PTH (181.91 ± 102.37 versus 195.47 ± 111.71 pg/ml, p = 0.695). No further variation was observed after 6 months compared with 3 months of follow up. However, after 12 months of treatment, there was a significant decrease in PTH concentrations compared with baseline (181.91 ± 102.37 versus 152.47± 70.16 pg/ml, p = 0.028) as well as serum calcium (11.73 ± 0.85 versus 10.20± 0.95 mg/dl, p < 0.001); serum phosphorus significantly increased (2.41 ± 0.48 versus 2.71 ± 0.43 mg/dl, p = 0.01). Normocalcemia (S-Ca < 10.2 mg/dl) was achieved in 55% of patients. The medication was usually well tolerated (83.4%). Most common adverse events were nausea and vomiting, especially at the beginning of therapy. Conclusion: Cinacalcet rapidly reduced serum calcium in patients with PHPT and this reduction remained stable after 1 year of treatment. We also observed a decrease in PTH. Cinacalcet is an effective alternative in nonsurgical

  2. In Vivo Confocal Microscopy 1 Year after Autologous Cultured Limbal Stem Cell Grafts.

    PubMed

    Pedrotti, Emilio; Passilongo, Mattia; Fasolo, Adriano; Nubile, Mario; Parisi, Graziella; Mastropasqua, Rodolfo; Ficial, Sara; Bertolin, Marina; Di Iorio, Enzo; Ponzin, Diego; Marchini, Giorgio

    2015-08-01

    To correlate clinical, impression cytologic, and in vivo confocal microscopy findings on the corneal surface after cultured limbal stem cell transplantation. Prospective, interventional, noncomparative, masked case series. Thirteen patients with limbal stem cell deficiency after unilateral (9 eyes) or bilateral (2 eyes) chemical burn, liquid nitrogen injury (1 eye), or herpes simplex virus infection (1 eye). Limbal cells were harvested from healthy or less affected eyes, cultured on 3T3 cells and fibrin glue, and transplanted to the patient's injured eye. Patients underwent clinical examination and impression cytologic examination of the central cornea before and 1 year after intervention. In vivo confocal microscopy scans were obtained in all corneal quadrants after 1 year. The interexamination agreement was established by calculation of the Cohen's κ coefficient. Results of surgery were assessed considering clinical signs (successful: restoration of transparent, avascular, and stable corneal epithelium without neovascularization in central corneal surface; partially successful: recurrence of superficial neovascularization; failed: recurrent epithelial defects, pannus, and inflammation), phenotype of cells covering the corneal surface (conjunctivalized corneal surface: cytokeratin 12 [cK12]-negative and mucin 1 [MUC1]-positive cells; mixed epithelium: cK12-positive and MUC1-positive cells; corneal epithelium: cK12-positive and MUC1-negative cells), and cell morphologic features (corneal epithelium: multilayered polygonal and flat cells with hyperreflective nuclei; conjunctival epithelium: stratified cuboidal or polygonal cells, hyperreflective cytoplasm, and barely defined borders; epithelial transition: transition of epithelial cells from the cornea to the conjunctiva over the corneal surface). We found a moderate to substantial degree of concordance between confocal microscopy and clinical evaluation (κ = 0.768) and between confocal microscopy and impression

  3. A single institution's 1-year experience with uterine fibroid embolization marketing.

    PubMed

    Ciacci, Joseph; Taussig, Jacob; Kouri, Brian; Bettmann, Michael

    2011-09-01

    To assess the impact of various marketing techniques on the referral pattern for uterine fibroid embolization (UFE) at an academic interventional radiology practice over a 1-year period. All referrals to the interventional radiology clinic for UFE from January 1, 2009, to December 31, 2009, were retrospectively reviewed. A standard intake sheet was completed by the interventional clinic secretary at the time of initial patient contact that included the source of the referral (radio, television, newspaper, mailing, Internet, physician, friend, other). All patients who proceeded to consultation were seen in the interventional radiology clinic by attending interventional radiologists in a university-based academic center. The referral pattern was analyzed with respect to the number of patients who contacted the clinic, the number of actual clinic visits, the number of magnetic resonance (MR) imaging examinations performed before and after the procedure, the total number of embolization cases performed, and the subsequent downstream revenue. During the 1-year period, 344 patients contacted the interventional radiology clinic regarding UFE resulting in 171 consultations and 100 pelvic MR imaging examinations performed before the procedure. Sixty-two patients proceeded to UFE, and 32 patients underwent follow-up pelvic MR imaging. These results show a significant increase from eight cases the previous year and are presumably attributable almost entirely to the directed marketing campaign. The marketing initiative consisted primarily of print and radio advertisements, with the latter being the most effective. The total advertising cost for the year was approximately $24,706, of which $20,520 was for radio advertisements. The radio advertisements generated 69% (237 of 344) of the referrals and 69% (43 of 62) of the UFE procedures. Using Medicare reimbursement rates, the radio advertisements generated $281,994 in UFE technical fees and $50,329 in MR imaging technical fees

  4. A 1-year, three-couple expedition as a crew analog for a Mars mission.

    PubMed

    Leon, Gloria R; Atlis, Mera M; One